Search results for: Greek public hospital sector

Authors: Genevieve R. Kan, Jolyon Ford

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Background: Caesarean section has become the routine route of delivery for breech fetuses, but breech cesarean deliveries are hypothesized to have poorer immediate neonatal outcomes when compared to cephalic deliveries. In accordance with this, in many Australian hospitals, the pediatric team is routinely required to attend every elective breech cesarean section in case urgent resuscitation is required. Our study aimed to determine whether term elective breech deliveries indeed had worse immediate neonatal outcomes at delivery, which will justify the necessity of pediatric staff presence at every elective breech cesarean delivery and influence the workload for the pediatric team. Objective: Elective breech cesarean deliveries were compared to elective cephalic cesarean deliveries at 37 weeks gestation or above to evaluate the immediate neonatal outcomes (Apgar scores <7 at 5 minutes, and Special Care Nursery admissions on Day 1 of life) of each group. Design: A retrospective cohort study Method: This study examined 2035 elective breech and cephalic singleton cesarean deliveries at term over 5 years from July 2017 to July 2022 at Frankston Hospital, a metropolitan hospital in Melbourne, Australia. There were 260 breech deliveries and 1775 cephalic deliveries. De-identified patient data were collected retrospectively from the hospital’s electronically integrated pregnancy and birth records to assess demographics and neonatal outcomes. Results: Apgar scores <7 at 5 minutes of life were worse in the breech group compared to the cephalic group (3.4% vs 1.6%). Special Care Nursery admissions on Day 1 of life were also higher for the breech cohort compared to the cephalic cohort (9.6% vs 8.7%). Conclusions: Our results support the expected findings that breech deliveries are associated with worse immediate neonatal outcomes. It, therefore, suggests that routine attendance at elective breech cesarean deliveries by the pediatric team is indeed required to assist with potentially higher needs for neonatal resuscitation and special care nursery admission.

Keywords: breech, cesarean section, Apgar scores, special care nursery admission

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Authors: Ursula D'Almeida, Danielly Aliprandi

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A car-based development is observed in our cities, what leads to social and environmental impacts, such as air pollution, excessive noises and the substitution of public open spaces for roads and parking lots. Concerning the efforts to promote a sustainable development, a key issue is the reduction of fossil fuels consumption. An alternative to the pollutant gases emission, especially from urban transportation, is the incentive for active transport. The promoting of non-motorized travels and locomotion ways that only depend on human propulsion meets the sustainable mobility notion. Walking is one of the healthiest, cleanest, most natural and economical means to move around. Also, it integrates part of public transportation travels. Since walking demands physical effort, it is sensitive to environmental conditions. In urban space, not always we come across pedestrian friendly road structures. Based on the theory of walkability, the present paper aims to discuss the walking conditions in city centers by analyzing the distribution of urban services and uses, and this also regarding sidewalks quality. The case study presented is the urban center in the medium-sized Brazilian city Campos dos Goytacazes, in Rio de Janeiro State. The study also brings contributions to the recovering of underused public open spaces, especially by encouraging their use and appropriation through valuing non-motorized travels conditions.

Keywords: active transport, historical center, sustainable mobility, walking

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Authors: A. Aljohani, D. Moore, D. D. Ahiaga-Dagbui

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Cost overruns are endemic in the delivery of construction projects. The problem is global. It occurs irrespective of type and size of the project, its location, procurement method or client. The size of overruns can be as high as 200% in some cases. Projects thus unfortunately often make the news headlines, not for their immense socio-economic contribution to society, but for being poorly procured. In Saudi Arabia, two-thirds of construction projects are publicly procured by the Saudi government, which has been invested Billions of dollars in infrastructure projects each year as part of an ambitious strategic development agenda to shift from mainly oil dependency to multi-source dependency. However, reports show that about 3,000 public projects face diverse issues related to time and cost overrun. As part of an on-going study to develop a framework for effective public procurement for the Saudi Arabian construction industry, this paper reports the initial findings of the causes of cost overruns in the context of the Gulf State. It also evaluates the interface between some of the front-end loading issues in public procurement in Saudi and their effects on project performance. A systematic review of the existing literature on construction cost overruns, with focus on the Saudi Arabian construction industry has been used. One of the initial findings is that a fixed-price contract is usually used by the client in an attempt to transfer all financial risks to the contractors. This has the unintended consequence of creating a turbulent environment for the delivery of the project which leads to project abandonment by contractors, poor quality of work and substantial rework. Further work is being undertaken to empirically verify the initial findings reported in this paper and their generalizability for the construction industry as a whole.

