Search results for: Local centers

Authors: Rosa Hendijani, Amir Ghadimi Herfeh

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Nutrition labels are diet-related health policies. They help individuals improve food-choice decisions and reduce intake of calories and unhealthy food elements, like cholesterol. However, many individuals do not pay attention to nutrition labels or fail to appropriately understand them. According to the literature, thinking and cognitive styles can have significant effects on attention to nutrition labels. According to the author's knowledge, the effect of global/local processing on attention to nutrition labels have not been previously studied. Global/local processing encourages individuals to attend to the whole/specific parts of an object and can have a significant impact on people's visual attention. In this study, this effect was examined with an experimental design using the eye-tracking technique. The research hypothesis was that individuals with local processing would pay more attention to nutrition labels, including nutrition tables and traffic lights. An experiment was designed with two conditions: global and local information processing. Forty participants were randomly assigned to either global or local conditions, and their processing style was manipulated accordingly. Results supported the hypothesis for nutrition tables but not for traffic lights.

Keywords: eye-tracking, nutrition labelling, global/local information processing, individual differences

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Authors: Narges Solaymani

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Definition of Nurse: Nurse: A person who is educated and skilled in the field of scientific principles and professional skills of health care, treatment, and medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: nurse, intensive care, CPR, bandage

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Authors: Nana Weng

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Localization in the aspect of human resource means more diversity and more opportunities. The main purpose of this article is to identify the perception of local employees and intermediate managers (non-Japanese) and figure out exploratory factors which have been contributing and blocking the level of localization in the aspect of human resource management by using EFA (Exploratory Factors Analysis). Questionnaires will be designed for local employees and managers to inquire about the perceptions of regulations and implementation regarding recruitment, training and development, promotion and rewarding. The study finds that Japanese firms have worked well in the process of localization, especially in hiring and training local staffs in Taiwan. The significance of this study lies in paying more attention to the perception of local employees and intermediate managers regarding localization rather than interviews results from Japanese expatriates or top HR managers who are in charging of localization policy-making.

Keywords: Japanese firms in Taiwan, localization of human resources, exploratory factors analysis, local employees and intermediate managers

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Authors: Nuhi Arslani, Stojan Potrc, Timotej Mikuljan

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Background: In Department of Abdominal and General Surgery of University Medical Centre Maribor, we treated 578 patients for rectal cancer between 2004 and 2014. During and after treatment we especially concentrated on monitoring local and systemic complications. Methods: For analysis, we used data gathered from preoperative diagnostic tests, reports gathered during operation, reports from the pathohistologic review, and reports on complications after surgery and follow up. Results: In the case of 573 (out of 578) patients (99.1%) we performed resection. R0 was achieved in 551 patients (96,1%). R1 was achieved in 8 patients (1,4%). R2 was achieved in 14 patients (2,4%). Local complications were reported in 78 (13.5%) patients and systemic complications were reported in 68 (11.7%). We would like to point out the low number of local and systemic complications. Conclusions: With advances in surgical techniques, with a multimodal-multidisciplinary approach and with the use of total mesorectal excision we experienced a significant improvement in reducing the number of local and systemic complications in patients with rectal cancer. However, there still remains the question for truly optimal care for each patient with rectal cancer and his quality of life after surgical treatment.

Keywords: local complications, rectal cancer, resection, systemic complications

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Authors: Khaled Selatnia

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Nowadays, the traffic congestion becomes increasingly a chronic problem. Sometimes, the cause is attributed to the recurrent road works that create barriers to the efficient movement. But congestion, which usually occurs in cities, can take diverse forms and magnitudes. The case study of Biskra city in Algeria and the diagnosis of its road network show that throughout all the micro regional system, the road network seems at first quite dense. However, this density although it is important, does not cover all areas. A major flow is concentrated in the axis Sidi Okba – Biskra – Tolga. The largest movement of people in the Wilaya (prefecture) revolves around these three centers and their areas of influence. Centers farthest from the trio are very poorly served. This fact leads us to ask questions about the extent of congestion in Biskra city and its relationship to the imbalance of the urban framework. The objective of this paper is to highlight the impact of the urban fact on the traffic congestion.

