Search results for: healthcare sectors

Authors: Jameelah Omolara Yaqub

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One of the main reasons for the existence of central bank is that it is believed that central banks have some influence on private sector decisions which will enable the Central Bank to achieve some of its objectives especially that of stable price and economic growth. By the assumption of the New Keynesian theory that prices are fully flexible in the short run, the central bank can temporarily influence real interest rate and, therefore, have an effect on real output in addition to nominal prices. There is, therefore, the need for the Central Bank to monitor, respond to, and influence private sector decisions appropriately. This thus shows that the Central Bank and the private sector will both affect and be affected by each other implying considerable interdependence between the sectors. The interdependence may be simultaneous or not depending on the level of information, readily available and how sensitive prices are to agents’ expectations about the future. The aim of this paper is, therefore, to determine whether the interdependence between asset prices and monetary policy are simultaneous or not and how important is this relationship. Studies on the effects of monetary policy have largely used VAR models to identify the interdependence but most have found small effects of interaction. Some earlier studies have ignored the possibility of simultaneous interdependence while those that have allowed for simultaneous interdependence used data from developed economies only. This study, therefore, extends the literature by using data from a developing economy where information might not be readily available to influence agents’ expectation. In this study, the direction of relationship among variables of interest will be tested by carrying out the Granger causality test. Thereafter, the interaction between asset prices and monetary policy in Nigeria will be tested. Asset prices will be represented by the NSE index as well as real estate prices while monetary policy will be represented by money supply and the MPR respectively. The VAR model will be used to analyse the relationship between the variables in order to take account of potential simultaneity of interdependence. The study will cover the period between 1980 and 2014 due to data availability. It is believed that the outcome of the research will guide monetary policymakers especially the CBN to effectively influence the private sector decisions and thereby achieve its objectives of price stability and economic growth.

Keywords: asset prices, granger causality, monetary policy rate, Nigeria

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Authors: Ali Kharazi, Hassanali Aghajani, Hesami Azizi

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Tourism entrepreneurship is a growing field that has the potential to create new opportunities for sustainable development. The purpose of this study is to identify and classify the entrepreneurial opportunities in the blind tourism industry in Khuzestan Province of Iran that can be created through the operation of blinds’ tours. This study used a mixed methods approach. The qualitative data was collected through semi-structured interviews with 15 tourist guides and tourism activists, while the quantitative data was collected through a questionnaire survey of 40 blind people who had participated in blinds’ tours. The findings of this study suggest that there are a number of entrepreneurial opportunities in the blind tourism industry in Khuzestan Province, including (1) developing and providing accessible tourism services, such as tours, accommodations, restaurants, and transportation, (2) creating and marketing blind-friendly tourism products and experiences (3) training and educating tourism professionals on how to provide accessible and inclusive tourism services. This study contributes to the theoretical understanding of tourism entrepreneurship by providing insights into the entrepreneurial opportunities in the blind tourism industry. The findings of this study can be used to develop policies and programs that support the development of the blind tourism industry. The qualitative data were analyzed using content analysis. The quantitative data were analyzed using descriptive statistics and inferential statistics. This study examines the entrepreneurial opportunities within the blind tourism industry in Khuzestan Province, Iran. In addition, Khuzestan province has made relatively good development in the field of blinds’ tourism. Blind tourists have become loyal customers of blinds’ tours, which has increased their self-confidence and social participation. Tourist guides and centers of tourism services are interested in participating in blinds’ tours more than before, and even other parts outside the tourism field have encouraged sponsorship. Education had a great impact on the quality of tourism services, especially for the blind. It has played a significant role in improving the quality of tourism services for the blind. However, the quality and quantity of infrastructure should be increased in different sectors of tourism services to foster future growth. These opportunities can be used to create new businesses and jobs and to promote sustainable development in the region.