Keywords: cost overrun, public procurement, Saudi Arabia, construction projects

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Authors: Imelda Albert Gisip, Tarisah T. Z. Taman

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In Asia, particularly in Malaysia, women entrepreneurs contribute substantially to economic growth. This paper presents a review of women entrepreneurs’ program, focusing on Creating Millionaires among Young Women Entrepreneurs (CREAM@YWE) program in Sabah Malaysia, which aims to accelerate entrepreneurship among young women in Sabah Malaysia. Entrepreneurs are seen as essential for growth, job creation, and social progress, and the virtues of small business for Sabah Maju Jaya (SMJ), the Sabah state government Sabah State development plan for the year 2021-2025. SMJ guides the direction of the government's policies and programs, further guiding the implementation in a planned and strategic manner to achieve targets and goals that coincide with the development needs of the state. One of the government’s agendas is to put more effort into ensuring that women entrepreneurs are well supported and enhanced. Thus, The CreaM@YWE Program was developed in 2018 with the main objective is to produce competitive young women entrepreneurs in Sabah and achieve "millionaire" status. CreaM@YWE Program is an innovation process specifically developed to accelerate the entrepreneurship sector, particularly for women entrepreneurs in Sabah, by incorporating strategic partnerships and collaborations with government agencies and industry players. Being the first of its kind in Sabah, the novelty of this project is providing a supportive ecosystem, including six months of intensive courses guided through "hands-holding”, collaborations with strategic partners, and easy access to government assistance. Since its inception, the program has significantly impacted society’s wellbeing, particularly in empowering young women entrepreneurs in Sabah for the past six years, and has produced many successful women entrepreneurs with “millionaire” status. Generally, improving the women’s enterprise sector in Malaysia needs an overall environment that provides development opportunities for women entrepreneurs, including access to resources and support services. Since achieving the goal of women's entrepreneurship policy requires effective partnerships and inclusiveness, Cream @YWE Program has managed to practice these in assisting small entrepreneurs among young women in Sabah in accessing public goods and business opportunities. This proves that achieving women’s economic empowerment requires sound policies, a holistic approach, and long-term commitment. Thus, this paper presents how the Cream@YWE Program has been supporting Sabah young women entrepreneurs by reforming the business environment to help create opportunities for women while addressing the few existing gender-specific hurdles.

Keywords: young, women, entrepreneurs, Sabah, Malaysia

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Authors: Meng Qing Feng, Otsile Morake

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Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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Authors: Gatot Dwi Hendro, Hayyan ul Haq

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This work aims to explore the strategy in embodying the ecological validity in creating the sustainability of public policy, particularly in strengthening the green economy in Indonesia. This green economy plays an important role in supporting the national development in Indonesia, as it is a part of the national policy that posits the primary priority in Indonesian governance. The green economy refers to the national development covering strategic natural resources, such as mining, gold, oil, coal, forest, water, marine, and the other supporting infrastructure for products and distribution, such as fabrics, roads, bridges, and so forth. Thus, all activities in those national development should consider the sustainability. This sustainability requires the strong commitment of the national and regional government, as well as the local governments to put the ecology as the main requirement for issuing any policy, such as licence in mining production, and developing and building new production and supporting infrastructures for optimising the national resources. For that reason this work will focus on the strategy how to embody the ecological values and norms in the public policy. In detail, this work will offer the method, i.e. legal techniques, in visualising and embodying the norms and public policy that valid ecologically. This ecological validity is required in order to maintain and sustain our collective life.

Keywords: ecological validity, sustainable development, coherence, Indonesian Pancasila values, environment, marine

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Authors: Umar Sheikh Tahir

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Before al-Ghazālī, Islamic scholars perceived logic as an intrusive knowledge. The knowledge therefore, did not receive ample attention among scholars on how it should be adapted into Islamic sciences. General scholarship in that period rejects logic as an instrumental knowledge. This attitude became unquestionable to the scholars from different perspectives with diversification of suggestions in the pre-al-Ghazālī’s period. However, al-Ghazālī proclaimed with new perspective that transform Logic from ‘intrusive knowledge’ to a useful tool for Islamic sciences. This study explores the contributions of al-Ghazālī to epistemology regarding the use and the relevance of Logic. The study applies qualitative research methodology dealing strictly with secondary data from medieval age and contemporary sources. The study concludes that al-Ghazālī’s contributions which supported the transformation of Logic to useful tool in the Muslim world were drawn from his experience within Islamic tradition. He succeeded in reconciling Islamic tradition with the wisdom of Greek sciences.

Keywords: Al-Ghazālī, classical logic, epistemology, Islamdom and Islamic sciences

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Fahimeh Hooshyar, Seyyed Mojtaba Abtahi

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Democracy which is, in its greek roots, consisted of “Demo” (People) and “Kratic” (people) is referring to governing of the people or governing by the people. in its widest definition it refers to a common lifestyle in which all the people has the equal potentials for social participating. But in political perspective, democracy is looking for the equal participation right of the citizens in political decision-making process. in this viewpoint, the democracy is solely a political construct or a social-political style in which all the values are relative. In this definition of the democracy emphasis is on equality of the people based on the governing rule and the natural social and political rights of every member of humankind. This notion of democracy by no means is a self reliant idea and the need of an ideological basis for approaching to this idea is inevitable. In this paper we are trying to define the inter-relations of democracy and its philosophical basis to Islamic fundamental ideas. Our approach to this topic would be a philosophical ideological one.