Keywords: congestion, urban framework, regional, urban and regional studies

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Authors: Handan Ertaş

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The subject of government reform which is started to be discussed all over the world today has also deeply affected Turkey. Turkey, who aims to come to the level of the developed countries and not to fall behind the change must immediately complete the reform issue. For this, the government needs to be redefined and changed in accordance with the new public administration. In the first part of this study, the new public administration reforms in the world are generally explained and then the reforms in Local Government Regulations in Turkey are evaluated with the method of Content Analysis.

Keywords: reform, local administration, neo-liberalism, globalisation

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Authors: Mandisi Matyana

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Although the South African local government is doing all the best in ensuring improved service delivery for the citizens, service delivery disparity still remains the real challenge for other municipalities. The unequal distribution of services within municipal wards is causing unequal happiness among the citizens; hence others do enjoy different provided municipal services, while others do not. It is acknowledged that less access to municipal services infringes one’s rights, such as the right to human dignity and the right to life. Some of the municipal services are basic services and they are the mainstay of human survival, such as water, housing, etc. It is quite evident that the service delivery disparity could be caused by the various factors within the local municipality affairs, including both administrative and political factors. Therefore, this study is undertaken to check and evaluate the main foundations of service delivery disparity in ensuring equal development of the state, particularly for local communities. The study used the qualitative method to collect the data from the citizens of Winnie Madikizela Mandela Local Municipality. An extensive literature was also conducted in understanding the causes of service delivery disparity. Study findings prove that the service delivery disparity could be caused by factors such as political interference in administration, corruption and fraud, elevated unemployment levels, inadequate institutional capacity, etc. Therefore, the study recommends strong community participation and constant external supervision in the local government so as to encourage openness in local government to ensure fair administration towards services to be provided.

Keywords: administration, development, municipal services, service delivery disparity, Winnie Madikizela Mandela local municipality

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Authors: Yuan-Hong Ho, Chiung-Ju Huang

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This article presents a monitoring indicators system that predicts whether a local government in Taiwan is heading for fiscal distress and identifies a suitable fiscal policy that would allow the local government to achieve fiscal balance in the long run. This system is relevant to stockholders’ interest, simple for national audit bodies to use, and provides an early warning of fiscal distress that allows preventative action to be taken.

Keywords: fiscal health, fiscal distress, monitoring signals, 10-point scale

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Authors: Baoshan Wei, Shuai Han, Xing Zhang

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Local obstacle avoidance is critical for mobile robot navigation. It is a challenging task to ensure path optimality and safety in cluttered environments. We proposed an Environment Aware Dynamic Window Approach in this paper to cope with the issue. The method integrates environment characterization into Dynamic Window Approach (DWA). Two strategies are proposed in order to achieve the integration. The local goal strategy guides the robot to move through openings before approaching the final goal, which solves the local minima problem in DWA. The adaptive control strategy endows the robot to adjust its state according to the environment, which addresses path safety compared with DWA. Besides, the evaluation shows that the path generated from the proposed algorithm is safer and smoother compared with state-of-the-art algorithms.

Keywords: adaptive control, dynamic window approach, environment aware, local obstacle avoidance, mobile robots

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Authors: Young-Kwang Lee, Eun-Gu Ji, Min-Joo Kim, Seung-Jae Oh

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The purpose of this study is to develop a social participation activity scale for the elderly. As a result of exploratory factor analysis, confirmatory factor analysis was conducted using maximum likelihood method using bundled items. In conclusion, thirteen items of social participation activity scale seemed appropriate. Finally, convergent validity and discriminant validity were verified on the scale with the fit. The convergent validity was based on the variance extracted value. In other words, the hypothesis that the variables are the same is rejected and the validity is confirmed. This study extensively considered the measurement items of the social participation activity scale used to measure social participation activities of the elderly. In the future, it will be meaningful that it can be used as a tool to verify the effectiveness of services in organizations that provide social welfare services to elderly people such as comprehensive social welfare centers and the elderly comprehensive social welfare centers.

