Search results for: decision to choose the spa service

Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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Authors: Mehrdad Abkenari, Orod Zarrinkafsh, Mohsen Ramezan Shirazi

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Construction projects initiate in complicated dynamic environments and, due to the close relationships between project parameters and the unknown outer environment, they are faced with several uncertainties and risks. Success in time, cost and quality in large scale construction projects is uncertain in consequence of technological constraints, large number of stakeholders, too much time required, great capital requirements and poor definition of the extent and scope of the project. Projects that are faced with such environments and uncertainties can be well managed through utilization of the concept of risk management in project’s life cycle. Although the concept of risk is dependent on the opinion and idea of management, it suggests the risks of not achieving the project objectives as well. Furthermore, project’s risk analysis discusses the risks of development of inappropriate reactions. Since evaluation and prioritization of construction projects has been a difficult task, the network structure is considered to be an appropriate approach to analyze complex systems; therefore, we have used this structure for analyzing and modeling the issue. On the other hand, we face inadequacy of data in deterministic circumstances, and additionally the expert’s opinions are usually mathematically vague and are introduced in the form of linguistic variables instead of numerical expression. Owing to the fact that fuzzy logic is used for expressing the vagueness and uncertainty, formulation of expert’s opinion in the form of fuzzy numbers can be an appropriate approach. In other words, the evaluation and prioritization of construction projects on the basis of risk factors in real world is a complicated issue with lots of ambiguous qualitative characteristics. In this study, evaluated and prioritization the risk parameters and factors with fuzzy logy method by combination of three method DEMATEL (Decision Making Trial and Evaluation), ANP (Analytic Network Process) and TOPSIS (Technique for Order-Preference by Similarity Ideal Solution) on Construction Management.

Keywords: fuzzy logy, risk, prioritization, assessment

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Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen

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The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.

Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology

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Authors: Joanna Peksa, Faith Dillon-Lee

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Current developments in the Western economies have turned some universities into corporate institutions driven by practices of production and commodity. Academia is increasingly becoming integrated into national economies as a result of students paying fees and is consequently using business practices in student retention and engagement. With these changes, pedagogy status as a priority within the institution has been changing in light of these new demands. New strategies have blurred the boundaries that separate a student from a client. This led to a change of the dynamic, disrupting the traditional idea of the knowledge market, and emphasizing the corporate aspect of universities. In some cases, where students are seen primarily as a customer, the purpose of academia is no longer to educate but sell a commodity and retain fee-paying students. This paper considers opposing viewpoints on the commodification of higher education, reflecting on the reality of maintaining a pedagogic grounding in an increasingly commercialized sector. By analysing a case study of the Student Success Festival, an event that involved academic and marketing teams, the differences are considered between the respective visions of the pedagogic arm of the university and the corporate. This study argues that the initial concept of the event, based on the principles of gamification, independent learning, and cognitive criticality, was more clearly linked to a grounded pedagogic approach. However, when liaising with the marketing team in a crucial step in the creative process, it became apparent that these principles were not considered a priority in terms of their remit. While the study acknowledges in the power of pedagogy, the findings show that a pact of concord is necessary between different stakeholders in order for students to benefit fully from their learning experience. Nevertheless, while issues of power prevail and whenever power is unevenly distributed, reaching a consensus becomes increasingly challenging and further research should closely monitor the developments in pedagogy in the UK higher education.

Keywords: economic pressure, commodification, pedagogy, gamification, public service, marketization

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Authors: Chenhao Zhu

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Quantitative mapping is playing a growing role in guiding urban planning, such as using a heat map created by CFX, CFD2000, or Envi-met, to adjust the master plan. However, there is no effective quantitative link between the mappings and planning formation. So, in many cases, the decision-making is still based on the planner's subjective interpretation and understanding of these mappings, which limits the improvement of scientific and accuracy brought by the quantitative mapping. Therefore, in this paper, an effort has been made to give a methodology of building a parametric link between the mapping and planning formation. A parametric planning process based on radiant mapping has been proposed for creating an urban green system. In the first step, a script is written in Grasshopper to build a road network and form the block, while the Ladybug Plug-in is used to conduct a radiant analysis in the form of mapping. Then, the research creatively transforms the radiant mapping from a polygon into a data point matrix, because polygon is hard to engage in the design formation. Next, another script is created to select the main green spaces from the road network based on the criteria of radiant intensity and connect the green spaces' central points to generate a green corridor. After that, a control parameter is introduced to adjust the corridor's form based on the radiant intensity. Finally, a green system containing greenspace and green corridor is generated under the quantitative control of the data matrix. The designer only needs to modify the control parameter according to the relevant research results and actual conditions to realize the optimization of the green system. This method can also be applied to much other mapping-based analysis, such as wind environment analysis, thermal environment analysis, and even environmental sensitivity analysis. The parameterized link between the mapping and planning will bring about a more accurate, objective, and scientific planning.

Keywords: parametric link, mapping, urban green system, radiant intensity, planning strategy, grasshopper

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Authors: Yi-Fan Lin, Peter P. Howley, Frank A. Tuyl

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Quality measurement and reporting systems are used in healthcare internationally. In Australia, the Australian Council on Healthcare Standards records and reports hundreds of clinical indicators (CIs) nationally across the healthcare system. These CIs are measures of performance in the clinical setting, and are used as a screening tool to help assess whether a standard of care is being met. Existing analysis and reporting of these CIs incorporate Bayesian methods to address sampling variation; however, such assessments are retrospective in nature, reporting upon the previous six or twelve months of data. The use of Bayesian methods within statistical process control for monitoring systems is an important pursuit to support more timely decision-making. Our research has developed and assessed a new graphical monitoring tool, similar to a control chart, based on the beta-binomial posterior predictive (BBPP) distribution to facilitate the real-time assessment of health care organizational performance via CIs. The BBPP charts have been compared with the traditional Bernoulli CUSUM (BC) chart by simulation. The more traditional “central” and “highest posterior density” (HPD) interval approaches were each considered to define the limits, and the multiple charts were compared via in-control and out-of-control average run lengths (ARLs), assuming that the parameter representing the underlying CI rate (proportion of cases with an event of interest) required estimation. Preliminary results have identified that the BBPP chart with HPD-based control limits provides better out-of-control run length performance than the central interval-based and BC charts. Further, the BC chart’s performance may be improved by using Bayesian parameter estimation of the underlying CI rate.