Keywords: Islam, democracy, democracy’s philosophical basis, secularism, fundamentalism

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Authors: A. Lambert-Mogiliansky

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In this paper, we investigate the properties of simple rules for reappointment aimed at holding a public official accountable and monitor his activity. The public official allocates budget resources to various activities which results in the delivery of public services to citizens. He has discretion over the use of resource so he can divert some of them for private ends. Because of a liability constraint, zero diversion can never be secured in all states. The optimal reappointment mechanism under complete information is shown to exhibit some leniency thus departing from the zero tolerance principle. Under asymmetric information (about the state), a rule with random verification in a pre-announced subset is shown to be optimal in a class of common rules. Surprisingly, those common rules make little use of hard information about service delivery when available. Similarly, PO's claim about his record is of no value to improve the performance of the examined rules. In contrast requesting that the PO defends his records publicly can be very useful if the service users are given the chance to refute false claims with cheap talk complaints: the first best complete information outcome can be approached in the absence of any observation by the manager of the accountability mechanism.

Keywords: accountability, corruption, persuasion, debate

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Authors: A. Mukrimah, M. Mohd Parid, H. F. Lim

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Wetland ecosystem has valuable resources that contribute to national income generation and public well-being, either directly by resources that have a market value or indirectly by resources that have no market value. Economic approach is used to evaluate the resources to determine the best use of wetland resources and should be emphasized in policy development planning. This approach is to prevent imbalance in the allocation of resources and welfare benefits. A case study was conducted in 2016 to assess the economic value of wetland ecosystem services at Pulau Kukup National Parks (PKNP). This study has applied dichotomous choice survey design Contingent Valuation Method (CVM) to investigate empirically the willingness-to-pay (WTP) by the public. The study interviewed 400 household respondents at Pontian, Johor. Analysis showed 81% of household interviewed were willing to contribute to the Wetland Conservation Trust Fund. The results also indicated that on average a household was willing to pay RM87 annually. By taking into account 21,664 households in Pontian district in 2016, public’s contribution to conserves wetland ecosystem at PKNP was calculated to be RM1, 884,334. From the public’s interest to contribute to the conservation of wetland ecosystem services at PKNP, it indicates that more concerted effort is needed by both the federal and state governments to conserve and rehabilitate the mangrove ecosystem in Malaysia.

Keywords: environmental economy, economic valuation, choice experiment, Pulau Kukup national parks

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Authors: Burcu Doymus, Fatma N. Kok, Sakip Onder

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Titanium and titanium-based materials are commonly used to replace or regenerate the injured or lost tissues because of accidents or illnesses. Hospital infections and strong bond formation at the implant-tissue interface are directly affecting the success of the implantation as weak bonding with the native tissue and hospital infections lead to revision surgery. The purpose of the presented study is to modify the surface of the titanium substrates with nano/microspheres for local drug delivery and to prevent hospital infections. Firstly, titanium surfaces were silanized with APTES (3-Triethoxysilylpropylamine) following the negatively charged oxide layer formation. Then characterization studies using Scanning Electron Microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) were done on the modified surfaces. Secondly, microspheres/nanospheres were prepared with chitosan that is a natural polymer and having valuable properties such as non-toxicity, high biocompatibility, low allergen city and biodegradability for biomedical applications. Antibiotic (ciprofloxacin) loaded micro/nanospheres have been fabricated using emulsion cross-linking method and have been immobilized onto the titanium surfaces with different immobilization techniques such as covalent bond and entrapment. Optimization studies on size and drug loading capacities of micro/nanospheres were conducted before the immobilization process. Light microscopy and SEM were used to visualize and measure the size of the produced micro/nanospheres. Loaded and released drug amounts were determined by using UV- spectrophotometer at 278 nm. Finally, SEM analysis and drug release studies on the micro/nanospheres coated Ti surfaces were done. As a conclusion, it was shown that micro/nanospheres were immobilized onto the surfaces successfully and drug release from these surfaces was in a controlled manner. Moreover, the density of the micro/nanospheres after the drug release studies was higher on the surfaces where the entrapment technique was used for immobilization. Acknowledgement: This work is financially supported by The Scientific and Technological Research Council Of Turkey (Project # 217M220)

Keywords: chitosan, controlled drug release, nanosphere, nosocomial infections, titanium

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Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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Authors: Mochammad Indra Permana, Andhiani Sharfina Arnellya, Dika Pramita Destiani, Budhi Prihartanto

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Cardiovascular disease is the cause of the highest mortality rates in the world. The number of cardiovascular disease patients is increasing every year. Data obtained from World Health Organization (WHO) that 17,5 million people died from this disease. The condition of cardiovascular diseases such as atrial fibrillation, myocardial infarction, venous thromboembolism, and several other conditions need anticoagulant therapy. Results of the anticoagulant therapy are measured not only by the effectiveness of International Normalized Ratio (INR) value but also by the quality of life of the patients. The purpose of this study was to determine the quality of life of patients on oral anticoagulant therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This is a cross-sectional study with collecting data from the quality of life questionnaire and medical record of the patients. The results of this study showed that 28 patients (46,7%) had a good quality of life, 30 patients (50%) had a moderate quality of life, and 2 patients (3,3%) had a poor quality of life with no significant differences in quality of life based on age, gender, diagnosis, and duration of drug use.