Keywords: entrepreneurship, tourism, blind, sustainable development, Khuzestan

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Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

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In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

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Authors: Daud Muhammad

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Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

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Authors: Layal Mansour

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The aim of this paper is to identify whether oil price volatility or geopolitical risks can predict future financial stress periods or economic recessions in Kuwait. We construct the first Financial Stress Index for Kuwait (FSIK) that includes informative vulnerable indicators of the main financial sectors: the banking sector, the equities market, and the foreign exchange market. The study covers the period from 2000 to 2020, so it includes the two recent most devastating world economic crises with oil price fluctuation: the Covid-19 pandemic crisis and Ukraine-Russia War. All data are taken by the central bank of Kuwait, the World Bank, IMF, DataStream, and from Federal Reserve System St Louis. The variables are computed as the percentage growth rate, then standardized and aggregated into one index using the variance equal weights method, the most frequently used in the literature. The graphical FSIK analysis provides detailed information (by dates) to policymakers on how internal financial stability depends on internal policy and events such as government elections or resignation. It also shows how monetary authorities or internal policymakers’ decisions to relieve personal loans or increase/decrease the public budget trigger internal financial instability. The empirical analysis under vector autoregression (VAR) models shows the dynamic causal relationship between the oil price fluctuation and the Kuwaiti economy, which relies heavily on the oil price. Similarly, using vector autoregression (VAR) models to assess the impact of the global geopolitical risks on Kuwaiti financial stability, results reveal whether Kuwait is confronted with or sheltered from geopolitical risks. The Financial Stress Index serves as a guide for macroprudential regulators in order to understand the weakness of the overall Kuwaiti financial market and economy regardless of the Kuwaiti dinar strength and exchange rate stability. It helps policymakers predict future stress periods and, thus, address alternative cushions to confront future possible financial threats.

Keywords: Kuwait, financial stress index, causality test, VAR, oil price, geopolitical risks

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Authors: M. S. Said, J. A. Ghani, C. H. Che Hassan, N. N. Wan, M. A. Selamat, R. Othman

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Metal Matrix Composite (MMCs) have attracted considerable attention as a result of their ability to provide high strength, high modulus, high toughness, high impact properties, improved wear resistance and good corrosion resistance than unreinforced alloy. Aluminium Silicon (Al/Si) alloys Metal Matrix composite (MMC) has been widely used in various industrial sectors such as transportation, domestic equipment, aerospace, military, construction, etc. Aluminium silicon alloy is MMC reinforced with aluminium nitride (AlN) particle and becomes a new generation material for automotive and aerospace applications. The AlN material is one of the advanced materials with light weight, high strength, high hardness and stiffness qualities which have good future prospects. However, the high degree of ceramic particles reinforcement and the irregular nature of the particles along the matrix material that contribute to its low density, is the main problem that leads to the machining difficulties. This paper examines tool wear when milling AlSi/AlN Metal Matrix Composite using a TiB2 coated carbide cutting tool. The volume of the AlN reinforced particle was 10%. The milling process was carried out under dry cutting condition. The TiB2 coated carbide insert parameters used were the cutting speed of (230 m/min, feed rate 0.4mm tooth, DOC 0.5mm, 300 m/min, feed rate 0.8mm/tooth, DOC 0.5mm and 370 m/min, feed rate 0.8, DOC 0.4m). The Sometech SV-35 video microscope system was used for tool wear measurements respectively. The results have revealed that the tool life increases with the cutting speed (370 m/min, feed rate 0.8 mm/tooth and depth of cut 0.4mm) constituted the optimum condition for longer tool life which is 123.2 min. While at medium cutting speed, it is found that the cutting speed of 300m/min, feed rate 0.8 mm/tooth and depth of cut 0.5mm only 119.86 min for tool wear mean while the low cutting speed give 119.66 min. The high cutting speed gives the best parameter for cutting AlSi/AlN MMCs materials. The result will help manufacture to machining the AlSi/AlN MMCs materials.