Keywords: average run length (ARL), bernoulli cusum (BC) chart, beta binomial posterior predictive (BBPP) distribution, clinical indicator (CI), healthcare organization (HCO), highest posterior density (HPD) interval

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Authors: Chitra Rajagopal, Indra Deo Kumar, Ila Chauhan, Ruchi Joshi, Binoy Bhargavan

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Reliability and safety are essential for the success of mission-critical and safety-critical defense systems. Humans are part of the entire life cycle of defense systems development and deployment. The majority of industrial accidents or disasters are attributed to human errors. Therefore, considerations of human performance and human reliability are critical in all complex systems, including defense systems. Defense systems are operating from the ground, naval and aerial platforms in diverse conditions impose unique physical and psychological challenges to the human operators. Some of the safety and mission-critical defense systems with human-machine interactions are fighter planes, submarines, warships, combat vehicles, aerial and naval platforms based missiles, etc. Human roles and responsibilities are also going through a transition due to the infusion of artificial intelligence and cyber technologies. Human operators, not accustomed to such challenges, are more likely to commit errors, which may lead to accidents or loss events. In such a scenario, it is imperative to understand the human factors in defense systems for better systems performance, safety, and cost-effectiveness. A case study using Task Analysis (TA) based methodology for assessment and reduction of human errors in the Air and Missile Defense System in the context of emerging technologies were presented. Action-oriented task analysis techniques such as Hierarchical Task Analysis (HTA) and Operator Action Event Tree (OAET) along with Critical Action and Decision Event Tree (CADET) for cognitive task analysis was used. Human factors assessment based on the task analysis helps in realizing safe and reliable defense systems. These techniques helped in the identification of human errors during different phases of Air and Missile Defence operations, leading to meet the requirement of a safe, reliable and cost-effective mission.

Keywords: defence systems, reliability, risk, safety

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Authors: H. H. Elewa, E. M. Ramadan, A. M. Nosair

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Rainfall water harvesting is considered as an important tool for overcoming water scarcity in arid and semi-arid region. Wadi Watir in the southeastern part of Sinai Peninsula is considered as one of the main and active basins in the Gulf of Aqaba drainage system. It is characterized by steep hills mainly consist of impermeable rocks, whereas the streambeds are covered by a highly permeable mixture of gravel and sand. A comprehensive approach involving the integration of geographic information systems, remote sensing and watershed modeling was followed to identify the RWH capability in this area. Eight thematic layers, viz volume of annual flood, overland flow distance, maximum flow distance, rock or soil infiltration, drainage frequency density, basin area, basin slope and basin length were used as a multi-parametric decision support system for conducting weighted spatial probability models (WSPMs) to determine the potential areas for the RWH. The WSPMs maps classified the area into five RWH potentiality classes ranging from the very low to very high. Three performed WSPMs' scenarios for W. Watir reflected identical results among their maps for the high and very high RWH potentiality classes, which are the most suitable ones for conducting surface water harvesting techniques. There is also a reasonable match with respect to the potentiality of runoff harvesting areas with a probability of moderate, low and very low among the three scenarios. WSPM results have shown that the high and very high classes, which are the most suitable for the RWH are representing approximately 40.23% of the total area of the basin. Accordingly, several locations were decided for the establishment of water harvesting dams and cisterns to improve the water conditions and living environment in the study area.

Keywords: Sinai, Wadi Watir, remote sensing, geographic information systems, watershed modeling, runoff water harvesting

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Authors: Aline M. Dantas, Alexander T. Sack, Elisabeth Bruggen, Peiran Jiao, Teresa Schuhmann

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Risk-taking behavior has been associated with the activity of specific prefrontal regions of the brain, namely the right dorsolateral prefrontal cortex (DLPFC) and the ventromedial prefrontal cortex (VMPFC). While the deactivation of the rDLPFC has been shown to lead to increased risk-taking behavior, the functional relationship between VMPFC activity and risk-taking behavior is yet to be clarified. Correlational evidence suggests that the VMPFC is involved in valuation processes that involve risky choices, but evidence on the functional relationship is lacking. Therefore, this study uses brain stimulation to investigate the role of the VMPFC during risk-taking behavior and replicate the current findings regarding the role of the rDLPFC in this same phenomenon. We used continuous theta-burst stimulation (cTBS) to inhibit either the VMPFC or DLPFC during the execution of the computerized Maastricht Gambling Task (MGT) in a within-subject design with 30 participants. We analyzed the effects of such stimulation on risk-taking behavior, participants’ choices of probabilities and average values, and response time. We hypothesized that, compared to sham stimulation, VMPFC inhibition leads to a reduction in risk-taking behavior by reducing the appeal to higher-value options and, consequently, the attractiveness of riskier options. Right DLPFC (rDLPFC) inhibition, on the other hand, should lead to an increase in risk-taking due to a reduction in cognitive control, confirming existent findings. Stimulation of both the rDLPFC and the VMPFC led to an increase in risk-taking behavior and an increase in the average value chosen after both rDLPFC and VMPFC stimulation compared to sham. No significant effect on chosen probabilities was found. A significant increase in response time was observed exclusively after rDLPFC stimulation. Our results indicate that inhibiting DLPFC and VMPFC separately leads to similar effects, increasing both risk-taking behavior and average value choices, which is likely due to the strong anatomical and functional interconnection of the VMPFC and rDLPFC.

