Search results for: tertiary institutions

Authors: Margaret Schmuhl, Michelle Cubellis

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Violence against women (VAW) is a widespread social problem affecting nearly two million women in the United States each year. Recently, feminist criminologists have sought to examine patriarchy as a guiding framework for understanding violence against women. Literature on VAW often examines measures of structural gender equality, often overlooking ideological patriarchy which is necessary for structural inequality to remain unchallenged. Additionally, empirical literature generally focuses on extreme forms of VAW, rape, and femicide, often neglecting more common types of violence. This literature, under the theoretical guidance of the Liberal, Radical, and Marxist feminist traditions, finds mixed support for the relationship of patriarchy and VAW. Explanations for these inconsistencies may include data availability, and the use of different operationalizations of structural patriarchy. Research is needed to examine fuller operationalizations of patriarchy in social institutions and to extend this theoretical framework to the criminal justice response to VAW (i.e., clearance rates). This study examines sexual violence clearance rates under the theoretical guidance of these feminist traditions using incident- and county-level data from National Incident Based Reporting System and other sources in multilevel modelling. The findings suggest mixed support for the feminist hypotheses and that patriarchy and gender equality differentially affect arrest clearance rates and clearance through exceptional means for sexual violence.

Keywords: clearance rates, gender equality, multilevel modelling, patriarchy, sexual victimization, violence against women

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Authors: Jasmin Cowin

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Augmented reality digital technologies, big data, and the need for a teacher workforce able to meet the demands of a knowledge-based society are poised to lead to major changes in the field of education. This paper explores applications and educational use cases of augmented reality digital technologies for educational organizations during the Fourth Industrial Revolution. The Fourth Industrial Revolution requires vision, flexibility, and innovative educational conduits by governments and educational institutions to remain competitive in a global economy. Educational organizations will need to focus on teaching in and for a digital age to continue offering academic knowledge relevant to 21st-century markets and changing labor force needs. Implementation of contemporary disciplines will need to be embodied through learners’ active knowledge-making experiences while embracing ubiquitous accessibility. The power of distributed ledger technology promises major streamlining for educational record-keeping, degree conferrals, and authenticity guarantees. Augmented reality digital technologies hold the potential to restructure educational philosophies and their underpinning pedagogies thereby transforming modes of delivery. Structural changes in education and governmental planning are already increasing through intelligent systems and big data. Reimagining and redesigning education on a broad scale is required to plan and implement governmental and institutional changes to harness innovative technologies while moving away from the big schooling machine.

Keywords: fourth industrial revolution, artificial intelligence, big data, education, augmented reality digital technologies, distributed ledger technology

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Authors: Sisaye Tamrat Ayalew

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This paper focuses on the educational philosophy of universities in Ethiopia and the debates surrounding it. It highlights the contradictory views on the role of universities, with some perceiving them as practical problem-solving institutions and others emphasizing the production and dissemination of knowledge. The aim of this study is to critically explore the debates around the educational philosophy of universities in Ethiopia. It also seeks to examine how the understanding of this philosophy contributes to the marginalization of youth in the country. This research adopts a phenomenological qualitative research design. It aims to understand the impact of socio-economic and political factors on university education and how youth from disadvantaged backgrounds experience marginalization in the job market. The study reveals that the understanding of educational philosophy varies across different contexts and over time. In the Ethiopian context, the philosophy of universities lacks a disinterested pursuit of knowledge and instrumentalist epistemology. Instead, it oversimplifies the philosophy to the point of devaluing knowledge and treating certificates as commodities, even in the absence of formal training. In conclusion, this research highlights the need for a critical appraisal of the educational philosophy of universities in Ethiopia. It emphasizes the negative impact of an oversimplified and commodified approach to knowledge on the empowerment of youth. By bringing attention to these issues, this study contributes to the broader understanding of the role of universities in society and calls for reforms in the Ethiopian education sector to promote empowerment rather than disempowerment.

Keywords: philosophy of universities, marginalized youth, diploma mill, instrumentalist epistemology, disinterested pursuit

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Authors: Esam Roshdy, Saleh AlRashdi, Turki Alharbi, Rawan Eskandarani, Zurina Cabilo

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Introduction/ background: Consultation in the Emergency Department constitute a major part of the work flow every day. Any delay in the consultation process have a major impact on the length of stay and patient disposition and thus affect the total waiting time of patients in the ED. King Fahad medical City in Riyadh City, Saudi Arabia is considered a major Tertiary hospital where there is high flow of patients of different categories visiting the ED. The importance of decreasing consultation time and decision for final disposition of patients was recognized and interpreted in this project to find ways to improve the patient flow in the department and thus the total patient disposition and outcome. Aim / Objectives: 1. To monitor the time of consultation for patients in the Emergency department and its impact on the length of stay of patients in the ED. 2. To detect and assess the problems that lead to long consultation times in the ED, and reach a targeted time of 2 hours for final disposition of patients, according to recognized international and our institutional consultation policy, to reach the final goal of decreasing total length of stay and thus improve the patient flow in the ED. Methods: Data was collected retrospectively for a 92 charts of consultations done in the ED over 2 month’s period. The data was analyzed to get the median of Total Consultation Time. A survey was conducted among all ED staff to determine the level of knowledge about the total consultation time and the compliance to the institutional policy target of 2 hours. A second Data sample of 168 chart was collected after awareness campaign and education of all ED staff about the importance of reaching the target consultation time and compliance to the institutional policy. Results: We have found that there is room for improvement in our overall consultation time. This was found to be more frequent with certain specialties. Our surveys have showed that many ED staff are not familiar or not compliant with our consultation policy which was not clear for everyone. Post-intervention data have showed that awareness of the importance to decrease the total consultation time and compliance alone to the targeted goal have had a huge impact on overall improvement and decreasing the time of final decision and disposition of the patient and the overall patient length of stay in the ED. Conclusion: Working on improving Consultation time in the Emergency Department is a major factor in improving overall length of stay and patient flow. This improvement helps in the overall patient disposition and satisfaction. Plan: As a continuation of our project we are planning to focus on the conflict of admission cases where more than one specialty is involved in the care of patients. We are planning to collect data on the time it takes to resolve and reach final disposition of those patients, and its impact on the length of stay and our department flow and the overall patient outcome and satisfaction.

