Search results for: oral public health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13370

Search results for: oral public health

13190 Beyond the Travel: The Impact of Public Transport on Quality of Life

Authors: Shadab Bahreini

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Public transportation is one of the most important aspects of cities, which impacts various factors of the Quality of Life (QoL) of citizens. A passenger's experience is influenced by a variety of indicators in addition to the cost and safety of the trip. This article intends to investigate how QoL is affected by public transport in an urban environment by introducing a literature review of QoL and Quality of Urban Life (QoUL), investigating the intersection of QoL and public transport, and reviewing the background theory for Transport Quality of Life (TQoL). The article proposes a Public Transport Quality of Life (PTQoL) framework comprised of a set of indicators that measure how public transport impacts QoL across personal (physical and mental), socioeconomic, and environmental dimensions. The study proposes using the framework to evaluate objective or subjective factors affecting a person's QoL regarding public transport. Finally, it concludes that public transport is a key component in shaping QoL in urban environments and that policymakers and urban planners should use the PTQoL framework to make evidence-based decisions to improve public transport systems and their impact on QoL.

Keywords: public transport, quality of life, subjective and objective indicators, urban environment

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13189 Systematic and Meta-Analysis of Navigation in Oral and Maxillofacial Trauma and Impact of Machine Learning and AI in Management

Authors: Shohreh Ghasemi

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Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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13188 Factors Associated with Seroconversion of Oral Polio Vaccine among the Children under 5 Year in District Mirpurkhas, Pakistan 2015

Authors: Muhammad Asif Syed, Mirza Amir Baig

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Background: Pakistan is one of the two remaining polio-endemic countries, posing a significant public health challenge for global polio eradication due to failure to interrupt polio transmission. Country specific seroprevalence studies help in the evaluation of immunization program performance, the susceptibility of population against polio virus and identification of existing level of immunity with factors that affect seroconversion of the oral polio vaccine (OPV). The objective of the study was to find out factors associated with seroconversion of the OPV among children 6-59 months in Pakistan. Methods: A Hospital based cross-sectional serosurvey was undertaken in May-June 2015 at District Mirpurkhas, Sindh-Pakistan. Total 180 children aged 6–59 months were selected by using systematic random sampling from Muhammad Medical College Hospital, Mirpurkhas. Demographic, vaccination history and risk factors information were collected from the parents/guardian. Blood sample was collected and tested for the detection of poliovirus IgG antibodies by using ELISA Kit. The IgG titer <10 IU/ml, 50 to <150 IU/ml and >150 IU/ml was defined as negative, weak positive and positive immunity respectively. Pearson Chi-square test was used to determine the difference in seroprevalence in univariate analysis. Results: A total of 180 subjects were enrolled mean age was 23 months (7 -59 months). Off these 160 (89%) children were well and 18 (10%) partially protected against polio virus. Two (1.1%) children had no protection against polio virus as they had <10 IU/ml poliovirus IgG antibodies titer. Both negative cases belong from the female gender, age group 12-23 months, urban area and BMI <50 percentile. There was a difference between normal and the wasting children; it did attain statistical significance (χ2= 35.5, p=0.00). The difference in seroconversion was also observed in relation to the gender (χ2=6.23, p=0.04), duration of breast feeding (χ2=18.6, p=0.04), history of diarrheal disease before polio vaccine administration (χ2=7.7, p=0.02), and stunting (χ2= 114, p=0.00). Conclusion: This study demonstrated that near 90% children achieve seroconversion of OPV and well protected against polio virus. There is an urgent need to focus on factors like duration of breast feeding, diarrheal diseases and malnutrition (acute and chronic) among the children as an immunization strategy.

Keywords: seroconversion, oral polio vaccine, Polio, Pakistan

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13187 New Public Management: Step towards Democratization

Authors: Aneri Mehta, Krunal Mehta

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Administration is largely based on two sciences: ‘management science’ and ‘political science’. The approach of new public management is more inclined towards the management science. Era of ‘New Public Management’ has affected the developing countries very immensely. Public management reforms are needed to enhance the development of the countries. This reform mainly includes capacity building, control of corruption, political decentralization, debureaucratization and public empowerment. This gives the opportunity to create self-sustaining change in the governance. This paper includes the link of approach of new public management and their effect on building effective democratization in the country. This approach mainly focuses on rationality and effectiveness of governance system. These need to have deep efforts on technological, organizational, social and cultural fields. Bringing citizen participation in governance is main objective of NPM. The shift from traditional public management to new public management have low success rate of reforms. This research includes case study of RTI which is a big step of government towards citizen centric approach of governance. The aspect of ‘publicness’ in the democratic policy implementation is important for good governance in India.

