Search results for: healthcare regulations

Authors: Samar Swaid

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Today, corporates are moving toward the adoption of Design-Thinking techniques to develop products and services, putting their consumer as the heart of the development process. One of the leading companies in Design-Thinking, IDEO (Innovation, Design, Engineering Organization), defines Design-Thinking as an approach to problem-solving that relies on a set of multi-layered skills, processes, and mindsets that help people generate novel solutions to problems. Design thinking may result in new ideas, narratives, objects or systems. It is about redesigning systems, organizations, infrastructures, processes, and solutions in an innovative fashion based on the users' feedback. Tim Brown, president and CEO of IDEO, sees design thinking as a human-centered approach that draws from the designer's toolkit to integrate people's needs, innovative technologies, and business requirements. The application of design thinking has been witnessed to be the road to developing innovative applications, interactive systems, scientific software, healthcare application, and even to utilizing Design-Thinking to re-think business operations, as in the case of Airbnb. Recently, there has been a movement to apply design thinking to machine learning and artificial intelligence to ensure creating the "wow" effect on consumers. The Association of Computing Machinery task force on Data Science program states that" Data scientists should be able to implement and understand algorithms for data collection and analysis. They should understand the time and space considerations of algorithms. They should follow good design principles developing software, understanding the importance of those principles for testability and maintainability" However, this definition hides the user behind the machine who works on data preparation, algorithm selection and model interpretation. Thus, the Data Science program includes design thinking to ensure meeting the user demands, generating more usable machine learning tools, and developing ways of framing computational thinking. Here, describe the fundamentals of Design-Thinking and teaching modules for data science programs.

Keywords: data science, design thinking, AI, currculum, transformation

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Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

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Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

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Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

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Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

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Authors: Patrice Conner

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Nanotechnologies have enormous potential to contribute to human flourishing in responsible and sustainable ways. They are rapidly developing field of science, technology and innovation. As enabling technologies, their full scope of applications is potentially very wide. Major implications are expected in many areas, e.g. healthcare, information and communication technologies, energy production and storage, materials science/chemical engineering, manufacturing, environmental protection, consumer products, etc. However, nanotechnologies are unlikely to realize their full potential unless their associated societal and ethical issues are adequately attended. Namely nanotechnologies and nanoparticles may expose humans and the environment to new health risks, possibly involving quite different mechanisms of interference with the physiology of human and environmental species. One of the building blocks of the ‘safe, integrated and responsible’ approach is standardization. Both the Economic and Social Committee and the European Parliament have highlighted the importance to be attached to standardization as a means to accompany the introduction on the market of nanotechnologies and nanomaterials, and a means to facilitate the implementation of regulation. ISO and CEN have respectively started in 2005 and 2006 to deal with selected topics related to this emerging and enabling technology. In the beginning of 2010, EC DG ‘Enterprise and Industry’ addressed the mandate M/461 to CEN, CENELEC and ETSI for standardization activities regarding nanotechnologies and nanomaterials. Thus CEN/TC 352 ‘Nanotechnologies’ has been asked to take the leadership for the coordination in the execution of M/461 (46 topics to be standardized) and to contact relevant European and International Technical committees and interested stakeholders as appropriate (56 structures have been identified). Prior requests from M/461 deal with characterization and exposure of nanomaterials and any matters related to Health, Safety and Environment. Answers will be given to: - What are the structures and how they work? - Where are we right now and how work is going from now onwards? - How CEN’s work and targets deal with and interact with global matters in this field?

Keywords: characterization, environmental protection, exposure, health risks, nanotechnologies, responsible and sustainable ways, safety

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Authors: Clement Yeboah

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Prior research concludes that environmental commitment positively drives organisational performance. Nonetheless, the nexus and conditions under which environmental commitment capabilities contribute to a firm’s performance are less understood. The purpose of this quantitative relational study was to examine the relationship between environmental commitment and 500 firms’ performances in Ghana. The researchers further seek to draw insights from the resource-based view to conceptualize environmental commitment and green procurement practices as resource capabilities to enhance firm performance. The researchers used insights from the contingent resource-based view to examine green leadership orientation conditions under which environmental commitment capability contributes to firm performance through green procurement practices. The study’s conceptual framework was tested on primary data from some firms in the Ghanaian market. PROCESS Macro was used to test the study’s hypotheses. Beyond that, green procurement practices mediated the association between environmental commitment capabilities and the firm’s performance. The study further seeks to find out whether green leadership orientation positively moderates the indirect relationship between environmental commitment capabilities and firm performance through green procurement practices. While conventional wisdom suggests that improved environmental commitment capabilities help improve a firm’s performance, this study tested this presumed relationship between environmental commitment capabilities and firm performance and provides theoretical arguments and empirical evidence to justify how green procurement practices uniquely and in synergy with green leadership orientation transform this relationship. The study results indicated a positive correlation between environmental commitment and firm performance. This result suggests that firms that prioritize environmental sustainability and demonstrate a strong commitment to environmentally responsible practices tend to experience better overall performance. This includes financial gains, operational efficiency, enhanced reputation, and improved relationships with stakeholders. The study's findings inform policy formulation in Ghana related to environmental regulations, incentives, and support mechanisms. Policymakers can use the insights to design policies that encourage and reward firms for their environmental commitments, thereby fostering a more sustainable and environmentally responsible business environment. The findings from such research can influence the design and development of educational programs in Ghana, specifically in fields related to sustainability, environmental management, and corporate social responsibility (CSR). Institutions may consider integrating environmental and sustainability topics into their business and management courses to create awareness and promote responsible practices among future business professionals. Also the study results can also promote the adoption of environmental accounting practices in Ghana. By recognizing and measuring the environmental impacts and costs associated with business activities, firms can better understand the financial implications of their environmental commitments and develop strategies for improved performance.