Keywords: anticoagulant, cardiovascular diseases, INR, quality of life

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Authors: Le Jiang, Chua Jinxing

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Introduction: The recent outbreak of Ebola virus disease in the west Africa has drawn global concern. With a high fatality rate and direct human-to-human transmission, it has spread between countries and caused great damages for patients and family who are affected. Being the designated hospital to manage epidemic outbreak in Singapore, Tan Tock Seng Hospital (TTSH) is facing great challenges in preparation and managing of potential outbreak of emerging infectious disease such as Ebola virus disease. Aim: We conducted an infection control drill in TTSH emergency department to assess the readiness of healthcare and allied health workers in managing suspected Ebola patients. It also helps to review current Ebola clinical protocol and work instruction to ensure more smooth and safe practice in managing Ebola patients in TTSH emergency department. Result: General preparedness level of staffs involved in managing Ebola virus disease in TTSH emergency department is not adequate. Knowledge deficits of staffs on Ebola personal protective equipment gowning and degowning process increase the risk of potential cross contamination in patient care. Loopholes are also found in current clinical protocol, such as unclear instructions and inaccurate information, which need to be revised to promote better staff performance in patient management. Logistic issues such as equipment dysfunction and inadequate supplies can lead to ineffective communication among teams and causing harm to patients in emergency situation. Conclusion: The infection control drill identified the need for more well-structured and clear clinical protocols to be in place to promote participants performance. In addition to quality protocols and guidelines, systemic training and annual refresher for all staffs in the emergency department are essential to prepare staffs for the outbreak of Ebola virus disease. Collaboration and communication with allied health staffs are also crucial for smooth delivery of patient care and minimising the potential human suffering, properties loss or injuries caused by disease. Therefore, more clinical drills with collaboration among various departments involved are recommended to be conducted in the future to monitor and assess readiness of TTSH emergency department in managing Ebola virus disease.

Keywords: ebola, emergency department, infection control drill, Tan Tock Seng Hospital

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Authors: Collen T. Masilo, Brane Semolic, Pieter Steyn

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The Internet Protocol Television (IPTV) and Hybrid Fibre-Coaxial (HFC) Broadband industrial sector landscape are rapidly changing and organisations within the industry need to stay competitive by exploring new business models so that they can be able to offer new services and products to customers. The business challenge in this industrial sector is meeting or exceeding high customer expectations across multiple content delivery modes. The increasing challenges in the IPTV and HFC broadband industrial sector encourage service providers to form strategic partnerships with key suppliers, marketing partners, advertisers, and technology partners. The need to form enterprise collaborative networks poses a challenge for any organisation in this sector, in selecting the right strategic partners who will ensure that the organisation’s services and products are marketed in new markets. Partners who will ensure that customers are efficiently supported by meeting and exceeding their expectations. Lastly, selecting cooperation partners who will represent the organisation in a positive manner, and contribute to improving the performance of the organisation. Companies in the IPTV and HFC broadband industrial sector tend to form informal partnerships with suppliers, vendors, system integrators and technology partners. Generally, partnerships are formed without thorough analysis of the real reason a company is forming collaborations, without proper evaluations of prospective partners using specific selection criteria, and with ineffective performance monitoring of partners to ensure that a firm gains real long term benefits from its partners and gains competitive advantage. Similar tendencies are illustrated in the research case study and are based on Skyline Communications, a global leader in end-to-end, multi-vendor network management and operational support systems (OSS) solutions. The organisation’s flagship product is the DataMiner network management platform used by many operators across multiple industries and can be referred to as a smart system that intelligently manages complex technology ecosystems for its customers in the IPTV and HFC broadband industry. The approach of the research is to develop the most efficient business model that can be deployed to improve a strategic partnership programme in order to significantly improve the performance and growth of organisations participating in a collaborative network in the IPTV and HFC broadband industrial sector. This involves proposing and implementing a new strategic partnership model and its main features within the industry which should bring about significant benefits for all involved companies to achieve value add and an optimal growth strategy. The proposed business model has been developed based on the research of existing relationships, value chains and business requirements in this industrial sector and validated in 'Skyline Communications'. The outputs of the business model have been demonstrated and evaluated in the research business case study the IPTV and HFC broadband service provider 'Skyline Communications'.