Keywords: public management, development, public empowerment, governance

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13186 Use of Oral Communication Strategies: A Study of Bangladeshi EFL Learners at the Graduate Level

Authors: Afroza Akhter Tina

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This paper reports on an investigation into the use of specific types of oral communication strategies, namely ‘topic avoidance’, ‘message abandonment’, ‘code-switching’, ‘paraphrasing’, ‘restructuring’, and ‘stalling’ by Bangladeshi EFL learners at the graduate level. It chiefly considers the frequency of using these strategies as well as the students and teachers attitudes toward such uses. The participants of this study are 66 EFL students and 12 EFL teachers of Jahangirnagar University. Data was collected through questionnaire, oral interview, and classroom observation form. The findings reveal that the EFL students tried to employ all the strategies to various extents due to the language difficulties they encountered in their oral English performance. Among them, the mostly used strategy was ‘stalling’ or the use of fillers, followed by ‘code-switching’. The least used strategies were ‘topic avoidance’, ‘restructuring’, and ‘paraphrasing’. The findings indicate that the use of such strategies was related to the contexts of situation and data-elicitation tasks. It also reveals that the students were not formally trained to use the strategies though the majority of the teachers and students acknowledge them as helpful in communication. Finally the study suggests that an awareness of the nature and functions of these strategies can contribute to the overall improvement of the learners’ communicative competence in spoken English.

Keywords: communicative strategies, competency, attitude, frequency

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13185 Parameter Estimation for the Oral Minimal Model and Parameter Distinctions Between Obese and Non-obese Type 2 Diabetes

Authors: Manoja Rajalakshmi Aravindakshana, Devleena Ghosha, Chittaranjan Mandala, K. V. Venkateshb, Jit Sarkarc, Partha Chakrabartic, Sujay K. Maity

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Oral Glucose Tolerance Test (OGTT) is the primary test used to diagnose type 2 diabetes mellitus (T2DM) in a clinical setting. Analysis of OGTT data using the Oral Minimal Model (OMM) along with the rate of appearance of ingested glucose (Ra) is performed to study differences in model parameters for control and T2DM groups. The differentiation of parameters of the model gives insight into the behaviour and physiology of T2DM. The model is also studied to find parameter differences among obese and non-obese T2DM subjects and the sensitive parameters were co-related to the known physiological findings. Sensitivity analysis is performed to understand changes in parameter values with model output and to support the findings, appropriate statistical tests are done. This seems to be the first preliminary application of the OMM with obesity as a distinguishing factor in understanding T2DM from estimated parameters of insulin-glucose model and relating the statistical differences in parameters to diabetes pathophysiology.

Keywords: oral minimal model, OGTT, obese and non-obese T2DM, mathematical modeling, parameter estimation

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13184 Brazilian Environmental Public Policies Analysis

Authors: Estela Macedo Alves

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This paper is an overview on public policy analysis focused on the study of Brazilian public policy making process. The methodology is based on the review of some theories on the subject, linking them to Brazilian reality. The study presents basic policy analysis concepts, such as policy, polity and politics. It is emphasized John Kingdon's Multiple Stream Model, because of its clarifying aspects concerning public policies formulation process in democratic countries. In this path it was possible to establish interpretations on environmental public policies in Brazil and understand its methods, instead of presenting only a case study. At the end, it is possible to connect theory with Brazilian reality, identifying negative and positive points of its political processes and structure.

Keywords: Brazilian policies, environmental public policy, multiple stream model, public policy analysis

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13183 Improving the Competency of Undergraduate Nursing Students in Addressing a Timely Public Health Issue

Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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13182 Present State of Local Public Transportation Service in Local Municipalities of Japan and Its Effects on Population

Authors: Akiko Kondo, Akio Kondo

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We are facing regional problems to low birth rate and longevity in Japan. Under this situation, there are some local municipalities which lose their vitality. The aims of this study are to clarify the present state of local public transportation services in local municipalities and relation between local public transportation services and population quantitatively. We conducted a questionnaire survey concerning regional agenda in all local municipalities in Japan. We obtained responses concerning the present state of convenience in use of public transportation and local public transportation services. Based on the data gathered from the survey, it is apparent that we should some sort of measures concerning public transportation services. Convenience in use of public transportation becomes an object of public concern in many rural regions. It is also clarified that some local municipalities introduce a demand bus for the purpose of promotion of administrative and financial efficiency. They also introduce a demand taxi in order to secure transportation to weak people in transportation and eliminate of blank area related to public transportation services. In addition, we construct a population model which includes explanatory variables of present states of local public transportation services. From this result, we can clarify the relation between public transportation services and population quantitatively.