Keywords: firm’s performance, green procurement practice, environmental commitment, environmental management, sustainability

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Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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Authors: Luciana S. Almeida

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Nanotechnology has revolutionized the world of science and technology bringing great expectations due to its great potential of application in the most varied industrial sectors. The same characteristics that make nanoparticles interesting from the point of view of the technological application, these may be undesirable when released into the environment. The small size of nanoparticles facilitates their diffusion and transport in the atmosphere, water, and soil and facilitates the entry and accumulation of nanoparticles in living cells. The main objective of this study is to evaluate the environmental regulatory process of nanomaterials in the Brazilian scenario. Three specific objectives were outlined. The first is to carry out a global scientometric study, in a research platform, with the purpose of identifying the main lines of study of nanomaterials in the environmental area. The second is to verify how environmental agencies in other countries have been working on this issue by means of a bibliographic review. And the third is to carry out an assessment of the Brazilian Nanotechnology Draft Law 6741/2013 with the state environmental agencies. This last one has the aim of identifying the knowledge of the subject by the environmental agencies and necessary resources available in the country for the implementation of the Policy. A questionnaire will be used as a tool for this evaluation to identify the operational elements and build indicators through the Environment of Evaluation Application, a computational application developed for the development of questionnaires. At the end will be verified the need to propose changes in the Draft Law of the National Nanotechnology Policy. Initial studies, in relation to the first specific objective, have already identified that Brazil stands out in the production of scientific publications in the area of nanotechnology, although the minority is in studies focused on environmental impact studies. Regarding the general panorama of other countries, some findings have also been raised. The United States has included the nanoform of the substances in an existing program in the EPA (Environmental Protection Agency), the TSCA (Toxic Substances Control Act). The European Union issued a draft of a document amending Regulation 1907/2006 of the European Parliament and Council to cover the nanoform of substances. Both programs are based on the study and identification of environmental risks associated with nanomaterials taking into consideration the product life cycle. In relation to Brazil, regarding the third specific objective, it is notable that the country does not have any regulations applicable to nanostructures, although there is a Draft Law in progress. In this document, it is possible to identify some requirements related to the environment, such as environmental inspection and licensing; industrial waste management; notification of accidents and application of sanctions. However, it is not known if these requirements are sufficient for the prevention of environmental impacts and if national environmental agencies will know how to apply them correctly. This study intends to serve as a basis for future actions regarding environmental management applied to the use of nanotechnology in Brazil.

Keywords: environment; management; nanotecnology; politics

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Authors: Zahid Ullah, Atlas Khan

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In today's data-driven world, the role of mathematics in bridging the gap between theory and applications is becoming increasingly vital. This abstract highlights the significance of mathematics as a powerful tool for analyzing, interpreting, and extracting meaningful insights from vast amounts of data. By integrating mathematical principles with real-world applications, researchers can unlock the full potential of data-driven decision-making processes. This abstract delves into the various ways mathematics acts as a bridge connecting theoretical frameworks to practical applications. It explores the utilization of mathematical models, algorithms, and statistical techniques to uncover hidden patterns, trends, and correlations within complex datasets. Furthermore, it investigates the role of mathematics in enhancing predictive modeling, optimization, and risk assessment methodologies for improved decision-making in diverse fields such as finance, healthcare, engineering, and social sciences. The abstract also emphasizes the need for interdisciplinary collaboration between mathematicians, statisticians, computer scientists, and domain experts to tackle the challenges posed by the data-driven landscape. By fostering synergies between these disciplines, novel approaches can be developed to address complex problems and make data-driven insights accessible and actionable. Moreover, this abstract underscores the importance of robust mathematical foundations for ensuring the reliability and validity of data analysis. Rigorous mathematical frameworks not only provide a solid basis for understanding and interpreting results but also contribute to the development of innovative methodologies and techniques. In summary, this abstract advocates for the pivotal role of mathematics in bridging theory and applications in a data-driven world. By harnessing mathematical principles, researchers can unlock the transformative potential of data analysis, paving the way for evidence-based decision-making, optimized processes, and innovative solutions to the challenges of our rapidly evolving society.

Keywords: mathematics, bridging theory and applications, data-driven world, mathematical models

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Authors: Mareike Dornhoefer, Madjid Fathi

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Water supply and water quality are key problems of mankind at the moment and - due to increasing population - in the future. Management disciplines like water, environment and quality management therefore need to closely interact, to establish a high level of water quality and to guarantee water supply in all parts of the world. Groundwater remediation is one aspect in this process. From a knowledge management perspective it is only possible to solve complex ecological or environmental problems if different factors, expert knowledge of various stakeholders and formal regulations regarding water, waste or chemical management are interconnected in form of a knowledge base. In general knowledge management focuses the processes of gathering and representing existing and new knowledge in a way, which allows for inference or deduction of knowledge for e.g. a situation where a problem solution or decision support are required. A knowledge base is no sole data repository, but a key element in a knowledge based system, thus providing or allowing for inference mechanisms to deduct further knowledge from existing facts. In consequence this knowledge provides decision support. The given paper introduces an environmental knowledge system in water management. The proposed environmental knowledge system is part of a research concept called Green Knowledge Management. It applies semantic technologies or concepts such as ontology or linked open data to interconnect different data and information sources about environmental aspects, in this case, water quality, as well as background material enriching an established knowledge base. Examples for the aforementioned ecological or environmental factors threatening water quality are among others industrial pollution (e.g. leakage of chemicals), environmental changes (e.g. rise in temperature) or floods, where all kinds of waste are merged and transferred into natural water environments. Water quality is usually determined with the help of measuring different indicators (e.g. chemical or biological), which are gathered with the help of laboratory testing, continuous monitoring equipment or other measuring processes. During all of these processes data are gathered and stored in different databases. Meanwhile the knowledge base needs to be established through interconnecting data of these different data sources and enriching its semantics. Experts may add their knowledge or experiences of previous incidents or influencing factors. In consequence querying or inference mechanisms are applied for the deduction of coherence between indicators, predictive developments or environmental threats. Relevant processes or steps of action may be modeled in form of a rule based approach. Overall the environmental knowledge system supports the interconnection of information and adding semantics to create environmental knowledge about water environment, supply chain as well as quality. The proposed concept itself is a holistic approach, which links to associated disciplines like environmental and quality management. Quality indicators and quality management steps need to be considered e.g. for the process and inference layers of the environmental knowledge system, thus integrating the aforementioned management disciplines in one water management application.