Keywords: AlSi/AlN Metal Matrix Composite milling process, tool wear, TiB2 coated carbide tool, manufacturing engineering

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Authors: Ashok Tejankar, Rohan K. Pathrikar

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Maharashtra is covered by heterogeneous flows of Deccan basaltic terrains of upper cretaceous to lower Eocene age. It consist mainly different types of basalt flow, having heterogeneous Geohydrological characters. The study area Aurangabad dist. lies in the central part of Maharashtra. The study area is typically covered by Deccan traps formation mainly basalt type of igneous volcanic rock. The area is located in the survey of India toposheet No. 47M and laying between 19° to 20° north latitudes and 74° to 76° east longitudes. Groundwater is the primary source for fresh water in the study area. There has been a growing demand for fresh water in domestic & agriculture sectors. Due to over exploitation and rainfall failure has been created an irrecoverable stress on groundwater in study area. In an effort to maintain the water table condition in balance, artificial recharge is being implemented. The selection of site for artificial recharge is a very important task in recharge basalt. The present study aims at sitting artificial recharge structure at village Pachod in basaltic terrain of the Godavari-Purna river basin in Aurangabad district of Maharashtra, India. where the average annual rainfall is 650mm. In this investigation, integrated remote sensing and GIS techniques were used and various parameters like lithology, structure, etc. aspect of drainage basins, landforms and other parameters were extracted from visual interpretation of IRS P6 Satellite data and Survey of India (SIO) topographical sheets, aided by field checks by carrying well inventory survey. The depth of weathered material, water table conditions, and rainfall data were been considered. All the thematic information layers were digitized and analyzed in Arc-GIS environment and the composite maps produced show suitable site, depth of bed rock flows for successful artificial recharge in village Pachod to increase groundwater potential of low laying area.

Keywords: hard rock, artificial recharge, remote sensing, GIS

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Authors: Marvin Eslava

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The over-arching aim of this research is to determine the potential contribution of local food resources to the tourism growth of Nueva Vizcaya. It reviews some of the underpinning concepts and to provide a set of considerations for stakeholders to maximize the opportunity of local food can offer to businesses and the wider community. The basis of the study is to develop a sustainable food tourism model for Nueva Vizcaya. For the purpose of this research, there were 60 total numbers of respondents classified as samples from a six municipality. The respondents of the study were stakeholder consisting of government official, local producers, businessman and Non-government organizations in the selected municipalities of Nueva Vizcaya. Stratified purposive sampling was the appropriate technique that was used to the local government officials and employees, NGOs including the businessmen who are associated with local food resources and local producers. The documentary study, focus group discussion and survey questionnaire was used in order to meet the objectives of the study. Kruskall Wallis test was used to test the variances the ratings of the participants. This was used in the computation of hypothesis. The study concluded that the province of Nueva Vizcaya is blessed for its rich farmlands and fertile mountain soil boasts to produce high quality agricultural products. It is a home of various different indigenous groups creating a wide range of local cuisine. The province has substantial local food development evidence by the various food tourism related resources, increase in facilities and celebrating food tourism related events. The local food resources provide extensive potential economic empowerment and help in building the identity of the province. In addition, the local food resources extensively enhance the agriculture sector and other attractions in the province. Finally, it helps to preserve the authenticity of the food culture and generated pride among all stakeholders extensively. All stakeholders have the same perception on the potential contribution of local food resources to the development of the province of Nueva Vizcaya. The public and private sectors are cognizant on their roles to support the production of local food resources in Nueva Vizcaya. Major challenges and barriers in the development of sustainable food tourism in Nueva Vizcaya include production or supply and marketing.