Keywords: decision-making, risk-taking behavior, brain stimulation, TMS

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Authors: Xiyue Wang, Shaoning Yan

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Cities in China today is faced with an increasingly serious river ecological crisis accompanying with the development of urbanization: waterlogging on account of the fragmented urban natural hydrological system; the limited ecological function of the hydrological system caused by a destruction of water system and waterfront ecological environment. Additionally, the eco-hydrological processes of rivers are affected by various environmental factors, which are more complex in the context of urban environment. Therefore, efficient hydrological monitoring and analysis tools, accurate and visual hydrological and hydraulic models are becoming more important basis for decision-makers and an important way for landscape architects to solve urban hydrological problems, formulating sustainable and forward-looking schemes. The study mainly introduces the river and flood analysis model based on the platform of Autodesk Civil 3D. Taking the Luanhe River in Qian'an City of Hebei Province as an example, the 3D models of the landform, river, embankment, shoal, pond, underground stream and other land features were initially built, with which the water transfer simulation analysis, river floodplain analysis, and river ecology analysis were carried out, ultimately the real-time visualized simulation and analysis of rivers in various hypothetical scenarios were realized. Through the establishment of digital hydrological and hydraulic model, the hydraulic data can be accurately and intuitively simulated, which provides basis for rational water system and benign urban ecological system design. Though, the hydrological and hydraulic model based on Autodesk Civil3D own its boundedness: the interaction between the model and other data and software is unfavorable; the huge amount of 3D data and the lack of basic data restrict the accuracy and application range. The hydrological and hydraulic model based on Autodesk Civil3D platform provides more possibility to access convenient and intelligent tool for urban planning and monitoring, a solid basis for further urban research and design.

Keywords: visualization, hydrological and hydraulic model, Autodesk Civil 3D, urban river

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Authors: Li-Fang CHou, Chun-Jung Tseng, Sung-Chun Tsai

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Zhong-Yong represents unique values and cognitive beliefs of Chinese culture. Zhong-Yong thinking emphasizes (a) holistic thinking and perspective taking, (b) tolerance of contradictions, and (c) pursuance of a person’s interpersonal and inner harmony. With a unique way of naïve dialectical thinking based on Chinese culture, previous studies have found that people with higher Zhong-Yong thinking have more cognitive resources and resilience to make decision for dilemmas and cope stresses. Creativity is defined as the behavior to create novel and value products and viewed as the most important capital for individuals and enterprises. However, the relationship between Zhong-Yong thinking and creativity is still remaining to be unexplored. Three studies were conducted to explore the effects of Zhong-Yong thinking on creativity. In Study1, with 87 undergraduate students from a university in southern Taiwan as participants, we used questionnaire to measure Zhong-Yong thinking and processed creative task (unusual uses task) to get indicators of fluency and flexibility. After controlling background and openness to experience of Big five, the results showed that Zhong-Yong thinking had significant positive effects on fluency and flexibility. In Study 2, 97 undergraduate students were recruited to do Zhong-Yong thinking task and creative task. The result showed that, compared with control group, the participants had higher creative performance after being primed with Zhong-Yong thinking. In Study 3, we adopted questionnaire survey and took 397 employees from private enterprises in Taiwan as sample. Besides the main effects of Zhong-Yong thinking, the moderating effects on the relationship between leadership behavior and employee’s creative performance were also investigated. We found that (a) Zhong-Yong thinking was positively associated to creative performance; (b) Zhong-Yong thinking strengthened the positive effects of transformational and authoritative leadership on creative performance. Finally, the implications of theory/practice and limitations/future directions were also discussed.

Keywords: Zhong-Yong thinking, creativity and creative performance, unusual uses task, transformational leadership, authoritative leadership

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Authors: Kisik Song, Sungjoo Lee

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With the growing importance of intangible assets recently, the impact of patent infringement on the business of a company has become more evident. Accordingly, it is essential for firms to estimate the risk of patent infringement risk before developing a technology and create new technology ideas to avoid the risk. Recognizing the needs, several attempts have been made to help develop new technology opportunities and most of them have focused on identifying emerging vacant technologies from patent analysis. In these studies, the IPC (International Patent Classification) system or keywords from text-mining application to patent documents was generally used to define vacant technologies. Unlike those studies, this study adopted F-term, which classifies patent documents according to the technical features of the inventions described in them. Since the technical features are analyzed by various perspectives by F-term, F-term provides more detailed information about technologies compared to IPC while more systematic information compared to keywords. Therefore, if well utilized, it can be a useful guideline to create a new technology idea. Recognizing the potential of F-term, this paper aims to suggest a novel approach to developing new technology ideas to avoid patent infringement based on F-term. For this purpose, we firstly collected data about F-term and then applied text-mining to the descriptions about classification criteria and attributes. From the text-mining results, we could identify other technologies with similar technical features of the existing one, the patented technology. Finally, we compare the technologies and extract the technical features that are commonly used in other technologies but have not been used in the existing one. These features are presented in terms of “purpose”, “function”, “structure”, “material”, “method”, “processing and operation procedure” and “control means” and so are useful for creating new technology ideas that help avoid infringing patent rights of other companies. Theoretically, this is one of the earliest attempts to adopt F-term to patent analysis; the proposed methodology can show how to best take advantage of F-term with the wealth of technical information. In practice, the proposed methodology can be valuable in the ideation process for successful product and service innovation without infringing the patents of other companies.

Keywords: patent infringement, new technology ideas, patent analysis, F-term

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Authors: Ayoade Adeyemi, Leo Nherera, Paul Trueman, Antje Emmermann

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Background and objectives: Radiofrequency (RF) generated plasma chondroplasty is considered a promising treatment alternative to mechanical debridement (MD) with a shaver. The aim of the study was to perform a cost-effectiveness analysis comparing costs and outcomes following COBLATION chondroplasty versus mechanical debridement in patients with knee pain associated with a medial meniscus tear and idiopathic ICRS grade III focal lesion of the medial femoral condyle from a payer perspective. Methods: A decision-analytic model was developed comparing economic and clinical outcomes between the two treatment options in German patients following knee chondroplasty. Revision rates based on the frequency of repeat arthroscopy, osteotomy and conversion to total knee replacement, reimbursement costs and outcomes data over a 4-year time horizon were extracted from published literature. One-way sensitivity analyses were conducted to assess uncertainties around model parameters. Threshold analysis determined the revision rate at which model results change. All costs were reported in 2016 euros, future costs were discounted at a 3% annual rate. Results: Over a 4 year period, COBLATION chondroplasty resulted in an overall net saving cost of €461 due to a lower revision rate of 14% compared to 48% with MD. Threshold analysis showed that both options were associated with comparable costs if COBLATION revision rate was assumed to increase up to 23%. The initial procedure costs for COBLATION were higher compared to MD and outcome scores were significantly improved at 1 and 4 years post-operation versus MD. Conclusion: The analysis shows that COBLATION chondroplasty is a cost-effective option compared to mechanical debridement in the treatment of patients with a medial meniscus tear and idiopathic ICRS grade III defect of the medial femoral condyle.