Keywords: elderly, social participation, scale development, validity

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Authors: Betek Cecilia Kunseh, Musampa Christopher

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Despite significant investment and important progress, access to safe potable water continues to be one of the most pressing challenges for rural communities in O R Tambo District Municipality. This is coupled with the low income of most residents and government's policy which obliges municipalities to supply basic water usually set at 6 kilolitres per month to each household free of charge. During the research, data was collected from three local municipalities of O. R. Tambo, i.e. King Sabata Dalindyebo, Mhlontlo and Ingquza Hill local municipalities. According to the result, significant differences exist between the sources of water in the different local municipalities from which data was collected. The chi square was use to calculated the differences between the sources of water and the calculated critical value of the District Municipality was 18.77 which is more than the stipulated critical value of 3.84. More people in Mhlontlo Local Municipality got water from the taps while a greater percentage of households in King Sataba Dalindyebo and Ingquza hill local municipalities got their water from the natural sources. 77% of the sample population complained that there have been no improvements in water provision because they still get water from natural sources and even the remaining 33% that were getting water from the taps still have to depend on natural sources because the taps are most of the time broken and it takes a long time to fix them.

Keywords: availability, water, sources, supply

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Authors: Renee Nank

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Nongovernmental organizations that operate in other countries are, under American law, permitted to apply for and receive special tax status even when their programs and services are situated in other countries. NGO's are lauded as incubators for innovation as they typically tackle difficult problems that public and private organizations are unable or uninterested in addressing. Little research has been undertaken that explores both the extent of these organizations in number and reach, their impact on addressing local issues they seek to resolve, and their effect on local social economies - namely job creation. This study explores the landscape of these NGOs that are afforded tax benefits in the U.S., but operate in other countries, the degree to which they are entrepreneurial and innovate, and their effect on local social economies. This applies this lens to particular cases by exploring in greater depth several American NGO's operating in Mexico.

Keywords: civil society, nongovernmental organizations, social entrepreneurship, social economy, NGO innovation

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Authors: Cuong V Nguyen, Ralph Horne, John Fien, France Cheong

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Social vulnerability to climate change is increasingly being acknowledged, and proposals to measure and manage it are emerging. Building upon this work, this paper proposes an approach to social vulnerability assessment using a new mechanism to aggregate and account for causal relationships among components of a Social Vulnerability Index (SVI). To operationalize this index, the authors propose a means to develop an appropriate primary dataset, through application of a specifically-designed household survey questionnaire. The data collection and analysis, including calibration and calculation of the SVI is demonstrated through application in case study city in central coastal Vietnam. The calculation of SVI at the fine-grained local neighbourhood scale provides high resolution in vulnerability assessment, and also obviates the need for secondary data, which may be unavailable or problematic, particularly at the local scale in developing countries. The SVI household survey is underpinned by the results of a Delphi survey, an in-depth interview and focus group discussions with local environmental professionals and community members. The research reveals inherent limitations of existing SVIs but also indicates the potential for their use in assessing social vulnerability and making decisions associated with responding to climate change at the local scale.

Keywords: climate change, local scale, social vulnerability, social vulnerability index

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Authors: Oluwasina Folajinmi, Kate Ssamulla, Penninah Lutung, Daniel Reijer