Keywords: local food resources, contribution, food tourism, benefits

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: Svetlana Gudkova

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The Internet of Things experiences a rapid growth bringing inevitable changes into many spheres of human activities. As the Internet has changed the social and business landscape, IoT as its extension, can bring much more profound changes in economic value creation and competitiveness of the economies. It has been already recognized as the next industrial revolution. However, the development of IoT is in a great extent stimulated by the entrepreneurial activity. To expand and reach its full potential it requires proactive entrepreneurs, who explore the potential and create innovative ideas pushing the boundaries of IoT technologies' application further. The goal of the research is to analyze, how entrepreneurs utilize the opportunities created by IoT and how do they stimulate the development of IoT through discovering of new ways of generating economic value and creating opportunities, which attract other entrepreneurs. The qualitative research methods have been applied to prepare the case studies. Entrepreneurs are recognized as an engine of economic growth. They introduce innovative products and services into the market through the creation of a new combination of the existing resources and utilizing new knowledge. Entrepreneurs not only create economic value but what is more important, they challenge the existing business models and invent new ways of value creation. Through identification and exploitation of entrepreneurial opportunities, they create new opportunities for other entrepreneurs. It makes the industry more attractive to other profit/innovation-driven start-ups. IoT creates numerous opportunities for entrepreneurs in the different industries. Smart cities, healthcare, manufacturing, retail, agriculture, smart vehicles and smart buildings benefit a lot from IoT-based breakthrough innovations introduced by entrepreneurs. They reinvented successfully the business models and created new entrepreneurial opportunities for other start-ups to introduce next innovations.

Keywords: entrepreneurship, internet of things, breakthrough innovations, start-ups

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Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

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Authors: Freda Adomaa, Samuel Oppong Boampong, Charles Gyamfi Rahman

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The living and working environment of migrants and their access to healthcare services induce good or poor health. This study was conducted to assess the factors associated with rural-urban migration and its associated health hazards among female adolescents. A sample size of two hundred (200) was chosen in which all responded to questionnaires comprising closed-ended questions, which were distributed to gather data from the respondents, after which it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The utilized three causes of rural-urban migration thus political, economic and socio-cultural. The study revealed that political situations such as regional inequality (65.4%) and ethnic conflicts (78.2%) whereas economic factors such as lack of amenities (82.3%), lack of employment in rural communities (77.4%), lack of education (74%), and poverty (85.3%) as well as socio-cultural factors such as divorced parents (65.6%), media influence (79.1%), family conflicts (59.4%) and appealing urban informal sector (65.2%) are major causes of migration. Respondents’ encountered challenges such as poor remuneration for services (87.2%), being maltreated by a colleague or worker (69%), sleeping in open space (73.3%), and harassment by the task force (71.4%) and teenage pregnancies (58.5%). The study concluded that the three variables play a key role in adolescent migration and when they travel they end up getting involved in serious health hazardous behaviors such as rapes as well as physical and psychological harassments’. The study, therefore, recommends that vocational training of the rural people on small scale industries (non-farm) activities that could generate an income for the rural household should be introduced.

Keywords: rural, urban, migration, female health hazards

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Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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Authors: Mehri Sadat Alavinasab Ashgezari, Gholam Reza Nabi Bidhendi, Fatemeh Sadat Alavinasab Ashkezari

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Atmospheric aerosol loading (AAL) from anthropogenic sources is an evidence in industrial development. The accelerated trends in material consumption at the global scale in recent years demonstrate consumption paradigms sensible to the planetary boundaries (PB). This paper is a statistical approach on recognizing the path of climate-relevant bulk materials production (CBMP) of steel, cement and plastics to AAL via an updated and validated spatiotemporal distribution. The methodology of statistical analysis used the most updated regional or global databases or instrumental technologies. This corresponded to a selection of processes and areas capable for tracking AAL within the last decade, analyzing the most validated data while leading to explore the behavior functions or models. The results also represented a correlation within socio economic metabolism idea between the materials specified as macronutrients of society and AAL as a PB with an unknown threshold. The selected country contributors of China, India, US and the sample country of Iran show comparable cumulative AAL values vs to the bulk materials domestic extraction and production rate in the study period of 2012 to 2022. Generally, there is a tendency towards gradual descend in the worldwide and regional aerosol concentration after 2015. As of our evaluation, a considerable share of human role, equivalent 20% from CBMP, is for the main anthropogenic species of aerosols, including sulfate, black carbon and organic particulate matters too. This study, in an innovative approach, also explores the potential role of AAL control mechanisms from the economy sectors where ordered and smoothing loading trends are accredited through the disordered phenomena of CBMP and aerosol precursor emissions. The equilibrium states envisioned is an approval to the well-established theory of Spin Glasses applicable in physical system like the Earth and here to AAL.