Keywords: COBLATION, cost-effectiveness, knee chondroplasty, mechanical debridement

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Authors: S. Jayasinghe, R. B. N. Dissanayake

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Optimization modelling together with the Network models and Linear Programming techniques is a powerful tool in problem solving and decision making in real world applications. This study developed a mathematical model to optimize the net profit by minimizing the transportation cost. This model focuses the transportation among decentralized production plants to a centralized distribution centre and then the distribution among island wide agencies considering the customer satisfaction as a requirement. This company produces basically 9 types of food items with 82 different varieties and 4 types of non-food items with 34 different varieties. Among 6 production plants, 4 were located near the city of Mawanella and the other 2 were located in Galewala and Anuradhapura cities which are 80 km and 150 km away from Mawanella respectively. The warehouse located in the Mawanella was the main production plant and also the only distribution plant. This plant distributes manufactured products to 39 agencies island-wide. The average values and average amount of the goods for 6 consecutive months from May 2013 to October 2013 were collected and then average demand values were calculated. The following constraints are used as the necessary requirement to satisfy the optimum condition of the model; there was one source, 39 destinations and supply and demand for all the agencies are equal. Using transport cost for a kilometer, total transport cost was calculated. Then the model was formulated using distance and flow of the distribution. Network optimization and linear programming techniques were used to originate the model while excel solver is used in solving. Results showed that company requires total transport cost of Rs. 146, 943, 034.50 to fulfil the customers’ requirement for a month. This is very much less when compared with data without using the model. Model also proved that company can reduce their transportation cost by 6% when distributing to island-wide customers. Company generally satisfies their customers’ requirements by 85%. This satisfaction can be increased up to 97% by using this model. Therefore this model can be used by other similar companies in order to reduce the transportation cost.

Keywords: mathematical model, network optimization, linear programming

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Authors: Armando T. Zúñiga

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As the number of English Language Learners (ELLs) in public schools continues to grow, so does the achievement gap between ELLs and other student populations. In an effort to support classroom teachers with effective instructional strategies for this student population, many districts have created instructional coaching positions specifically to support classroom teachers of ELLs—ELL Teachers on Special Assignment (ELL TOSAs). This study employed a gap analysis framework to the ELL TOSA professional support program in one California school district to examine knowledge, motivation, and organizational influences (KMO) on the ELL TOSAs’ goal of supporting classroom teachers of ELLs. Three themes emerged as a result of data analysis. First, there was evidence to illustrate the interaction between knowledge and the organization. Data from ELL TOSAs indicated an understanding of the role that collaboration plays in coaching and how to operationalize it in their support of teachers. Further, all of the ELL TOSAs indicated they have received professional development on effective strategies for instructional coaching. Additionally, a large percentage of the ELL TOSAs indicated a knowledge of modeling as an effective coaching practice. Accordingly, all of the ELL TOSAs indicated that they had knowledge of feedback as an effective coaching strategy. However, there was not sufficient evidence to support that they learned the latter two strategies through professional development. A second theme surfaced as there was evidence to illustrate an interaction between motivation and the organization. Some ELL TOSAs indicated that their sense of self-efficacy was affected by conflicting roles and expectations for the job. Most of the ELL TOSAs indicated that their sense of self-efficacy was affected by an increased workload brought about by fiscal decision making. Finally, there was evidence illustrating the interaction between the organization and motivation. The majority of the of ELL TOSAs indicated that there is confusion about how their roles are perceived, leaving the ELL TOSAs to feel that their actions did not contribute to instructional change. In conclusion, five research-based recommendations to support ELL TOSA goal attainment and considerations for future research on instructional coaches for classroom teachers of ELLs are provided.

Keywords: English language development, English language acquisition, language and leadership, language coaching, English language learners, second language acquisition

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Authors: Muhammad Afzal, Shahbaz Mushtaq, Duc-Anh-An-Vo, Kathryn Reardon Smith, Thanh Ma

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Climate change has become one of the most challenging environmental issues in the 21st century. Climate change-induced natural disasters, especially floods, are the major factors of livelihood vulnerability, impacting millions of individuals worldwide. Evaluating and mitigating the effects of floods requires an in-depth understanding of the relationship between vulnerability and livelihood capital assets. Using an integrated approach, sustainable livelihood framework, and system thinking approach, the study developed a conceptual model of a generalized livelihood system in District Rajanpur, Pakistan. The model visualizes the livelihood vulnerability system as a whole and identifies the key feedback loops likely to influence the livelihood vulnerability. The study suggests that such conceptual models provide effective communication and understanding tools to stakeholders and decision-makers to anticipate the problem and design appropriate policies. It can also serve as an evaluation technique for rural livelihood policy and identify key systematic interventions. The key finding of the study reveals that household income, health, and education are the major factors behind the livelihood vulnerability of the rural poor of District Rajanpur. The Pakistani government tried to reduce the livelihood vulnerability of the region through different income, health, and education programs, but still, many changes are required to make these programs more effective especially during the flood times. The government provided only cash to vulnerable and marginalized families through income support programs, but this study suggests that along with the cash, the government must provide seed storage facilities and access to crop insurance to the farmers. Similarly, the government should establish basic health units in villages and frequent visits of medical mobile vans should be arranged with advanced medical lab facilities during and after the flood.