Keywords: water quality, environmental knowledge system, green knowledge management, semantic technologies, quality management

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Authors: Lun Lou, Jintu Fan

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While personal protective equipment (PPE) prevents the healthcare personnel from exposing to harmful surroundings, it creates a barrier to the dissipation of body heat and perspiration, leading to severe heat stress during prolonged exposure, especially in hot environments. It has been found that most of the existed personal cooling strategies have limitations in achieving effective cooling performance with long duration and lightweight. This work aimed to develop a lightweight (<1.0 kg) and less expensive wearable air cooling and dehumidifying system (WCDS) that can be applied underneath the protective clothing and provide 50W mean cooling power for more than 5 hours at 35°C environmental temperature without compromising the protection of PPE. For the WCDS, blowers will be used to activate an internal air circulation inside the clothing microclimate, which doesn't interfere with the protection of PPE. An air cooling and dehumidifying chamber (ACMR) with a specific design will be developed to reduce the air temperature and humidity inside the protective clothing. Then the cooled and dried air will be supplied to upper chest and back areas through a branching tubing system for personal cooling. A detachable ice cooling unit will be applied from the outside of the PPE to extract heat from the clothing microclimate. This combination allows for convenient replacement of the cooling unit to refresh the cooling effect, which can realize a continuous cooling function without taking off the PPE or adding too much weight. A preliminary thermal manikin test showed that the WCDS was able to reduce the microclimate temperature inside the PPE averagely by about 8°C for 60 minutes when the environmental temperature was 28.0 °C and 33.5 °C, respectively. Replacing the ice cooling unit every hour can maintain this cooling effect, while the longest operation duration is determined by the battery of the blowers, which can last for about 6 hours. This unique design is especially helpful for the PPE users, such as health care workers in infectious and hot environments when continuous cooling and dehumidifying are needed, but the change of protective clothing may increase the risk of infection. The new WCDS will not only improve the thermal comfort of PPE users but can also extend their safe working duration.

Keywords: personal thermal management, heat stress, ppe, health care workers, wearable device

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Authors: Snigdha Sahai, Devaki Chikkavenkatappa Yellappa

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This study outlines approaches for testing and validating stochastic models used in epidemiology, focusing on the integration and functional testing of simulation code. It details methods for combining simple functions into comprehensive simulations, distinguishing between deterministic and stochastic components, and applying tests to ensure robustness. Techniques include isolating stochastic elements, utilizing large sample sizes for validation, and handling special cases. Practical examples are provided using R code to demonstrate integration testing, handling of incorrect inputs, and special cases. The study emphasizes the importance of both functional and defensive programming to enhance code reliability and user-friendliness.

Keywords: computational epidemiology, epidemiology, public health, infectious disease modeling, statistical analysis, health data analysis, disease transmission dynamics, predictive modeling in health, population health modeling, quantitative public health, random sampling simulations, randomized numerical analysis, simulation-based analysis, variance-based simulations, algorithmic disease simulation, computational public health strategies, epidemiological surveillance, disease pattern analysis, epidemic risk assessment, population-based health strategies, preventive healthcare models, infection dynamics in populations, contagion spread prediction models, survival analysis techniques, epidemiological data mining, host-pathogen interaction models, risk assessment algorithms for disease spread, decision-support systems in epidemiology, macro-level health impact simulations, socioeconomic determinants in disease spread, data-driven decision making in public health, quantitative impact assessment of health policies, biostatistical methods in population health, probability-driven health outcome predictions

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Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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Authors: Nur Fareza Mustapha

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Solutions to policy problems need to be curated to the local context, taking into account the trajectory of the local development path to ensure its efficacy. For Kuala Lumpur, rapid urbanization and migration into the city for the past few decades have increased the demand for housing to accommodate a growing urban population. As a critical factor affecting housing affordability, land supply constraints have been attributed to intensifying market pressures, which grew in tandem with the demands of urban development, along with existing institutional constraints in the governance of land. While demand-side pressures are inevitable given the fixed supply of land, supply-side constraints in regulations distort markets and if addressed inappropriately, may lead to mistargeted policy interventions. Given Malaysia’s historical development, regulatory barriers for land may originate from the British colonial period, when many aspects of the current laws governing tenure were introduced and formalized, and henceforth, became engrained in the system. This research undertakes a postcolonial institutional analysis approach to uncover the causal mechanism driving the evolution of land tenure systems in post-colonial Kuala Lumpur. It seeks to determine the sources of these shifts, focusing on the incentives and bargaining positions of actors during periods of institutional flux/change. It aims to construct a conceptual framework to further this understanding and to elucidate how this historical trajectory affects current access to urban land markets for housing. Archival analysis is used to outline and analyse the evolution of land tenure systems in Kuala Lumpur while stakeholder interviews are used to analyse its impact on the current urban land market, with a particular focus on the provision of and access to affordable housing in the city. Preliminary findings indicate that many aspects of the laws governing tenure that were introduced and formalized during the British colonial period have endured until the present day. Customary rules of tenure were displaced by rules following a European tradition, which found legitimacy through a misguided interpretation of local laws regarding the ownership of land. Colonial notions of race and its binary view of native vs. non-natives have also persisted in the construction and implementation of current legislation regarding land tenure. More concrete findings from this study will generate a more nuanced understanding of the regulatory land supply constraints in Kuala Lumpur, taking into account both the long and short term spatial and temporal processes that affect how these rules are created, implemented and enforced.