Keywords: consultation time, impact, length of stay, in the ED

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Authors: Omolaja Akolade Oluwaseunfunmi

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This study seeks to ascertain the origin and history of terrorism in Nigeria, determine the causes of terrorism in Nigeria, examine Nigeria’s foreign policies from 1999 to 2015, evaluate how terrorist groups like Boko Haram and the Indigenous People of Biafra (IPOB) have affected Nigeria’s foreign policies in the international arena; ascertain the measures taken by the government in tackling terrorist acts in Nigeria and give recommendations on how to tackle this menace. The methodology used in this research is the analytical method. The study derives its data from both primary and secondary sources. Findings from fieldwork showed that terrorism has also become one of the most important fundamentals of Nigeria’s foreign policies and relations; respondents from the people interviewed showed that terrorism is a menace and that terrorism must be adequately tackled in other to achieve Nigeria’s foreign policy. Furthermore, results revealed that the fight against the scourge has increasingly gained legitimacy and justification among the international community particularly as many countries consider it to be their international obligation to support the global movement to ameliorate or eliminate the menace. In conclusion, this research made, among other recommendations, that the Nigerian government should ensure the provision of a good life for its citizens, the inter-connectivity of terrorist organizations must be defeated, the government should undergo a foreign policy drive designed at rebuilding its image in the international environment, and also the promotion of peace education among various government, religious institutions, private sector, and civil society groups should be encouraged.

Keywords: foreign policy, Boko Haram, movement for the emancipation of Niger delta (MEND), terrorism

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Authors: Nadeem Yousuf Khan

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This paper proposes the formation of a digital emergency response system (dERS) in the aged, long-term care, and chronic disease setups in the post-COVID healthcare ecosystem, focusing on the Asia Pacific market where the aging population is increasing significantly. It focuses on the use of digital technologies such as wearables, a global positioning system (GPS), and mobile applications to build an integrated care system for old folks with co-morbidities and other chronic diseases. The paper presents a conceptual framework of a connected digital health ecosystem that not only provides proactive care to registered patients but also prevents the damages due to sudden conditions such as strokes by alerting and treating the patients in a digitally connected and coordinated manner. A detailed review of existing digital health technologies such as wearables, GPS, and mobile apps was conducted in context with the new post-COVID healthcare paradigm, along with a detailed literature review on the digital health policies and usability. A good amount of research papers is available in the application of digital health, but very few of them discuss the formation of a new framework for a connected digital ecosystem for the aged care population, which is increasing around the globe. A connected digital emergency response system has been proposed by the author whereby all registered patients (chronic disease and aged/long term care) will be connected to the proposed digital emergency response system (dERS). In the proposed ecosystem, patients will be provided with a tracking wrist band and a mobile app through which the control room will be monitoring the mobility and vitals such as atrial fibrillation (AF), blood sugar, blood pressure, and other vital signs. In addition to that, an alert in case if the patient falls down will add value to this system. In case of any variation in the vitals, an alert is sent to the dERS 24/7, and dERS clinical staff immediately trigger that alert which goes to the connected hospital and the adulatory service providers, and the patient is escorted to the nearest connected tertiary care hospital. By the time, the patient reaches the hospital, dERS team is ready to take appropriate clinical action to save the life of the patient. Strokes or myocardial infarction patients can be prevented from disaster if they are accessible to engagement healthcare. This dERS will play an effective role in saving the lives of aged patients or patients with chronic co-morbidities.

Keywords: aged care, atrial fibrillation, digital health, digital emergency response system, digital technology

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Authors: Khader Musbah Titi

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In this era, traditional education systems do not meet the new challenges created by emerging technologies. On the other hand, eLearning offers all the necessary tools to meet these challenges. Using the Internet has brought numerous benefits to most educational institutions; it has also stretched traditional problems of plagiarism, cheating, stealing, vandalism, and spying into the cyberspace. This research discusses these issues in an eLearning environment. It attempts to provide suggestions and possible solutions to some of these issues. The main aim of this research is to conduct a survey at Irbid National University (INU), one of the oldest and biggest universities in Jordan, to study information related to moral and ethical issues in e-learning environment that affect the construction of the students’ characters in the future. The study will focus on student’s behavior and actions through the Internet using Learning Management System (LMS). Another aim of this research is to analyze the opinions of the instructors and last year students at INU about ethical behavior and interaction through LMS. The results show that educational institutes that use LMS should focus on student character development along with field knowledge. According to disadvantages, the results of the study showed that most of students behave unethically in their online activities (cheating, plagiarism, copy/paste etc.) while studying online courses through LMS. The result showed that instructors play a major role in the character development of students. The result also showed that academic institute must have variant mechanisms and strict policy in LMS to control unethical actions of students.