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Background: Despite of well-verified benefits of anti-retroviral therapy (ART) in prolonging life expectancy being lost to follow-up (LTFU) presents a challenge to the success of ART programs in resource limited countries like Nigeria. In several studies of ART programs in developing countries, researchers have reported that there has been a high rate of LTFU among patients receiving care and treatment at ART treatment centers. This study seeks to determine the cause of LTFU among HIV clients. Method: A descriptive cross sectional study focused on a population of 9,280 persons living with HIV/AIDS who were enrolled in nine treatment centers in Nigeria (both pre-ART and ART patients were included). Out of the total population, 1752 (18.9%) were found to be LTFU. Of this group we randomly selected 1200 clients (68.5%) their d patients’ information was generated through a database. Data on demographics and CD4 counts, causes of LTFU were analyzed and summarized. Results: Out of 1200 LTFU clients selected, 462 (38.5%) were on ART; 341 clients (73.8%) had CD4 level < 500cell/µL and 738 (61.5%) on pre-ART had CD4 level >500/µL. In our records we found telephone number for 675 (56.1%) of these clients. 675 (56.1%) were owners of a phone. The majority of the client’s 731 (60.9%) were living at not more than 25km away from the ART center. A majority were females (926 or 77.2%) while 274 (22.8%) were male. 675 (56.1%) clients were reported traced via telephone and home address. 326 (27.2%) of clients phone numbers were not reachable; 173 (14.4%) of telephone numbers were incomplete. 71 (5.9%) had relocated due to communal crises and expert client trackers reported that some patient could not afford transportation to ART centers. Conclusion: This study shows that, low health education levels, poverty, relocations and lack of reliable phone contact were major predictors of LTFU. Periodic updates of home addresses, telephone contacts including at least two next of kin, phone text messages and home visits may improve follow up. Early and consistent tracking of missed appointments is crucial. Creation of more ART decentralized centres are needed to avoid long distances.

Keywords: anti-retroviral therapy, HIV/AIDS, predictors, lost to follow up

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Authors: Chorom Baek, Sungwon Choi

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The purpose of this study is to analyze the supervision system, and the training and continuing education of mental health professionals in USA, UK, Australia (New Zealand), Japan, and so on, and to deduce the implications of Korean mental health service system. In order to accomplish the purpose of this study, following methodologies were adopted: review on the related literatures, statistical data, the related manuals, online materials, and previous studies concerning issues in those countries for the past five years. The training program in Korea was compared with the others’ through this literature analysis. The induced matters were divided with some parts such as training program, continuing education, educational procedure, and curriculum. Based on the analysis, discussion and implications, the conclusion and further suggestion of this study are as follows: First, Korean Clinical Psychology of Association (KCPA) should become more powerful health main training agency for quality control. Second, actual authority of health main training agency should be a grant to training centers. Third, quality control of mental health professionals should be through standardization and systemization of promotion and qualification management. Fourth, education and training about work of supervisors and unification of criteria for supervision should be held. Fifth, the training program for mental health license should be offered by graduate schools. Sixth, legitimated system to protect the right of mental health trainees is needed. Seventh, regularly continuing education after licensed should be compulsory to keep the certification. Eighth, the training program in training centers should meet KCPA requirement. If not, KCPA can cancel the certification of the centers.

Keywords: clinical psychology, Korea, mental health system, training program

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Authors: Gordon Newlove Asamoah, Wendy Ama Oti

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This study focused on evaluating access to finance for local oil field companies in Ghana. The study adopted a census survey design in evaluating access to finance for local oil field companies in Ghana. The respondents of this study were 30 management members of three oil field companies in Ghana. The data collected was analysed using Statistical Package for Social Scientists (SPSS) to generate tables and graphs for interpretation. The results show that most companies use equity financing in combination with other forms of financing to finance their business activities. This research has shown the various challenges bordering on the financing of local oil and gas projects, with emphasis on the challenges of raising funds by indigenous oil companies. Financing of the projects by indigenous oil field companies in Ghana is preferably achieved through equity finance mainly because it is the easiest to get compared to all the other forms of financing available. Other sources of financing available are debt financing, joint venture, and retained earnings from the profits generated from their operations. The study made recommendations to local oil field companies as to how they can make good use of the capital market to raise financing.

Keywords: access, financing, oil fields, Ghana

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Authors: Awangku Hassanal Bahar Pengiran Bagul

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Ecotourism has been the signature tourism activity for Sabah since the 90s, and it has become a model of sustainable tourism development for Malaysia due to its ability to enhance conservation activities and local community development. This paper outlines the experience in developing indicators for the success of the local community participation of an ecotourism site, Sukau, in Sabah. The research was qualitative in nature and employed case study as its methodology. The outcome of this research suggested that Sukau has a mixed success with local community participation for the ecotourism activity. The community is in need of coaching and capacity building to intensify the ecotourism activity However, the ecotourism has successfully promoted conservation at its surrounding area.

