Search results for: Greek public hospital sector

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo N. Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: While delays to care exist in resource rich settings, greater delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of traumatic brain injury (TBI) in Sub Saharan Africa (SSA). While many LMICs have government subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold. First, due to a lack of a functional CT scanner at the tertiary hospital, patients need to arrange their own transportation to the nearby private facility for CT scans. Second, self-financing for the private CT scans ranges from $80 - $130, which is near the average monthly income in Kampala. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified ‘three delays’ framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Morolake Josephine Adeagbo

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South Africa is one of those countries that openly rejected racism, and this is entrenched in its Bill of Rights. Despite the acceptance and incorporation of racial integration into the South Africa Constitution, the implementation within some sectors, most especially the educational sector, seems difficult. Recent occurrences of racism in some higher institutions of learning in South Africa are indications that racial integration / racial transformation is still farfetched in the country’s higher educational sector. It is against this background that this study was conducted to understand how gender and residential background influence racial integration in a South African university which was predominantly a white Afrikaner institution. Using a quantitative method to test the attitude of different categories of undergraduate students at the university, this study found that the factors- residential background and gender- used in measuring student’s attitude do not necessarily have a significant relationship towards racial integration. However, this study concludes with a call for more research with a range of other factors in order to better understand how racial integration can be promoted in South African institutions of higher learning.

Keywords: racial integration, gender, residential background, transformation

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Authors: Sujen Man Shrestha, Kanchan Thapa, Tista Prasai Joshi

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Background: The present study was carried out to determine suspended particles and respirable particles of diameter less than 1 micrometers (PM1) on road side and some distance of outside from road; and to compare the respiratory symptoms between traffic police men and shop keepers directly 'exposed' to traffic fumes and office worker stay in 'protected' enclosed environment. Methods: Semi structured questionnaire was used to collect the data among case and control after getting verbal informed consent among the convenience sample of traffic police, shopkeepers and officials in three different locations in Kathmandu. Secondary data analysis of hospital data of three hospitals of Kathmandu was also performed. The data on air Particulate Matter was taken by Haz Dust. Results: The result showed air quality of road side traffic is unhealthy and there was increasing trends of respiratory illness in hospital outpatient department (OPD). The people who were exposed found to have more risk of developing respiratory diseases symptoms. Conclusions: The study concluded that air pollution level is strong contributing factor for respiratory diseases and further recommended strong, epidemiological studies with larger sample size, less bias, and also measuring other significant physical and chemicals parameters of air pollution.

Keywords: heavy traffic cities, Kathmandu, particulate pollution, respiratory symptoms

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Authors: Ojo Johnson Adelakun

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This study explores the long-term relationships between manufacturing output (MO) and several economic determinants, interest rate (IR), inflation rate (INF), exchange rate (EX), credit to the private sector (CPSM), gross claims on the government sector (GCGS), using monthly data from March 1966 to December 2023. Employing advanced econometric techniques including Fully Modified Ordinary Least Squares (FMOLS), Dynamic Ordinary Least Squares (DOLS), and Canonical Cointegrating Regression (CCR), the analysis provides several key insights. The findings reveal a positive association between interest rates and manufacturing output, which diverges from traditional economic theory that predicts a negative correlation due to increased borrowing costs. This outcome is attributed to the financial resilience of large enterprises, allowing them to sustain investment in production despite higher interest rates. In addition, inflation demonstrates a positive relationship with manufacturing output, suggesting that stable inflation within target ranges creates a favourable environment for investment in productivity-enhancing technologies. Conversely, the exchange rate shows a negative relationship with manufacturing output, reflecting the adverse effects of currency depreciation on the cost of imported raw materials. The negative impact of CPSM underscores the importance of directing credit efficiently towards productive sectors rather than speculative ventures. Moreover, increased government borrowing appears to crowd out private sector credit, negatively affecting manufacturing output. Overall, the study highlights the need for a coordinated policy approach integrating monetary, fiscal, and financial sector strategies. Policymakers should account for the differential impacts of interest rates, inflation, exchange rates, and credit allocation on various sectors. Ensuring stable inflation, efficient credit distribution, and mitigating exchange rate volatility are critical for supporting manufacturing output and promoting sustainable economic growth. This research provides valuable insights into the economic dynamics influencing manufacturing output and offers policy recommendations tailored to South Africa’s economic context.

Keywords: domestic credit, government claims, financial variables, manufacturing output, financial analysis

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Authors: Kuo-Wei Hsu, Shu-Fang Huang

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Global trend in creative economies promoted the modernization process of the development of cultural and creative industries and technology coincided with the craft industry towards value-added industrial restructuring. Due to government support and economic motivation in the private sector, regional craft products have emerged across counties and cities all over Taiwan which have led to an increased focus on craft culture promotion. However, most craft industry corporations in Taiwan are micro-enterprise, restricted operating profitability. This phenomenon shows the weakness of craft industry constitution when facing the rapid expansion of global economic commerce and manufacturing. In recent years, combining public and private enterprise, Platform business models revolutionary changed in craft industries’ original operation and transaction models. Therefore, this study attempts to explore the effects by implementing platform strategy on bamboo industry development in Nantou, the hometown of crafts in Taiwan, with an experimental investigation. This study concluded that platform strategy increases essence and insubstantial value for the bamboo industry in Taiwan. This study explored the economic value added of Taiwan bamboo village with three perspectives: Community participation, Culture Conservation, Regional Rejuvenation.