Keywords: colonial discourse, historical institutionalism, housing, land policy, post-colonial city

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Authors: Yaron Covo, Tamar Kofman, Shira Palti

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Over the recent decades, debates about the engagement of fans in football governance have focused on the club level and national level, emphasizing the significance of fans’ involvement in increasing the connection of clubs with the community, and in safeguarding the transparency, accountability, and clubs’ financial stability. This paper will offer a different conceptual justification for providing fans with access to decision-making processes in football. First, it will suggest that the participation of fans is necessary for addressing discriminatory practices against women in football stadiums. Second, it will argue that fans’ involvement in football governance is important not only at the club and national level but also at the global level, relying on the principles of Global Administrative Law. In contemporary men’s football, female fans face different forms of discrimination. Iranian women are still prohibited from attending football games at the domestic level; In Saudi Arabia, female fans are only permitted to enter designated family areas; Qatar – the host of the 2022 FIFA world cup – requires women to attend matches wearing modest clothing. Similarly, in Turkey, Lebanon, UAE, and Algeria, women face cultural barriers when attending men’s football games. In other countries, female fans suffer from subtle discrimination, including micro-aggressions, misogyny, sexism, and noninstitutionalized exclusion. Despite the vital role of fans in world football and the importance of football for many women’s lives, little has been done to address this problem. While FIFA recognizes that these discriminatory practices contradict its statutes, this recognition fails to materialize into meaningful change. This paper will argue that FIFA’s omission stems from two interrelated characteristics of world football: (1) the ultra-masculine nature of the game; (2) the insufficient recognition of fans’ significance. While fans have been given a voice in various football bodies on the domestic level, FIFA has yet to allow the representation of fans as stakeholders in world football governance. Since fans are a more heterogeneous group than players, the voices of those fans who do not fit the ultra-masculine model are not heard. Thus, by focusing mainly on male players, FIFA reproduces the hegemonic masculinity that feeds back into fan dynamics and marginalizes female fans. To rectify this problem, we will call on FIFA to provide fans and female fans in particular, with voice mechanisms and access to decision-making processes. In addition to its impact on the formation of fans’ identities, such a move will allow fans to demand better enforcement of existing anti-discrimination norms and new regulations to address their needs. The literature has yet to address the relationship between fans’ gender discrimination and global football governance. Building on Global Administrative Law scholarship and feminist theories, this paper will aim to fill this gap.

Keywords: fans, FIFA, football governance, gender discrimination, global administrative law, human rights

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Authors: Sharvari Parikh

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Climate change has always been looked upon as a threat. Increased use of fossil fuels, depletion of bio diversity, certain human activities, rising levels of Greenhouse Gas (GHG) emissions are the factors that have caused climate change. Climate change is creating new risks and aggravating the existing ones. The paper focuses on breaking the stereotypical perception of climate change and draws attention towards the constructive side of it. Researches around the world have concluded that climate change has provided us with many untapped opportunities. The next 15 years will be crucial, as it is in our hands whether we are able to grab these opportunities or just let the situation get worse. The world stands at a stage where we cannot think of making a choice between averting climate change and promoting growth and development. In fact, the solution to climate change itself has got economic opportunities. The data evidences from the paper show how we can create the opportunity to improve the lives of the world’s population at large through structural change which will promote environment friendly investments. Rising Investment in green energy and increased demand of climate friendly products has got ample of employment opportunities. Old technologies and machinery which are employed today lack efficiency and demand huge maintenance because of which we face high production cost. This can be drastically brought down by adaptation of Green technologies which are more accessible and affordable. Overall GDP of the world has been heavily affected in aggravating the problems arising out of increasing weather problems. Shifting to green economy can not only eliminate these costs but also build a sound economy. Accelerating the economy in direction of low-carbon future can lessen the burdens such as subsidies for fossil fuels, several public debts, unemployment, poverty, reduce healthcare expenses etc. It is clear that the world will be dragged into the ‘Darker phase’ if the current trends of fossil fuels and carbon are being consumed. Switching to Green economy is the only way in which we can lift the world from darker phase. Climate change has opened the gates for ‘Green and Clean economy’. It will also bring countries of the world together in achieving the common goal of Green Economy.

Keywords: climate change, economic opportunities, green economy, green technology

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Authors: Juan Peña Aguilar, Lilia Villasana, Rodrigo Valencia, Alberto Pastrana, Martin Vivanco, Juan Peña C

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Each year a growing number of companies entering Mexico in search of the domestic market share. These activities, including stores, telephone long distance and local raw materials and energy, and particularly the financial sector, have managed to significantly increase its weight in the flows of FDI in Mexico , however, you should consider whether these trends FDI are positive for the Mexican economy and these activities increase Mexican exports in the medium term , and its share in GDP , gross fixed capital formation and employment. In general stresses that these activities, by far, have been unable to significantly generate linkages with the rest of the economy, a process that has not favored with competitiveness policies and activities aimed at these neutral or horizontal. Since the nineties foreign direct investment (FDI) has shown a remarkable dynamism, both internationally and in Latin America and in Mexico. Only in Mexico the first recipient of FDI in importance in Latin America during 1990-1995 and was displaced by Brazil since FDI increased from levels below 1 % of GDP during the eighties to around 3 % of GDP during the nineties. Its impact has been significant not only from a macroeconomic perspective , it has also allowed the generation of a new industrial production structure and organization, parallel to a significant modernization of a segment of the economy. The case of Mexico also is particularly interesting and relevant because the destination of FDI until 1993 had focused on the purchase of state assets during privatization process. This paper aims to present FDI flows in Mexico and analyze the different business strategies that have been touched and encouraged by the FDI. On the one hand, looking briefly discuss regulatory issues and source and recipient of FDI sectors. Furthermore, the paper presents in more detail the impacts and changes that generated the FDI contribution of FDI in the Mexican economy , besides the macroeconomic context and later legislative changes that resulted in the current regulations is examined around FDI in Mexico, including aspects of the Free Trade Agreement (NAFTA). It is worth noting that foreign investment can not only be considered from the perspective of the receiving economic units. Instead, these flows also reflect the strategic interests of transnational corporations (TNCs) and other companies seeking access to markets and increased competitiveness of their production networks and global distribution, among other reasons. Similarly it is important to note that foreign investment in its various forms is critically dependent on historical and temporal aspects. Thus, the same functionality can vary significantly depending on the specific characteristics of both receptor units as sources of FDI, including macroeconomic, institutional, industrial organization, and social aspects, among others.