Keywords: LMS, cyber ethics, e-learning, IT ethics, students’ behaviors

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Authors: Sanjeeb Kumar Mishra, Aartee Jha, Madhu Thapa, Pragati Gautam

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Introduction: High myopia has become a matter of global concern as it is a major risk factor for glaucoma. Various optic nerve head changes occur in high myopia over time. This might lead to difficulty in detecting pathologies associated with high myopia through conventional funduscopy examinations only. Bruch’s Membrane Opening (Area and Minimum Rim Width) is considered an anatomically more accurate and reliable landmark than the conventional clinical disc margin. Study Design: It was a hospital based cross-sectional and non-interventional type of study. Purpose: The purpose of our study was to measure Bruch’s Membrane Opening (area and Minimum Rim Width) in high myopic eyes and correlate it with axial length. Methods: A cross-sectional study was conducted at B.P Koirala Lions Center for Ophthalmic Studies, a tertiary-level eye center in Nepal. 80 eyes of 40 subjects (40% male and 60% female) aged 18-35 years with high myopia (Spherical Equivalent (SE) ≥ -6D) were taken as cases. Among them, RE of 39 and LE of 34 myopic subjects were included in the study. Spectral Domain-Optical Coherence Tomography of both the eyes of myopic patients was performed using Glaucoma Module Premiere Edition (GMPE) with Anatomic Positioning System (APS) to measure Bruch’s Membrane Opening (Area and Minimum Rim Width). Axial length in myopic patients was measured using Partial Coherence Interferometry (IOL Master). Results: Among 40 myopic subjects, 16 (40%) were males, whereas 24 (60%) were females. The mean age of myopic subjects was 24.64 ± 5.10 years, with minimum and maximum ages of 18 years and 35 years, respectively. The mean BMO area was 2.28 0.48 mm² in right eye and 2.15 0.59 mm² in left eye. BMO area in high myopic patient was significantly correlated with axial length. The correlation analysis of BMO area with axial length in RE and LE was found to be statistically significant at (r=0.465, p<0.003) and (r=0.374, p< 0.029), respectively. Likewise, the mean BMO-MRW was 325.69 ± 96µm in right eye and 339.20 ± 79.50µm in left eye. There was a significant correlation of BMO-MRW with axial length in both the eyes of myopic subjects. Moreover, a significant negative correlation of Inferior temporal, Nasal, and Inferior nasal quadrants (p<0.05) of BMO-MRW of right eye was found with axial length of right eye, whereas all the BMO-MRW quadrants of left eye were negatively correlated (p<0.05) with axial length in left eye. No significant differences were found between right eye and left eye on comparing means of refractive error, axial length, BMO area, and BMO-MRW. Conclusion: From this study, it can be concluded that BMO area enlarges in high myopia with an increase in axial length. Additionally, BMO-MRW thinning occurs along with the BMO enlargement and increases with axial length. There were no significant differences in refractive error, axial length, BMO area, and BMO-MRW between right eye and left eye.

Keywords: high myopia, Bruch’s membrane opening, Bruch’s membrane opening minimum rim width, spectral domain optical coherence tomography

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Authors: Bernice Badal

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The South African English curriculum emphasizes the adoption of the Communicative Approach (CA) using Communicative Language Teaching (CLT) methodologies to develop English as a second language (ESL) learners’ communicative competence in contexts such as township schools in South Africa. However, studies indicate that the adoption of the approach largely remains a rhetoric. Poor English language proficiency among learners and poor student performance, which continues from the secondary to the tertiary phase, is widely attributed to a lack of English language proficiency in South Africa. Consequently, this qualitative study, using a mix of classroom observations and interviews, sought to investigate teacher knowledge of Communicative Competence and the methods and strategies ESL teachers used to develop their learners’ communicative competence. The success of learners’ ability to develop communicative competence in contexts such as township schools in South Africa is inseparable from materials, tasks, teacher knowledge and how they implement the approach in the classrooms. Accordingly, teacher knowledge of the theory and practical implications of the CLT approach is imperative for the negotiation of meaning and appropriate use of language in context in resource-impoverished areas like the township. Using a mix of interviews and observations as data sources, this qualitative study examined teachers’ definitions and knowledge of Communicative competence with a focus on how it influenced their classroom practices. The findings revealed that teachers were not familiar with the notion of communicative competence, the communication process, and the underpinnings of CLT. Teachers’ narratives indicated an awareness that there should be interactions and communication in the classroom, but a lack of theoretical understanding of the types of communication necessary scuttled their initiatives. Thus, conceptual deficiency influences teachers’ practices as they engage in classroom activities in a superficial manner or focus on stipulated learner activities prescribed by the CAPS document. This study, therefore, concluded that partial or limited conceptual and coherent understandings with ‘teacher-proof’ stipulations for classroom practice do not inspire teacher efficacy and mastery of prescribed approaches; thus, more efforts should be made by the Department of Basic Education to strengthen the existing Professional Development workshops to support teachers in improving their understandings and application of CLT for the development of Communicative competence in their learners. The findings of the study contribute to the field of teacher knowledge acquisition, teacher beliefs and practices and professional development in the context of second language teaching and learning with a recommendation that frameworks for the development of communicative competence with wider applicability in resource-poor environments be developed to support teacher understanding and application in classrooms.

Keywords: communicative competence, CLT, conceptual understanding of reforms, professional development

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Authors: Paraskevi Liosatou

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Climate change is considered to be of global concern being amplified by the fact that by its nature, cannot be spatially limited. This fact makes necessary the intergovernmental decision-making procedures. In the intergovernmental level, the institutions such as the United Nations Framework Convention on Climate Change and the Intergovernmental Panel on Climate Change develop efforts, methods, and practices in order to plan and suggest climate mitigation and adaptation measures. These measures are based on specific scientific findings and methods making clear the strong connection between science and policy. In particular, these scientific recommendations offer a series of practices, methods, and choices mitigating the problem by aiming at the indirect mitigation of the causes and the factors amplifying climate change. Moreover, modern production and economic context do not take into consideration the social, political, environmental and spatial dimensions of the problem. This work studies the decision-making process working in international and European level. In this context, this work considers the policy tools that have been implemented by various intergovernmental organizations. The methodology followed is based mainly on the critical study of standards and process concerning the connections and cooperation between science and policy as well as considering the skeptic debates developed. The finding of this work focuses on the links between science and policy developed by the institutional and scientific mechanisms concerning climate change mitigation. It also analyses the dimensions and the factors of the science-policy framework; in this way, it points out the causes that maintain skepticism in current scientific circles.