Keywords: platform strategy, craft industry, economic value-added

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Authors: Ayodele James Akinola

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This study investigated the use of English in doctor-patient interaction in a university teaching hospital from a southwestern state in Nigeria with the aim of identifying the role of communication in an L2, patterns of communication, discourse strategies, pragmatic acts, and contexts that shape the interaction. Jacob Mey’s Pragmatic Acts notion complemented with Emanuel and Emanuel’s model of doctor-patient relationship provided the theoretical standpoint. Data comprising 7 audio-recorded doctors-patient interactions were collected from a University Hospital in Oyo state, Nigeria. Interactions involving the use of English language were purposefully selected. These were supplemented with patients’ case notes and interviews conducted with doctors. Transcription was patterned alongside modified Arminen’s notations of conversation analysis. In the study, interaction in English between doctor and patients has the preponderance of direct-translation, code-mixing and switching, Nigerianism and use of cultural worldviews to express medical experience. Irrespective of these, three patterns communication, namely the paternalistic, interpretive, and deliberative were identified. These were exhibited through varying discourse strategies. The paternalistic model reflected slightly casual conversational conventions and registers. These were achieved through the pragmemic activities of situated speech acts, psychological and physical acts, via patients’ quarrel-induced acts, controlled and managed through doctors’ shared situation knowledge. All these produced empathising, pacifying, promising and instructing practs. The patients’ practs were explaining, provoking, associating and greeting in the paternalistic model. The informative model reveals the use of adjacency pairs, formal turn-taking, precise detailing, institutional talks and dialogic strategies. Through the activities of the speech, prosody and physical acts, the practs of declaring, alerting and informing were utilised by doctors, while the patients exploited adapting, requesting and selecting practs. The negotiating conversational strategy of the deliberative model featured in the speech, prosody and physical acts. In this model, practs of suggesting, teaching, persuading and convincing were utilised by the doctors. The patients deployed the practs of questioning, demanding, considering and deciding. The contextual variables revealed that other patterns (such as phatic and informative) are also used and they coalesced in the hospital within the situational and psychological contexts. However, the paternalistic model was predominantly employed by doctors with over six years in practice, while the interpretive, informative and deliberative models were found among registrar and others below six years of medical practice. Doctors’ experience, patients’ peculiarities and shared cultural knowledge influenced doctor-patient communication in the study.

Keywords: pragmatics, communication pattern, doctor-patient interaction, Nigerian hospital situation

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Authors: Muhammad Naveed, Yang Caixia

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The need for national space legislation is pivotal, particularly in light of the fact that in recent years space activities have grown immensely both in volume and diversity. Countries are progressively developing capabilities in space exploration and scientific discoveries, market their capabilities to manufacture satellites, provide launch services from their facilities and are looking to privatize and commercialize their space resources. Today, nations are also seeking to comprehend the technological and financial potential of the private sector and are considering to share their financial burdens with them and to limit their exposures to risks, but they are lagging behind in legal framework in this regard. In the perspective of these emerging developments, it is therefore, felt that national space legislation should be enacted with the goal of building and implementing a vibrant and transparent legal framework at the national level to hasten investments and to ensure growth in this capital intensive - highly yield strategic sector. This study looks at (I) the international legal framework that governs space activities; (II) motivation behind making national space laws; and (III) the need for national space legislation. The paper concludes with some recommendations with regards to the conceivable future direction for national space legislation, in particular space empowered sub-areas for countries.

Keywords: international conventions, national legislation, space faring nations, space law

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Authors: Ricky Leung

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Artificial intelligence (AI) and machine learning (ML) have revolutionized the way health organizations approach social media. The sheer volume of data generated through social media can be overwhelming, but AI and ML can help organizations effectively manage this information to improve the health and well-being of individuals and communities. One way AI can be used to enhance social media in health organizations is through sentiment analysis. This involves analyzing the emotions expressed in social media posts to better understand public opinion and respond accordingly. This can help organizations gauge the impact of their campaigns, track the spread of misinformation, and improve communication with the public. While social media is a useful tool, researchers and practitioners have expressed fear that it will be used for the spread of misinformation, which can have serious consequences for public health. Health organizations must work to ensure that AI systems are transparent, trustworthy, and unbiased so they can help minimize the spread of misinformation. In conclusion, AI and ML have the potential to greatly enhance the use of social media in health organizations. These technologies can help organizations effectively manage large amounts of data and understand stakeholders' sentiments. However, it is important to carefully consider the potential consequences and ensure that these systems are carefully designed to minimize the spread of misinformation.