Keywords: livelihood vulnerability, rural communities, flood, sustainable livelihood framework, system dynamics, Pakistan

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Authors: Marja A. Bernardo, Coreena A. Bueser, Cybele Lara R. Abad, Raul V. Destura

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Pneumocystis jirovecii pneumonia (PCP) is the most common opportunistic infection among people with HIV. Early consideration of PCP should be made even in patients whose HIV status is unknown as delay in treatment may be fatal. The use of absolute lymphocyte count (ALC) has been suggested as an alternative predictor of PCP especially in resource limited settings where PCR testing is costly or delayed. Objective: To determine whether the absolute lymphocyte count (ALC) can be used as a screening tool to predict Pneumocystis pneumonia in patients with unknown HIV status admitted at a private tertiary hospital. Methods: A retrospective cross-sectional study was conducted at a private tertiary medical center. Inpatient medical records of patients aged 18 years old and above from January 2012 to May 2014, in whom a clinical diagnosis of Pneumocystis jirovecii pneumonia was made were reviewed for inclusion. Demographic data, clinical features, hospital course, PCP PCR and HIV results were recorded. Independent t-test and chi-square analysis was used to determine any statistical difference between PCP-positive and PCP-negative groups. Mann-Whitney U-test was used for comparison of hospital stay. Results: There were no statistically significant differences in baseline characteristics between PCP positive and negative groups. While both the percent lymphocyte count (0.14 ± 0.13 vs 0.21 ± 0.16) and ALC (1160 ± 528.67 vs 1493.70 ± 988.61) were lower for the PCP-positive group, only the percent lymphocyte count reached a statistically significant difference (p= 0.067 vs p= 0.042). Conclusion: A quick determination of the ALC may be useful as an additional parameter to help screen for and diagnose pneumocystis pneumonia. In our study, the ALC of patients with PCP appear to be lower than in patients without PCP. A low ALC (e.g. below 1200) may help with the decision regarding empiric treatment. However, it should be used in conjunction with the patient’s clinical presentation, as well as other diagnostic tests. Larger, prospective studies incorporating the ALC with other clinical predictors are necessary to optimally predict those who would benefit from empiric or expedited management for potential PCP.

Keywords: Pneumocystis carinii pneumonia, Absolute Lymphocyte Count, infection, PCP

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Authors: Benjamin Newman

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The picture of an adverse contest between two parties has often been used as an archetypal description of the Anglo-American adversarial criminal trial. However, in actuality, guilty pleas and plea-bargains have been dominating the procedure for over the last half-a-century. Characterised by two adverse parties, the court adjudicative system in the Anglo-American world adhere to the adversarial procedure, and while further features have been attributed and the values that are embedded within the procedure vary, it is a system that we have no adequate theory. Damaska had argued that the adversarial conflict-resolution mode of administration of justice stems from a liberal laissez-faire concept of a value neutral liberal state. Having said that, the court’s neutrality has been additionally rationalised in light of its liberal end as a safeguard from the state’s coercive force. Both conceptions of the court’s neutrality conflict in cases where the by-standing role disposes of its liberal duty in safeguarding the individual. Such is noticeable in plea bargains, where the defendant has the liberty to plead guilty, despite concerns over wrongful convictions and deprivation of liberty. It is an inner liberal tension within the notion of criminal adversarialism, between the laissez-faire mode which grants autonomy to the parties and the safeguarding liberal end of the trial. Langbein had asserted that the adversarial system is a criminal procedure for which we have no adequate theory, and it is by reference to political and moral theories that the research aims to articulate a normative account. The paper contemplates on the above liberal-tension, and by reference to Duff’s ‘calling-to-account’ theory, argues that autonomy is of inherent value to the criminal process, being considered a constitutive element in the process of being called to account. While the aspiration is that the defendant’s guilty plea should be genuine, the guilty-plea decision must be voluntary if it is to be considered a performative act of accountability. Thus, by valuing procedural autonomy as a necessary element within the criminal adjudicative process, it assimilates a liberal procedure, whilst maintaining the liberal end by holding the defendant to account.

Keywords: liberal theory, adversarial criminal procedure, criminal law theory, liberal perfectionism, political liberalism

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Authors: Maha Ben Salem

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The transformative aspect of emerging adulthood brings about a development of self-processes, including changes in self-esteem and personal goals. Success in this life stage entails the emotional growth necessary to navigate the demands and challenges of college life. Understanding the concept of self-awareness within this particular age group sheds light on emerging adults’ internal world and the transformative aspect of their emotional growth. Uncovering the thoughts' processes that foster or hinder self-awareness is important to the understanding of how emerging adults learn to make themselves positive or negative. However, existing research in self-awareness has explored this phenomenon mostly using quantitative research methodology or through tying an individual’s level of self-awareness to specific actions or outcomes. Little is known about the process of how college students emerging adults notice and monitor their inner thoughts and emotions. Methodology and theoretical orientation: A grounded theory study using in-depth semi-structured interview was utilized. Nine interviews have been conducted. A constructionist framework was employed to generate a theory as for how self-awareness facilitates specific patterns of thinking in emerging adults. The choice of grounded theory emanates from a lack of knowledge regarding underlying thinking procedures and internal states that emerging adult college students navigate in an attempt to make meaning out of the new academic experience and life stage. Findings: Initial data analysis generated the following categories of the theory: (a) a non-judgmental perception of negative thinking and negative emotions that allow for a better understanding of the self; (b) negative state of mind is easy to overcome when it is accepted and acknowledged; (c) knowledge of the actual and desired self-generates an intentional decision to shift to a positive mindset. Preliminary findings indicate that college academic and social environment foster a new understanding of the self that yield a change in mindset and in self-knowledge.

Keywords: college environment, emergent adults, grounded theory, positive mindset, self-awareness

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Authors: Maria Inês Faria, João Miguel Simão

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Frequently, the Sustainable Development paradigm is considered the contemporary societies flag and is has been assuming different nuances on local and global dialogues. This reveals the ambivalent character associated to its implementation due, namely, to the kind of synergies that political institutions, social organizations and citizenry can actually create. The Sustainable Development concept needs further discussion so that it can be useful in decision-making processes. In fact, the polysemic nature of this concept has consistently undermined its credibility leading, among other factors, to the talk and action gap, as well as to misappropriations of this notion. The present study focuses on the importance in questioning the sustainable development operationalization, "To walk the talk", and intends, in a broad sense, identify prospects and the elements of sustainability that are included in strategic plans (global, national and local) and, in the strict sense, confront discourse and practice in the context of local public policies for sustainable development, in particular with regard to the implementation of Local Agenda 21 in the municipality of Beja (Portugal) in order to analyze at what extent the strategies adopted and implemented are aligned with the paradigm of sustainable development. The method is based on critical analysis of literature and official documentation, using three complementary approaches: a) exploratory review of literature in order to identify publications on sustainability and sustainable development; b) this second approach complements the first, focused on the official documentation for the adoption and implementation of sustainable development, which is produced in the global plan, regional, national and local levels; c) and the approach which is focused on official documentation that expresses the policy options, the strategic lines and actions for sustainable development implementation Beja´s Municipality. The main results of this study highlight the type of alignment of the Beja´s Municipality sustainable policies, concerning the officially stipulated for the promotion of sustainable development on the international agenda, stressing the potentialities, constraints and challenges of Agenda 21 Local implementation.