Keywords: climate change, climate change mitigation, climate change skepticism, IPCC, skepticism

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Authors: Abdul Latheef O. Mavukkandy

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Islamization of knowledge (IOK) is an intellectual movement emerged in the middle of 1970s to address the threats by modern western civilizational onslaughts. This paper analyzes the discourse of Islamization of knowledge with special reference to the views of Kamal Hassan who prefers an alternative term called 'Islamicization'. First of all the theoretical and practical outlines of IOK movement were presented by Ismail Raji al-Faruqi in his book 'Islamization of Knowledge; General Principles and Work Plan' in 1982. He identified that the educational system in the Muslim world accounted for the decline of Muslim Ummah through de-Islamization and demoralization. So, the need for IOK was an academic challenge to reconstruct the Ummah. Kamal Hassan kept just different view from Ismail Raji al-Faruqi and Muhammed Naquib al-Attas that he coined the terms 'Relevantization and Contextualization'. So, he wanted the 'Islamization of Islamic Revealed Knowledge'. So, he used Islamization of Human Knowledge (IOHK) instead of IOK. As part of this movement, the IOK identified that the textbooks used in Muslim educational institutions systematically keep the students estranged from Islam and its heritage. Furthermore, the modern secular knowledge develops secular attitude devoid of Islamic moral philosophy and the sense of mission in life. Based upon the content analysis of some of the sources, this study found that Islamization of Knowledge is an important movement in Islamic world, but the IOK project is not practicable completely because of the lack of trained teachers and resources. Although, the project resulted in the foundation of some universities and publishing more works, journals and doctoral thesis on different dimensions of Islamization of Knowledge.

Keywords: Islamization, Islamicization, releventization, human knowledge

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Adelaide Rethabile Motshabi Pitso-Mbili

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Higher education institutions (HEIs) are under pressure in producing PhD graduates so that they can position themselves higher in terms of rankings. However, hospitality and tourism higher degree enrolment numbers are very low within South African universities. Furthermore, hospitality and tourism students choose these fields of study because they want to travel, be social, and have fun. Students in higher education are anxious about their future after studies as they are particularly worried about the job conditions in the hospitality and tourism sector, the remuneration, and the status perceptions of many jobs in the sector. Hence, there is a need for a continuous increase in the level of education with the formation of professional aptitudes and personnel quality. In order to understand the reasons for low enrolments, this study aims to explore the perceptions of the final year in tourism and hospitality diploma students towards enrolling for higher degree qualifications after their graduation. This paper utilised a quantitative research method, and data was gathered through questionnaires. In addition, the Linkert scale design was used for questionnaires. The questionnaires were distributed to 137 hospitality and tourism students who are on their exit level at Walter Sisulu University. SPSS was used to analyse data. The findings revealed that students do not wish to continue studying for higher degrees as they believe higher degrees are not important for the industry. Furthermore, families already have financial expectations as they think one qualification is enough. In addition, some students mentioned that they would love to study further, but lack of funding is a problem since NSFAS only funds the first qualification. Thus, it is recommended that students are made aware of the benefits and opportunities available after obtaining higher degrees.

Keywords: hospitality and tourism education, higher degrees, higher education, student’s perceptions, hospitality and tourism sector

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Authors: Safia Asif, Saadia Bano

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In a world with rapidly depleting resources, using artificial lighting during daytime is an act of human ignorance. Imitated light is the major source of energy consumption in public buildings. Despite, the fact that substantial working hours of these buildings usually persist in natural daylight time; there is a trend of isolated, un-fenestrated and a-contextual interiors majorly dependent on active energy sources. On the contrary, if direct and un-controlled sunlight is allowed inside the building, it will create visual and thermal discomfort. Controlled daylighting with appropriate design mechanisms is one of the important aspects of achieving thermal and visual comfort. The natural sunlight can be utilized intelligently with the help of architectural thermal controlling mechanisms to achieve a healthy and productive environment. This paper is an attempt to investigate and analyze the importance of daylighting with reference to energy efficiency and thermal comfort. For this purpose, three public buildings including two educational institutions and one general post office are selected, as case-studies in the context of Karachi, Pakistan. Various parameters of visual and thermal comfort are analyzed which includes orientation, ceiling heights, overall building profile along with daylight controlling mechanisms in terms of penetration, distribution, protection, and control. In the later part of the research, a questionnaire survey is also conducted to evaluate the user experience in terms of adequate daylighting and thermal comfort.