Keywords: AI, ML, social media, health organizations

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Authors: Teju N. Adisa-Farrar

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In European cities, social, political and cultural geographies of blackness exist. Organizations create spaces to discuss, express, and expose the realities of young people of African descent creating an Afropean lifestyle with transnational affiliations. Focusing on black and brown spaces produced by and for the young people of African descent in Vienna and Brussels, it became clear a multidisciplinary approach would be necessary. Using Cultural Studies frameworks along with Communications Theories on Black Public Spheres and Social-Geography, a basis was created for exploring the creative, political, and economic responses of young people who are apart of the historically (and contemporary) oppressed and excluded groups of the African Diaspora. Through this intrinsic study, it became apparent that spaces created and reclaimed by young people of the African Diaspora were more inclusive and democratic than other spaces. The organizations studied have used city life as the platform to express their struggles and celebrations of their multicultural identity; clearly using historical, global black and Pan-African movements as the basis for local adaptation of an African Diaspora identity.

Keywords: African diaspora, black public sphere, identity, spaces, geographies

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Authors: Mohd Dahlan Abdul Malek, Muhamad Idris, Adi Fahrudin, Ida Shafinaz Mohamed Kamil, Husmiati Yusuf, Edeymend Reny Japil, Wan Anor Wan Sulaiman, Lailawati Madlan, Alfred Chan, Nurfarhana Adillah Aftar, Mahirah Masdin

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This research intended to develop a valid and reliable instrument of the Satisfaction with Life Scale (SWLS) to measure satisfaction with life (SWL) constructs among public and private university students in Sabah, Malaysia, through the exploratory factor analysis (EFA) procedure. The pilot study obtained a sample of 108 students from public and private education institutions in Sabah, Malaysia, through an online survey using a self-administered questionnaire. The researchers performed the EFA procedure on SWL construct using IBM SPSS 25. The Bartletts' Test of Sphericity is highly significant (Sig. = .000). Furthermore, the sampling adequacy by Kaiser-Meyer-Olkin (KMO = 0.839) is excellent. Using the extraction method of Principal Component Analysis (PCA) with Varimax Rotation, a component of the SWL construct is extracted with an eigenvalue of 3.101. The variance explained for this component is 62.030%. The construct of SWL has Cronbach's alpha value of .817. The development scale and validation confirmed that the instrument is consistent and stable with both private and public college and university student samples. It adds a remarkable contribution to the measurement of SWLS, mainly in the context of higher education institution students. The EFA outcomes formed a configuration that extracts a component of SWL, which can be measured by the original five items established in this research. This research reveals that the SWL construct is applicable to this study.

Keywords: satisfaction, university students, measurement, scale development

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Authors: Philipp Sommer, Amgad Agoub

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The construction sector significantly impacts global CO₂ emissions, particularly through the energy usage of residential buildings. To address this, various governments, including Germany's, are focusing on reducing emissions via sustainable refurbishment initiatives. This study examines the application of machine learning (ML) to estimate energy demands dynamically in residential buildings and enhance the potential for large-scale sustainable refurbishment. A major challenge in Germany is the lack of extensive publicly labeled datasets for energy performance, as energy performance certificates, which provide critical data on building-specific energy requirements and consumption, are not available for all buildings or require on-site inspections. Conversely, England and other countries in the European Union (EU) have rich public datasets, providing a viable alternative for analysis. This research adapts insights from these English datasets to the German context by developing a comprehensive data schema and calibration dataset capable of predicting building energy demand effectively. The study proposes a minimal feature set, determined through feature importance analysis, to optimize the ML model. Findings indicate that ML significantly improves the scalability and accuracy of energy demand forecasts, supporting more effective emissions reduction strategies in the construction industry. Integrating energy performance certificates into municipal heat planning in Germany highlights the transformative impact of data-driven approaches on environmental sustainability. The goal is to identify and utilize key features from open data sources that significantly influence energy demand, creating an efficient forecasting model. Using Extreme Gradient Boosting (XGB) and data from energy performance certificates, effective features such as building type, year of construction, living space, insulation level, and building materials were incorporated. These were supplemented by data derived from descriptions of roofs, walls, windows, and floors, integrated into three datasets. The emphasis was on features accessible via remote sensing, which, along with other correlated characteristics, greatly improved the model's accuracy. The model was further validated using SHapley Additive exPlanations (SHAP) values and aggregated feature importance, which quantified the effects of individual features on the predictions. The refined model using remote sensing data showed a coefficient of determination (R²) of 0.64 and a mean absolute error (MAE) of 4.12, indicating predictions based on efficiency class 1-100 (G-A) may deviate by 4.12 points. This R² increased to 0.84 with the inclusion of more samples, with wall type emerging as the most predictive feature. After optimizing and incorporating related features like estimated primary energy consumption, the R² score for the training and test set reached 0.94, demonstrating good generalization. The study concludes that ML models significantly improve prediction accuracy over traditional methods, illustrating the potential of ML in enhancing energy efficiency analysis and planning. This supports better decision-making for energy optimization and highlights the benefits of developing and refining data schemas using open data to bolster sustainability in the building sector. The study underscores the importance of supporting open data initiatives to collect similar features and support the creation of comparable models in Germany, enhancing the outlook for environmental sustainability.