Keywords: public transportation, local municipality, regional analysis, regional issue

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13181 The Role of Gender in Influencing Public Speaking Anxiety

Authors: Fadil Elmenfi, Ahmed Gaibani

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This study investigates the role of gender in influencing public speaking anxiety. Questionnaire survey was administered to the samples of the study. Technique of correlation and descriptive analysis will be further applied to the data collected to determine the relationship between gender and public speaking anxiety. This study could serve as a guide to identify the effects of gender differences on public speaking anxiety and provide necessary advice on how to design a way of coping with or overcoming public speaking anxiety.

Keywords: across culture, communication, English language competence, gender, postgraduate students, speaking anxiety

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13180 Assessment of Negative Impacts Affecting Public Transportation Modes and Infrastructure in Burgersfort Town towards Building Urban Sustainability

Authors: Ntloana Hlabishi Peter

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The availability of public transportation modes and qualitative infrastructure is a burning issue that affects urban sustainability. Public transportation is indispensable in providing adequate transportation means to people at an affordable price, and it promotes public transport reliance. Burgersfort town has a critical condition on the urban public transportation infrastructure which affects the bus and taxi public transport modes and the existing infrastructure. The municipality is regarded as one of the mining towns in Limpopo Province considering the availability of mining activities and proposal on establishment of a Special Economic Zone (SEZ). The study aim is to assess the efficacy of current public transportation infrastructure and to propose relevant recommendations that will unlock the possibility of future supportable public transportation systems. The Key Informant Interview (KII) was used to acquire data on the views from commuters and stakeholders involved. There KII incorporated three relevant questions in relation to services rendered in public transportation. Relevant literature relating to public transportation modes and infrastructure revealed the imperatives of public transportation infrastructure, and relevant legislation was reviewed concerning public transport infrastructure. The finding revealed poor conditions on the public transportation ranks and also inadequate parking space for public transportation modes. The study reveals that 100% of people interviewed were not satisfied with the condition of public transportation infrastructure and 100% are not satisfied with the services offered by public transportation sectors. The findings revealed that the municipality is the main player who can upgrade the existing conditions of public transportation. The study recommended that an intermodal transportation facility must be established to resolve the emerging challenges.

Keywords: public transportation, modes, infrastructure, urban sustainability

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13179 Comparative Study Between Oral and Intralesional Injection of Beta Blocker in the Treatment of Infantile Capillary Hemangioma

Authors: Nadeen Eltoukhy, Sahar S. Sheta, Walaa Elnaggar, Karim Bakr

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Purpose: The aim of this study is to compare the clinical efficacy and side effects of oral versus intralesional propranolol treatment of infantile capillary hemangiomas in infants. Methods: The study enrolled 40 infants diagnosed with infantile capillary hemangiomas. Patients were divided into 2 groups: Group A (Non-invasive group) included 20 infants who received oral propranolol hydrochloride starting at a dose of 1 mg/kg/day BID, then increased to a max of 2 mg/kg/day BID gradually over 2 weeks for 3 months. Group B (Invasive group) included 20 infants who received intralesional propranolol injection at a dose of 1 mg/mL; the volume of the injected drug depended on the size of the lesion (0.2 mL injected per cm of lesion diameter), with a maximum volume of 1 mL for a lesion of 5 cm diameter under complete aseptic conditions in the operating theater. Results: At three months after initiating treatment, the circumferential size of the hemangioma showed a statistically significant decrease in both groups; in Group A from 3.66±2.89 cm to 1.56±1.26 cm with p-value <0.05 and in Group B from 2.99±2.73 cm to 1.32±1.18 cm with p-value <0.05. There is no statistically significant comparative difference between the two groups (p-value = 0.538 = insignificant). Regarding the complications of oral propranolol, one patient (5%) had bradycardia, and one patient (5%) had diarrhea. In the injection group, 20 patients (100%) had local edema, and one patient (5%) had a local infection. Conclusions: Both oral non-invasive and intralesional invasive propranolol are safely used to successfully treat and decrease the size of infantile hemangioma while showing no statistically comparative difference between both treatment techniques.

Keywords: hemangioma, oral beta blocker, intralesional beta blocker, infants

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13178 Health Expenditure and its Place in Economy: The Case of Turkey

Authors: Ayşe Coban, Orhan Coban, Haldun Soydal, Sükrü Sürücü

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While health is a source of prosperity for individuals, it is also one of the most important determinants of economic growth for a country. Health, by increasing the productivity of labor, contributes to economic growth. Therefore, countries should give the necessary emphasis to health services. The primary aim of this study is to analyze the changes occurring in health services in Turkey by examining the developments in the sector. In this scope, the second aim of the study is to reveal the place of health expenditures in the Turkish economy. As a result of the analysis in the dataset, in which the 1999-2013 periods is considered, it was determined that some increase in health expenditures took place and that the increase in the share of health expenditures in GDP was too small. Furthermore, analysis of the results points out that in financing health expenditures, the public sector is prominent compared to the private sector.