Keywords: daylight, public buildings, sustainable architecture, visual and thermal comfort

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Authors: David B. Kisakye, Paul Mugabi

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Biomass briquettes have been identified as a plausible and close alternative to commonly used energy fuels such as charcoal and firewood, whose prices are escalating due to the dwindling natural resource base. However, briquettes do not seem to be as popular as would be expected. This study assessed the production, distribution, and acceptability of the briquettes in the Kampala district. A total of 60 respondents, 50 of whom were briquette users and 10 briquette producers, were sampled from five divisions of Kampala district to evaluate consumer acceptability, preference for briquette type and shape. Households and institutions were identified to be the major consumers of briquettes, while community-based organizations were the major distributors of briquettes. The Chi-square test of independence showed a significant association between briquette acceptability and briquette attributes of substitutability and low cost (p < 0,05). The Kruskal Wallis test showed that low-income class people preferred non-carbonized briquettes. Gender, marital status, and income level also cause variation in preference for spherical, stick, and honeycomb briquettes (p < 0,05). The major challenges faced by briquette users in Kampala were; production of a lot of ash, frequent crushing, and limited access to briquettes. The producers of briquettes were mainly challenged by regular machine breakdown, raw material scarcity, and poor carbonizing units. It was concluded that briquettes have a market and are generally accepted in Kampala. However, user preferences need to be taken into account by briquette produces, suitable cookstoves should be availed to users, and there is a need for standards to ensure the quality of briquettes.

Keywords: consumer acceptability, biomass residues, briquettes, briquette producers, distribution, fuel, marketability, wood fuel

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Authors: Li Wang, Dan Shu, Shiguang Pang, Lixiu Wang, Bing Xiang Yang, Qian Liu

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Background: Cancer is one of the most severe diseases in childhood; long-term treatment and its side effects significantly impact the patient's physical, psychological, social functioning and quality of life while also placing substantial physical and psychological burdens on caregivers and families. Family resilience is crucial for children with cancer, helping them cope better with the disease and supporting the family in facing challenges together. As a family-level variable, family resilience requires information from multiple family members. However, to our best knowledge, there is currently no research investigating family resilience from both the perspectives of pediatric cancer patients and their caregivers. Therefore, this study aims to investigate the family resilience and quality of life of pediatric cancer patients from a patient–caregiver dyadic perspective. Methods: A total of 149 dyads of patients diagnosed with pediatric cancer patients and their principal caregivers were recruited from oncology departments of 4 tertiary hospitals in Wuhan and Taiyuan, China. All participants completed questionnaires that identified their demographic and clinical characteristics as well as assessed their family resilience and quality of life for both the patients and their caregivers. K-means cluster analysis was used to identify different clusters of family resilience based on the reports from patients and caregivers. Multivariate logistic regression and linear regression are used to analyze the factors influencing family resilience and quality of life, as well as the relationship between the two. Results: Three clusters of family resilience were identified: a cluster of high family resilience (HR), a cluster of low family resilience (LR), and a cluster of discrepant family resilience (DR). Most (67.1%) families fell into the cluster with low resilience. Characteristics such as the types of caregivers perceived social support of the patient were different among the three clusters. Compared to the LR group, families where the mother is the caregiver and where the patient has high social support are more likely to be assigned to the HR. The quality of life for caregivers was consistently highest in the HR cluster and lowest in the LR cluster. The patient's quality of life is not related to family resilience. In the linear regression analysis of the patient's quality of life, patients who are the first-born have higher quality of life, while those living with their parents have lower quality of life. The participants' characteristics were not associated with the quality of life for caregivers. Conclusions: In most families, family resilience was low. Families with maternal caregivers and patients receiving high levels of social support are more inclined to be higher levels of family resilience. Family resilience was linked to the quality of life of caregivers of pediatric cancer patients. The clinical implications of this findings suggest that healthcare and social support organizations should prioritize and support the participation of mothers in caregiving responsibilities. Furthermore, they should assist families in accessing social support to enhance family resilience. This study also emphasizes the importance of promoting family resilience for enhancing family health and happiness, as well as improving the quality of life for caregivers.

Keywords: pediatric cancer, cluster analysis, family resilience, quality of life

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Authors: Murat Arıbaş, Uğur Özcan

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Due to the increasing number of universities and academics, the fund of the universities for research activities and grants/supports given by government institutions have increased number and quality of academic research projects. Although every academic research project has a specific purpose and importance, limited resources (money, time, manpower etc.) require choosing the best ones from all (Amiri, 2010). It is a pretty hard process to compare and determine which project is better such that the projects serve different purposes. In addition, the evaluation process has become complicated since there are more than one evaluator and multiple criteria for the evaluation (Dodangeh, Mojahed and Yusuff, 2009). Mehrez and Sinuany-Stern (1983) determined project selection problem as a Multi Criteria Decision Making (MCDM) problem. If a decision problem involves multiple criteria and objectives, it is called as a Multi Attribute Decision Making problem (Ömürbek & Kınay, 2013). There are many MCDM methods in the literature for the solution of such problems. These methods are AHP (Analytic Hierarchy Process), ANP (Analytic Network Process), TOPSIS (Technique for Order Preference by Similarity to Ideal Solution), PROMETHEE (Preference Ranking Organization Method for Enrichment Evaluation), UTADIS (Utilities Additives Discriminantes), ELECTRE (Elimination et Choix Traduisant la Realite), MAUT (Multiattribute Utility Theory), GRA (Grey Relational Analysis) etc. Teach method has some advantages compared with others (Ömürbek, Blacksmith & Akalın, 2013). Hence, to decide which MCDM method will be used for solution of the problem, factors like the nature of the problem, types of choices, measurement scales, type of uncertainty, dependency among the attributes, expectations of decision maker, and quantity and quality of the data should be considered (Tavana & Hatami-Marbini, 2011). By this study, it is aimed to develop a systematic decision process for the grant support applications that are expected to be evaluated according to their scientific adequacy by multiple evaluators under certain criteria. In this context, project evaluation process applied by The Scientific and Technological Research Council of Turkey (TÜBİTAK) the leading institutions in our country, was investigated. Firstly in the study, criteria that will be used on the project evaluation were decided. The main criteria were selected among TÜBİTAK evaluation criteria. These criteria were originality of project, methodology, project management/team and research opportunities and extensive impact of project. Moreover, for each main criteria, 2-4 sub criteria were defined, hence it was decided to evaluate projects over 13 sub-criterion in total. Due to superiority of determination criteria weights AHP method and provided opportunity ranking great number of alternatives TOPSIS method, they are used together. AHP method, developed by Saaty (1977), is based on selection by pairwise comparisons. Because of its simple structure and being easy to understand, AHP is the very popular method in the literature for determining criteria weights in MCDM problems. Besides, the TOPSIS method developed by Hwang and Yoon (1981) as a MCDM technique is an alternative to ELECTRE method and it is used in many areas. In the method, distance from each decision point to ideal and to negative ideal solution point was calculated by using Euclidian Distance Approach. In the study, main criteria and sub-criteria were compared on their own merits by using questionnaires that were developed based on an importance scale by four relative groups of people (i.e. TUBITAK specialists, TUBITAK managers, academics and individuals from business world ) After these pairwise comparisons, weight of the each main criteria and sub-criteria were calculated by using AHP method. Then these calculated criteria’ weights used as an input in TOPSİS method, a sample consisting 200 projects were ranked on their own merits. This new system supported to opportunity to get views of the people that take part of project process including preparation, evaluation and implementation on the evaluation of academic research projects. Moreover, instead of using four main criteria in equal weight to evaluate projects, by using weighted 13 sub-criteria and decision point’s distance from the ideal solution, systematic decision making process was developed. By this evaluation process, new approach was created to determine importance of academic research projects.