Keywords: community, ecotourism, rural development, success, sustainable tourism

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Authors: Sovit Pujari

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In the developing countries like Nepal, the community-based forest management approach has often been glorified as one of the best forest management alternatives to maximize the forest benefits. Though the approach has succeeded to construct a local level institution and conserve the forest biodiversity, how the local communities perceived about the forest benefits, the question always remains silent among the researchers and policy makers. The paper aims to explore the understanding of forest benefits from the perspective of local communities who used the forests in terms of institutional stability, equity and livelihood opportunity, and ecological stability. The paper revealed that the local communities have mixed understanding over the forest benefits. The institutional and ecological activities carried out by the local communities indicated that they have a better understanding over the forest benefits. However, inequality while sharing the forest benefits, low pricing strategy and its negative consequences in the valuation of forest products and limited livelihood opportunities indicating the poor understanding.

Keywords: community based forest management, low pricing strategy, forest benefits, livelihood opportunities, Nepal

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Authors: Wichian Sriprachan, Chutikarn Sriviboon

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The objectives of this research were to study the management of local towns and to develop a better model of town management according to the Philosophy of Sufficiency Economy. This study utilized qualitative research, field research, as well as documentary research at the same time. A total of 10 local towns or Tambons of Supanburi province, Thailand were selected for an in-depth interview. The findings revealed that the model of local town management according to Philosophy of Sufficient Economy was in a level of “good” and the model of management has the five basic guidelines: 1) ability to manage budget information and keep it up-to-date, 2) ability to decision making according to democracy rules, 3) ability to use check and balance system, 4) ability to control, follow, and evaluation, and 5) ability to allow the general public to participate. In addition, the findings also revealed that the human resource management according to Philosophy of Sufficient Economy includes obeying laws, using proper knowledge, and having integrity in five areas: plan, recruit, select, train, and maintain human resources.

Keywords: management, local town (Tambon), principles of sufficiency economy, marketing management

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Authors: Ahmed Mudi, Bala Zakar

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The paper assesses the impact of safe motherhood initiative on maternal health of women in Gumel Local Government Area of Jigawa State. The work will specifically concentrate on the background on safe motherhood scheme and maternal health of women. The objective of this paper is to assess the level of safe motherhood scheme in Gumel local government area, to find out the level of maternal health in Gumel local government as well as to determine the impact of safe motherhood scheme on maternal health on women in Gumel Local Government Area Jigawa State. Various literature on the topic are reviewed, the paper adopts survey design and use questionnaire to collect data from the respondent. The study comprises 350 women selected from six rural communities in Gumel using random sampling techniques, and the data was analysed by simple frequency and percentage. The research concluded that safe motherhood initiative has a significant impact on the maternal health of women in Gumel Local Government Area of Jigawa State. Finally, suitable recommendations were given on how to improve the scheme to ensure better maternal health in the region.

Keywords: action, assessment, maternal health, safe motherhood, surgery

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Authors: Maythaya Preeyanon

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Chanthaburi Province is a province with people of many nationalities, such as Thai, Chinese, Vietnamese, Chong, and Khmer, resulting in a cultural mix in the past. What is a famous cultural transmission of Chanthaburi province is Chanthaburi reed mat weaving. Due to the suitability of both the climate and topography near the edge of the location, reeds have the qualities to be used to produce mats very well. There have been improvements in the methods of planting, dyeing, and weaving into various patterns that have been passed down as folk wisdom from generation to generation. Currently, there are brands of products belonging to the new generation that add creativity and add value through storytelling. Revive the value of reed mat products to increase in value until they can be exported to sell abroad. This research has therefore been conducted in order to decipher the success in transferring the Chanthaboon reed mat culture capital which has successfully advanced to being a creative economy so that it can be applied to other types of local wisdom or other local products.