Keywords: health, health service, health expenditures, Turkey

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13177 The Relationship between Citizens’ Perception of Public Officials’ Ethical Performance and Public Trust in the Government in Egypt

Authors: Nevine Henry Wasef

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The research discusses how Egyptian citizens perceive the performance of public sector officials, particularly the ethical values manifested in their behavior. It aims at answering the question of how Egyptian citizens’ perception of public officials affects citizens' trust in the government at large and the process of public service delivery specifically. The hypothesis is that public opinion about civil servants’ ethical values would be proportional to citizens’ trust in the government, which means that the more citizens regard administrators with high ethical standards, the higher trust in the government they would have and vice versa. The research would focus on the independent variable of trust in the government and the dependent variable of public perception of administrators’ ethical performance. The data would be collected through surveys designed to measure the public evaluation of public officials they are interacting with and the quality of services delivered to them. The study concludes that implementing ethical values in public administration has a crucial role in improving citizens’ trust in the government based on various case studies of governments that successfully adopted ethical training programs for their civil servants.

Keywords: trust, distrust, ethics, performance, integrity, values, public service

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13176 Multiracial Society and Oral Tradition: A Study through Secondary Data

Authors: Jesvin Puay-Hwa Yeo, Laavanya Kathiravelu, Sa’Eda Binte Buang

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In the early days, myths and taboos were used by our ancestors to give explanations to the existence of nature and man, as well as to propitiate fortunes and to avoid unluckiness and harm. Myths and taboos are deeply rooted in our cultures and environment, and they form certain characteristics of any society, even in modern societies. With decades of the three main ethnic communities in Singapore – Malay, Indian and Chinese – living together, there has been intermingling and intermixing of traditions and practices. This may mean that what we think is a ‘Malay’ practice is actually one that is a hybrid of the Chinese and Malay. A good example would be the practice of covering all mirrors in a house of mourning. Therefore, the proposed seeks to explore and understand the underlying social influences of Singapore’s oral tradition. As part of a bigger cultural research project: Designing Cultures, the proposed paper focused on using secondary data to contribute to the overall cultural understanding of the integral connections between oral traditions, people and landscapes. The proposed paper will discuss in details the initials findings of the research project, including the two manners that contributed to the intermixing of myths and taboos. The first is the presence of social institutions such as religions, and the second is the presence of cross-cultural minorities such as the Straits Chinese. As well as other observations included the use and influence of Chinese oral traditions such as folklore among the early Chinese immigrants through social institutions.

Keywords: cultural belief, multiracial society, myths, oral tradition

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13175 Real Time PCR Analysis of microRNA Expression in Oral Cancer

Authors: Karl Kingsley

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Many mechanisms are involved in the control of cellular differentiation and growth, which are often dysregulated in many cancers. Many distinct pathways are involved in these mechanisms of control, including deoxyribonuclease (DNA) methyltransferase and histone deacetylase (HDAC) activation that controls both genetic and epigenetic modifications and micro ribonucleic acid (RNA) expression. Less is known about the expression of DNA methyltransferase (DNMT) and HDAC in oral cancers and the effect on microRNA expression. The primary objective of this study was to evaluate the expression of DNMT and HDAC family members in oral cancer and the concomitant expression of cancer-associated microRNAs. Using commercially available oral cancers, including squamous cell carcinoma (SCC)-4, SCC-9, SCC-15, and SCC-25, RNA was extracted and screened for DNMT, HDAC, and microRNA expression using highly-specific primers and quantitative polymerase chain reaction (qPCR). These data revealed low or absent expression of DNMT-1, which is associated with cellular differentiation but increased expression of DNMT-3a and DNMT-3b in all SCC cell lines compared with normal non-cancerous cell controls. In addition, no expression of HDAC1 and HDAC2 expression was found among the normal, non-cancerous cells but was highly expressed in each of the SCC cell lines examined. Differential expression of oncogenic and cancer-associated microRNAs was also observed among the SCC cell lines, including miR-21, miR-133, miR-149, miR-155, miR-365, and miR-720. These findings also appeared to vary according to observed growth rates among these cells. These data may be the first to demonstrate the expression and association between HDAC and DNMT3 family members among oral cancers. In addition, the differential expression of these epigenetic modifiers may be associated with the expression of specific microRNAs in these cancers, which have not previously been observed to the best of the author's knowledge. In addition, some associations and relationships may exist between the expression of these biomarkers and the rates of growth and proliferation, which may suggest that these expression patterns might represent potentially useful biomarkers to determine tumor aggressiveness and other phenotypic behaviors among oral cancers.

