Search results for: healthcare policy instruments

Authors: Kingkan Chumjamras

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There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

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Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

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Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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Authors: Fangfei Li

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This research was conducted to explore how Chinese overseas students, who rarely received teacher feedback during their undergraduate studies in China, engaged in a different feedback provision context in the UK universities. In particular, this research provides some insights into Chinese students’ perspectives on how they made sense of the teacher feedback they obtained and how they took it on board in their assignments. Research questions in this study are 1) What are Chinese overseas students’ perceptions of teacher feedback on courses in UK higher education? 2) How do they respond to the teacher feedback they obtained? 3) What factors might influence their engagement with teacher feedback? Multiple case studies of five Chinese overseas students in a UK university have been carried out to address the research questions. The main data collection instruments are various types of semi-structured interviews, consisting of background interviews, scenario-based activities, stimulated recall sessions and retrospective interviews. Research findings indicate that student engagement with teacher feedback is a complex learning process incorporating several stages: from initial teacher input to ultimate transformational learning. Apart from students interpreting teachers’ comments/suggestions by themselves, students’ understandings of and responses to teacher feedback could also be influenced by pre-submission guidance, peer discussion, use of exemplars and post-submission discussion with teachers. These are key factors influencing students to make use of teacher feedback. Findings also reveal that the level of students’ reflections on tutor feedback influences the quality of their assignments and even their future learning. To sum up, this paper will discuss the current concepts of teacher feedback in existing studies and research findings of this study from which reconceptualization of teacher feedback has occurred.

Keywords: Chinese students, student engagement, teacher feedback, the UK higher education

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Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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Authors: Laraba Bala Mohammed

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Education is a very vital tool in enhancement of the general development of individuals in the society who would participate effectively in national development processes, including people with special need, educating children with special needs is one of the greatest challenges of this millennium, this is because professionals in the field of special education are operating in an exciting and rapidly changing phenomenon. Inclusive education in Nigeria is not a new development in the teaching and learning process, but the most important aspect is the utilization and effective integration of people with special needs in the society. This paper focuses on the need of parents, government, professionals in the field of special education and stakeholders to work together for the full implementation of inclusive education in Nigeria.

Keywords: inclusive education, national policy, education, special needs

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Authors: Miky Lee, K. Kim, D. Lim, D. Cho

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This paper presents the planning, rationale for test specification derivation, sampling requirements, test facilities, and result analysis used to conduct lifetime expectancy endurance tests on power window switches (PWS) considering thermally induced mechanical stress under diurnal cyclic temperatures during normal operation (power cycling). The detail process of analysis and test results on the selected PWS set were discussed in this paper. A statistical approach to ‘life time expectancy’ was given to the measurement standards dealing with PWS lifetime determination through endurance tests. The approach choice, within the framework of the task, was explained. The present task was dedicated to voltage drop measurement to derive lifetime expectancy while others mostly consider contact or surface resistance. The measurements to perform and the main instruments to measure were fully described accordingly. The failure data from tests were analyzed to conclude lifetime expectancy through statistical method using Weibull cumulative distribution function. The first goal of this task is to develop realistic worst case lifetime endurance test specification because existing large number of switch test standards cannot induce degradation mechanism which makes the switches less reliable. 2nd goal is to assess quantitative reliability status of PWS currently manufactured based on test specification newly developed thru this project. The last and most important goal is to satisfy customer’ requirement regarding product reliability.

Keywords: power window switch, endurance test, Weibull function, reliability, degradation mechanism

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Authors: Neil Jordan M. Uy, Fe Pelilia V. Hernandez

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A counselor is always regarded as a professional who embodies the willingness to help others through the process of counseling. He is knowledgeable and skillful of the different theories, tools, and techniques that are useful in aiding the client to cope with their dilemmas. The negative experiences of the clients that are shared during the counseling session can affect the professional counselor. Compassion fatigue, a professional impairment, is characterized by the decline of one’s productivity and the feeling of anxiety and stress brought about as the counselor empathizes, listens, and cares for others. This descriptive type of research aimed to explore variables that are predictors of compassion fatigue utilizing three research instruments; Demographic Profile Sheet, Professional Quality of Life Scale, and Neo-Pi-R. The 52 respondents of this study were counselors from the different Dominican schools in the Philippines. Generally, the counselors have low level of compassion fatigue across personal characteristics (age, gender, years of service, highest educational attainment, and professional status) and personality traits (extraversion, agreeableness, conscientiousness, openness, and neuroticism). ANOVA validated the findings of this that among the personal characteristics and personality traits, extraversion with f-value of 3.944 and p-value of 0.026, and conscientiousness, with f-value of 4.125 and p-value of 0.022 were found to have significant difference in the level of compassion fatigue. A very significant difference was observed with neuroticism with f-value of 6.878 and p-value 0.002. Among the personal characteristics and personal characteristics, only neuroticism was found to predict compassion fatigue. The computed r2 value of 0.204 using multiple regression analysis suggests that 20.4 percent of compassion fatigue can be predicted by neuroticism. The predicting power of neuroticism can be computed from the regression model Y=0.156x+26.464; where x is the number of neuroticism.