Keywords: atmospheric aeroso loading, material flows, climate bulk materials, industrial ecology

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Authors: Manzoor Ahmad

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The rapid advancement of mobile technology has transformed the way businesses engage with consumers, making mobile marketing a crucial strategy for organizations worldwide. This paper presents a comprehensive study on the adoption of mobile marketing in Pakistan, aiming to provide valuable insights into the current landscape, challenges, and opportunities in this emerging market. To achieve this objective, a mixed-methods approach was employed, combining quantitative surveys and qualitative interviews with industry experts, marketers, and consumers. The study encompassed a diverse range of sectors, including retail, telecommunications, banking, and e-commerce, ensuring a comprehensive understanding of mobile marketing practices across different industries. The findings indicate that mobile marketing has gained significant traction in Pakistan, with a growing number of organizations recognizing its potential for reaching and engaging with consumers effectively. Factors such as increasing smartphone penetration, affordable data plans, and the rise of social media usage have contributed to the widespread adoption of mobile marketing strategies. However, several challenges and barriers to mobile marketing adoption were identified. These include issues related to data privacy and security, limited digital literacy among consumers, inadequate infrastructure, and cultural considerations. Additionally, the study highlights the need for tailored and localized mobile marketing strategies to address the diverse cultural and linguistic landscape of Pakistan. Based on the insights gained from the study, practical recommendations are provided to support organizations in optimizing their mobile marketing efforts in Pakistan. These recommendations encompass areas such as consumer targeting, content localization, mobile app development, personalized messaging, and measurement of mobile marketing effectiveness. This research contributes to the existing literature on mobile marketing adoption in developing countries and specifically sheds light on the unique dynamics of the Pakistani market. It serves as a valuable resource for marketers, practitioners, and policymakers seeking to leverage mobile marketing strategies in Pakistan, ultimately fostering the growth and success of businesses operating in this region.

Keywords: mobile marketing, digital marketing, mobile advertising, adoption of mobile marketing

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Authors: Qingyu Zhang, Helin Ma, Lili Weng, Mei Cao

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Green supply chain management has been an important organizational strategy to reduce environmental risks and improve financial performance. Firms have to adopt green supply chain practices to meet the official regulations and reduce peer pressure in China. This paper exhibits an empirical study of the drivers of green supply chain management practices and the environmental and economic performance of green supply chain management implementation in Chinese firms. While China is the fastest-growing emerging economy, it has paid a high ecological price. It is reported that China hosts 7 of the world’s 10 most polluted cities. The continued environmental deterioration and the resultant heightened regulatory control and public scrutiny have posed new operating challenges to firms conducting business in China. These challenges make the country an ideal setting to conduct the present study. A research questionnaire was developed to gather data in China. The questionnaire targeted managers and employees in Chinese companies. The data were collected in the last quarter of 2015, involving industries such as electronic & communicational equipment, textile & clothing, pharmaceutical & healthcare, and so on. This study confirms and validates that (1) both internal and external drivers play a significant role in the implementation of green supply chain management practices; (2) green purchase and investment recovery have a significant impact on firms’ environmental and economic performance; (3) with the improvement of the firms’ environmental performance, their economic performance will improve.