Keywords: Academic projects, Ahp method, Research projects evaluation, Topsis method.

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Authors: Priyanka Gupta, Nilanjana Bairagi, Deepti Gupta

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New pathogenic strains of microbes are continually emerging and resistance of bacteria to antibiotics is growing. Hospitals in India have a high burden of infections in their intensive care units and general wards. Rising incidence of hospital infections is a matter of great concern in India. This growth is often attributed to the absence of effective infection control strategies in healthcare facilities. Government, therefore, is looking for cost effective strategies that are effective against HAIs. One possible method is by application of an antimicrobial finish on the uniform. But there are limited studies to show the effect of antimicrobial activity of antimicrobial finish treated nurses’ uniforms in a real hospital set up. This paper proposes a prospective non-destructive sampling technique, based on the use of a detachable fabric patch, to assess the effectiveness of silver based antimicrobial agent across five wards in a tertiary care government hospital in Delhi, India. Fabrics like polyester and polyester cotton blend fabric which are more prevalent for making coats were selected for the study. Polyester and polyester cotton blend fabric was treated with silver based antimicrobial (AM) finish. At the beginning of shift, a composite patch of untreated and treated fabric respectively was stitched on the abdominal region on the left and right side of the washed white coat of participating nurse. At the end of the shift, the patch was removed and taken for bacterial sampling on Brain Heart Infusion (BHI) plates. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). All patches treated with silver based antimicrobial agent showed decreased bacterial counts. Percent reduction in the bacterial colonies after the antimicrobial treatment in both fabrics was 81.0 %. Antimicrobial finish was equally effective in reducing microbial adhesion on both fabric types. White coats of nurses become progressively contaminated during clinical care. Type of fabric used to make the coat can affect the extent of contamination which is higher on polyester cotton blend as compared to 100% polyester. The study highlights the importance of silver based antimicrobial finish in the area of uniform hygiene. Bacterial load can be reduced by using antimicrobial finish on hospital uniforms. Hospital staff uniforms endowed with antimicrobial properties may be of great help in reducing the occurrence and spread of infections.

Keywords: antimicrobial finish, bacteria, infection control, silver, white coat

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Authors: P. C. Kutschera, Elena C. Tesoro, Mary Grace Talamera-Sandico, Jose Maria G. Pelayo III

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Second generation military Filipino Amerasians comprise a formidable contemporary segment of the estimated 250,000-plus biracial Amerasians in the Philippines today. Overall, they are a stigmatized and socioeconomically marginalized diaspora, historically; they were abandoned or estranged by U.S. military personnel fathers assigned during the century-long Colonial, Post-World War II and Cold War Era of permanent military basing (1898-1992). Indeed, U.S. military personnel remain stationed in smaller numbers in the Philippines today. This inquiry is an outgrowth of two recent small sample studies. The first surfaced the impact of the U.S. military prostitution system on formation of the ‘Derivative Amerasian Family Construct’ on first generation Amerasians; a second, qualitative case study suggested the continued effect of the prostitution systems' destructive impetuous on second generation Amerasians. The intent of this current qualitative, multiple-case study was to actively seek out second generation sex industry toilers. The purpose was to focus further on this human phenomenon in the post-basing and post-military prostitution system eras. As background, the former military prostitution apparatus has transformed into a modern dynamic of rampant sex tourism and prostitution nationwide. This is characterized by hotel and resorts offering unrestricted carnal access, urban and provincial brothels (casas), discos, bars and pickup clubs, massage parlors, local barrio karaoke bars and street prostitution. A small case study sample (N = 4) of female and male second generation Amerasians were selected. Sample formation employed a non-probability ‘snowball’ technique drawing respondents from the notorious Angeles, Metro Manila, Olongapo City ‘AMO Amerasian Triangle’ where most former U.S. military installations were sited and modern sex tourism thrives. A six-month study and analysis of in-depth interviews of female and male sex laborers, their families and peers revealed a litany of disturbing, and troublesome experiences. Results showed profiles of debilitating human poverty, history of family disorganization, stigmatization, social marginalization and the ghost of the military prostitution system and its harmful legacy on Amerasian family units. Emerging were testimonials of wayward young people ensnared in a maelstrom of deep economic deprivation, familial dysfunction, psychological desperation and societal indifference. The paper recommends that more study is needed and implications of unstudied psychosocial and socioeconomic experiences of distressed younger generations of military Amerasians require specific research. Heretofore apathetic or disengaged U.S. institutions need to confront the issue and formulate activist and solution-oriented social welfare, human services and immigration easement policies and alternatives. These institutions specifically include academic and social science research agencies, corporate foundations, the U.S. Congress, and Departments of State, Defense and Health and Human Services, and Homeland Security (i.e. Citizen and Immigration Services) It is them who continue to endorse a laissez-faire policy of non-involvement over the entire Filipino Amerasian question. Such apathy, the paper concludes, relegates this consequential but neglected blood progeny to the status of humiliating destitution and exploitation. Amerasians; thus, remain entrapped in their former colonial, and neo-colonial habitat. Ironically, they are unwitting victims of a U.S. American homeland that fancies itself geo-politically as a strong and strategic military treaty ally of the Philippines in the Western Pacific.