Keywords: big five personality traits, compassion fatigue, counselors, professional quality of life scale

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Authors: Olfa Kaabia, Ilyes Abid, Khaled Guesmi

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This pioneer paper studies whether and how Bitcoin shocks are transmitted to the U.S economy. We employ a new methodology: TVP FAVAR model with stochastic volatility. We use a large dataset of 111 major U.S variables from 1959:m1 to 2016:m12. The results show that Bitcoin shocks significantly impact the U.S. economy. This significant impact is pronounced in a volatile and increasing U.S economy. The Bitcoin has a positive relationship on the U.S real activity, and a negative one on U.S prices and interest rates. Effects on the Monetary Policy exist via the inter-est rates and the Money, Credit and Finance transmission channels.

Keywords: bitcoin, US economy, FAVAR models, stochastic volatility

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Authors: Ahmad Abdulkadir Ibrahim

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The Islamic law of transactions laid down the methods and instruments of accounting and analyzed its basic assumptions in the modern world. There is a need to examine the implications of accounting initiatives in the Muslim world and attempt to outline the important characteristics of Islamic accounting and how Islamic accounting resolves the problem of measuring the cost of Murabaha goods in case of exchange rate variation. The research tends to discuss an analytical approach to the Islamic accounting concept as well as elaborating the jurisprudential matter and practical aspects of accounting in Islamic financial transactions. It also aims to alert the practitioners of accounting in the Islamic world to be aware of the concept of accounting in Islamic jurisprudence and its historical development. The methodology adopted in this research is the qualitative method through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that Islamic accounting is unique in its norms as it has been characterized by fairness, accuracy in measuring tools, truthfulness, mutual trust, moderation in making a profit, and tolerance. It was also qualified by capacity and flexibility in terms of the tools and terminology used and invented by Islamic jurisprudence in the accounting system, which indicates its validity and consistency anytime and anywhere. An important conclusion of the research also lies in the refutation of the popular idea that an Italian writer known as Luca Pacilio was the first writer who developed the basis of double-entry due to the presented proofs by Muslim scholars of critical accounting developments, which cannot be ignored. It concludes further that Islamic jurisprudence draws the accounting system codified in the foundations of a market that is far from usury, fraud, cheating, and unfair competition in all areas.

Keywords: accounting, Islamic accounting, Islamic transactions, Islamic jurisprudence, double entry, murabaha, characteristics

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Authors: H. Lee, J. Park

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In this present study, for the first time, we retrieved the Formaldehyde (HCHO) Vertical Column Density (HCHOVCD) using Pandora instruments in Seoul, a megacity in northeast Asia, for the period between 2012 and 2014 and investigated the temporal characteristics of HCHOVCD. HCHO Slant Column Density (HCHOSCD) was obtained using the Differential Optical Absorption Spectroscopy (DOAS) method. HCHOSCD was converted to HCHOVCD using geometric Air Mass Factor (AMFG) as Pandora is the direct-sun measurement. The HCHOVCDs is low at 12:00 Local Time (LT) and is high in the morning (10:00 LT) and late afternoon (16:00 LT) except for winter. The maximum (minimum) values of Pandora HCHOVCD are 2.68×1016 (1.63×10¹⁶), 3.19×10¹⁶ (2.23×10¹⁶), 2.00×10¹⁶ (1.26×10¹⁶), and 1.63×10¹⁶ (0.82×10¹⁶) molecules cm⁻² in spring, summer, autumn, and winter, respectively. In terms of seasonal variations, HCHOVCD was high in summer and low in winter which implies that photo-oxidation plays an important role in HCHO production in Seoul. In comparison with the Ozone Monitoring Instrument (OMI) measurements, the HCHOVCDs from the OMI are lower than those from Pandora. The correlation coefficient (R) between monthly HCHOVCDs values from Pandora and OMI is 0.61, with slop of 0.35. Furthermore, to understand HCHO mixing ratio within Planetary Boundary Layer (PBL) in Seoul, we converted Pandora HCHOVCDs to HCHO mixing ratio in the PBL using several meteorological input data from the Atmospheric InfraRed Sounder (AIRS). Seasonal HCHO mixing ratio in PBL converted from Pandora (OMI) HCHOVCDs are estimated to be 6.57 (5.17), 7.08 (6.68), 7.60 (4.70), and 5.00 (4.76) ppbv in spring, summer, autumn, and winter, respectively.