Keywords: economic performance, environmental performance, external driver, green supply chain management

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Authors: Sharifah Sumayyah Engku Alwi, Masrah Azrifah Azmi Murad

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The development of the information technology and Internet has been transforming the healthcare industry. The internet is continuously accessed to seek for health information and there are variety of sources, including search engines, health websites, and social networking sites. Providing more and better information on health may empower individuals, however, ensuring a high quality and trusted health information could pose a challenge. Moreover, there is an ever-increasing amount of information available, but they are not necessarily accurate and up to date. Thus, this paper aims to provide an insight of the models and frameworks related to online health information seeking of consumers. It begins by exploring the definition of information behavior and information seeking to provide a better understanding of the concept of information seeking. In this study, critical factors such as performance expectancy, effort expectancy, and social influence will be studied in relation to the value of seeking health information. It also aims to analyze the effect of age, gender, and health status as the moderator on the factors that influence online health information seeking, i.e. trust and information quality. A preliminary survey will be carried out among the health professionals to clarify the research problems which exist in the real world, at the same time producing a conceptual framework. A final survey will be distributed to five states of Malaysia, to solicit the feedback on the framework. Data will be analyzed using SPSS and SmartPLS 3.0 analysis tools. It is hoped that at the end of this study, a novel framework that can improve online health information seeking is developed. Finally, this paper concludes with some suggestions on the models and frameworks that could improve online health information seeking.

Keywords: information behavior, information seeking, online health information, technology acceptance model, the theory of planned behavior, UTAUT

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Authors: Mehrdad Akbarzadeh, Afsaneh Abrisham

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Introduction: Critical thinking skills are crucial for nurses, particularly those working in neonatal care, where quick and informed decision-making is essential. This study aims to evaluate the effectiveness of critical thinking skills on job performance among neonatal nurses. Methods: A cross-sectional study was conducted with 450 neonatal nurses from a hospital in Mashhad. Participants were assessed using the Critical Thinking Questionnaire (CThQ) to measure their critical thinking abilities across various subscales, including Analyzing, Evaluating, Creating, Remembering, Understanding, and Applying. Additionally, a custom Job Performance Checklist completed by supervising nurses, was used to evaluate job performance across several dimensions. Data were collected and analyzed using SPSS V.23. Correlation analysis was conducted to determine the relationship between critical thinking skills and job performance. Results: The mean age of the nurses was 33.46 ± 14.2 years, with 79.15% being female. The nurses demonstrated high proficiency in critical thinking, with notable scores in the Creating (23.98 ± 4.8), Applying (17.35 ± 3.2), and Evaluating (16.67 ± 3.4) subscales. The results indicate a significant positive correlation between several critical thinking subscales and job performance. The Creating subscale exhibited the strongest correlation (R = 0.79, p < 0.001), followed by Overall CThQ (R = 0.68, p = 0.039) and Evaluating (R = 0.67, p = 0.041). Analyzing (R = 0.45, p = 0.013) and Understanding (R = 0.41, p = 0.015) also showed significant correlations with job performance. Remembering (R = 0.29, p = 0.061) and Applying (R = 0.43, p = 0.057) were not significantly correlated with job performance. Conclusion: The findings indicate that critical thinking skills, especially in creating and evaluating, are strongly associated with job performance in neonatal nurses. Enhancing these skills through targeted training programs could improve job performance, particularly in decision-making and time management. This study underscores the importance of critical thinking in neonatal care and its impact on nursing efficacy and patient outcomes.

Keywords: critical thinking, job performance, neonatal nurses, healthcare quality

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Thomas Trouton, Sebastian Tanner, Manvir Sandher