Keywords: growth, partnership, selection criteria, value chain

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Authors: Eliane Cristina De Carvalho Mendoza Meza

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The Brazilian Federal Constitution from 1988 innovated with decentralized management, sharing the decision process among the federal government, states, and municipality (federalism). This innovation gave the opportunity to the civil society participates in the public policy agenda, including the municipal one; the state recognized that new actors were needed now it has been one more actor and not the only one. It was in this context that the woman’s Policy Secretaries were created in the three levels of government: federal, state and municipal. It intend to reduce the historical and social differences between men and women, especially in the poorest municipalities, working in a network basis with other secretaries, governmental institutions and non-governmental organizations to promote actions that can result in benefits and empowerment for women. In addition, they promote actions to protect them from domestic violence and to help them to learn how generate income. It was not a calm process, women have been fighting for their rights since the 1970s and despite the gender equality was recognized in the Federal Constitution of 1988, just in 2013 it was possible to see a real growth in the creation of municipal Women’s Policy Secretary. In 2009, just 6.5% of the cities in Brazil had implemented the Secretary; in 2013, it was 11%. The municipality realized that the gender issue was in reality a public problem, so the municipal agenda incorporated it and transformed in public policy, creating the municipal Women’s Policy Secretary. The introduction of a gender policy in Brazilian municipalities shows us that the female citizens are treated as political subjects and it is the first step to try to compensate inequality between men and women in the local level. It becomes more important when the Brazilian federalism is analyzed. In Brazil, the federal government controls the municipalities’ budgets to implement federal public policies and others federal interests, so having a public policy of gender approved by the actors in the local government with so little freedom to manage is something very important. It is necessary mark some points: taking a gender policy to the poorest cities is a form to protect all citizens with no distinction, men and women, as recommended in the Federal Constitution; not all problems in a city center in the municipal agenda, this only happens when a problem is perceived as an issue, it means the women situation was perceived as important, so that it became a public policy; at least, the gender public policy intend to emancipate and contemplate the empowerment of women.

Keywords: federalism, gender, municipal agenda, social participation

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Authors: Rehema Kabare

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As urban development initiatives continue to emerge and are implemented amid rapid urbanization and climate change effects in the global south, the plight of women is only being noticed. The pandemic exposed the atrocities, violence and unsafety women and girls face daily both in their homes and in public urban spaces. This is a result of poorly implemented and managed urban structures, which women have been left out of during design and implementation for centuries. The UN Habitat’s HerCity toolkit provides a unique opportunity to change course for both governments and civil society actors where women and girls are onboarded onto urban development initiatives, with their designs and ideas being the focal point. This toolkit proves that when women and girls design, they design for everyone. The HerCity HerStreets, Public Space Improvement Initiative, resulted in a design that focused on two aspects: Streets are a shared resource, and Streets are public spaces. These two concepts illustrate that for streets to be experienced effectively as cultural spaces, they need to be user-friendly, safe and inclusive. This report demonstrates how the HerCity HerStreets as a pilot project can be a benchmark for designing urban spaces in African cities. The project focused on five dimensions to improve the air quality of the space, the space allocation to street vending and bodaboda (passenger motorcycle) stops parking and the green coverage. The process displays how digital tools such as Minecraft and Kobo Toolbox can be utilized to improve citizens’ participation in the development of public spaces, with a special focus on including vulnerable groups such as women, girls and youth.

Keywords: urban space, sustainable development, gender and the city, digital tools and urban development

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Authors: H. Kalboussi, A. Aloui, W. Boughattas, M. Maoua, A. Brahem, S. Chatti, O. El Maalel, F. Debbabi, N. Mrizak, Y. Ben Youssef, A. Khlif, I. Bougmiza

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Background: In recent decades, the incidence of children's hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and Methods: Our study is a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012,and which included children with acute leukemia compared to children unharmed by neoplastic disease . Cases and controls were matched by age and gender. Our objective was to: - Describe the socio-occupational characteristics of the parents of children with acute leukemia. - Identify potential occupational factors implicated in the genesis of acute leukemia. Result: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0,009, OR = 3.9; CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5; ICa = [1.09 -11.6]. 25.7 % of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006), OR = 1.46, IC = [1.38 - 1.56]. The parental occupational exposures associated to the occurrence of acute leukemia in children were: - Pesticides with a statistically significant difference (p = 0.03), OR = 2.94, IC = [1.06 - 8.13]. This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75; ICa = [1.27 - 11.03]. - Cement without a statistically non-significant difference (p = 0.2). This difference has become significant after adjustment with the different variables pa = 0.03; ORa = 2.67; ICa = [1.06 - 6.7]. Conclusion: Parental exposure to occupational risk factors may play a role in the pathogenesis of acute leukemia in children.