Keywords: formaldehyde, OMI, Pandora, remote sensing

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Authors: Sulastriningsih Djumingin

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This study has some objectives. It aims at describing the ability of the second-grade students to write review text without applying the Lesson Study model at SMPN 18 Makassar. Second, it seeks to describe the ability of the second-grade students to write review text by applying the Lesson Study model at SMPN 18 Makassar. Third, it aims at testing the effectiveness of the Lesson Study model in writing review text at SMPN 18 Makassar. This research was true experimental design with posttest Only group design involving two groups consisting of one class of the control group and one class of the experimental group. The research populations were all the second-grade students at SMPN 18 Makassar amounted to 250 students consisting of 8 classes. The sampling technique was purposive sampling technique. The control class was VIII2 consisting of 30 students, while the experimental class was VIII8 consisting of 30 students. The research instruments were in the form of observation and tests. The collected data were analyzed using descriptive statistical techniques and inferential statistical techniques with t-test types processed using SPSS 21 for windows. The results shows that: (1) of 30 students in control class, there are only 14 (47%) students who get the score more than 7.5, categorized as inadequate; (2) in the experimental class, there are 26 (87%) students who obtain the score of 7.5, categorized as adequate; (3) the Lesson Study models is effective to be applied in writing review text. Based on the comparison of the ability of the control class and experimental class, it indicates that the value of t-count is greater than the value of t-table (2.411> 1.667). It means that the alternative hypothesis (H1) proposed by the researcher is accepted.

Keywords: application, lesson study, review text, writing

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Authors: Ipenyi Peter

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Discipline is an issue that tends to undermine the provision of quality education in tertiary institutions in Nigeria. This is because the overall goals of tertiary institutions, as enunciated in the National Policy of Education, can hardly be achieved by all the stakeholders without strict conformity and adherence to the rules and regulations and the ideals of the entire society. The adherence is essential for the general welfare of the society. This paper critically X-rayed the causes of indiscipline in tertiary institutions in Nigeria. Such courses include laxity in home control and parental supervision, school, teacher and societal factors as well as government influence. The paper recommended among others such strategies as enculturation, acculturation as well as the acquisition of a certain number of generic skills for dealing with discipline and ethical issues in tertiary institutions in Nigeria.

Keywords: discipline, education, tertiary institutions, society

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Authors: Mary Katherine Hoth

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Despite racial and ethnic disparities in American psychiatry being well-documented, there remains an apathetic attitude among nurses and providers within the field to engage in active antiracism and provide equitable, recovery-oriented care. It is insufficient to be a “colorblind” nurse or provider and state that call care provided is identical for every patient. Maintaining an attitude of “colorblindness” perpetuates the racism prevalent throughout healthcare and leads to negative patient outcomes. The purpose of this literature review is to highlight the how the historical beginnings of psychiatry have evolved into the disparities seen in today’s practice, as well as to provide some insight on methods that providers and nurses can employ to actively participate in challenging these racial disparities. Background The application of psychiatric medicine to White people versus Black, Indigenous, and other People of Color has been distinctly different as a direct result of chattel slavery and the development of pseudoscience “diagnoses” in the 19th century. This weaponization of the mental health of Black people continues to this day. Population The populations discussed are Black, Indigenous, and other People of Color, with a primary focus on Black people’s experiences with their mental health and the field of psychiatry. Methods A literature review was conducted using CINAHL, EBSCO, MEDLINE, and PubMed databases with the following terms: psychiatry, mental health, racism, substance use, suicide, trauma-informed care, disparities and recovery-oriented care. Articles were further filtered based on meeting the criteria of peer-reviewed, full-text availability, written in English, and published between 2018 and 2023. Findings Black patients are more likely to be diagnosed with psychotic disorders and prescribed antipsychotic medications compared to White patients who were more often diagnosed with mood disorders and prescribed antidepressants. This same disparity is also seen in children and adolescents, where Black children are more likely to be diagnosed with behavior problems such as Oppositional Defiant Disorder (ODD) and White children with the same presentation are more likely to be diagnosed with Attention Hyperactivity Disorder. Medications advertisements for antipsychotics like Haldol as recent as 1974 portrayed a Black man, labeled as “agitated” and “aggressive”, a trope we still see today in police violence cases. The majority of nursing and medical school programs do not provide education on racism and how to actively combat it in practice, leaving many healthcare professionals acutely uneducated and unaware of their own biases and racism, as well as structural and institutional racism. Conclusions Racism will continue to grow wherever it is given time, space, and energy. Providers and nurses have an ethical obligation to educate themselves, actively deconstruct their personal racism and bias, and continuously engage in active antiracism by dismantling racism wherever it is encountered, be it structural, institutional, or scientific racism. Agents of change at the patient care level not only improve the outcomes of Black patients, but it will also lead the way in ensuring Black, Indigenous, and other People of Color are included in research of methods and medications in psychiatry in the future.