Keywords: machine learning, remote sensing, residential building, energy performance certificates, data-driven, heat planning

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: disposal, healthcare waste, management, Montserrado County, Monrovia

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Authors: B. E. Weber, N. Vrielink, M. G. Rietbergen

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This paper explores the long-term effects of the Energy Box trajectory on households in the private rental sector, specifically households experiencing energy poverty. The concept of energy poverty has been getting increasing attention among policymakers over the past few years. In the Netherlands, as far as we know, there are no national policies on alleviating energy poverty, which negatively impacts energy-poor households. The Energy Box can help households experiencing energy poverty by stimulating them to improve the energy efficiency of their home by changing their energy-saving behavior. Important long-term effects are that respondents indicate that they live in a more environmentally friendly way and that they save money on their energy bills. Households feel engaged with the concept of energy-saving and can see the benefits of changing their energy-saving behavior. Respondents perceived the Energy Box as a means to live more environmentally friendly, instead of it solely being a means to save money on energy bills. The findings show that most respondents signed up for the Energy Box are interested in energy-saving as a lifestyle choice instead of a financial choice, which would likely be the case for households experiencing energy poverty.

Keywords: energy-saving behavior, energy poverty, poverty, private rental sector

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Authors: S. P. Akinbogun, P. Oloruntoyin

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One of the millennium development goals is the reduction of illiteracy. The state of user friendliness of the educational buildings is expected to play a significant role in the quest, particularly among the physically challenged. This study considers the state of access of educational buildings to disabled on wheel chair and crutches. It draws context from one of the federal universities in Nigeria. The study is basically qualitative; data were collected through structured interview and observation to assess compliance with the prescribed accessibility standard of academic buildings in the Federal University of Technology Akure. The study found that narrow entrances and routes of buildings, raised steps at entrances of the buildings, and ramps were absent. This implies exclusion as it renders most of the buildings inaccessible to wheelchair users. Perhaps, it accounts for low enrolment of wheelchair users in the institution despite many of them in the city. The implication is a challenge in the achievement of the millennium development goal concerning the reduction in the level of illiteracy in the country. The study suggests that government should strictly ensure that public buildings should satisfy or retrofitted to meet disabled access before development approval. This should be followed with the issuance of certificate of compliance upon completion.

Keywords: public building, accessibility, physically challenged, education

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Authors: Madhukar Kasarla, Sumit Fogla, Kiran Panuganti, Gaurav Jain, Abhijit Ramanujam, Astha Jain, Shashank Kraleti, Sharat Musham, Arun Chaudhury

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Patients have often chosen to travel for care — making pilgrimages to academic meccas and state-of-the-art hospitals for sophisticated surgery. This culture is still persistent in the landscape of US healthcare, with hundred thousand of visitors coming to the shores of United States to seek the high quality of medical care. One of the major challenges in this form of medical tourism has been the language barrier. Thus, an Iraqi patient, with immediate needs of communicating the healthcare needs to the treating team in the hospital, may face huge barrier in effective patient-doctor communication, delaying care and even at times reducing the quality. To circumvent these challenges, we are proposing the use of a state-of-the-art tool, Talk2All, which can translate nearly one hundred international languages (and even sign language) in real time. The tool is an easy to download app and highly user friendly. It builds on machine learning principles to decode different languages in real time. We suggest that the use of Talk2All will tremendously enhance communication in the hospital setting, effectively breaking the language barrier. We propose that vigorous incorporation of Talk2All shall overcome practical challenges in international medical and surgical tourism.

Keywords: language translation, communication, machine learning, medical tourism

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Authors: Felipa de Mello-Sampayo

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The aim of this study is to undertake, from patient’s perspective, the timing and probability of using teledermatology, comparing it with a conventional referral system. The dynamic stochastic model’s main value-added consists of the concrete application to patients waiting for dermatology surgical intervention. Patients with low health level uncertainty must use teledermatology treatment as soon as possible, which is precisely when the teledermatology is least valuable. The results of the model were then tested empirically with the teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, links the primary care centers of 24 health districts with the hospital’s dermatology department via the corporate intranet of the Portuguese healthcare system. Health level volatility can be understood as the hazard of developing skin cancer and the trend of health level as the bias of developing skin lesions. The results of the survival analysis suggest that the theoretical model can explain the use of teledermatology. It depends negatively on the volatility of patients' health, and positively on the trend of health, i.e., the lower the risk of developing skin cancer and the younger the patients, the more presurgical teledermatology one expects to occur. Presurgical teledermatology also depends positively on out-of-pocket expenses and negatively on the opportunity costs of teledermatology, i.e., the lower the benefit missed by using teledermatology, the more presurgical teledermatology one expects to occur.