Keywords: Asian Americans, diaspora, Filipino Amerasians, military prostitution, stigmatization

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Authors: Rurui Liu

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Universities have been one of the most important institutions in society. They shoulder the responsibility to do research and teach further generations. Therefore, the governance of universities has been a heated topic and has been learned for years. Recently, it witnessed great changes, for example, the massification of Higher Education, marketization, and privatization. As a result, more stakeholders are involved in the governance of Higher Education, among which students’ participation in HE becomes more important. However, the research about students’ participation in HE governance in China is not sufficient, and the situation requires improvement. The paper aims to not only fill in the research gap but also put forward practical suggestions to follow the world’s trend of HE governance. The methodology of this paper is literature analysis with comparative studies between China and western countries. The research points out that the current situation of students’ participation in HE governance is unideal due to problems in three fields, values and concepts, mechanisms and systems, as well as student unions. Then, the policy implications are based on these reasons: universities should highlight students’ status, respect their subjectivity and adhere to the service awareness; the government requires to build a sound legal system while universities should establish complete mechanisms and systems; student unions should be encouraged by universities to take part in HE governance affairs with sufficient funds, and autonomy. On the one hand, this paper is a further application of four rationales (consumerism, political-realism, communitarian, democracy, and consequentialism) created by Luescher‐Mamashela for the inevitable trend of students’ participation in HE governance. On the other hand, the suggestions it made benefit the students, universities, and society in practical ways.

Keywords: students’ participation, higher education governance, Chinese higher education, university power

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Authors: Mariella Pinna

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Sustainable entrepreneurship is an innovative corporate approach to create value combining economic, social and environmental goals over time. In the last two decades, the interest in sustainable entrepreneurship has flourished thanks to its potential to answer the current challenges of sustainable development. As a result, scholars are increasingly interested in understanding the determinants of the intentions to become a sustainable entrepreneur and consistent behavior. To date, prior studies provided empirical evidence for the influence of attitudes, perceived feasibility and desirability, values, and personality traits on the decision-making process of becoming a sustainable entrepreneur. Conversely, scant effort has been provided to understand which factors inhibit sustainable entrepreneurial intentions and behaviors. Therefore a global understanding of the sustainable entrepreneurship decision-making process is missing. This paper contributes to the debate on sustainable entrepreneurship by proposing a conceptual model that combines the factors which are predicted to facilitate and hinder the proclivity of individuals to become sustainable entrepreneurs. More in particular, the proposed framework theorizes about the role of the characteristics of the prospective sustainable entrepreneur (e.g., socio-demographic, psychological, cultural), the positive antecedents (e.g., attitude, social feasibility and desirability, among others) and the negative precursors (e.g., neutralization) in influencing sustainable entrepreneurship intentions and subsequent behavior. The proposed framework is expected to shed further light on the decision-making process of becoming a sustainable entrepreneur, which in turn, is of practical relevance for public policy institutions and the society as a whole to enhance the favorable conditions to create new sustainable ventures.

Keywords: sustainable entrepreneurship, entrepreneurial intentions, entrepreneurial decision-making, antecedents of entrepreneurial intention and behavior

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Authors: Desmond Wade, Alfredo Ormazabal

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Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

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Authors: Doriane Micaela Andeme Bikoro, Samuel Fosso Wamba, Jean Robert Kala Kamdjoug

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Currently one of the leading fields in the market of technological innovation is digital health. In developed countries, this booming innovation is experiencing an exponential speed. We understand that in developed countries, e-health could also revolutionize the practice of medicine and therefore fill the many failures observed in medical care. Everything leads to believe that future technology is oriented towards the medical sector. The aim of this work is to explore at the same time the technological resources and the potential of health care based on new technologies; it is a case study in a rural area of Southern Cameroon. Among other things, we will make a census of the shortcomings and problems encountered, and we will propose various appropriate solutions. The work methodology used here is essentially qualitative. We used two qualitative data collection techniques, direct observation, and interviews. In fact, we spent two weeks in the field observing and conducting some semi-directive interviews with some of those responsible for these health structures. This study was conducted in three health facilities in the south of the country; including two health centers and a rural hospital. Many technological failures have been identified in the day-to-day management of these health facilities and especially in the administration of health care to patients. We note major problems such as the digital divide, the lack of qualified personnel, the state of isolation of this area. This is why various proposals are made to improve the health sector in Cameroon both technologically and medically.

Keywords: Cameroon, capacities, census, digital health, qualitative method, rural area

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Authors: Cherrie Lowe

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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.