Keywords: sustainable development, Local Agenda 21, sustainable local public policies, Beja

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Authors: Taylor La Carriere

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“What I had madly possessed was not she, but my own creation, another, fanciful Lolita perhaps, more real than Lolita; overlapping, encasing he and having no will, no consciousness indeed, no life of her own,” Vladimir Nabokov writes in his seminal work, Lolita. Throughout Nabokov’s novel, the eponymous character is rendered nonexistent through unreliable narrator Humbert Humbert’s impenetrable narrative, infused with lyrical rationalization. Instead, Lolita is “safely solipsised,” as Humbert muses, solidifying the potential for the erasure of Lolita’s agency and identity. In this literary work, Lolita’s voice is reduced to a nearly invisible presence, only seen through the eyes of her captor. However, in Stanley Kubrick’s film adaptation of Lolita (1962), the “nymphet,” as Nabokov coins, reemerges with a voice of her own, fueled by a lyric impulse, that displaces Humbert’s first-person narration. The lyric, as defined by Catherine Ing, is the voice of the invisible; it is also characterized by performance, the concentrated utterance of individual emotion, and the appearance of spontaneity. The novel’s lyricism is largely in the service of Humbert’s “seductive” voice, while the film reorients it more to Lolita’s subjectivity. Through a close analysis of Kubrick’s cinematic techniques, this paper examines the emergence and translation of Lolita’s voice in contrast with Humbert’s attempts to silence her in Nabokov’s Lolita, hypothesizing that Kubrick translates Lolita’s presence into a visual and aural voice with lyrical attributes, exemplified through the establishment of an altered power dynamic, Sue Lyon’s transformative performance as the titular character, Nelson Riddle and Bob Harris’ musical score, and the omission of Humbert’s first-person point-of-view. In doing so, the film reclaims Lolita’s agency by taking instances of Lolita’s voice in the novel as depicted in the last half of the work and expanding upon them in a way only cinematic depictions could allow. The results of this study suggest that Lolita’s voice in Kubrick’s adaptation functions without disrupting the lyricism present in Nabokov’s source text, materializing through the actions, expressions, and performance of Sue Lyon in the film. This voice, fueled by a lyric impulse of its own, refutes the silence bestowed upon the titular character and enables its ultimate reclamation upon the silver screen.

Keywords: cinema, adaptation, Lolita, lyric voice

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Authors: Mohamed F. Othman

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Manchester, Britain has become the destination of immigrants from different parts of the world. As a result, it is currently home to over 150 different ethnic languages. The present study investigates minority language policy and planning at the micro-level of the city. In order to get an in-depth investigation of such a policy, it was decided to cover it from two angles: the first is the policy making process. This was aimed at getting insights on how decisions regarding the provision of government services in minority languages are taken and what criteria are employed. The second angle is the service provider; i.e. the different departments in Manchester City Council (MCC), the NHS, the courts, and police, etc., to obtain information on the actual provisions of services. Data was collected through semi-structured interviews with different personnel representing different departments in MCC, solicitors, interpreters, etc.; through the internet, e.g. the websites of MCC, NHS, courts, and police, etc.; and via personal observation of provisions of community languages in government services. The results show that Manchester’s language policy is formulated around two concepts that work simultaneously: one is concerned with providing services in community languages in order to help minorities manage their life until they acquire English, and the other with helping the integration of minorities through encouraging them to learn English. In this regard, different government services are provided in community languages, though to varying degrees, depending on the numerical strength of each individual language. Thus, it is concluded that there is awareness in MCC and other government agencies working in Manchester of the linguistic diversity of the city and there are serious attempts to meet this diversity in their services. It is worth mentioning here that providing such services in minority languages are not meant to support linguistic diversity, but rather to maintain the legal right to equal opportunities among the residents of Manchester and to avoid any misunderstanding that may result due to the language barrier, especially in such areas as hospitals, courts, and police. There is actually no explicitly-mentioned language policy regarding minorities in Manchester; rather, there is an implied or covert policy resulting from factors that are not explicitly documented. That is, there are guidelines from the central government, which emphasize the principle of equal opportunities; then the implementation of such guidelines requires providing services in the different ethnic languages.

Keywords: community language, covert language policy, micro-language policy and planning, minority language

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Authors: Mihir Halder

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The main aim and objective of the eighteen-month long Diploma in Primary Education (DPED) teacher education training course for in-service primary teachers in Bangladesh is to acquire professional knowledge as well as make them proficient in professional practice. The training, therefore, introduces a variety of theoretical and practical approaches as well as some professional development activities—lesson study being one of them. But, in the field of mathematics teaching, even after implementing the lesson study method, the desired practical teaching skills of the teachers have not been developed. In addition, elementary students also remain quite raw in mathematics. Although there have been various studies to solve the problem, the need for the teachers' views on mathematical ideas has not been taken into consideration. The researcher conducted the research to find out the cause of the discussed problem. In this case, two teams of nine DPED trainee teachers and two instructors conducted two lesson studies in two schools located in the city and town of Khulna Province, Bangladesh. The researcher observed group lesson planning by trainee teachers, followed by a trainee teacher teaching the planned lesson plan to an actual mathematics classroom, and finally, post-teaching reflective discussion in each lesson study. Two DPED instructors acted as mentors in the lesson study. DPED trainee teachers and instructors were asked about mathematical concepts and classroom practices through questionnaires as well as videotaped mathematics classroom teaching. For this study, the DPED mathematics course, curriculum, and assessment activities were analyzed. In addition, the mathematics lesson plans prepared by the trainee teachers for the lesson study and their pre-teaching and post-teaching reflective discussions were analyzed by some analysis categories and rubrics. As a result, it was found that the trainee teachers' views of mathematics are not mature, and therefore, their mathematics teaching practice is not appropriate. Therefore, in order to improve teachers' mathematics teaching, the researcher recommended including some action-oriented aspects in each phase of mathematics lesson study in DPED—for example, emphasizing mathematics concepts of the trainee teachers, preparing appropriate teaching materials, presenting lessons using the problem-solving method, using revised rubrics for assessing mathematics lesson study, etc.