Keywords: teledermatology, wait time, uncertainty, opportunity cost, survival analysis

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Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

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This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

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Authors: Mohammed Messaoudi

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The higher education sector in Algeria has witnessed in recent years a remarkable transformation, as it witnessed the integration of institutions within the modern technological environment and harnessing all appropriate mechanisms to raise the level of education and the level of training. Observers and those interested that it is necessary for the Algerian university to enter this field, especially with the efforts that seek to employ modern technology in the sector and encourage investment in this field, in addition to the state’s keenness to move towards building a path to benefit from modern technology, and to encourage energies in light of a reality that carries many Aspirations and challenges by achieving openness to the new digital environment and keeping pace with the ranks of international universities. Higher education is one of the engines of development for societies, as it is a vital field for the transfer of knowledge and scientific expertise, and the university is at the top of the comprehensive educational system for various disciplines in light of the achievement of a multi-dimensional educational system, and amid the integration of three basic axes that establish the sound educational process (teaching, research, relevant outputs efficiency), and according to a clear strategy that monitors the advancement of academic work, and works on developing its future directions to achieve development in this field. The Algerian University is considered one of the service institutions that seeks to find the optimal mechanisms to keep pace with the changes of the times, as it has become necessary for the university to enter the technological space and thus ensure the quality of education in it and achieve the required empowerment by dedicating a structure that matches the requirements of the challenges on which the sector is based, amid unremitting efforts to develop the capabilities. He sought to harness the mechanisms of communication and information technology and achieve transformation at the level of the higher education sector with what is called higher education technology. The conceptual framework of information and communication technology at the level of higher education institutions in Algeria is determined through the factors of organization, factors of higher education institutions, characteristics of the professor, characteristics of students, the outcomes of the educational process, and there is a relentless pursuit to achieve a positive interaction between these axes as they are basic components on which the success and achievement of higher education are based for his goals.

Keywords: Information and communication technology, Algerian university, scientific and cognitive development, challenges

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Authors: Andri Andri, Susanthy Djajalaksana, Iin Noor Chozin

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Background: Despite advances in asthma therapies, a proportion of patients with asthma continue to have difficulty in gaining adequate asthma control. Complex immunological mechanisms and oxidative stress affect this condition, including the role of malondialdehyde (MDA) as a marker of inflammation. This research aimed to determine the effect of polyphytopharmaca administration on the value of asthma control test (ACT), blood eosinophils level and markers of MDA serum inflammation in patients with asthma. Method: Quasi experimental approach was conducted toward 15 stable asthma patients who were not fully controlled in outpatient pulmonary clinic, Public Hospital of Dr. Saiful Anwar Malang. Assessments of ACT values, eosinophil levels, and serum MDA levels were carried out before and after administration of polyphytopharmaca which contained a combination of 100 mg Nigella sativa extract, Kleinhovia hospita 100 mg, Curcuma xanthorrhiza 75 mg, and Ophiocephalus striatus 100 mg, three times daily with two capsules for 12 weeks. The ACT value was determined by the researcher by asking the patient directly, blood eosinophil levels were calculated by analyzing blood type counts, and serum MDA levels were detected by the qPCR method. Result: There was a significant enhancement of ACT value (18.07 ± 2.57 to 22.06 ± 1.83, p = 0.001) (from 60% uncontrolled ACT to 93.3% controlled ACT), a significant decrease in blood eosinophils levels (653.15 ± 276.15 pg/mL to 460.66 ± 202.04 pg/mL, p = 0.038), and decreased serum MDA levels (109.64 ± 53.77 ng / ml to 78.68 ± 64.92 ng/ml, p = 0.156). Conclusion: Administration of polyphytopharmaca can increase ACT value, decrease blood eosinophils levels and reduce MDA serum in stable asthma patients who are not fully controlled.

Keywords: asthma control test, eosinophils levels, malondialdehyde, polyphytopharmaca

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Authors: Arvind Dhingra, Tejinder Singh Saggu

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As the energy demands rise and the pollution levels grow, it becomes imperative for us to save energy in all the fields in which it is used. The industrial sector is the major commercial energy consuming sector in India, where electrical energy is the most common and widely used type of energy. As the demand and price of energy are increasing day by day, therefore, the subject of energy conservation is a concern for most energy users particularly industry. Judicious use of energy becomes imperative for third world developing country being presence of energy crisis. This paper provides some measure for energy saving that can be commonly recommended for a rolling unit of steel industry. A case of hot rolling unit in JSL Stainless Ltd., Hisar for energy conservation is given. Overall improvement in energy consumption in light of the stated recommendation is illustrated along with the proposed utilization of the techniques and their applications. Energy conservation in conventional motor with replacement or use of star delta star converter, reduction in cable losses, replacement of filament of LED lamps, replacement of conventional transformer with cast resin dry type transformer and provision of energy management system for energy conservation and per unit production cost reduction are elaborated in this paper.

