bluuebunny/crossref_metadata_2025 huggingface dataset:
Perception of students on the teaching methodologies utilized at Khesar Gyalpo University of Medical Sciences of Bhutan
Authors: Tenzin Karma , Pem Deki , Gyeltshen Tempa
Published: December 2020

Introduction: Recently, there have been numerous innovations in the field of medical education. Teaching methodology is one of the areas that have received the most attention. The aim of this study was to assess the students’ perceptions of the effectiveness of different teaching methods, teaching aids and forms of evaluation at two faculties under Khesar Gyalpo University of Medical Sciences of Bhutan.

Methods: This analytical cross-sectional study was conducted between 1st June and 31st July 2015 using a self-administered questionnaire in 150 first year and 148 final year students from the Faculty of Nursing and Public Health and Faculty of Traditional Medicine. Each participant completed a questionnaire containing items soliciting their opinions on teaching methods, teaching tools, and assessment methods.

Results: Modern teaching methods are being practiced at the two faculties studied under KGUMSB. PowerPoint presentation and overhead projector were most preferred by both the groups. Also there was lack of exposure to computer-assisted learning in both the groups.

Conclusions: We conclude that the teaching methodologies at KGUMSB are in line with current trends. However, this study also reveals that there is a need to institute robust strategies to encourage more computer-assisted learning.
Uterine didelphys: diagnosis in late pregnancy
Authors: Dorji Namkha , Gyeltshen Nidup
Published: December 2020

Introduction: Uterus didelphys is a rare mullerian duct anomaly (MDA) and often remains undiagnosed till pregnancy or delivery. Obstetric complications can arise especially if undiagnosed in labour with malpresentation or thick inelastic vaginal septum. Some presents with dyspareunia or dysmenorrhea in the presence of a varying degree of longitudinal vaginal septum. Rarely delayed diagnosis can lead to complications that include endometriosis, adhesions, infertility, etc.
Characteristics of Helicobacter pylori infection in a National Referral Hospital in Bhutan
Authors: Adhikari Chhabi Lal , Dhakal Guru Prasad , Suwisith Nongluck , Dargay Sonam , Sharma Krishna P
Published: December 2020

Introduction: Helicobacter pylori (H. pylori) is a bacterium causing chronic gastric infection and may cause gastric cancer. It was necessary to see the trend of infection, especially in symptomatic patients. This retrospective descriptive study was aimed to describe the characteristics of H. pylori infection in Bhutanese patients referred for an endoscopy to the National Referral Hospital, Thimphu.
Methods: The sample of the study was randomized 380 medical records of the patients who underwent upper gastrointestinal endoscopy and Rapid Urea Test for symptomatic dyspepsia and peptic ulcer. Data was collected using a survey form designed by the researchers. Data analysis was done using descriptive statistics and either Chi-square or Fisher’s exact test.
Results: The prevalence of H. pylori infection was very high (76.6%). The mean age of the infection was 42 with a range from 15 to 84 years. The highest prevalence of infection was observed in the age group 20-29 years (82.7%) and lowest in the oldest age group 70-84 years (66.7%). The analysis showed no significant difference in infection amongst age groups, gender, and endoscopic findings to the positive results at 5% significant level except for monthly prevalence (p<0.001). Gastritis was the commonest endoscopy finding (153/380) and gastro-duodenitis had the highest positivity rate (88.9%).
Conclusion: The prevalence of infection was relatively high compared with previous studies. Young and middle-aged adults had a high prevalence and this group needs to be given priority for screening and eradication treatment considering limited resources to prevent associated gastric cancer in Bhutan.
Angiofibrolipoma of the soft palate: A very rare cause of upper air way obstruction in an infant.
Authors: Gyamtsho Sonam
Published: December 2020

Introduction: Infants and children are very prone to air way obstruction due to smaller and immature air ways. There are multiple causes of upper airway obstruction in infants like infections, congenital lesions and rarely tumours of the upper airway. However, angiofibrolipoma, a rare variant of lipoma causing intermittent respiratory distress in an infant has not been reported until now.
Objective: To report a very rare case of angiofibrolipoma arising from the soft palate in an infant.
Case report: Two and half months old female child reported to the department of otolaryngology with a history of intermittent airway obstruction since one month of age. After evaluation she was found to have a fleshy polypoidal mass above the laryngeal inlet arising from soft palate causing airway compromise. She underwent surgical excison with bipolar cautery under general anaesthesia.
Conclusion: Few cases of angiofibrolipoma has been reported in adults but none has been reported in children. This is to report a case of angiofibrolipoma in child causing airway obstruction.
Decision-Making Models for Using Multimedia Marketing in Enterprises
Authors: Hsieh Pei-Hsuan , Hsiung Yu-Lu
Published: December 2020