Keywords: foreign direct investment (FDI), competitiveness, neoliberal regime, globalization, gross domestic product (GDP), NAFTA, macroeconomic

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Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Akhentoolove Corbin, Leta De Jonge, Charmaine De Jonge

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Introduction: Various writers have promoted the adoption of the 4th R in the education curricula (relationships, respect, reasoning, religion, computing, science, art, conflict management, music) and the 5th R (responsibility). They argue that the traditional 3 Rs are not adequate for the modern environment and the requirements for students to become functional citizens in society. In particular, the developing countries of the anglophone Caribbean (most of which are tiny islands) are susceptible to the dangers and complexities of climate change and global economic volatility. These proposed additions to the 3Rs do have some justification, but this research considers Resilience as even more important and relevant in a world that is faced with the negative prospects of climate change, poverty, discrimination, and economic volatility. It is argued that the foundation for resilient citizens, workers, and workplaces, must be built in the elementary and secondary/middle schools and then through the tertiary level, to achieve an outcome of more resilient students. Government, business, and society require widespread resilience to be capable of ‘bouncing back’ and be more adaptable, transformational, and sustainable. Methodology: The paper utilises a mixed-methods approach incorporating a questionnaire and interviews to determine participants’ opinions on the importance and relevance of resilience in the schools’ curricula and to government, business, and society. The target groups are as follows: educators at all levels, education administrators, members of the business sector, public sector, and 3rd sector. The research specifically targets the anglophone Caribbean developing countries (Barbados, Guyana, Jamaica, Trinidad, St. Lucia, and St Vincent, and the Grenadines). The research utilises SPSS for data analysis. Major Findings: The preliminary findings suggest that the majority of participants support the adoption of resilience as a 4th R in the curricula of the elementary, secondary/middle schools, and tertiary level in the anglophone Caribbean. The final results will allow the researchers to reveal more specific details on any variations among the islands in the sample andto engage in an in-depth discussion of the relevance and importance of resilience as the 4th R. Conclusion: Results seem to suggest that the education system should adopt the 4th R of resilience so that educators working in collaboration with the family and community/village can develop young citizens who are more resilient and capable of manifesting the behaviours and attitudes associated with ‘bouncing back,’ adaptability, transformation, and sustainability. These findings may be useful for education decision-makers and governments in these Caribbean islands, who have the authority and responsibility for the development of education policy, laws, and regulations.

Keywords: education, resilient students, adaptable, transformational, resilient citizens, workplaces, government

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Authors: Ruben Peralta, Sam Thomas, Nazia Hirani, Ayman El-Menyar, Hassan Al-Thani, Mohammed Al-Thani, Mohammed Al-Hajjaj, Rafael Consunji

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Moderate to severe work-related injuries [WRI's] are a leading cause of trauma admission in Qatar but information on risk factors for their incidence are lacking. This study aims to document and analyze the predictive characteristics for WRI to inform the creation of targeted interventions to improve worker safety in Qatar. This study was conducted as part of the NPRP grant # 7 - 1120 - 3 - 288, titled "A Unified Registry for Occupational Injury Prevention in Qatar”. 266 workers were interviewed using a standard questionnaire, during ‘World Day for Safety and Health at Work’, a Ministry of Public Health event, none refused interview. Nurses and doctors from the Hamad Trauma Center conducted the interviews. Questions were translated into the worker’s native language when it was deemed necessary. Standard information on epidemiologic characteristics and incidence of work-related injury were collected and compared between nationalities and those injured versus those not injured. 262 males and 4 females were interviewed. 17 [6.4%] reported a WRI in the last 24 months. More than half of the injured worked in construction [59%] followed by water supply [11.8%]. Factors significantly associated with recent injury were: Working for a company with > 500 employees and speaking Hindi. Protective characteristics included: Being from the Philippines or Sri Lanka, speaking Arabic, working in healthcare, an office or trading and company size between 100-500 employees. Years of schooling and working in Qatar were not predictive factor for WRI. The findings from this survey should guide future research that will better define worker populations at an increased risk for WRI and inform recruiters and sending countries. A focus on worker language skills, interventions in the construction industry and occupational safety in large companies is needed.

Keywords: occupational injury, prevention, safety, trauma, work related injury

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Authors: Zeleke Ayalew Alemu

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This study aims to investigate tax administration constraints in Addis Ababa with a focus on small and medium-sized enterprises by identifying issues and constraints in tax administration and assessment. The study identifies problems associated with taxpayers and tax-collecting authorities in the city. The research used qualitative and quantitative research designs and employed questionnaires, focus group discussion and key informant interviews for primary data collection and also used secondary data from different sources. The study identified many constraints that taxpayers are facing. Among others, tax administration offices’ inefficiency, reluctance to respond to taxpayers’ questions, limited tax assessment and administration knowledge and skills, and corruption and unethical practices are the major ones. Besides, the tax laws and regulations are complex and not enforced equally and fully on all taxpayers, causing a prevalence of business entities not paying taxes. This apparently results in an uneven playing field. Consequently, the tax system at present is neither fair nor transparent and increases compliance costs. In case of dispute, the appeal process is excessively long and the tax authority’s decision is irreversible. The Value Added Tax (VAT) administration and compliance system is not well designed, and VAT has created economic distortion among VAT-registered and non-registered taxpayers. Cash registration machine administration and the reporting system are big headaches for taxpayers. With regard to taxpayers, there is a lack of awareness of tax laws and documentation. Based on the above and other findings, the study forwarded recommendations, such as, ensuring fairness and transparency in tax collection and administration, enhancing the efficiency of tax authorities by use of modern technologies and upgrading human resources, conducting extensive awareness creation programs, and enforcing tax laws in a fair and equitable manner. The objective of this study is to assess problems, weaknesses and limitations of small and medium-sized enterprise taxpayers, tax authority administrations, and laws as sources of inefficiency and dissatisfaction to forward recommendations that bring about efficient, fair and transparent tax administration. The entire study has been conducted in a participatory and process-oriented manner by involving all partners and stakeholders at all levels. Accordingly, the researcher used participatory assessment methods in generating both secondary and primary data as well as both qualitative and quantitative data on the field. The research team held FGDs with 21 people from Addis Ababa City Administration tax offices and selected medium and small taxpayers. The study team also interviewed 10 KIIs selected from the various segments of stakeholders. The lead, along with research assistants, handled the KIIs using a predesigned semi-structured questionnaire.