Keywords: mathematics lesson study, knowledge of mathematics, knowledge of teaching mathematics, teachers' views

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Authors: Hasan Ziari, Hassan Fazaeli, Seyed Javad Vaziri Kang Olyaei, Asma Sadat Dabiri

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The presence of cracks in concrete pavements is a place for the ingression of corrosive substances, acids, oils, and water into the pavement and reduces its long-term durability and level of service. One of the causes of early cracks in concrete pavements is the plastic shrinkage. This shrinkage occurs due to the formation of negative capillary pressures after the equilibrium of the bleeding and evaporation rates at the pavement surface. These cracks form if the tensile stresses caused by the restrained shrinkage exceed the tensile strength of the concrete. Different climate conditions change the rate of evaporation and thus change the balance time of the bleeding and evaporation, which changes the severity of cracking in concrete. The present study examined the relationship between the balance time of bleeding and evaporation and the area of cracking in the concrete slabs using the standard method ASTM C1579 in 27 different environmental conditions by using continuous video recording and digital image analyzing. The results showed that as the evaporation rate increased and the balance time decreased, the crack severity significantly increased so that by reducing the balance time from the maximum value to its minimum value, the cracking area increased more than four times. It was also observed that the cracking area- balance time curve could be interpreted in three sections. An examination of these three parts showed that the combination of climate conditions has a significant effect on increasing or decreasing these two variables. The criticality of a single factor cannot cause the critical conditions of plastic cracking. By combining two mild environmental factors with a severe climate factor (in terms of surface evaporation rate), a considerable reduction in balance time and a sharp increase in cracking severity can be prevented. The results of this study showed that balance time could be an essential factor in controlling and predicting plastic shrinkage cracking in concrete pavements. It is necessary to control this factor in the case of constructing concrete pavements in different climate conditions.

Keywords: bleeding and cracking severity, concrete pavements, climate conditions, plastic shrinkage

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Authors: Lucas Paganin, Viliam Makis

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With the advent of globalization, the market competition has become a major issue for most companies. One of the main strategies to overcome this situation is the quality improvement of the product at a lower cost to meet customers’ expectations. In order to achieve the desired quality of products, it is important to control the process to meet the specifications, and to implement the optimal maintenance policy for the machines and the production lines. Thus, the overall objective is to reduce process variation and the production and maintenance costs. In this paper, an integrated model involving Statistical Process Control (SPC) and maintenance is developed to achieve this goal. Therefore, the main focus of this paper is to develop the jointly optimal maintenance and statistical process control policy minimizing the total long run expected average cost per unit time. In our model, the production process can go out of control due to either the deterioration of equipment or other assignable causes. The equipment is also subject to failures in any of the operating states due to deterioration and aging. Hence, the process mean is controlled by an Xbar control chart using equidistant sampling epochs. We assume that the machine inspection epochs are the times when the control chart signals an out-of-control condition, considering both true and false alarms. At these times, the production process will be stopped, and an investigation will be conducted not only to determine whether it is a true or false alarm, but also to identify the causes of the true alarm, whether it was caused by the change in the machine setting, by other assignable causes, or by both. If the system is out of control, the proper actions will be taken to bring it back to the in-control state. At these epochs, a maintenance action can be taken, which can be no action, or preventive replacement of the unit. When the equipment is in the failure state, a corrective maintenance action is performed, which can be minimal repair or replacement of the machine and the process is brought to the in-control state. SMDP framework is used to formulate and solve the joint control problem. Numerical example is developed to demonstrate the effectiveness of the control policy.

Keywords: maintenance, semi-Markov decision process, statistical process control, Xbar control chart

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Authors: Tania Vasquez Mata, Luis A. Herrera, Cristian Arriaga Canon

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Background: Locally advanced breast cancer of the luminal B phenotype, poses challenges due to its variable response to neoadjuvant chemotherapy. A predictive biomarker is needed to identify patients who will not respond to treatment, allowing for alternative therapies. This study aims to validate the use of the lncRNA GATA3-AS1, as a predictive biomarker using RNA in situ hybridization. Research aim: The aim of this study is to determine if GATA3-AS1 can serve as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Methodology: The study utilizes RNA in situ hybridization with predesigned probes for GATA3-AS1 on Formalin-Fixed Paraffin-Embedded tissue sections. The samples underwent pretreatment and protease treatment to enable probe penetration. Chromogenic detection and signal evaluation were performed using specific criteria. Findings: Patients who did not respond to neoadjuvant chemotherapy showed a 3+ score for GATA3-AS1, while those who had a complete response had a 1+ score. Theoretical importance: This study demonstrates the potential clinical utility of GATA3-AS1 as a biomarker for resistance to neoadjuvant chemotherapy. Identifying non-responders early on can help avoid unnecessary treatment and explore alternative therapy options. Data collection and analysis procedures: Tissue samples from patients with locally advanced luminal B breast cancer were collected and processed using RNA in situ hybridization. Signal evaluation was conducted under a microscope, and scoring was based on specific criteria. Questions addressed: Can GATA3-AS1 serve as a predictive biomarker for neoadjuvant chemotherapy response in locally advanced luminal B breast cancer? Conclusion: The lncRNA GATA3-AS1 can be used as a biomarker for resistance to neoadjuvant chemotherapy in patients with locally advanced luminal B breast cancer. Its identification through RNA in situ hybridization of tissue obtained from the initial biopsy can aid in treatment decision-making.