Keywords: oral cancer, DNA methyltransferase, histone deacetylase, microRNA

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13174 Public-Public Partnership and Tourism Development Strategy: The Case of Municipality of Gazi Baba in Macedonia

Authors: Dejan Metodijeski, Elizabeta Mitreva, Nako Taskov, Oliver Filiposki

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Tourism development strategies are an important link in the tourism policy that is used to make its management better and easier. A public-public partnership (PUP) is a partnership between two or more public authorities or between a public authority and any non-profit organization with the goal of providing services and facilities or transferring technical skills. The paper presents this kind of partnership between two public authorities in Macedonia, the Municipality of Gazi Baba on one hand, and the University of Goce Delcev on the other. The main idea of this partnership is the development of a tourism strategy for the Municipality of Gazi Baba by the University on one side, and on the other, the construction of a mini park in the court of the University by the Municipality. This paper presents the causes and analyzes the procedures relating to this partnership and the methodology of the tourism development strategy. It contains a relevant literature review related to PUPs and tourism development strategy. The results and benefits of this partnership are presented with figures.

Keywords: public-public partnership, tourism development strategy, municipality of Gazi Baba, Macedonia

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13173 Bayesian Prospective Detection of Small Area Health Anomalies Using Kullback Leibler Divergence

Authors: Chawarat Rotejanaprasert, Andrew Lawson

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Early detection of unusual health events depends on the ability to detect rapidly any substantial changes in disease, thus facilitating timely public health interventions. To assist public health practitioners to make decisions, statistical methods are adopted to assess unusual events in real time. We introduce a surveillance Kullback-Leibler (SKL) measure for timely detection of disease outbreaks for small area health data. The detection methods are compared with the surveillance conditional predictive ordinate (SCPO) within the framework of Bayesian hierarchical Poisson modeling and applied to a case study of a group of respiratory system diseases observed weekly in South Carolina counties. Properties of the proposed surveillance techniques including timeliness and detection precision are investigated using a simulation study.

Keywords: Bayesian, spatial, temporal, surveillance, prospective

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13172 Evaluating a Peer-To-Peer Health Education Program in Public Housing Communities during the COVID-19 Pandemic

Authors: Jane Oliver, Angeline Ferdinand, Jessica Kaufman, Peta Edler, Nicole Allard, Margie Danchin, Katherine B. Gibney

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Background: The cohealth Health Concierge program operated in Melbourne, Australia, from July 2020 to 30 June 2022. The program was designed to provide place-based peer-to-peer COVID-19 education and support to culturally and linguistically diverse residents of high-rise public housing estates. During this time, the COVID-19 public health response changed frequently. We conducted a mixed-methods evaluation to determine the program’s impact on residents’ trust, engagement and communication with health services and public health activities. Methods: The RE-AIM model was used to assess program reach, effectiveness, adoption, implementation and maintenance and the evaluation was informed by a Project Reference Group including end-users. Data were collected between March and May 2022 in four estates where the program operated. We surveyed 301 residents, conducted qualitative interviews with 32 stakeholders and analyzed data from 20,901 forms reporting interactions between Health Concierges and residents collected from August 2021 to May 2022. These forms outlined the support provided by Health Concierges during each interaction. Results: Overall, the program was effective in guiding residents to testing and vaccination services and facilitating COVID-19 safe practices. Nearly two-thirds (191; 63.5%) of the 301 surveyed participants reported speaking with a Health Concierge in the previous six months, and some described having meaningful conversations with them. Despite this, many of the interactions residents described having with Health Concierges were superficial. When considering surveyed participants’ responses to the adapted Public Health Disaster Trust Scale, the mean score across all estates was 2.3 (or slightly more than ‘somewhat confident’) in public health authorities’ ability to respond to a localized infectious disease outbreak. While the program was valued during the rapidly changing public health response, many felt it had failed to evolve in the ‘living with COVID’ phase. Some residents expressed frustration with Health Concierges’ having perceived inactive, passive roles - although other residents felt Health Concierges were helpful and appreciated them. A perception that the true impact of Health Concierges’ work was underrecognized was widely voiced by health staff. All 20,901 Interaction Forms identified COVID-19-related supports provided to residents; almost all included provision of facemasks and/or hand sanitiser and 78% identified additional supports that were also provided, most frequently provision of other health information. Conclusions: The program disseminated up-to-date information to a diverse population within a rapidly changing public health setting. Health Concierges were able promote COVID-19-safe behaviours, including vaccine uptake, and link residents with support services. We recommend the program be revised and continued. New programs that draw on the Health Concierge model may be valuable in supporting future pandemic responses and should be considered in preparedness planning.