Keywords: hematological malignancies, children, parents, occupational exposure

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Authors: Igone Guerra, Xabier Barandiaran

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The deep crisis (economic, social and cultural) in which Europe and Gipuzkoa, in the Basque Country (Spain), have been immersed in since 2008 forces governments to face a necessary transformation. These challenges demand different solutions and answers to meet the needs of the citizens. Adapting to continuous and sometimes abrupt changes in the social and political landscape requires an undeniable will to reinvent the way in which governments practice politics. This reinvention of government should help us build different organizations that, first, develop challenging public services, second, respond effectively to the needs of the citizens, and third, manage scarce resources, ultimately offering a contemporary concept of public value. In this context, the Etorkizuna Eraikiz initiative was designed to face the future challenges of the territory in a collaborative way. The aim of the initiative is to promote an alternative form of governance to generate common good and greater public value. In Etorkizuna Eraikiz democratic values, such as collaboration, participation, and accountability are prominent. This government approach is based on several features such as the creation of relational spaces to design and deliberate about the public politics or the promotion of a team-working approach, breaking down the silos between and within organizations, as an exercise in defining a shared vision regarding the Future of the Territory. A future in which the citizens are becoming actors in the problem-solving process and in the construction of a culture of participation and collective learning. In this paper, the Etorkizuna Eraikiz initiative will be presented (vision and methodology) as a model of a local approach to public policy innovation resulting in a way of governance that is more open and collaborative. Based on this case study, this paper explores the way in which collaborative governance leads to better decisions, better leadership, and better citizenry. Finally, the paper also describes some preliminary findings of this local approach, such as the level of knowledge of the citizenry about the projects promoted within Etorkizuna Eraikiz as well as the link between the challenges of the territory, as identified by the citizenry, and the political agenda promoted by the provincial government. Regarding the former, the Survey on the socio-political situation of Gipuzkoa showed that 27.9% of the respondents confirmed that they knew about the projects promoted within the initiative and gave it a mark of 5.71. In connection with the latter, over the last three years, 65 millions of euros have been allocated for a total of 73 projects that have covered socio-economic and political challenges such as aging, climate change, mobility, participation in democratic life, and so on. This governance approach of Etorkizuna Eraikiz has allowed the local government to match the needs of citizens to the political agenda fostering in this way a shared vision about the public value.

Keywords: collaborative governance, citizen participation, public good, social listening, public innovation

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Authors: Dawit Hoyiso, Abinet Arega, Terefe Markos

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Background: - In spite of all the various programs and strategies to promote the use of research finding there is still gap between theory and practice. Difference in outcomes, health inequalities, and poorly performing health service continue to present a challenge to all nurses. A number of studies from various countries have reported that nurses’ experience of evidence-based practice is low. In Ethiopia there is an information gap on the extent of evidence based nursing practice and its associated factors. Objective: - the study aims to assess the implementation of evidence based nursing practice and associated factors among nurses in Jimma zone public hospitals. Method: - Institution based cross-sectional study was conducted from March 1-30/2015. A total of 333 sampled nurses for quantitative and 8 in-depth interview of key informants were involved in the study. Semi-structured questionnaire was adapted from funk’s BARRIER scale and Friedman’s test. Multivariable Linear regression was used to determine significance of association between dependent and independent variables. Pretest was done on 17 nurses of Bedele hospital. Ethical issue was secured. Result:-Of 333 distributed questionnaires 302 were completed, giving 90.6% response rate. Of 302 participants 245 were involved in EBP activities to different level (from seldom to often). About forty five(18.4%) of the respondents had implemented evidence based practice to low level (sometimes), one hundred three (42 %) of respondents had implemented evidence based practice to medium level and ninety seven (39.6 %) of respondents had implemented evidence based practice to high level(often). The first greatest perceived barrier was setting characteristic (mean score=26.60±7.08). Knowledge about research evidence was positively associated with implementation of evidence based nursing practice (β=0.76, P=0.008). Similarly, Place where the respondent graduated was positively associated with implementation of evidence based nursing practice (β=2.270, P=0.047). Also availability of information resources was positively associated with implementation of evidence based practice (β=0.67, P= 0.006). Conclusion: -Even though larger portion of nurses in this study were involved in evidence-based practice whereas small number of participants had implemented frequently. Evidence-based nursing practice was positively associated with knowledge of research, place where respondents graduated, and the availability of information resources. Organizational factors were found to be the greatest perceived barrier. Intervention programs on awareness creation, training, resource provision, and curriculum issues to improve implementation of evidence based nursing practice by stakeholders are recommended.

Keywords: evidence based practice, nursing practice, research utilization, Ethiopia

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Authors: Xavier Ruiz Del Portal

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This paper incorporates mobility between the legal and black economies into a model of tax evasion with endogenous labor supply in which underreporting is possible in one sector but impossible in the other. We have found that the results of the effects along the extensive margin (number of evaders) become more robust and conclusive than those along the intensive margin (hours of illegal work) usually considered by the literature. In particular, it is shown that the following policies reduce the number of evaders: (a) larger and more progressive evasion penalties; (b) higher detection probabilities; (c) an increase in the legal sector wage rate; (d) a decrease in the moonlighting wage rate; (e) higher costs for creating opportunities to evade; (f) lower opportunities to evade, and (g) greater psychological costs of tax evasion. When tax concealment and illegal work also are taken into account, the effects do not vary significantly under the assumptions in Cowell (1985), except for the fact that policies (a) and (b) only hold as regards low- and middle-income groups and policies (e) and (f) as regards high-income groups.