This study has three purposes: to understand the enterprises’ expectations and needs of using multimedia marketing, to examine the reasons behind enterprises’ rejection of multimedia marketing, and to verify whether multimedia marketing meets the expectations of the enterprises. This study combines the technology acceptance model (TAM) and expectation confirmation theory (ECT) to investigate Taiwanese enterprises’ perspectives of using multimedia marketing by employing the questionnaire technique. A total of 288 valid paper questionnaires (143 companies did not use multimedia marketing, while 145 did) were collected after eliminating invalid ones. As a result, this study shows that TAM and ECT are suitable models for explaining the enterprises’ behavior of using multimedia marketing. Perceived ease of use is an important factor for enterprises that do not use multimedia marketing. In addition, both perceived ease of use and perceived usefulness are important factors that affect the enterprises’ continuance intention to adopt multimedia marketing.
Intelligent Image compression in Multi-agent system
Authors: Mishra Jibanananda , Mishra Bishnu Prasad , Parida Rabinarayana , Jena Ranjan Kumar
Published: December 2020

When using wireless sensor networks for real-time data transmission, some critical points should be considered. Restricted computational power, memory limitations, narrow bandwidth and energy supplied present strong limits in sensor nodes. Therefore, maximizing network lifetime and minimizing energy consumption are always optimization goals. To reduce the energy consumption of the sensor network during image transmission, an energy efficient image compression scheme is proposed. The image compression scheme reduces the required memory. To address the above mentioned concerns, in this paper we describe an approach of image transmission in WSNs , taking advantage of JPEG2000 still image compression standard and using MATLAB . These features were achieved using techniques: the Discrete Wavelet Transform (DWT), and Embedded Block Coding with Optimized Truncation (EBCOT). Performance of the proposed image compression scheme is investigated with respect to image quality and energy consumption. Simulation results are presented and show that the proposed scheme optimizes network lifetime and reduces significantly the amount of required memory by analyzing the functional influence of each parameter of this distributed image compression algorithm.
A Perspective Approach on Citizen Card System - Applicability And Opportunity
Authors: Devi Vijeyta , Priya Swapna
Published: December 2020

Citizen Card System in which every citizen of a country will have a unique 16 digit number Citizen Card System which would not just help the government track down individuals, but would make life far easier for citizens as they would not have to submit multiple documents each time they want to avail a new service—public private, government., regulatory authority or lawenforcement agency. This system will contain details like the name, sex, address, marital status, photo, identification mark and face biometrics. The Citizen Card is fundamentally prepared to identify citizens so that better security can be provided by identifying illegal immigrants and terrorists. The role the system envisions is to issue a Citizen Card System that can be verified and authenticated in an online, cost-effective manner, and that is robust enough to eliminate duplicate and fake identities.
Software Performance Analysis with Parallel Programming Approaches
Authors: Angadi Suneeta H. , Raju G. T. , B Abhishek
Published: December 2020

The term software performance engineering (SPE) is a systematic and quantitative approach for constructing software systems to meet the performance objectives such as response time, throughput, scalability and resource utilization. Optimization is major concern in achieving performance parameters. Optimization is performed during run-time, or in the design phase. This paper proposes the coding practices in Open Multi Processing (OpenMP) and Open Computing Language (OpenCL) that outperforms the conventional algorithms for searching, matrix multiplication and routing tasks in terms of response time.
Electric Field Analysis of High Voltage Insulators
Authors: Krishnan Rahul , Samanta Subhajit , R Sudha , Govardhan K
Published: December 2020

This paper involves designing and applying electric field analysis on multiple long rod insulators. Quality HV insulators are an integral part of power systems because they separate the Transmission lines carrying high voltages from the grounded poles. They must have the ability to withstand both high electrical and mechanical stress. So for this purpose modeling of long rod insulator was done with multiple materials such as ceramic, porcelain, and fiber glass and silicon rubber. Electric field analysis can be used to determine voltage profile of each material which in turn can be used to determine how much electrical stress the material can undertake. An attempt was made to model existing long rod insulator designs using software like Solidworks. Subsequently modifications were made to the design by changing parameters such as diameter of the insulator body, angle made by insulator cups etc. These models were then subjected to electric field analysis using finite element analysis software such as Elecnet or Comsol Multiphysics in order to identify the points where maximum electric field stress exists. Further modifications were made on order to reduce and equalize the electric field over the insulator surface.
IMPROVING LOCALIZATION ACCURACY IN WIRELESS SENSOR NETWORKS
Authors: KUMAR VINOD , YADAV SATYENDRA , SINGH ASHUTOSH KUMAR
Published: December 2020