Keywords: maternity, acuity, research, nursing workloads

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Authors: Rana F. Obeidat, Suzanne S. Dickerson, Gregory G. Homish, Nesreen M. Alqaissi, Robin M. Lally

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Background: Despite the fact that breast cancer is the most prevalent cancer among Jordanian women, practically nothing is known about their perceptions of early stage breast cancer and surgical treatment. Objective: To gain understanding of the diagnosis and surgical treatment experience of Jordanian women diagnosed with early stage breast cancer. Methods: An interpretive phenomenological approach was used for this study. A purposive sample of 28 Jordanian women who were surgically treated for early stage breast cancer within 6 months of the interview was recruited. Data were collected using individual interviews and analyzed using Heideggerian hermeneutical methodology. Results: Fear had a profound effect on Jordanian women’s stories of diagnosis and surgical treatment of early stage breast cancer. Women’s experience with breast cancer and its treatment was shaped by their pre-existing fear of breast cancer, the disparity in the quality of care at various health care institutions, and sociodemographic factors (e.g., education, age). Conclusions: Early after the diagnosis, fear was very strong and women lost perspective of the fact that this disease was treatable and potentially curable. To control their fears, women unconditionally trusted God, the health care system, surgeons, family, friends, and/or neighbors, and often accepted treatment offered by their surgeons without questioning. Implications for practice: Jordanian healthcare providers have a responsibility to listen to their patients, explore meanings they ascribe to their illness, and provide women with proper education and support necessary to help them cope with their illness.

Keywords: breast cancer, early stage, Jordanian, experience, phenomenology

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Authors: Michael Kho Lim

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This paper examines the status of the film industry as an industry in the Philippines—where or how it is classified in the Philippine industrial classification system and how this positioning gives the film industry an identity (or not) and affects (film) policy development and impacts the larger national economy. It is important to look at how the national government recognises Philippine cinema officially, as this will have a direct and indirect impact on the industry in terms of its representation, conduct of business, international relations, and most especially its implications on policy development and implementation. Therefore, it is imperative that the ‘identity’ of Philippine cinema be clearly established and defined in the overall industrial landscape. Having a clear understanding of Philippine cinema’s industry status provides a better view of the bigger picture and helps us determine cinema’s position in the national agenda in terms of priority setting, future direction and how the state perceives and thereby values the film industry as an industry. This will then serve as a frame of reference that will anchor the succeeding discussion. Once the Philippine film industry status is identified, the paper will then clarify how cultural policy is defined, understood, and applied in the Philippines in relation to Philippine cinema by reviewing and analyzing existing policy documents and pending bills in the Philippine Congress and Senate. Lastly, the paper delves into the roles that (national) cultural institutions and industry organisations play as primary drivers or support mechanisms and how they become platforms (or not) for the upliftment of the independent film sector and towards the sustainability of the film industry. The paper concludes by arguing that the role of the government and how government officials perceive and treats culture is far more important than cultural policy itself, as these policies emanate from them.

Keywords: cultural and creative industries, cultural policy, film industry, Philippine cinema

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Authors: Shuchi Bharti

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This article intends to analyse the transforming nature of state and corporate sector relationship in the light of evolving regulatory and institutional aspects pertaining to Corporate Social Responsibility (CSR) in India. The focus is on evaluating the accounts of law and decentred discourses, relevant within the changing regulatory and institutional paradigm that substantially goes ahead of formal legal control of state towards corporate actors. At this vantage point, it is important to understand the state’s posture towards a changing scenario particularly as the tone is set by regulatory parameters pertaining to CSR to drive process of engagement with the stakeholders. The tripartite framework of the article intends to focus on finding on the vital interconnected aspects of the CSR provisions (Section 135) of The Companies Act 2013 (The Act), rise of new institutions and the emergence of the decentred regulatory space. Thus is earmarked in a neo-liberal paradigm; state is witnessed to perform a responsive function in engendering enhanced public role for the corporate sector. In this overarching framework the aim is to undertake a causal, exploratory and relational analysis of aspects pertaining law, regulation and institutional transformations. Firstly, focus is drawn on to investigate the relational facets of the advent of law and regulatory framework of CSR. Secondly, in the light of the historical evolution, a causal connection is attempted between globalization, emergence of international soft law framework and the Indian case of CSR. Finally, I look into how the new Companies Act mandates CSR expenditure vis- a -vis multiple parameters and guidelines.

Keywords: corporate social responsibility, stakeholders, soft law, decentred regulation

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Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: Ali El Ksimi

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In today's digital academic environment, secure authentication methods are essential for managing sensitive user data, including that of students and faculty. The rise in cyber threats and data breaches has exposed the vulnerabilities of traditional authentication systems used in universities. Passwords, often the first line of defense, are particularly susceptible to hacking, phishing, and brute-force attacks. While multi-factor authentication (MFA) provides an additional layer of security, it can still be compromised and often adds complexity and inconvenience for users. As universities seek more robust security measures, blockchain technology emerges as a promising solution. Renowned for its decentralization, immutability, and transparency, blockchain has the potential to transform how user management is conducted in academic institutions. In this article, we explore a system that leverages blockchain technology specifically for managing user accounts within a university setting. The system enables the secure creation and management of accounts for different roles, such as administrators, teachers, and students. Each user is authenticated through a decentralized application (DApp) that ensures their data is securely stored and managed on the blockchain. By eliminating single points of failure and utilizing cryptographic techniques, the system enhances the security and integrity of user management processes. We will delve into the technical architecture, security benefits, and implementation considerations of this approach. By integrating blockchain into user management, we aim to address the limitations of traditional systems and pave the way for the future of digital security in education.

Keywords: blockchain, university, authentication, decentralization, cybersecurity, user management, privacy

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Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

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Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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