Keywords: disparities, psychiatry, racism, recovery-oriented care, trauma-informed care

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Authors: Nahela Nowshin, Rafia Sultana, Farzana Misha, Sabina F. Rashid

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Sexual and reproductive health and rights (SRHR) are currently an area of neglect for males (aged 15-24 years) in Bangladesh. The lack of focus on the male youth population has consequences not only for their own health and wellbeing, but the patriarchal structure of Bangladeshi society and socio-cultural norms mean that the male population’s SRH behavior can severely impact the lives of their female counterparts. A majority of sexual and reproductive health and rights-related research and interventions in the country are female-centric. Although the Government of Bangladesh has taken many initiatives to improve the SRHR of the general population, the male youth segment has not been prioritized in most of these interventions. There is an urgent need for male-youth-focused SRHR interventions in Bangladesh, but due to a lack of evidence-based research on this issue, there exist data gaps on how such interventions could be better designed and implemented. Therefore, to ascertain strategies for better program design and smoother implementation of male-youth-focused sexual and reproductive health and rights interventions, we carried out 25 key informant interviews with experts as well as focal persons involved in more than 20 ongoing and recently-ended SRHR-related interventions of national and international non-government organizations in which male youth were targeted or engaged. The results show that program implementers face several challenges at the field, organizational and policy levels. Some of the most common field challenges include high sensitivity to SRHR topics due to cultural reasons, difficulties in acquiring access to boys and young men due to their high mobility and engagement in labor for commercial purposes, as well as accessing them in hard-to-reach areas due to transportation and communication issues. Common organizational-level challenges include a lack of skilled manpower. Policy-level challenges include the prohibition of SRH service provision to unmarried adolescents and youth and lack of readiness of local governments to implement existing action plans. Some ways in which male-youth-focused SRHR interventions can be made more effective are through sensitization of service providers, awareness-raising at the community level to engage parents, advocacy to increase donor interest, and generating data on SRHR of male youth.

Keywords: Bangladesh, intervention, male, SRHR

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Authors: Ephraim Daka, Maxim Kotsemir

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The National system Innovation (NSI) have recently proliferated as a vehicle for addressing poverty and national competitiveness in the developing countries. While several governments in Sub-Saharan Africa have adopted the developed countries’ models of innovation to local conditions, the Zambian case is rather unique. This study highlights conceptual and socioeconomic challenges directed to the performances of the NSI. The paper analyses science and technology strategies with the inclusion of “innovation” and its effect towards improving socioeconomic elements. The authors reviewed STI policy and national strategy documents, followed by interviews compared to economical regional and national data sets. The NSI and its related to inter-linkages and support mechanism to socioeconomic development were explored.

Keywords: national system of innovation, socioeconomics, development, Zambia

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Authors: Salma M. Wakil

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Advances in the field of genetics overwhelmed detecting large number of inherited disorders at the molecular level and directed to the development of innovative technologies. These innovations have led to gene sequencing, prenatal mutation detection, pre-implantation genetic diagnosis; population based carrier screening and genome wide analyses using microarrays. Microarrays are widely used in establishing clinical and diagnostic setup for genetic anomalies at a massive level, with the advent of cytoscan molecular karyotyping as a clinical utility card for detecting chromosomal aberrations with high coverage across the entire human genome. Unlike a regular karyotype that relies on the microscopic inspection of chromosomes, molecular karyotyping with cytoscan constructs virtual chromosomes based on the copy number analysis of DNA which improves its resolution by 100-fold. We have been investigating a large number of patients with Developmental Delay and Intellectual disability with this platform for establishing micro syndrome deletions and have detected number of novel CNV’s in the Arabian population with the clinical relevance.