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The use of simulation in undergraduate and postgraduate medical curricula is ever-growing, is a useful addition to the traditional apprenticeship model of learning within medical education, and better prepares graduates for the team-based approach to healthcare seen in real-life clinical practice. As a learning tool, however, undergraduate medical students often have little understanding of the theory behind the use of medical simulation and have little experience in planning and delivering their own simulated teaching sessions. We designed and implemented a student-selected component (SSC) as part of the undergraduate medical curriculum at the University of Buckingham Medical School to introduce students to the concepts behind the use of medical simulation in education and allow them to plan and deliver their own simulated medical scenario to their peers. The SSC took place over a 2-week period in the 3rd year of the undergraduate course. There was a mix of lectures, seminars and interactive group work sessions, as well as hands-on experience in the simulation suite, to introduce key concepts related to medical simulation, including technical considerations in simulation, human factors, debriefing and troubleshooting scenarios. We evaluated the success of our SSC using “Net Promotor Scores” (NPS) to assess students’ confidence in planning and facilitating a simulation-based teaching session, as well as leading a debrief session. In all three domains, we showed an increase in the confidence of the students. We also showed an increase in confidence in the management of common medical emergencies as a result of the SSC. Overall, the students who chose our SSC had the opportunity to learn new skills in medical education, with a particular focus on the use of simulation-based teaching, and feedback highlighted that a number of students would take these skills forward in their own practice. We demonstrated an increase in confidence in several domains related to the use of medical simulation in education and have hopefully inspired a new generation of medical educators.

Keywords: simulation, SSC, teaching, medical students

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Authors: Muhammad Bilal Qadir, Danish Umer, Amir Shahzad

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The use of conductive materials in smart and interactive textiles is gaining significant importance for creating value addition, innovation, and functional product development. These products find their potential applications in health monitoring, military, protection, communication, sensing, monitoring, actuation, fashion, and lifestyles. The materials which are most commonly employed in such type of interactive textile include intrinsically conducting polymers, conductive inks, and metallic coating on textile fabrics and inherently conducting metallic fibre yarns. In this study, silver coated polyester filament yarn is explored for the development of multifunctional interactive gloves. The composite yarn was developed by covering the silver coated polyester filament around the polyester spun yarn using hollow spindle technique. The electrical and tensile properties of the yarn were studied. This novel yarn was used to manufacture a smart glove to explore the antibacterial, functional, and interactive properties of the yarn. The change in electrical resistance due to finger movement at different bending positions and antimicrobial properties were studied. This glove was also found useful as an interactive tool to operate the commonly used touch screen devices due to its conductive nature. The yarn can also be used to develop the sensing elements like stretch, strain, and piezoresistive sensors. Such sensor can be effectively used in medical and sports textile for performance monitoring, vital signs monitoring and development of antibacterial textile for healthcare and hygiene.

Keywords: conductive yarn, interactive textiles, piezoresistive sensors, smart gloves

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and novel data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. To the best of our knowledge, this is the first work to apply modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Okhee Woo

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Purpose: The aim of this study is to evaluate 2-year cumulative effective radiation dose and cumulative organ dose on regular follow-up computed tomography (CT) scans in patients with breast cancer and to establish personalized low-dose CT protocol. Methods and Materials: A retrospective study was performed on the patients with breast cancer who were diagnosed and managed consistently on the basis of routine breast cancer follow-up protocol between 2012-01 and 2016-06. Based on ICRP (International Commission on Radiological Protection) 103, the cumulative effective radiation doses of each patient for 2-year follow-up were analyzed using the commercial radiation management software (Radimetrics, Bayer healthcare). The personalized effective doses on each organ were analyzed in detail by the software-providing Monte Carlo simulation. Results: A total of 3822 CT scans on 490 patients was evaluated (age: 52.32±10.69). The mean scan number for each patient was 7.8±4.54. Each patient was exposed 95.54±63.24 mSv of radiation for 2 years. The cumulative CT radiation dose was significantly higher in patients with lymph node metastasis (p = 0.00). The HER-2 positive patients were more exposed to radiation compared to estrogen or progesterone receptor positive patient (p = 0.00). There was no difference in the cumulative effective radiation dose with different age groups. Conclusion: To acknowledge how much radiation exposed to a patient is a starting point of management of radiation exposure for patients with long-term CT follow-up. The precise and personalized protocol, as well as iterative reconstruction, may reduce hazard from unnecessary radiation exposure.