Keywords: energy audit, energy conservation, energy efficient motors

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Authors: A. Olusegun Egunjobi, Samson Sunday Adekunte

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This study investigated the teachers’ and learners’ ICT-readiness assessment for agricultural science instruction in secondary schools in Ogun State, Nigeria. However, the sample population of 6 and 120 agricultural science teachers and learners were randomly selected respectively from 3 public and 3 private senior secondary schools in Ado-Odo/Ota Local Government Area of Ogun State, Nigeria. Descriptive survey design of ex post-facto type was adopted for the study. Two structured questionnaires tagged Teachers’ and Learners’ Questionnaires on ICT-Readiness for Agricultural Science Instruction TQICTRASI and LQICTRASI respectively were used for data collection. The two questionnaires were subjected to Cronbach alpha coefficient with the results 0.86 and 0.82 respectively. Five research hypotheses were tested at 0.05 level of significance. Findings revealed that teachers in private senior secondary school (SSS) were more ready and prepared than their counterparts in public SSS with the result t-value = 4.25 greater than t-critical = 2.77, df = 4 at p<0.05. Also, learners in private SSS were more prepared and ready for the utilisation of ICT-facilities for agricultural science instruction with the result t-value = 3.51 greater than t-critical = 1.98, df = 118 at p<0.05. However, male and female learners in both private and public SSS were equally prepared and ready for the ICT-facilities utilisation for agricultural science instruction, thus, there were no significant differences in their ICT-readiness. Therefore, the study proffered that, both male and female teachers and learners should be more ICT-compliant and always ready to upgrade their skills and knowledge in ICT-facilities, utilisation for agricultural science instruction and even for other school subjects particularly in Ogun State and in generally in Nigeria.

Keywords: ICT-readiness, teachers’ and learners’ assessment, private and public senior secondary schools, agricultural science instruction

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Authors: Anu Paul, Varghese Paul

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The focal aspire of e-Government (eGovt) is to offer citizen-centered service delivery. Accordingly, the citizenry consumes services from multiple government agencies through national portal. Thus, eGovt is an enterprise with the primary business motive of transparent, efficient and effective public services to its citizenry and its logical structure is the eGovernment Enterprise Architecture (eGEA). Since eGovt is IT oriented multifaceted service-centric system, EA doesn’t do much on an automated enterprise other than the business artifacts. Service-Oriented Architecture (SOA) manifestation led some governments to pertain this in their eGovts, but it limits the source of business artifacts. The concurrent use of EA and SOA in eGovt executes interoperability and integration and leads to Service-Oriented e-Government Enterprise (SOeGE). Consequently, agile eGovt system becomes a reality. As an IT perspective eGovt comprises of centralized public service artifacts with the existing application logics belong to various departments at central, state and local level. The eGovt is renovating to SOeGE by apply the Service-Orientation (SO) principles in the entire system. This paper explores IT perspective of SOeGE in India which encompasses the public service models and illustrated with a case study the Passport service of India.

Keywords: enterprise architecture, service-oriented e-Government enterprise, service interface layer, service model

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Authors: Chee Kwan Foong, Foong Mei Kei

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This study aimed to investigate the influence of self-stigma, perceived public stigma, assertiveness and gender role beliefs on attitudes toward seeking professional psychological help. Two hundred and fifty young adults from universities in Brunei were recruited through convenience sampling to complete a survey. Individuals facing higher stigmatisation (both self-stigma and public-stigma) had less positive attitude towards seeking professional psychological help. Individuals who were more assertive had more positive attitude towards seeking professional psychological help. For males, individuals with more traditional gender role belief showed less positive attitude towards seeking professional psychological help. For female, there was no relationship between gender role beliefs and attitude towards seeking professional psychological help. Results confirmed there was a significant mediating effect between public stigma and attitude toward seeking professional psychological help. This study could guide the mental-health professionals in promoting more positive help-seeking attitude and raise the awareness about mental challenges which could assist in reducing stigmatization, and therefore, gain a deeper understanding.

Keywords: assertiveness, attitude towards seeking professional psychological help, gender role beliefs, stigmatization

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Authors: Mirko Klaric

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In different countries, sub-municipal units have different organizational and political positions. In some countries, the role of sub-municipal units is important; in others, it is marginal. That depends on the organization of the local government system in different countries, and the political role of local self-government units, their size, public authorities, and the possibility for managing various local public tasks. This paper attempts to analyze the sub-municipal government as an organizational form of local governance participation of citizens in the local community with a comparative perspective. Secondly, it presents elements that generally format sub-municipal government as a tool for strengthening of democratization processes in local government units. Those elements are crucial for the understanding of the dynamic in relation to local government vs. sub-municipal government. Special focus is put on the sub-municipal government in South-Eastern European countries, which have a common history and institutional framework, with this main question: how can sub-municipal government contribute to strengthening democratic processes in these countries. In centralized countries, the sub-municipal government usually has a reduced role, which relates to managing public tasks connected with local community needs. The purpose of this comparative research methodology is used for analyzing the present organization and role of sub-municipal government in local government systems in Croatia and other significant countries in Europe, with a special focus on the states in South-Eastern Europe and Croatia. Comparative analyses attempt to show that local government systems with bigger local government units have more significant sub-municipal government. On the other hand, local government systems with small local government units don’t have a strong sub-municipal government. Finally, this paper aims to present ideas on how the sub-municipal government can improve decentralization and contribute to better development of the local community and the whole of society.