Keywords: microarrays, molecular karyotyping, developmental delay, genetics

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Authors: Saskia Köbschall

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The idea of ‘being close to nature’ and the ways of achieving this proximity are socially and historically constructed, as are notions of nakedness and nudity. During the colonial period, nudity and clothedness functioned as instruments of racial domination. Nakedness became central to the colonialists’ thinking, to their binary of the ‘civilized’ and those ‘close to nature’, therefore turning the level of perceived unclothedness into a measurement of ‘civilization'. While being ‘one with nature’ continued to be a criterion of backwardness in the colonies, it emerged as a futuristic and avant-garde endeavor in the metropole: In Germany, at the height of its colonial expansion, the Life Reform Movement (Lebensreformbewegung) called for the liberation of the white body from the ‘constraints of civilization’, for its ‘return to nature’ via practices like nudism. Despite this simultaneity, the scholarship of the life reform and the nudist movement in particular does not address the colonial past of the movement or its repercussions in the present. Taking the biography of prominent life reformist Hans Paasche (1881 - 1920) as a starting point, this paper explores the work of imperial legacies in the history and present of the German nudist movement. Paasche started his career as a German colonial officer, participating in the brutal obliteration of the Maji-Maji uprising (1905/06) that claimed the lives of nearly 200.000 people. Once a passionate game hunter, he later became a known nature conservationist; once a self-proclaimed explorer of Africa, he later became one of the most prominent advocates of nudism and vegetarianism. The paper joins conceptual and historical research in order to address the German nudist movement’s colonial past and understand its repercussions in the present.

Keywords: Germany, life reform, colonialism, archives, nudity, nature

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Authors: Rosita Kanapeckaite

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The modern operational military environment is a combination of factors such as change, uncertainty, complexity and ambiguity. Stiehm (2002) refers to such situations as VUCA situations. VUCA is an acronym commonly used to describe the volatility, uncertainty, complexity and ambiguity of various situations and conditions. Increasingly fast-paced military operations require military personnel to demonstrate readiness and resilience under stressful conditions in order to maintain the optimum cognitive and physical performance necessary to achieve success. Military resilience can be defined as the ability to cope with the negative effects of setbacks and associated stress on military performance and combat effectiveness. In the volatile, uncertain, complex and ambiguous modern operational environment, both current and future operations require and place a higher priority on enhancing and maintaining troop readiness and resilience to win decisively in multidimensional combat. This paper explores the phenomenon of soldiers' psychological resilience, theories of leadership, and commitment to the organisation. The aim of the study is to examine the relationship between soldiers' psychological resilience, leadership style and commitment to the organisation. The study involved 425 professional soldiers, the research method was a questionnaire survey. The instruments used were measures of psychological resilience, leadership styles and commitment to the organisation. Results: transformational leadership style predicts higher psychological resilience, and psychologically resilient professional servicemen are more committed to the organisation. The study confirms the importance of soldiers' psychological resilience for their commitment to the organisation. The paper also discusses practical applications.