Keywords: computed tomography, breast cancer, effective radiation dose, cumulative organ dose

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Authors: K. Yang, Y. Wei, M. Zhang, S. Yong, R. Torah, J. Tudor, S. Beeby

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E-textiles are traditional textiles with integrated electronic functionality. It is an emerging innovation with numerous applications in fashion, wearable computing, health and safety monitoring, and the military and medical sectors. The piezoelectric effect is a widespread and versatile transduction mechanism used in sensor and actuator applications. Piezoelectric materials produce electric charge when stressed. Conversely, mechanical deformation occurs when an electric field is applied across the material. Lead Zirconate Titanate (PZT) is a widely used piezoceramic material which has been used to fabricate e-textiles through screen printing, electro spinning and hydrothermal synthesis. This paper explores an alternative fabrication process: Spray coating. Spray coating is a straightforward and cost effective fabrication method applicable on both flat and curved surfaces. It can also be applied selectively by spraying through a stencil which enables the required design to be realised on the substrate. This work developed a sprayable PZT based piezoelectric ink consisting of a binder (Fabink-Binder-01), PZT powder (80 % 2 µm and 20 % 0.8 µm) and acetone as a thinner. The optimised weight ratio of PZT/binder is 10:1. The components were mixed using a SpeedMixer DAC 150. The fabrication processes is as follows: 1) Screen print a UV-curable polyurethane interface layer on the textile to create a smooth textile surface. 2) Spray one layer of a conductive silver polymer ink through a pre-designed stencil and dry at 90 °C for 10 minutes to form the bottom electrode. 3) Spray three layers of the PZT ink through a pre-designed stencil and dry at 90 °C for 10 minutes for each layer to form a total thickness of ~250µm PZT layer. 4) Spray one layer of the silver ink through a pre-designed stencil on top of the PZT layer and dry at 90 °C for 10 minutes to form the top electrode. The domains of the PZT elements were aligned by polarising the material at an elevated temperature under a strong electric field. A d33 of 37 pC/N has been achieved after polarising at 90 °C for 6 minutes with an electric field of 3 MV/m. The application of the piezoelectric textile was demonstrated by fabricating a pressure sensor to switch an LED on/off. Other potential applications on e-textiles include motion sensing, energy harvesting, force sensing and a buzzer.

Keywords: piezoelectric, PZT, spray coating, pressure sensor, e-textile

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Authors: Sandra Thompson, Paul Dervan

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Ireland’s first Technological University (TU Dublin) was established on 1st January 2019, and its creation is an exciting new milestone in Irish Higher Education. TU Dublin is now Ireland’s biggest University supporting 29,000 students across three campuses with 3,500 staff. The University aspires to create work-ready graduates who are socially responsible, open-minded global thinkers who are ambitious to change the world for the better. As graduates, they will be enterprising and daring in all their endeavors, ready to play their part in transforming the future. Feedback from Irish employers and students coupled with evidence from other authoritative sources such as the World Economic Forum points to a need for greater focus on the development of students’ employability skills as they prepare for today’s work environment. Moreover, with an increased focus on Universal Design for Learning (UDL) and inclusiveness, there is recognition that students are more than a numeric grade value. Robust grading systems have been developed to track a student’s performance around discipline knowledge but there is little or no global consensus on a definition of transversal skills nor on a unified framework to assess transversal skills. Education and industry sectors are often assessing one or two skills, and some are developing their own frameworks to capture the learner’s achievement in this area. Technological University Dublin (TU Dublin) have discovered and implemented a framework to allow students to develop, assess and record their transversal skills using transformative learning theory. The model implemented is an adaptation of Student Transformative Learning Record - STLR which originated in the University of Central Oklahoma (UCO). The purpose of this paper therefore, is to examine the views of students, staff and employers in the context of deploying a Transformative Learning model within the University to assess transversal skills. It will examine the initial impact the transformative learning model is having socially, personally and on the University as an organization. Crucially also, to identify lessons learned from the deployment in order to assist other Universities and Higher Education Institutes who may be considering a focused adoption of Transformative Learning to meet the challenge of preparing students for today’s work environment.

Keywords: assessing transversal skills, higher education, transformative learning, students

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