Keywords: taxation, tax system, tax administration, small and medium enterprises

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Authors: Hui-Chieh Li

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Circular economy promotes greater resource productivity and avoids pollution through greater recycling and re-use which bring benefits for both the environment and the economy. The concept is contrast to a linear economy which is ‘take, make, dispose’ model of production. A well-design reverse logistics service strategy could enhance the willingness of recycling of the users and reduce the related logistics cost as well as carbon emissions. Moreover, the recycle brings the manufacturers most advantages as it targets components for closed-loop reuse, essentially converting materials and components from worn-out product into inputs for new ones at right time and right place. This study considers demand-supply interaction, time-dependent recycle demand, time-dependent surplus value of recycled product and constructs models on recycle service strategy for the recyclable waste collector. A crucial factor in optimizing a recycle service strategy is consumer demand. The study considers the relationships between consumer demand towards recycle and product characteristics, surplus value and user behavior. The study proposes a recycle service strategy which differs significantly from the conventional and typical uniform service strategy. Periods with considerable demand and large surplus product value suggest frequent and short service cycle. The study explores how to determine a recycle service strategy for recyclable waste collector in terms of service cycle frequency and duration and vehicle type for all service cycles by considering surplus value of recycled product, time-dependent demand, transportation economies and demand-supply interaction. The recyclable waste collector is responsible for the collection of waste product for the manufacturer. The study also examines the impacts of utilization rate on the cost and profit in the context of different sizes of vehicles. The model applies mathematical programming methods and attempts to maximize the total profit of the distributor during the study period. This study applies the binary logit model, analytical model and mathematical programming methods to the problem. The model specifically explores how to determine a recycle service strategy for the recycler by considering product surplus value, time-dependent recycle demand, transportation economies and demand-supply interaction. The model applies mathematical programming methods and attempts to minimize the total logistics cost of the recycler and maximize the recycle benefits of the manufacturer during the study period. The study relaxes the constant demand assumption and examines how service strategy affects consumer demand towards waste recycling. Results of the study not only help understanding how the user demand for recycle service and product surplus value affects the logistics cost and manufacturer’s benefits, but also provide guidance such as award bonus and carbon emission regulations for the government.

Keywords: circular economy, consumer demand, product surplus value, recycle service strategy

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Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

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Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

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Authors: Sakshi Chopra, Harsimarpreet Kaur, Ashima Nehra

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Objectives: Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of secondary gains or motives, which may include financial compensation; avoiding work; getting lighter criminal sentences; or simply to attract attention or sympathy. Malingering is different from somatization disorder and factitious disorder. The prevalence of malingering is unknown and difficult to determine. In an estimated study in forensic population, it can reach up to 17% cases. But the accuracy of such estimates is questionable as successful malingerers are not detected and thus, not included. Methods: The case study of a 58 years old, right handed, graduate, pre-morbidly working in a national company with reported history of stroke leading to head injury; cerebral infarction/facial palsy and dementia. He was referred for disability certification so that his job position can be transferred to his son as he could not work anymore. A series of Neuropsychological tests were administered. Results: With a mental age of < 2.5 years; social adaptive functioning was overall < 20 showing profound Mental Retardation, less than 1 year social age in abilities of self-help, eating, dressing, locomotion, occupation, communication, self-direction, and socialization; severely impaired verbal and performance ability, 96% impairment in Activities of Daily Living, with an indication of very severe depression. With inconsistent and fluctuating medical findings and problem descriptions to different health professionals forming the board for his disability, it was concluded that this patient was malingering. Conclusions: Even though it can be easily defined, malingering can be very challenging to diagnosis. Cases of malingering impose a substantial economic burden on the health care system and false attribution of malingering imposes a substantial burden of suffering on a significant proportion of the patient population. Timely, tactful diagnosis and management can help ease this patient burden on the healthcare system. Malingering can be detected by only trained mental health professionals in the clinical setting.

Keywords: disability, India, malingering, neuropsychological assessment

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Authors: Alexander Otchere Fianko, Clement Yeboah, Evans Oteng

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Prior research concludes that Green Procurement Practices positively drive Organisational Performance. Nonetheless, the nexus and conditions under which Green Procurement Practices contribute to a Firm’s Performance are less understood. The purpose of this quantitative relational study was to examine the relationship between Green Procurement Practices and 500 Firms’ Performances in Ghana. The researchers further seek to draw insights from the resource-based view to conceptualize Green Procurement Practices and Environmental Commitment as resource capabilities to enhance Firm Performance. The researchers used insights from the contingent resource-based view to examine Green Leadership Orientation conditions under which Green Procurement Practices contribute to Firm Performance through Environmental Commitment Capabilities. The study’s conceptual framework was tested on primary data from some firms in the Ghanaian market. PROCESS Macro was used to test the study’s hypotheses. Beyond that, Environmental Commitment Capabilities mediated the association between Green Procurement Practices and the Firm’s Performance. The study further seeks to find out whether Green Leadership Orientation positively moderates the indirect relationship between Green Procurement Practices and Firm Performance through Environmental Commitment Capabilities. While conventional wisdom suggests that improved Green Procurement Practices help improve a Firm’s Performance, this study tested this presumed relationship between Green Procurement Practices and Firm Performance and provides theoretical arguments and empirical evidence to justify how Environmental Commitment Capabilities uniquely and in synergy with Green Leadership Orientation transform this relationship. The study results indicated a positive correlation between Green Procurement Practices and Firm Performance. This result suggests that firms that prioritize environmental sustainability and demonstrate a strong commitment to environmentally responsible practices tend to experience better overall performance. This includes financial gains, operational efficiency, enhanced reputation, and improved relationships with stakeholders. The study's findings inform policy formulation in Ghana related to environmental regulations, incentives, and support mechanisms. Policymakers can use the insights to design policies that encourage and reward firms for their Green Procurement Practices, thereby fostering a more sustainable and environmentally responsible business environment. The findings from such research can influence the design and development of educational programs in Ghana, specifically in fields related to sustainability, environmental management, and corporate social responsibility (CSR). Institutions may consider integrating environmental and sustainability topics into their business and management courses to create awareness and promote responsible practices among future business professionals. Also, the study results can also promote the adoption of environmental accounting practices in Ghana. By recognizing and measuring the environmental impacts and costs associated with business activities, firms can better understand the financial implications of their Green Procurement Practices and develop strategies for improved performance.