Keywords: cultural capital, creative economy, communication, local product

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Authors: Zahra Rakhshan Masoudi, Sona Rostampour Yasouri

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Considering that the only way to save the lives of patients and healthy people who have suffered sudden accidents is blood transfusion, what is important is the presence of the known HCV virus as the most important cause of the disease after blood transfusion. HCV is one of the major global problems, and its transmission through blood causes life-threatening complications and extensive legal, social and economic consequences. On the one hand, unfortunately, there is still no effective vaccine available to prevent HCV. In Iran, the exact statistics of the prevalence of this disease have not yet been fully announced. The main purpose of this study is to investigate the prevalence rate and rapid diagnosis of HCV among those who refer to laboratory centers in Tehran. From spring to winter of 1401 (2022-2023), 2166 blood samples were collected from laboratory centers in Tehran. Blood samples were evaluated for the presence of HCV by Electrochemiluminescence (ECL) and PCR techniques along with specific HCV primers. In general, 36 samples (1.6%) were tested positive by the mentioned techniques. The results indicated that the ECL technique is a sensitive and specific diagnostic method for detecting HCV in the early stages of the disease and can be very helpful and provide the possibility of starting the treatment steps to prevent the exacerbation of the disease earlier. Also, the results of PCR technique showed that PCR is an accurate, sensitive and fast method for definitive diagnosis of HCV. It seems that the incidence rate of this disease is increasing in Iran, and investigating the spread of the disease throughout Iran for a longer period of time in the continuation of our research can be helpful in the future to take the necessary measures to prevent the transmission of the disease to people and the rapid onset Treatment steps for patients with HCV should be carried out.

Keywords: electrochemiluminescence, HCV, PCR, prevalence

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Authors: Juliana Chiarini Balbino Fernandes

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This article aims to investigate the Spanish didactic book, entitled ‘El Calculo y La Medida en El Primer Grado de La Escuela Decroly’, written by Dr. O. Decroly and A. Hamaide, published in Madrid, in the year 1934. In addition to analyzing how mathematical knowledge is present in the proposed Centers of Interest. The textbooks, in addition to pedagogical tools, reflect a certain moment in society and allow the analysis of the theoretical-methodological proposal that can be implemented by the teacher. The study proposed here will be carried out by the lens of Cultural History, supported by Roger Chartier (1991) and by the concepts on textbooks, based on Alain Choppin (2004). The textbook selected for this study exposes a program of ideas associated with the method of Centers of Interest and arithmetic is linked to these interests. In the first courses (six to eight years), most centers can be considered to correspond to occasional calls, as they take advantage of events that arise spontaneously to work with observation, measurement, association and expression exercises. The program of ideas associated with Centers of Interest addresses the biological and social aspects of children, as long as they can express their needs for activities and games, satisfying the natural curiosity. Still, the program of associated ideas offers occasions for problems whose data are taken in observation exercises and concrete expressions (manuals, drawings). In the method applied at the school of L'Ermitage, school created by Decroly in Belgium in 1907, observation, is the basis of each center of interest. It offers the chance to compare and measure. To observe is more than to perceive; it is also to establish relations between the graded aspects of the same object, to seek relations between different intensities; is to verify successions, special and temporary relationships; is to make comparisons, to notice differences and similarities in block or datable (analysis), is to establish a bridge between the world and the thought. To make the observation more precise, it is important to compare, measure, and resort to considered objects as natural units of measure. Measurement and calculation are, therefore, quite naturally subject to observation. Thus, it is possible to make the child enter into the interest in the calculation, linking it to the observation. It was observed that the Centers of Interest, according to Decroly, should respond to the concerns and attend to the motivations of the students and the teaching of arithmetical must obey a logical seriation, considering the interest and the experience of the children. The teaching of arithmetical should not be limited to the schedule, it should cover every quantitative aspect that arises in the other disciplines. The feeling of unity is established in observation, association and expression, which coordinate a whole program of cultural activities, concentrating it around a central idea.