Keywords: community health, COVID-19 pandemic, infectious diseases, public health, community health workers

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13171 Determination of Organizational Cynicism Levels of Health Care Workers

Authors: Murat İskender Aktaş, Selma Söyük

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The aim of this work is to specify the levels of organizational cynicism health workers. Organizational cynicism concept is evaluated in three sub-branches and these are cognitive, affective, and behavioral. The main objective of the work is to answer the questions about the relationship of demographic characteristics like sub-branches of cynicism and age, marital status, education level, total working hours, occupational groups and income levels. As works in our country are analyzed, there have been studies about cynicism in health and other sectors. However, there were no master’s thesis or organizational cynicism research found about the public health professionals. This is why the aim was chosen as to specify the levels of organizational cynicism of public health professionals. The average of the answers of the health workers to the questions about cynicism levels are 2.86. As organizational cynicism is evaluated according to the sub-branches, cognitive subscale average score is 3.21 affective subscale average score is 2.68 and behavioral subscale average score is counted as 2.67. As the results are analyzed, it is seen that the behavioral subscale has the highest average. This shows that the workers are often criticizing the internal complaints and organizational information with their friends out of the organization.

Keywords: cynicism, organizational cynicism, health care workers

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13170 Challenges to Effective Public Sector Management in Developing Countries: The Networking and Communication Functions of Public Sector Managers in Nigeria and Ghana

Authors: Ethelbert Chinedu Nwokorie

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This empirical study analyzes the impact of communication and networking functions of Nigerian and Ghanaian public sector managers’ on public sector effectiveness. The focus is on which of these management functions public sector managers’ in these countries perform most, why, how and how does it affect effectiveness of public sector organizations in the two countries. This qualitative analysis was done by interviewing middle and top level managers in some selected public sector organizations in the two countries on their practical experiences. Findings reveal that ineffectiveness of public sector organizations in Ghana persists because public sector managers perform more of networking functions to promote their individual carrier success and progression in their various organizations, rather than achieving the organizations goals and objectives. In Nigeria, though majority of the interviewed public sector managers perform more communication functions than networking, they do this mostly by treating files and correspondences, instead of face-to-face communication and interaction with employees’. Hence, they hardly relate directly with their employees’ to find out how they are performing their jobs, their challenges, where they are having problems and why. The findings and recommendations of this study will help in improving effectiveness, quality and service delivery in Nigerian and Ghanaian public sector organizations and beyond.

Keywords: effectiveness, communication, employees, management, networking, organization, public sector

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13169 An Assessment of Radio-Based Education about Female Genital Cutting and Health and Human Rights Issues in Douentza, Mali

Authors: Juliet Sorensen, Megan Schliep

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Introduction: After a multidisciplinary assessment of health and human rights issues in central Mali, a musical album was created in 2014 in Douentza, Mali to provide health information on female genital mutilation/cutting (FGM/C), malaria, HIV/AIDS, girls’ education, breastfeeding, and sanitation. The objective of this study was to assess the impact of this album. Methods: A mixed-methods assessment was conducted with 149 individuals across 10 villages in Douentza Cercle. Analyses focused on the association of radio listening habits, age, sex, ethnicity and education with a public health knowledge score. Results: Over 90% of respondents reported daily radio listening, many listening five or more hours per day. Potential risks of FGM/C cited by participants included death (59%), difficulty in childbirth (48%), sterility (34%), and fistula (33%); when asked about their level of control over FGM/C, 28% stated they would never cut their daughters. Being a listener for 1-5 hours per day was associated with a 11.5% higher score of 'public health knowledge' compared to those listening only a little or not at all (p < 0.01). Education (marginal versus no formal education) was associated with 7.6% increased score (p < 0.01). Conclusion: Radio appears to be a significant part of community members’ daily routines and may be a valuable medium for transmitting information, particularly for lower literacy individuals.

Keywords: female genital cutting, public health and social justice education, radio, Mali

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13168 An Evaluation of Medical Waste in Health Facilities through Data Envelopment Analysis (DEA) Method: Turkey-Amasya Public Hospitals Union Model

Authors: Murat Iskender Aktaş, Sadi Ergin, Rasime Acar Aktaş

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In the light of fast-paced changes and developments in the health sector, the Ministry of Health started a new structuring with decree law numbered 663 within the scope of the Project of Transformation in Health. Accordingly, hospitals should ensure patient satisfaction through more efficient, more effective use of resources and sustainable finance by placing patients in the centre and should operate to increase efficiency to its maximum level while doing these. Within this study, in order to find out how efficient the hospitals were in terms of medical waste management between the years 2011-2014, the data from six hospitals of Amasya Public Hospitals Union were evaluated separately through Data Envelopment Analysis (DEA) method. First of all, input variables were determined. Input variables were the number of patients admitted to polyclinics, the number of inpatients in clinics, the number of patients who were operated and the number of patients who applied to the laboratory. Output variable was the cost of medical wastes in Turkish liras. Each hospital’s total medical waste level before and after public hospitals union; the amounts of average medical waste per patient admitted to polyclinics, per inpatient in clinics, per patient admitted to laboratory and per operated patient were compared within each group. In addition, average medical waste levels and costs were compared for Turkey in general and Europe in general. Paired samples t-test was used to find out whether the changes (increase-decrease) after public hospitals union were statistically significant. The health facilities that were unsuccessful in terms of medical waste management before and after public hospital union and the factors that caused this failure were determined. Based on the results, for each health facility that was ineffective in terms of medical waste management, the level of improvement required for each input was determined. The results of the study showed that there was an improvement in medical waste management applications after the health facilities became a member of public hospitals union; their medical waste levels were lower than the average of Turkey and Europe while the averages of cost of disposal were the highest.