Keywords: resilience, commitment, solders, leadership style

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Authors: Nirajan Shrestha

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Karnali is one of the most vulnerable provinces in Nepal, facing challenges from climate change, poverty, and natural calamities across different regions. In recent years, the province has been severely impacted by climate change stress such as temperature rises in glacier lake of mountainous region and spring source water shortages, particularly in hilly areas where settlements are located, and water sources have depleted from their original ground levels. As a result, Karnali could face a future without enough water for all. Deep causes of sustainable safe water supply have always been neglected in rural areas of Nepal, and communities are unfairly burdened with a challenge of keeping water facilities functioning in areas affected by frequent natural disasters where there is a substantial, well-documented funding gap between the revenues from user payments and the full cost of sustained services. The key importance of a permanent system to support communities in service delivery has been always underrated so far. The complexity of water service sustainability as a topic should be simplified to one clear indicator: the functionality rate, which can be expressed as uptime or the percentage of time that the service is delivered over the total time. For example, a functionality rate of 80% means that the water service is operational 80% of the time, while 20% of the time the system is not functioning. This represents 0.2 multiplied by 365, which equals 73 days every year, or roughly two and a half months without water. This percentage should be widely understood and used in Karnali. All local governments should report their targets and performance in improving it, and there should be a broader discussion about what target is acceptable and what can be realistically achieved. In response to these challenges, the Sustainable WASH for All (SUSWA) project has introduced innovative models and policy formulation strategies in various working local government. SUSWA’s approach, which delegates rural water supply and sanitation responsibilities to local governments, has been instrumental in addressing these issues. To keep pace with the growing demand, the province has adopted a service support center model, linking local governments with federal authorities to ensure effective service delivery to the communities By enhancing WASH governance through local governments engagement, capacity building and inclusive WASH policy frameworks, there is potential to address WASH gaps while fostering a circular economy. This strategy emphasizes resource recovery, waste minimization and the creation of local employment generation opportunities. The research highlights key governance mechanisms, innovative practices and policy interventions that can be scaled up across other regions. It also provides recommendations on how to leverage Karnali’s unique socio-economic and environmental context nature-based solutions to inspire innovation and drive sustainable WASH solutions. Key findings suggest that with strong ownership and leadership of local governments, community engagement and appropriate technology, Karnali Province can become a model for integrating WASH governance with circular economy concept, providing broader lessons for other regions in Nepal.

Keywords: vulnerable provinces, natural calamities, climate change stres, spring source depletion, resources recovery, governance mechanisms, appropriate technology, community engagement, innovation

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Authors: Adriana Haulica

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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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Authors: J. T. Manhire

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A tax authority wants to take actions it knows will foster the greatest degree of voluntary taxpayer compliance to reduce the “tax gap.” This paper suggests that even if a tax authority could attain a state of complete knowledge, there are constraints on whether and to what extent such actions would result in reducing the macro-level tax gap. These limits are not merely a consequence of finite agency resources. They are inherent in the system itself. To show that this is one possible interpretation of the tax gap data, the paper formulates known results in a different way by analyzing tax compliance as a population with a single covariate. This leads to a standard use of the logistic map to analyze the dynamics of non-compliance growth or decay over a sequence of periods. This formulation gives the same results as the tax gap studies performed over the past fifty years in the U.S. given the published margins of error. Limitations and recommendations for future work are discussed, along with some implications for tax policy.

Keywords: income tax, logistic map, tax compliance, tax law

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Authors: Amie Smith, Jodi-Lyn Benjamin

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In 2020, there are currently four generations in the nursing workforce: The Veterans, Boomers, Generation X and Generation Y (Gen Y). Understanding each generation and their growing needs will equip the workforce for when the Boomers prepare for retirement, with majority of nursing leadership positions to be potentially replaced with Gen Y nurses. In SA Medical Imaging(SAMI), at Flinders Medical Centre (FMC), it has been proven that despite challenges in succession planning, Gen Y nurse leaders are able to overcome these obstacles and provide the leadership necessary to meet the changing needs in healthcare and across organisations. Changing the culture in radiology nursing has been seen as an obstacle due to the historical nursing practices and resistance to adapt to current/future practice. As radiology advances so does the role of the nurse in imaging, this has required resilience and strong support through leadership as we change and develop the culture to keep up with the evolution of technology and standard of patient care. As a result of supporting Gen Y nurses in leadership roles, SAMI, FMC has seen a positive change in culture by creating a healthy work environment which has allowed Gen Y nurses to make long lasting contributions to the nursing profession.