Keywords: didactic book, centers of interest, mathematical knowledge, primary education

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Authors: Eyob Seife

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Immunization is a life-saving intervention which prevents needless suffering through sickness, disability, and death. Emphasis on data quality and use will become even stronger with the development of the immunization agenda 2030 (IA2030). Quality of data is a key factor in generating reliable health information that enables monitoring progress, financial planning, vaccine forecasting capacities, and making decisions for continuous improvement of the national immunization program. However, ensuring data of sufficient quality and promoting an information-use culture at the point of the collection remains critical and challenging, especially in hard-to-reach and pastoralist areas where Degehabur district is selected based on a hypothesis of ‘there is no difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical, and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Degehabur district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers, and reporting documents were reviewed at 5 health facilities (2 health centers and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and the district health office. A quality index (QI) was assessed, and the accuracy ratio formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed both over-reporting and under-reporting were observed at health posts when computing the accuracy ratio of the tally sheet to health post reports found at health centers for almost all antigens verified where pentavalent 1 was 88.3%, 60.4%, and 125.6% for Health posts A, B, and C respectively. For first-dose measles-containing vaccines (MCV), similarly, the accuracy ratio was found to be 126.6%, 42.6%, and 140.9% for Health posts A, B, and C, respectively. The accuracy ratio for fully immunized children also showed 0% for health posts A and B and 100% for health post-C. A relatively better accuracy ratio was seen at health centers where the first pentavalent dose was 97.4% and 103.3% for health centers A and B, while a first dose of measles-containing vaccines (MCV) was 89.2% and 100.9% for health centers A and B, respectively. A quality index (QI) of all facilities also showed results between the maximum of 33.33% and a minimum of 0%. Most of the verified immunization data accuracy ratios were found to be relatively better at the health center level. However, the quality of the monitoring system is poor at all levels, besides poor data accuracy at all health posts. So attention should be given to improving the capacity of staff and quality of monitoring system components, namely recording, reporting, archiving, data analysis, and using information for decision at all levels, especially in pastoralist areas where such kinds of study findings need to be improved beside to improving the data quality at root and health posts level.

Keywords: accuracy ratio, Degehabur District, regular childhood immunization program, quality of monitoring system, Somali Region-Ethiopia

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Authors: Christopher G. Harris, Guy D. Eslick

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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.

Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis

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Authors: Sihem Ferah, Karima Messaoudi

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Tourism is far from of being apprehended as a closed space limited to a defined area. The different experiences in the world have shown that tourism should be set up in the city, where locals can meet tourists, to know their history, tradition, culture, and relationship with the territory. In Algeria, the strategy employed in the context of promoting tourism is to integrate sustainable tourism based on a set of instruments such as the tourism expansion areas named ZET. Unfortunately, these areas have promoted the economic and environmental dimension, neglecting the social dimension which is the responsible of the community well–being. The case of Taleza village in Collo (characterized by its various potential) demonstrates clearly this paradox between the planned tourism in the ZET in Taleza as an economic product and the Tourism lived inside this local environment. When people by their genius and innovative action have succeeded to create an alternative tourism (social tourism) developed through guesthouses, sales of local products which have participated in promoting local Tourism Taleza. The aim of this research is to find a strong position between the planned space ZET and the village of Taleža where sustainable tourism can be installed that encourages the social membership, preservation of the natural heritage of Taleza and generates economic benefits that will ensure a local development of the village and will succeed in maintain sustainable tourism on its territory.