Keywords: public administration, local government, sub-municipal government, decentralization

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Authors: Erin Lawlor

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In 2008 Time magazine named terrorist rehabilitation as one of the best ideas of the year. The term deradicalisation has become synonymous with rehabilitation within security discourse. The allure for a “quick fix” when managing terrorist populations (particularly within prisons) has led to a focus on prescriptive programmes where there is a distinct lack of exploration into the drivers for a person to disengage or deradicalise from violence. It has been argued that to tackle a snowballing issue that interventions have moved too quickly for both theory development and methodological structure. This overly quick acceptance of a term that lacks rigorous testing, measuring, and monitoring means that there is distinct lack of evidence base for deradicalisation being a genuine process/phenomenon, leading to academics retrospectively attempting to design frameworks and interventions around a concept that is not truly understood. The UK Home Office has openly acknowledged the lack of empirical data on this subject. This lack of evidence has a direct impact on policy and intervention development. Extremism and deradicalisation are issues that affect public health outcomes on a global scale, to the point that terrorism has now been added to the list of causes of trauma, both in the direct form of being victim of an attack but also the indirect context of witnesses, children and ordinary citizens who live in daily fear. This study critiques current deradicalisation discourses to establish whether public health approaches offer opportunities for development. The research begins by exploring the theoretical constructs of both what deradicalisation, and public health issues are. Questioning: What does deradicalisation involve? Is there an evidential base on which deradicalisation theory has established itself? What theory are public health interventions devised from? What does success look like in both fields? From establishing this base, current deradicalisation practices will then be explored through examples of work already being carried out. Critiques can be broken into discussion points of: Language, the difficulties with conducting empirical studies and the issues around outcome measurements that deradicalisation interventions face. This study argues that a public health approach towards deradicalisation offers the opportunity to attempt to bring clarity to the definitions of radicalisation, identify what could be modified through intervention and offer insights into the evaluation of interventions. As opposed to simply focusing on an element of deradicalisation and analysing that in isolation, a public health approach allows for what the literature has pointed out is missing, a comprehensive analysis of current interventions and information on creating efficacy monitoring systems. Interventions, policies, guidance, and practices in both the UK and Australia will be compared and contrasted, due to the joint nature of this research between Sheffield Hallam University and La Trobe, Melbourne.

Keywords: radicalisation, deradicalisation, violent extremism, public health

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Authors: Chaiyaporn Yuksen

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Backgroud: Supraventricular tachycardia (SVT) is an abnormally fast atrial tachycardia characterized by narrow (≤ 120 ms) and constant QRS. Adenosine was the drug of choice; the first dose was 6 mg. It can be repeated with the second and third doses of 12 mg, with greater than 90% success. The study found that patients observed at 4 hours after normal sinus rhythm was no recurrence within 24 hours. The objective of this study was to investigate the factors that influence the recurrence of SVT after adenosine in the emergency department (ED). Method: The study was conducted retrospectively exploratory model, prognostic study at the Emergency Department (ED) in Faculty of Medicine, Ramathibodi Hospital, a university-affiliated super tertiary care hospital in Bangkok, Thailand. The study was conducted for ten years period between 2010 and 2020. The inclusion criteria were age > 15 years, visiting the ED with SVT, and treating with adenosine. Those patients were recorded with the recurrence SVT in ED. The multivariable logistic regression model developed the predictive model and prediction score for recurrence PSVT. Result: 264 patients met the study criteria. Of those, 24 patients (10%) had recurrence PSVT. Five independent factors were predictive of recurrence PSVT. There was age>65 years, heart rate (after adenosine) > 100 per min, structural heart disease, and dose of adenosine. The clinical risk score to predict recurrence PSVT is developed accuracy 74.41%. The score of >6 had the likelihood ratio of recurrence PSVT by 5.71 times Conclusion: The clinical predictive score of > 6 was associated with recurrence PSVT in ED.

Keywords: clinical prediction score, SVT, recurrence, emergency department

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Authors: Vikrum Malhotra, Manpreet Kaur, Ayesha Ghotto

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Background: Cardiac registries such as ACC Percutaneous Coronary Intervention Registry require high quality data to be abstracted, including data elements such as nuclear cardiology, diagnostic coronary angiography, and PCI. Introduction: The audit tool created is used by data abstractors to provide data audits and assess the accuracy and inter-rater reliability of abstraction performed by the abstractors for a health system. This audit tool solution has been developed across 13 registries, including ACC/NCDR registries, PCI, STS, Get with the Guidelines. Methodology: The data audit tool was used to audit internal registry abstraction for all data elements, including stress test performed, type of stress test, data of stress test, results of stress test, risk/extent of ischemia, diagnostic catheterization detail, and PCI data elements for ACC/NCDR PCI registries. This is being used across 20 hospital systems internally and providing abstraction and audit services for them. Results: The data audit tool had inter-rater reliability and accuracy greater than 95% data accuracy and IRR score for the PCI registry in 50 PCI registry cases in 2021. Conclusion: The tool is being used internally for surgical societies and across hospital systems. The audit tool enables the abstractor to be assessed by an external abstractor and includes all of the data dictionary fields for each registry.