Keywords: changing culture, Generation Y, radiology, nursing, leadership

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Authors: Nuno Biga

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The integration of serious games with gamification in management education and training has gained significant importance in recent years as innovative strategies are sought to improve target audience engagement and learning outcomes. This research builds on the author's previous work in this field and presents a case study that evaluates the ex-post impact of a sample of applications of the BIGAMES management simulator in the training of top managers from various hospital institutions. The methodology includes evaluating the reaction of participants after each edition of BIGAMES Accident & Emergency (A&E) carried out over the last 3 years, as well as monitoring the career path of a significant sample of participants and their feedback more than a year after their experience with this simulator. Control groups will be set up, according to the type of role their members held when they took part in the BIGAMES A&E simulator: Administrators, Clinical Directors and Nursing Directors. Former participants are invited to answer a questionnaire structured for this purpose, where they are asked, among other questions, about the importance and impact that the BIGAMES A&E simulator has had on their professional activity. The research methodology also includes an exhaustive literature review, focusing on empirical studies in the field of education and training in management and business that investigate the effectiveness of gamification and serious games in improving learning, team collaboration, critical thinking, problem-solving skills and overall performance, with a focus on training contexts in the health sector. The results of the research carried out show that gamification and serious games that simulate real scenarios, such as Business Interactive Games - BIGAMES©, can significantly increase the motivation and commitment of participants, stimulating the development of transversal skills, the mobilization of group synergies and the acquisition and retention of knowledge through interactive user-centred scenarios. Individuals who participate in game-based learning series show a higher level of commitment to learning because they find these teaching methods more enjoyable and interactive. This research study aims to demonstrate that, as executive education and training programs develop to meet the current needs of managers, gamification and serious games stand out as effective means of bridging the gap between traditional teaching methods and modern educational and training requirements. To this end, this research evaluates the medium/long-term effects of gamified learning on the professional performance of participants in the BIGAMES simulator applied to healthcare. Based on the conclusions of the evaluation of the effectiveness of training using gamification and taking into account the results of the opinion poll of former A&E participants, this research study proposes an integrated approach for the transversal application of the A&E Serious Game in various educational contexts, covering top management (traditionally the target audience of BIGAMES A&E), middle and operational management in healthcare institutions (functional area heads and professionals with career development potential), as well as higher education in medicine and nursing courses. The integrated solution called “BIGAMES A&E plus”, developed as part of this research, includes the digitalization of key processes and the incorporation of AI.

Keywords: artificial intelligence (AI), executive training, gamification, higher education, management simulators, serious games (SG), training effectiveness

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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: Famurewa Olumide Joseph, Akinsulore Adesanmi

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The current study investigated aggressive behaviour and its association with substance use disorder among senior secondary school students in Ilesha, Nigeria. Participants were three hundred and seventy-five (375) comprising (212) females and (163) males of senior secondary school students in Ilesa East and Ilesa West; who were randomly selected among the population of students from the schools. The mean age of the respondents was 14.61 years (S.D = 1.16), with 311 (82.9%) between 14 – 16 years. Female respondents were 212 (56.5%), while male respondents were 163 (43.5%). A cross sectional design was adopted. Three instruments were used for data collection. Buss Perry Aggression Questionnaire, Alcohol Use Disorder Identification Test (AUDIT) and Drug Abuse Screening Test (DAST). It was hypothesized that aggressive behaviour will be associated with substance use disorder among senior secondary school students in Ilesa East and Ilesa West. The result indicated that the overall prevalence of substance use disorder was 16.0%. Chi-Square test exploring the association between aggressive behaviour and substance use disorder shows that there is a significant association between aggressive behaviour and substance use disorder (χ2 =8.55, p =0.014). Results also showed that emotional problem (χ2 (2) =13.0; p = 0.001) was statistically significant while current medications intake (χ2 (2) =2.03; p =0.362) and overall wellbeing (χ2 (4) =2.49; p =0.646) were not statistically significant. There is an inverse association between prosocial behaviour and aggressive behaviour (r= -0.037, p>0.05). This indicates that as the level of prosocial behaviour increases, the level of aggressive behaviour among respondents decreases. However, alcohol use had no correlation with aggressive behaviour (r=0.070, p>0.05). Among the implications stated is that factors such as emotional symptoms, conduct problems, hyperactivity, peer problem and drug use contributed to the prevalence of aggressive behaviour among students. Suggestions for further studies were equally made.

Keywords: aggressive behaviour, alcohol, prevalence, students, substance use disorder (SUD)

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Authors: Yi-Hsiu Lai

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The present study aimed to elucidate the lexical-semantic processing for Chinese as second language (CSL) learners. Twenty L1 speakers of Chinese and twenty CSL learners in Taiwan participated in a picture naming task and a category fluency task. Based on their Chinese proficiency levels, these CSL learners were further divided into two sub-groups: ten CSL learners of elementary Chinese proficiency level and ten CSL learners of intermediate Chinese proficiency level. Instruments for the naming task were sixty black-and-white pictures: thirty-five object pictures and twenty-five action pictures. Object pictures were divided into two categories: living objects and non-living objects. Action pictures were composed of two categories: action verbs and process verbs. As in the naming task, the category fluency task consisted of two semantic categories – objects (i.e., living and non-living objects) and actions (i.e., action and process verbs). Participants were asked to report as many items within a category as possible in one minute. Oral productions were tape-recorded and transcribed for further analysis. Both error types and error frequency were calculated. Statistical analysis was further conducted to examine these error types and frequency made by CSL learners. Additionally, category effects, pictorial effects and L2 proficiency were discussed. Findings in the present study helped characterize the lexical-semantic process of Chinese naming in CSL learners of different Chinese proficiency levels and made contributions to Chinese vocabulary teaching and learning in the future.