Keywords: medical waste management, cost of medical waste, public hospitals, data envelopment analysis

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13167 English 2A Students’ Oral Presentation Errors: Basis for English Policy Revision

Authors: Marylene N. Tizon

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English instructors pay attention on errors committed by students as errors show whether they know or master their oral skills and what difficulties they may have in the process of learning the English language. This descriptive quantitative study aimed at identifying and categorizing the oral presentation errors of the purposively chosen 118 English 2A students enrolled during the first semester of school year 2013 – 2014. The analysis of the data for this study was undertaken using the errors committed by the students in their presentation. Marking and classifying of errors were made by first classifying them into linguistic grammatical errors then all errors were categorized further into Surface Structure Errors Taxonomy with the use of Frequency and Percentage distribution. From the analysis of the data, the researcher found out: Errors in tenses of the verbs (71 or 16%) and in addition 167 or 37% were most frequently uttered by the students. And Question and negation mistakes (12 or 3%) and misordering errors (28 or 7%) were least frequently enunciated by the students. Thus, the respondents in this study most frequently enunciated errors in tenses and in addition while they uttered least frequently the errors in question, negation, and misordering.

Keywords: grammatical error, oral presentation error, surface structure errors taxonomy, descriptive quantitative design, Philippines, Asia

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13166 Knowledge, Attitudes and Its Associated Factors on the Provision of Psychological First Aid during Response to Disasters among Public Health Midwives in Colombo

Authors: S. P. Hewagama

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Different kinds of distressing events happen in the world causing a wide range of reactions and feelings. Psychological first aid (PFA) is humane supportive response for suffering. All health workers especially PHMs who play a major role as first responders in a disaster should be able to provide basic PFA effectively. Aim of this study was to assess the knowledge, attitudes and associated factors on the provision of PFA among PHMs during disasters. A descriptive cross-sectional study was carried out among 307 Public Health Midwives in Colombo RDHS area. In the study population, 86.6% (n=266) of the respondents were aware of the term “Psychological first aid” while 13.4% (n=41) were not aware. The total knowledge score was good in majority 85.4%(n=262) of the respondents while only 14.3%(n=45) had a poor knowledge on PFA. There was the statistically significant difference in relation to the level of education with the total knowledge score. Comprehensive desirable attitudes towards PFA was low (30.61%, n=94). According to the study, only a less than a quarter (21.82%, (n = 67)) of the study population had received training on PFA. More than half (56%, n=172) of the respondents had experience in responding to disasters. Conclusions and Recommendations: The overall knowledge and attitudes were found to be satisfactory. However, it is important to improve the knowledge level of the PHMs by providing training and workshops on PFA.

Keywords: disaster, humane supportive assistance, psychological first aid, public health midwives

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13165 Effect of Oral Clonidine Premedication on Subarachnoid Block Characteristics of 0.5 % Hyperbaric Bupivacaine for Laparoscopic Gynecological Procedures – A Randomized Control Study

Authors: Buchh Aqsa, Inayat Umar

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Background- Clonidine, α 2 agonist, possesses several properties to make it valuable adjuvant for spinal anesthesia. The study was aimed to evaluate the clinical effects of oral clonidine premedication for laparoscopic gynecological procedures under subarachnoid block. Patients and method- Sixtyfour adult female patients of ASA physical status I and II, aged 25 to 45 years and scheduled for laparoscopic gynecological procedures under the subarachnoid block, were randomized into two comparable equal groups of 32 patients each to received either oral clonidine, 100 µg (Group I) or placebo (Group II), 90 minutes before the procedure. Subarachnoid block was established with of 3.5 ml of 0.5% hyperbaric bupivacaine in all patients. Onset and duration of sensory and motor block, maximum cephalad level, and the regression time to reach S1 sensory level were assessed as primary end points. Sedation, hemodynamic variability, and respiratory depression or any other side effects were evaluated as secondary outcomes. Results- The demographic profile was comparable. The intraoperative hemodynamic parameters showed significant differences between groups. Oral clonidine was accelerated the onset time of sensory and motor blockade and extended the duration of sensory block (216.4 ± 23.3 min versus 165 ± 37.2 min, P <0.05). The duration of motor block showed no significant difference. The sedation score was more than 2 in the clonidine group as compared to the control group. Conclusion- Oral clonidine premedication has extended the duration of sensory analgesia with arousable sedation. It also prevented the post spinal shivering of the subarachnoid block.