Keywords: biomarkers, breast neoplasms, genetics, neoadjuvant therapy, tumor

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Authors: Hala Alioua, Alberic Tellier

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This paper is designed to spotlight the research on corporate strategic planning, by emphasizing the role of middle manager of SBU’s and related issues such as the context of vision change. Previous research on strategic vision has been focused principally at the SME, with relatively limited consideration given to the role of middle managers SBU’s in the context of change. This project of research has been done by using a single case study. We formulated through our immersion for 2.5 years on the ground and by a qualitative method and abduction approach. This entity that we analyze is a subsidiary of multinational companies headquartered in Germany, specialized in manufacturing automotive equipment. The "Delta Company" is a French manufacturing plant that has undergone numerous changes over the past three years. The two major strategic changes that have a significant impact on the Delta plant are the strengths of its core business through « lead plant strategy» in 2011 and the implementation of a new strategic vision in 2014. These consecutive changes impact the purpose of the mission of the middle managers. The plant managers ask the following questions: How the middle managers make sense of the corporate strategic planning imposed by the parent company? How they appropriate the new vision and decline it into actions on the ground? We chose the individual interview technique through open-ended questions as the source of data collection. We first of all carried out an exploratory approach by interviewing 8 members of the Management committee’s decision and 19 heads of services. The first findings and results show that exist a divergence of opinion and interpretations of the corporate strategic planning among organization members and there are difficulties to make sense and interpretations of the signals of the environment. The lead plant strategy enables new projects which insure the workload of Delta Company. Nevertheless, it creates a tension and stress among the middle managers because its provoke lack of resources to the detriment of their main jobs as manufacturer plant. The middle managers does not have a clear vision and they are wondering if the new strategic vision means more autonomy and less support from the group.

Keywords: change, middle managers, vision, sensemaking

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Authors: Julie Mariam Abraham, G. J. Melendez-Torres

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Background. Maternal mortality is disproportionately higher in low- and middle- income countries (LMICs) compared to other parts of the world. At the current pace of progress, the Sustainable Development Goals for maternal mortality rate will not be achieved by 2030. A variety of factors influence the increased risk of maternal complications in LMICs. These are exacerbated by socio-economic and political factors, including poverty, illiteracy, and gender inequality. This paper aims to use realist synthesis to identify the contexts, mechanisms, and outcomes (CMOs) of maternal health interventions conducted in LMICs to inform evidence-based practice for future maternal health interventions. Methods. In May 2022, we searched four electronic databases for systematic reviews of maternal health interventions in LMICs published in the last five years. We used open and axial coding of CMOs to develop an explanatory framework for intervention effectiveness. Results. After eligibility screening and full-text analysis, 44 papers were included. The intervention strategies and measured outcomes varied within reviews. Healthcare system level contextual factors were the most frequently reported, and infrastructural capacity was the most reported context. The most prevalent mechanism was increased knowledge and awareness. Discussion. Health system infrastructure must be considered in interventions to ensure effective implementation and sustainability. Healthcare-seeking behaviours are embedded within social and cultural norms, environmental conditions, family influences, and provider attitudes. Therefore, effective engagement with communities and families is important to create new norms surrounding pregnancy and delivery. Future research should explore community mobilisation and involvement to enable tailored interventions with optimal contextual fit.

Keywords: maternal mortality, service delivery and organisation, realist synthesis, sustainable development goals, overview of reviews

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Authors: Hazel Pettifor, Charlie Wilson, David Mccollum, Oreane Edelenbosch

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Vehicle purchase is a technology adoption decision that will strongly influence future energy and emission outcomes. Global integrated assessment models (IAMs) provide valuable insights into the medium and long terms effects of socio-economic development, technological change and climate policy. In this paper we present a unique and transparent approach for improving the behavioural representation of these models by incorporating social influence effects to more accurately represent consumer choice. This work draws together strong conceptual thinking and robust empirical evidence to introduce heterogeneous and interconnected consumers who vary in their aversion to new technologies. Focussing on vehicle choice, we conduct novel empirical research to parameterise consumer risk aversion and how this is shaped by social and cultural influences. We find robust evidence for social influence effects, and variation between countries as a function of cultural differences. We then formulate an approach to modelling social influence which is implementable in both simulation and optimisation-type models. We use two global integrated assessment models (IMAGE and MESSAGE) to analyse four scenarios that introduce social influence and cultural differences between regions. These scenarios allow us to explore the interactions between consumer preferences and social influence. We find that incorporating social influence effects into global models accelerates the early deployment of electric vehicles and stimulates more widespread deployment across adopter groups. Incorporating cultural variation leads to significant differences in deployment between culturally divergent regions such as the USA and China. Our analysis significantly extends the ability of global integrated assessment models to provide policy-relevant analysis grounded in real-world processes.

Keywords: behavioural realism, electric vehicles, social influence, vehicle choice

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Authors: Yvonne Nanaama Brew, Bismark Jampim Abrokwah

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Children with disabilities in Ghana are not routinely registered, and this can imply that they may be neglected in national policy planning since global estimates may not be near the exact numbers. Although there are some studies with reports on the prevalence of disability among children in Ghana, reliable information on the prevalence, types of disability in children, and children who die with disabilities in the Greater Accra region are lacking. The current study seeks to investigate the incidence of disability among children two to fourteen years at selected districts in the Greater Accra region of Ghana. A cross-sectional design is adapted with a quantitative method for this study. Parents with disabled children who access child welfare clinics at the Greater Accra regional hospital, Maamobi hospital, Ga west, and Ga south district hospitals will be selected through purposive sampling for the study. An adapted UNICEF structured Ten Questions will be used to collect relevant data about participants. The responses to the questions will be either 'Yes' or 'No'. Parents with children who answer 'Yes' to a disability and purposively sampled parents with children who answer 'No' to disability will be invited to Child Health Clinic at the Greater Accra regional hospital for a free clinical assessment. Data will be entered into Microsoft Office Excel 2013 and imported into STATA version 15 for analysis. The study is expected to provide reliable disaggregated data on less than fourteen years of children with disabilities in the Greater Accra region. The findings and recommendations of the study will demonstrate the importance of early detection of disability and facilitate more quality and holistic planning of appropriate programmes that best safeguard the rights of children with disabilities in Ghana. It will help in policy and decision-making on children less than fourteen years with disabilities in Ghana. Also, findings will be useful for health facilities in Ghana to plan services for disabled children. Finally, the study is expected to add to the guides for the National Council of Persons with Disabilities to fulfill its legal mandate for disabled persons in Ghana.

Keywords: prevalence, disability, children, Ghana

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