Keywords: environmental commitment, firm’s performance, green procurement practice, green leadership orientation

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Authors: Alami Ilyass, Loubna Kharchoufa, Elachouri Mostafa

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The two great realms of living diversity are cultural and biological. Today, both are being lost at an alarming rate. Of all the Earth’s biological diversity, plant kingdom is of high significance, and most essential to human welfare, in fact, medicinal plants are extensively exploited for countless purposes. Among these multiple uses, medicinal plants are the most important source of medicine for humankind healthcare and well being. In recent years there has been a great surge of public interest in the use of herbs and plants. Some scientists have viewed this phenomenon as a modern “herbal renaissance”. The importance of plants as medicines in developed and developing countries has recently been acknowledged by the United Nations (UN). However, to date fewer than 5% of the approximately 250,000 species of higher plants have been exhaustively studied for their potential pharmacological activity. A number of drugs from ethnobotanical leads have provided significant milestones in Western medicine. Despite this success, pharmacognosy research on Moroccan flora needs more studies aimed at the exploration of their therapeutic potential. A major weakness is the absence of strong funding agencies in the country, and a real national drug discovery program. Moreover, the lack of the coordination between different universities and research institutions leads, in most cases, to a waste of time, money and efforts of many researchers. In this work, we focus our attention on research into traditional indigenous medicinal plants in Morocco. Three parts constitute the head lines of this work: In the first one, we take up Moroccan biodiversity matter, the second part is devoted principally to the state of research into medicinal plants by Moroccan scholars and the last one is consecrated to the debate of factors which handicap the progress of research on phytomedicine in Morocco. The objectives of the present study are twofold: first, to highlight the state of the medicinal plants researches in Morocco. Second goal is to assess and correlate the levels of knowledge of the local flora to the research on medicinal plants to attempt to build capacity for research within Moroccan Scientific community at rate of developing country.

Keywords: Morocco, medicinal plants, ethnobotanical, pharmacognosy, phytomedicine

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Soumava Boral, Sanjay K. Chaturvedi, Ian Howard, Kristoffer McKee, V. N. A. Naikan

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Due to strict regulations from government to enhance the possibilities of sustainability practices in industries, and noting the advances in sustainable manufacturing practices, it is necessary that the associated processes are also sustainable. Maintenance of large scale and complex machines is a pivotal task to maintain the uninterrupted flow of manufacturing processes. Appropriate maintenance practices can prolong the lifetime of machines, and prevent associated breakdowns, which subsequently reduces different cost heads. Selection of the best maintenance strategies for such machines are considered as a burdensome task, as they require the consideration of multiple technical criteria, complex mathematical calculations, previous fault data, maintenance records, etc. In the era of the fourth industrial revolution, organizations are rapidly changing their way of business, and they are giving their utmost importance to sensor technologies, artificial intelligence, data analytics, automations, etc. In this work, the effectiveness of several maintenance strategies (e.g., preventive, failure-based, reliability centered, condition based, total productive maintenance, etc.) related to a large scale and complex gearbox, operating in a steel processing plant is evaluated in terms of economic, social, environmental and technical criteria. As it is not possible to obtain/describe some criteria by exact numerical values, these criteria are evaluated linguistically by cross-functional experts. Fuzzy sets are potential soft-computing technique, which has been useful to deal with linguistic data and to provide inferences in many complex situations. To prioritize different maintenance practices based on the identified sustainable criteria, multi-criteria decision making (MCDM) approaches can be considered as potential tools. Multi-Attributive Ideal Real Comparative Analysis (MAIRCA) is a recent addition in the MCDM family and has proven its superiority over some well-known MCDM approaches, like TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) and ELECTRE (ELimination Et Choix Traduisant la REalité). It has a simple but robust mathematical approach, which is easy to comprehend. On the other side, due to some inherent drawbacks of Intuitionistic Fuzzy Sets (IFS) and Pythagorean Fuzzy Sets (PFS), recently, the use of Fermatean Fuzzy Sets (FFSs) has been proposed. In this work, we propose the novel concept of FF-MAIRCA. We obtain the weights of the criteria by experts’ evaluation and use them to prioritize the different maintenance practices according to their suitability by FF-MAIRCA approach. Finally, a sensitivity analysis is carried out to highlight the robustness of the approach.

Keywords: Fermatean fuzzy sets, Fermatean fuzzy MAIRCA, maintenance strategy selection, sustainable manufacturing, MCDM

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Authors: Rameshwar Dahal, S. Ping Ho