Keywords: oral clonidine, subarachnoid block, sensory analgesia, laparoscopic gynaecological

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13164 Public Art as Social Critique to Shape Urban-Scape

Authors: Po-Ching Wang

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Public art may be regarded as a social agenda. It is assumed that public art acts as an intermediate form that contributes significantly to community resurgence. That is, public art may be regarded as a verb/process or social intervention. It functions as a vanguard form, attacking boundaries and providing a sensibility for social strategy. Public art in tradition is generally expected to bring aesthetic pleasure to public. Contemporary public art, however, not only focuses on art installation, but it also often offers a process that aims to comment on, question, and challenge the socio-cultural status quo. During the last few decades, accelerated changes in the values and expectations brought to bear on varied urban issues, together with the destruction of the hegemony of traditional art and of museum authorities, has begun to contribute to freer and more democratic representations of public art. It is said that part of a public artwork’s role is to ruffle sacred feathers. In many cases, public art is created to address the dynamic social contradictions and mutability of public life; and artists and community participants approach public art from a variety of social critical perspectives and methodologies. Urban issues, such as social and environmental justice, health problems, violence, and political statements, provide plentiful source materials that fuel the performance of public art in many different settings. Further, public artworks have been extensively adopted to express social identity, make political statements, and/or to remedy social and environmental crises. Many murals on urban walls, for instance, reflect social conflicts and address civic rights, and these projects are usually the work of artists who though denied access to traditional gallery and museum channels are supported by community engagement and involvement. Public art as a social practice challenges the traditional western view of artistic practice. Art in the public realm creates a new media that provides a platform for a dialogical exchange between diverse social groups. It seems that public art has evolved as an arena for activism that addresses wide-ranging and highly controversial social issues and civilian concerns. The findings of this study indicate that public artworks are capable of playing a role of activist in facilitating community evolution via social progress.

Keywords: aesthetics, community regeneration, city development, publicness, public participation, social progress

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13163 An Analysis of Public Environmental Investment on the Sustainable Development in China

Authors: K. Y. Chen, Y. N. Jia, H. Chua, C. W. Kan

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As the largest developing country in the world, China is now facing the problem arising from the environment. Thus, China government increases the environmental investment yearly. In this study, we will analyse the effect of the public environmental investment on the sustainable development in China. Firstly, we will review the current situation of China's environmental issue. Secondly, we will collect the yearly environmental data as well as the information of public environmental investment. Finally, we will use the collected data to analyse and project the SWOT of public environmental investment in China. Therefore, the aim of this paper is to provide the relationship between public environmental investment and sustainable development in China. Based on the data collected, it was revealed that the public environmental investment had a positive impact on the sustainable development in China as well as the GDP growth. Acknowledgment: Authors would like to thank the financial support from the Hong Kong Polytechnic University for this work.

Keywords: China, public environmental investment, sustainable development, analysis

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13162 The Importance of Outside Classroom Activities in Developing Oral Fluency in an EFL Context

Authors: Maaly Jarrah

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In a study abroad context, students have the advantage of immersing themselves in the environment of the target language and being exposed to it. However, in and a stay home context, where English is not the mother tongue, students’ exposure to the second language is often times restricted to the classroom. Although language teachers are keen to develop inside class room activities and practices that increase the suitability of students to acquire a second language (Cook & Singleton, 2014), many would agree that class time is too limited to enhance students’ oral fluency skills. Consequently, creating opportunities outside the classroom for students to speak English is an effective strategy in compensating for students’ limited use of the L2. In an argument by Ortega (2012) external classroom activities have equal significance in enabling students learn English as a second language. The author further asserts that the activities provide a non-educational environment from which a student may feel free and comfortable to acquire new language skills. This study investigates the significance of outside classroom activities in promoting students’ oral proficiency. In addition, it reports on students’ perceptions of such activities. 15 participants from the American University of Kuwait took part in this study. Open-ended interviews were done to find out what the participants thought of these activities, and what they gained from them. Interview results show that students found outside classroom activities very effective in improving not only their oral fluency skills, but their confidence and critical thinking skills as well. The implications of this research study are for language practitioners and language programs in the EFL context to be aware of the benefits of incorporating outside classroom activities in language teaching.

Keywords: language teaching, oral fluency, outside classroom activities

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13161 Exploring Communities of Practice through Public Health Walks for Nurse Education

Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: education, innovation, nursing, urban

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