Keywords: income taxation, tax evasion, extensive margin responses, the penalty system

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Authors: Teo Yen Nee, Tham Siew Yean, Andrew Kam Jia Yi

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There are growing concerns about the effect of increasing outward foreign direct investment (OFDI) from Malaysia. These concerns emerged when OFDI surpassed inward FDI for the first time in 2007 and in the subsequent years as well. From a theoretical point of view, the effect of OFDI on exports remains inconclusive depending on the types and/or motivations of investment. Therefore, the objective of this paper is to investigate the effect of Malaysia’s OFDI on manufacturing exports, using a reduced form exports model. The manufacturing data used in this study covered 24 manufacturing industries for the period 2003-2010. The manufacturing sector is the fourth largest sector invested by Malaysia’s OFDI abroad. However, this sector is chosen for this study because total manufacturing trade contributed significantly to Malaysia’s economy growth as reflected by its significant share in the country’s gross domestic product (138.7%) in 2013. Furthermore, Malaysia’s exports are dominated by manufacturing goods. Consequently, the drastic increase in OFDI added concerns about its impact on the country’s exports. Since OFDI activities are still relatively new in Malaysia, this study is exploratory in nature due to a lack of firm level data. Using industry level panel data, the value added of this paper is to meet the research gap by examining the effect of Malaysia’s outward FDI on manufacturing exports. Overall, the findings show that lagged inward FDI, technology development, and industry size are found to positive and significantly influence manufacturing exports as compared to other factors. The insignificant impact of OFDI on manufacturing exports suggests market seeking investment is the main form of OFDI from Malaysia and the destination markets are not served by exports before so that there are no new exports created or displacement of exports. While the results show that there is no need to worry about OFDI’s negative impact on exports, policies should be undertaken to encourage OFDI from Malaysia to create new exports for the country.

Keywords: OFDI, manufacturing industries, exports, Malaysia

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Authors: Swapna Begum, Higano Yoshiro

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Dhaka is the capital city of Bangladesh. It is considered as one of the traffic congested cities in the world. The growth of the population of this city is increasing day by day. The land use pattern and the increased socio-economic characteristics increase the motor vehicle ownership of this city. The rapid unplanned urbanization and poor transportation planning have deteriorated the transport environment of this city. Also, the huge travel demand with non-motorized traffics on streets is accounted for enormous traffic congestion in this city. The land transport sector in Dhaka is mainly dependent on road transport comprised of both motorized and non-motorized modes of travel. This improper modal mix and the un-integrated system have resulted in huge traffic congestion in this city. Moreover, this city has no well-organized public transport system and any Mass Transit System to cope with this ever increasing demand. Traffic congestion causes serious air pollution and adverse impact on the economy by deteriorating the accessibility, level of service, safety, comfort and operational efficiency. Therefore, there is an imperative need to introduce a well-organized, properly scheduled mass transit system like (Bus Rapid Transit) BRT minimizing the existing problems.

Keywords: air pollution, BRT, mass transit, traffic congestion

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Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs

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Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.

Keywords: communication, COVID-19, hospital management, WhatsApp

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Authors: Bilgehan Gültekin, Tuba Gültekin

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The first stage to procure peace communication is to construct a mutual accordance, which can be defined as: To constitute reconciliation ground in order to open and constitute the right peace and dialogue areas. For example: In Turkey’s EU entry process, in order to procure French public opinion, to constitute a communication frame is a must. For the constitution of this frame, the titles of discussion in which it will be moved and for which French public opinion will show its support must be determined. The most important title of this ground is Turkey’s peace potential for Europe with its strategic position. For this reason, it’s is so strategic for peace communication that Turkey’s contributions for Europe and World should be opened up for discussion in public opinion in France and be introduced as a strong accordance ground.Peace based diplomacy, peace communication strategies and peace lobbying in the example of Turkey-France relations presents a strong peace titles.