Keywords: lexical-semantic processing, Mandarin Chinese, naming, category effects

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Authors: Md. Abud Darda

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Different options for natural gas production in wide geographic areas may be described through diffusion of innovation models. This type of modeling approach provides an indirect estimate of an ultimately recoverable resource, URR, capture the quantitative effects of observed strategic interventions, and allow ex-ante assessments of future scenarios over time. In order to ensure a sustainable energy policy, it is important to forecast the availability of this natural resource. Considering a finite life cycle, in this paper we try to investigate the natural gas production of Myanmar and Algeria, two important natural gas provider in the world energy market. A number of homogeneous and heterogeneous diffusion models, with convenient extensions, have been used. Models validation has also been performed in terms of prediction capability.

Keywords: diffusion models, energy forecast, natural gas, nonlinear production

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Authors: Şebnem Aslan, Demet Akarçay

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The objective of this study is to investigate the feelings of health employees occurred by bullying and the relationships between these feelings at work place. In this context, the relationships between bullying and the feelings of self-esteem, employee silence, anger, self- blame and shame. This study was conducted among 512 health employees in three hospitals in Konya by using survey method and simple random sampling. The scales of bullying, self-esteem, employee silence, anger, self-blame, and shame were performed within the study. The obtained data were analyzed with descriptive analysis, correlation, confirmative factor analysis, structural equation modeling and path analysis. The results of the study showed that while bullying had a positive effect on self-esteem (.61), employee silence (.41), anger (.18), a negative effect on self-blame and shame (-.26) was observed. Employee silence affected self-blame and shame (.83) as positively. Besides, self-esteem impacted on self- blame and shame (.18), employee silence (.62) positively and self-blame and shame was observed as negatively affecting on anger (-.20). Similarly, self-esteem was found as negatively affected on anger (-.13).

Keywords: bullying, self-esteem, employee silence, anger, shame and guilt, healthcare employee

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Authors: Lucie Litvack, Malaz Elsaddig, Kevin Jones

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There is strong evidence to support the efficacy of the World Health Organization (WHO) Surgical Safety Checklist in improving patient safety; however, its use can be associated with difficulties. This study uses qualitative data collected in Kitovu Healthcare Complex, a rural Ugandan hospital, to identify factors that may influence the use of the checklist in a low-income setting. Potential barriers to and motivators for the hospital’s use of this checklist are identified and explored through observations of current patient safety practices; semi-structured interviews with theatre staff; a focus group with doctors; and trial implementation of the checklist. Barriers identified include the institutional context; knowledge and understanding; patient safety culture; resources and checklist contents. Motivators for correct use include prior knowledge; team attitudes; and a hospital advocate. Challenges are complex and unique to this socioeconomic context. Stepwise change to improve patient safety practices, local champions, whole team training, and checklist modification may assist the implementation and sustainable use of the checklist in an effective way.

Keywords: anaesthesia, patient safety, Uganda, WHO surgical safety checklist

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Authors: Ashlesha Khanapure, Harsh Kashyap, Abhinav Anand, Sanjana Habib, Anupama Bidargaddi

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Technologies that are developing quickly are being developed daily in a variety of disciplines, particularly the medical field. For the purpose of detecting bone fractures in X-ray pictures of different body segments, our work compares the ResNet-50 and MobileNetV3 architectures. It evaluates accuracy and computing efficiency with X-rays of the elbow, hand, and shoulder from the MURA dataset. Through training and validation, the models are evaluated on normal and fractured images. While ResNet-50 showcases superior accuracy in fracture identification, MobileNetV3 showcases superior speed and resource optimization. Despite ResNet-50’s accuracy, MobileNetV3’s swifter inference makes it a viable choice for real-time clinical applications, emphasizing the importance of balancing computational efficiency and accuracy in medical imaging. We created a graphical user interface (GUI) for MobileNet V3 model bone fracture detection. This research underscores MobileNetV3’s potential to streamline bone fracture diagnoses, potentially revolutionizing orthopedic medical procedures and enhancing patient care.

Keywords: CNN, MobileNet V3, ResNet-50, healthcare, MURA, X-ray, fracture detection

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