Keywords: sustainable tourism, local development, rural areas, tourism expansion zone

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Authors: Yasin I. Tayem, Jamil Ahmed, Mahmood Bahzad, Abdullah Alnama, Fahad Al Asfoor, Mahmood A. Jalil, Mohammed Radhi, Ahmed Alenezi, Khalid A. J. Al-Khaja

Abstract:

Drug-drug interactions (DDIs) represent a significant cause of patient’s morbidity and mortality. The rate of DDIs is rapidly increasing worldwide with the increasing proportion of ageing population and frequent requirement of polypharmacy-prescription of multiple drugs to treat comorbidities. Prescribing physicians are responsible for checking their prescriptions for the presence and severity of DDIs. However, since a large number of new drugs are approved and marketed every year, new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely only upon their previous knowledge of medicine to avoid potential DDIs. The aim of this study was to explore the perceptions of physicians working at primary healthcare centers in Bahrain towards DDIs and how they manage them during their practice. Methodology: In this cross-sectional study, physicians working at all governmental primary healthcare centers in Bahrain were invited to voluntarily, privately and anonymously respond to a self-administered questionnaire. The questionnaire aims to assess their self-reported knowledge of DDIs and how they check for them in their practice. The participants were requested to provide socio demographic data and information related to their attitudes towards DDIs including strategies they employ for detecting and managing them, and their awareness of drugs which commonly cause DDIs. At the end of the questionnaire, an open-ended item was added to allow participants to further add any comment. Findings and Conclusions: The study is going on currently, and the results and conclusions will be presented at the conference.

Keywords: awareness, drug interactions, health centres, physicians

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Authors: Thiyam Tamphasana Devi, Bimlesh Kumar

Abstract:

A Computational Fluid Dynamics (CFD) technique has been applied to simulate the gas-liquid phase in double stirred tank of Rushton impeller. Eulerian-Eulerian model was adopted to simulate the multiphase with standard correlation of Schiller and Naumann for drag co-efficient. The turbulence was modeled by using standard k-ε turbulence model. The present CFD model predicts flow pattern, local gas hold-up, and local specific area. It also predicts local kLa (mass transfer rate) for single impeller. The predicted results were compared with experimental and CFD results of published literature. The predicted results are slightly over predicted with the experimental results; however, it is in reasonable agreement with other simulated results of published literature.

Keywords: Eulerian-Eulerian, gas-hold up, gas-liquid phase, local mass transfer rate, local specific area, Rushton Impeller

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Authors: Spencer Rutherford, Shadi Saleh

Abstract:

War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

Procedia PDF Downloads 125

Authors: Keiko Tamura, Munenari Inoguchi, Michiyo Tsuji

Abstract:

When disasters occur, in order to raise the speed of each decision making and response, it is common that delegation of authority is carried out. This tendency is particularly evident when the department or branch of the organization are separated by the physical distance from the main body; however, there are some issues to think about. If the department or branch is too dependent on the head office in the usual condition, they might feel lost in the disaster response operation when they are face to the situation. Avoiding this problem, an organization should decide how to delegate the authority and also who accept the responsibility for what before the disaster. This paper will discuss about the method which presents an approach for executing the delegation of authority process, implementing authorities, management by objectives, and preparedness plans and agreement. The paper will introduce the examples of efforts for the three research centers of Niigata University, Japan to arrange organizations capable of taking necessary actions for disaster response. Each center has a quality all its own. One is the center for carrying out the research in order to conserve the crested ibis (or Toki birds in Japanese), the endangered species. The another is the marine biological laboratory. The third one is very unique because of the old growth forests maintained as the experimental field. Those research centers are in the Sado Island, located off the coast of Niigata Prefecture, is Japan's second largest island after Okinawa and is known for possessing a rich history and culture. It takes 65 minutes jetfoil (high-speed ferry) ride to get to Sado Island from the mainland. The three centers are expected to be easily isolated at the time of a disaster. A sense of urgency encourages 3 centers in the process of organizational restructuring for enhancing resilience. The research team from the risk management headquarters offer those procedures; Step 1: Offer the hazard scenario based on the scientific evidence, Step 2: Design a risk management organization for disaster response function, Step 3: Conduct the participatory approach to make consensus about the overarching objectives, Step 4: Construct the unified operational action plan for 3 centers, Step 5: Simulate how to respond in each phase based on the understanding the various phases of the timeline of a disaster. Step 6: Document results to measure performance and facilitate corrective action. This paper shows the result of verifying the output and effects.

Keywords: delegation of authority, disaster response, risk management, unified command

Procedia PDF Downloads 99