Keywords: intercultural communication, mediation education, common sense leaders, artistic sensitivity

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Authors: Sagarjyoti Roy

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Dengue is an arboviral infection, belonging to family flaviviridae, comprising of four serotypes; DENV1, DENV2, DENV3 and DENV4. All four serotypes are capable of causing full-spectrum of clinical features, ranging from self-limiting fever to severe dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Complications may affect any organ system, including those involving gastrointestinal system and serositis. We report a case, of a 28 years, non-alcoholic male, presenting with a 7 day history of fever and malaise followed by abdominal pain and distension, from 4th day of fever. He was admitted in medicine department of RG KAR medical college hospital. Dengue fever was confirmed by NS1 and dengue IgM positivity. Platelet count was 30,000/cc (1.5- 4 lac/cc) and haematocrit was 52% (38- 50% for men). Clinicoradiological findings revealed bilateral pleural effusion, ascites and splenomegaly. Ascitic fluid was hemorrhagic in nature, with a high protein and RBC content. Liver function tests revealed mild transaminitis with normal coagulation profile. Patient was managed conservatively. A diagnosis of dengue fever complicated by serositis and spontaneous haemoperitoneum was made. The symptoms subsided after a hospital stay of 10 days. The case highlights haemorrhage into peritoneal cavity as a possible complication of dengue fever. Although a definite explanation requires more detailed studies, platelet or endothelial cell dysfunction might be contributory.

Keywords: ascites, dengue, haemoperitoneum, serositis

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Authors: Aulia Fitri

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This aims to seek which part of the linguistics with the common mistakes occurred between Instagram translation and human translation. Instagram is a social media account that is widely used by people in the world. Everyone with the Instagram account can consume the captions and pictures that are shared by their friends, celebrity, and public figures across countries. Instagram provides the machine translation under its caption space that will assist users to understand the language of their non-native. The researcher takes samples from an Indonesian public figure whereas the account is followed by many followers. The public figure tries to help her followers from other countries understand her posts by putting up the English version after the Indonesian version. However, the research on Instagram account has not been done yet even though the account is widely used by the worldwide society. There are 20 samples that will be analysed on the perspective of translation quality and linguistics tools. As the MT, Instagram tends to give a literal translation without regarding the topic meant. On the other hand, the human translation tends to exaggerate the translation which leads a different meaning in English. This is an interesting study to discuss when the human nature and robotic-system influence the translation result.

Keywords: human translation, machine translation (MT), translation quality, linguistic tool

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Authors: Berger Saintius, Edna Ariste, Djeamsly Salomon

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Background: Maternal mortality is a preventable global health problem that affects developed, developing, and underdeveloped countries alike. Globally, maternal mortality rates have declined since 1990, but 830 women die every day from pregnancy and childbirth-related causes that are often preventable. Haiti, with a number of 529 maternal deaths per 100,000 live births, is one of the countries with the highest maternal mortality rate in the Caribbean. This study consists of analyzing maternal death surveillance data in Haiti from 2017-2020. Method : A descriptive study was conducted; data were extracted from the National Epidemiological Surveillance Network of maternal deaths from 2017 to 2020. Sociodemographic variables were analyzed. Excel and Epi Info 7.2 were used for data analysis. Frequency and proportion measurements were calculated. Results: 756 deaths were recorded for the study period: 42 (6%) in 2017, 168 (22%) in 2018, 265 (35%) in 2019, and 281 (37%) in 2020. The North Department recorded the highest number of deaths, 167 (22%). 83(11%) in Les Cayes. 96% of these deaths are people aged between 15 and 49. Conclusion. Maternal mortality is a major health problem in Haiti. Mobilization, participation, and involvement of communities, increase in obstetric care coverage and promotion of Family Planning are among the strategies to fight this problem.

Keywords: epidemiology, maternal death, hospital, Haiti

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Authors: Camila Freire Barrios, Gonzalo Rivera Talavera

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The importance of public spaces has been shown for many years, and in different disciplines, with one example being their ability for developing a sustainable social environment, especially in mega cities like Lima. The aim of this study was to explore the process of space appropriation that occurs in the Peripheral Library of the district El Agustino in Lima, Peru. Space appropriation is a process by which people develop a link with a place within a specific sociocultural context. This process has been related to positive outcomes, such as: participation and in the development of compassionate behaviors with these places. To achieve the purpose of the research, a qualitative design was selected because this will allowed exploring in deep the process in an specific context. The study interviewed six adults, all of whom were deliberately chosen to have the longest residence time in the district and also utilized the library the most. In a complementary manner, two children and one adolescent were interviewed. Likewise, two observations were made on a weekday and weekend, and public documentation information was collected. As a result, five categories linked to this process were identified. It was found that the process of space appropriation begins with the needs of the people who arrive at the library, which provides benefits to these people by fulfilling them. Next in the process, through the construction of meanings, the library is then valued as a pleasant, productive, safe and regulated place; as a result, people become identified with the library. The identification generated is subsequently reflected in the level of participation that the person has in the library, which may go in a continuum from no participating at all to a more direct involvement in the library activities, as well as voluntary and altruistic work. Finally, this process leads to the library becoming part of the neighborhood. This study allows having a better understanding of how sociospatial processes work in a Latinamerican context and in cities like Lima, where the third of the country’s population lives. Also, Lima has grown in the past 50 years in a excessively way and with lack of planification. Therefore, these results brings new research questions and highlights the importance of learning how to design public spaces in order to promote these processes to develop.

Keywords: bond with the place, place identity, public spaces, space appropriation

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