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Although the demand for infrastructure development forms a promising market opportunity for international firms, the dominance of informal institutions over formal ones, investors are facing extraordinary institutional challenges when investing in emerging Least Developed Countries (LDCs). We believe that, in emerging LDCs, the project performance heavily depends on how well the entrants respond to the challenges exerted by the host institutional environments. Which primarily depends on how much they learn about the host institution and what strategy they apply in response. In Nepal, almost all international or global infrastructure projects are financed by international financers, so the procurement process of the infrastructure projects financed by foreign agencies is guided by the policies and regulations of the financer. Because of limited resources and the financers’ demand, contractors and consults are procured internationally. Moreover, the resources, including but not limited to construction material, manpower, and equipment, also need to be imported. Therefore, the involvement of international companies as an entrant in global infrastructure projects of LDCs is obvious. In a global project (GP), participants from different geographical and institutional environments hold different beliefs and have disparate interests. Therefore, the entrants face the challenges exerted by the host institutional environments. The entrants must either adapt to the institutions prevailing in the environment or resist the institutional pressures. It is hypothesized that, in emerging LDCs, the project performance heavily depends on how much the entrants learn about the host institutional knowledge and how well they respond to the institutional environments. While it is impossible to generalize the phenomenon and contextual conditions because of their vast diversity, this study has answered why and how participants’ level of institutional knowledge impacts the project's implementation performance. To draw that conclusion, firstly, we explored two typical GPs from Nepal. For this study, the data were collected by conducting interviews and examining the secondary data, such as the project reports published by the financers, project data provided by interviewees, and news reports. In an event analysis, firstly, we identify the sources, causes, or nature of the institutional challenges; secondly, we analyze the entrant’s responses to the exerted challenges and evaluate the impacts of the responses on the overall project performance. In this study, at first, the events occurred during the project implementation process have a causal link with the local institutions that demand the entrants’ response are extracted. Secondly, each event is scrutinized as the critical success factor of the case project. Finally, it is crucially examined whether and what institutional knowledge in these events played a critical role in project success or failure. The results also provide insights into the crucial institutional knowledge in LDCs and the subsequent strategy implications for undertaking projects in LDCs.

Keywords: emerging countries, LDC, project management, project performance, institutional knowledge, institutional theory

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Authors: Samrawit Tamrat Gebretsadik

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Recurrent wheezing is a common respiratory symptom among children, often indicative of underlying airway inflammation and hyperreactivity. Understanding the prevalence and associated factors of recurrent wheezing in specific age groups is crucial for targeted interventions and improved respiratory health outcomes. This study aimed to investigate the prevalence and associated factors of recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College in Ethiopia. A cross-sectional study design was employed, involving structured interviews with parents/guardians, medical records review, and clinical examination of children. Data on demographic characteristics, environmental exposures, family history of respiratory diseases, and socioeconomic status were collected. Logistic regression analysis was used to identify factors associated with recurrent wheezing. The study included X 6-year-old children, with a prevalence of recurrent wheezing found to be Y%. Environmental exposures, including tobacco smoke exposure (OR = Z, 95% CI: X-Y), indoor air pollution (OR = Z, 95% CI: X-Y), and presence of pets at home (OR = Z, 95% CI: X-Y), were identified as significant risk factors for recurrent wheezing. Additionally, a family history of asthma or allergies (OR = Z, 95% CI: X-Y) and low socioeconomic status (OR = Z, 95% CI: X-Y) were associated with an increased likelihood of recurrent wheezing. The impact of recurrent wheezing on the quality of life of affected children and their families was also assessed. Children with recurrent wheezing experienced a higher frequency of respiratory symptoms, increased healthcare utilization, and decreased physical activity compared to their non-wheezing counterparts. In conclusion, recurrent wheezing among 6-year-old children attending Adama Comprehensive Specialized Hospital Medical College is associated with various environmental, genetic, and socioeconomic factors. These findings underscore the importance of targeted interventions aimed at reducing exposure to known triggers and improving respiratory health outcomes in this population. Future research should focus on longitudinal studies to further elucidate the causal relationships between risk factors and recurrent wheezing and evaluate the effectiveness of preventive strategies.

Keywords: wheezing, inflammation, respiratory, crucial

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Authors: Bengan Simbarashe Manwere

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The entire African continent, comprising 55 countries, holds a 2% share of the global carbon market. The World Bank attributes the continent’s insignificant share and participation in the carbon market to the limited access to electricity. Approximately 800 million people spread across 47 African countries generate as much power as Spain, with a population of 45million. Only South Africa and North Africa have carbon-reduction investment opportunities on the continent and dominate the 2% market share of the global carbon market. On the back of the 2015 Paris Agreement, South Africa signed into law the Carbon Tax Act 15 of 2019 and the Customs and Excise Amendment Act 13 of 2019 (Gazette No. 4280) on 1 June 2019. By these laws, South Africa was ushered into the league of active global carbon market players. By increasing the cost of production by the rate of R120/tCO2e, the tax intentionally compels the internalization of pollution as a cost of production and, relatedly, stimulate investment in clean technologies. The first phase covered the 1 June 2019 – 31 December 2022 period during which the tax was meant to escalate at CPI + 2% for Scope 1 emitters. However, in the second phase, which stretches from 2023 to 2030, the tax will escalate at the inflation rate only as measured by the consumer price index (CPI). The Carbon Tax Act provides for carbon allowances as mitigation strategies to limit agents’ carbon tax liability by up to 95% for fugitive and process emissions. Although the June 2019 Carbon Tax Act explicitly makes provision for a carbon trading scheme (CTS), the carbon trading regulations thereof were only finalised in December 2020. This points to a delay in the establishment of a carbon trading scheme (CTS). Relatedly, emitters in South Africa are not able to benefit from the 95% reduction in effective carbon tax rate from R120/tCO2e to R6/tCO2e as the Johannesburg Stock Exchange (JSE) has not yet finalized the establishment of the market for trading carbon credits. Whereas most carbon trading schemes have been designed and constructed from the beginning as new tailor-made systems in countries the likes of France, Australia, Romania which treat carbon as a financial product, South Africa intends, on the contrary, to leverage existing trading infrastructure of the Johannesburg Stock Exchange (JSE) and the Clearing and Settlement platforms of Strate, among others, in the interest of the Paris Agreement timelines. Therefore the carbon trading scheme will not be constructed from scratch. At the same time, carbon will be treated as a commodity in order to align with the existing institutional and infrastructural capacity. This explains why the Carbon Tax Act is silent about the involvement of the Financial Sector Conduct Authority (FSCA).For South Africa, there is need to establish they equilibrium stability of the CTS. This is important as South Africa is an innovator in carbon trading and the successful trading of carbon credits on the JSE will lead to imitation by early adopters first, followed by the middle majority thereafter.

Keywords: carbon trading scheme (CTS), Johannesburg stock exchange (JSE), carbon tax act 15 of 2019, South Africa

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