Keywords: abstraction, cardiac registry, cardiovascular registry, registry, data

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Authors: Emilia K. H. Danielsson-Waters, Malaz Elsaddig, Kevin Jones

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Unfortunately, it is well known that neonatal deaths are a common and potentially preventable occurrence across the world. Neonatal resuscitation is a simple and inexpensive intervention that can effectively reduce this rate, and can be taught and implemented globally. This project is a follow-on from one in 2012, which found that neonatal resuscitation simulation was valuable for education, but would be better improved by being delivered by local staff. Methods: This study involved auditing the neonatal admission and death records within a rural Ugandan hospital, alongside implementing a Train-The-Trainer teaching scheme to teach Neonatal Resuscitation. One local doctor was trained for simulating neonatal resuscitation, whom subsequently taught an additional 14 staff members in one-afternoon session. Participants were asked to complete questionnaires to assess their knowledge and confidence pre- and post-simulation, and a survey to identify barriers and drivers to simulation. Results: The results found that the neonatal mortality rate in this hospital was 25% between July 2016- July 2017, with birth asphyxia, prematurity and sepsis being the most common causes. Barriers to simulation that were identified predominantly included a lack of time, facilities and opportunity, yet all members stated simulation was beneficial for improving skills and confidence. The simulation session received incredibly positive qualitative feedback, and also a 0.58-point increase in knowledge (p=0.197) and 0.73-point increase in confidence (0.079). Conclusion: This research shows that it is possible to create a teaching scheme in a rural hospital, however, many barriers are in place for its sustainability, and a larger sample size with a more sensitive scale is required to achieve statistical significance. This is undeniably important, because teaching neonatal resuscitation can have a direct impact on neonatal mortality. Subsequently, recommendations include that efforts should be put in place to create a sustainable training scheme, for example, by employing a resuscitation officer. Moreover, neonatal resuscitation teaching should be conducted more frequently in hospitals, and conducted in a wider geographical context, including within the community, in order to achieve its full effect.

Keywords: neonatal resuscitation, sustainable medical education, train-the-trainer, Uganda

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Authors: Felippe Clemente, Evaldo Henrique da Silva

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The need to adopt some type of industrial policy and innovation in Brazil is a recurring theme in the discussion of public interventions aimed at boosting economic growth. For many years, the country has adopted various policies to change its productive structure in order to increase the participation of sectors that would have the greatest potential to generate innovation and economic growth. Only in the 2000s, tax incentives as a policy to support industrial and technological innovation are being adopted in Brazil as a phenomenon associated with rates of productivity growth and economic development. In this context, in late 2004 and 2005, Brazil reformulated its institutional apparatus for innovation in order to approach the OECD conventions and the Frascati Manual. The Innovation Law (2004) and the 'Lei do Bem' (2005) reduced some institutional barriers to innovation, provided incentives for university-business cooperation, and modified access to tax incentives for innovation. Chapter III of the 'Lei do Bem' (no. 11,196/05) is currently the most comprehensive fiscal incentive to stimulate innovation. It complies with the requirements, which stipulates that the Union should encourage innovation in the company or industry by granting tax incentives. With its introduction, the bureaucratic procedure was simplified by not requiring pre-approval of projects or participation in bidding documents. However, preliminary analysis suggests that this instrument has not yet been able to stimulate the sector diversification of these investments in Brazil, since its benefits are mostly captured by sectors that already developed this activity, thus showing problems with moral hazard. It is necessary, then, to analyze the 'Lei do Bem' to know if there is indeed the need for some change, investigating what changes should be implanted in the Brazilian innovation policy. This work, therefore, shows itself as a first effort to analyze a current national problem, evaluating the effectiveness of the 'Lei do Bem' and suggesting public policies that help and direct the State to the elaboration of legislative laws capable of encouraging agents to follow what they describes. As a preliminary result, it is known that 130 firms used fiscal incentives for innovation in 2006, 320 in 2007 and 552 in 2008. Although this number is on the rise, it is still small, if it is considered that there are around 6 thousand firms that perform Research and Development (R&D) activities in Brazil. Moreover, another obstacle to the 'Lei do Bem' is the percentages of tax incentives provided to companies. These percentages reveal a significant sectoral correlation between R&D expenditures of large companies and R&D expenses of companies that accessed the 'Lei do Bem', reaching a correlation of 95.8% in 2008. With these results, it becomes relevant to investigate the law's ability to stimulate private investments in R&D.

Keywords: brazilian innovation system, moral hazard, R&D, Lei do Bem

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