The most fundamental problem of wireless sensor networks is localization (finding the geographical location of the sensors). Most of the localization algorithms proposed for sensor networks are based on Sequential Monte Carlo (SMC) method. To achieve high accuracy in localization it requires high seed node density and it also suffers from low sampling efficiency. There are some papers which solves this problems but they are not energy efficient. Another approach The Bounding Box method was used to reduce the scope of searching the candidate samples and thus reduces the time for finding the set of valid samples. In this paper we propose an energy efficient approach which will further reduce the scope of searching the candidate samples, so now we can remove the invalid samples from the sample space and we can introduce more valid samples to improve the localization accuracy. We will consider the direction of movement of the valid samples,
so that we can predict the next position of the samples more accurately, hence we can achieve high localization accuracy.
AMORPHOUS EVENT PREVENTION IN WIRELESS SENSOR NETWORK
Authors: SURENDHIRAN V. , SABARISH S. , PREMADEVI P.
Published: December 2020

In many applications wireless sensor can be used to detect the events in those applications. With the advances in sensing, communication, and computation, there is an increasing need to track mobile events such as air pollutant diffusion, toxic gas leakage, or wildfire spreading using mobile sensors such as robots. Lots of existing work use control
theory to plan the path of mobile sensors by assuming that the event evolution is known in advance. This assumption has severely limited the applicability of existing approaches. In this paper we aim to design a detecting, tracking and preventing approach that is capable of identifying multiple events with dynamic event signatures and providing event evolution history that may include event merge, split, create and destroy. We also focused on the power consumption.
ATTACKS IN MOBILE AD HOC NETWORKS: DETECTION AND COUNTER MEASURE
Authors: MADHUMATHI R. , BENAT J. JENNO RICHI
Published: December 2020

In Wireless Ad hoc network Stealthy packet dropping is a suite of four attacks—misrouting, power control, identity delegation, and colluding collision—that can be easily launched against multi hop wireless ad hoc network. Stealthy packet dropping disrupts the packet from reaching the destination through malicious behavior at an intermediate node. In the
same way Mobile ad hoc network also having the different types of attacks in network layer such as flooding attacks,rushing attacks, black hole attacks, gray hole attacks, wormhole attacks, sinkhole attacks, and Sybil attacks. We analyses different routing protocols and its route discovery technology.
SECURITY ARCHITECTURE FOR REAL- WORLD APPLICATIONS OF WIRELESS SENSOR NETWORK
Authors: PRIYA SHUBHI , SINGHA SONALI
Published: December 2020

With the recent capability of being applicable in enormous fields, the Wireless Sensor Networks (WSN) have drawn attention of researchers and industries in diverse areas. Being deployed in areas that are hostile, WSN pose lots of difficulties and challenges to the research fraternity. In this paper, we discuss a generalized security framework for real
world application of WSN. In particular we have considered the scenario of civil engineering field, a road tunnel. The proposed work mainly focus on security model for self adaptive lighting Model for road tunnel in WSN, and hence called Smart tunnel which provide the safety of the tunnels.
INCREASING THE LIFETIME OF HETEROGENEOUS SENSOR NETWORK BY USING GENETIC-FUZZY CLUSTERING
Authors: ABEDINI SEYED MOHAMMAD , KARIMI ABBAS
Published: December 2020

Wireless sensor network is composed of hundreds or thousands of sensor nodes which have computational, energy and memory limitation. Its duty is to receive information from its surrounding environment, analyze and process data and to send the received data to other nodes or base station. In these networks, sensor nodes are dependent on low power batteries to provide their energy. As energy is a challenging issue in these networks, clustering models are used to overcome this problem. In this paper, fuzzy logic and genetic algorithm are combined to increase the lifetime of the wireless sensor network. In other words, fuzzy logic is used to introduce the best nodes, those that in comparison to other nodes have more energy, density and centrality, to base station as cluster head candidate. Then, the number and place of cluster heads are determined in base station by using genetic algorithm. Also, the network acts heterogeneously and includes several nodes with different parameters.
ANALYSIS OF UNI PATH AND MULTI PATH ROUTING PROTOCOLS IN MOBILE ADHOC NETWORKS.
Authors: GIRI AVINASH , PRITHVIRAJ JITENDRA , VERMA ASHOK
Published: December 2020

A MANET is an interconnection of mobile devices by wireless links, which forms a dynamic topology. Routing protocols play a vital role in transmission of data across the network. The two major classifications of routing protocols are uni path and multi path. In this paper, we have evaluated the performance of a widely used on-demand uni path routing protocol called AODV and multi path routing protocol AOMDV and MDART . These protocol has been selected due to its edge over other protocols in various aspects, such as reducing delay, routing load etc. The evaluation of all the protocols is carried out in terms of different scenarios using NS2.
WIRELESS NETWORK SECURITY THREATS AND THEIR SOLUTIONS: A SHORT STUDY
Authors: DHINGRA MADHAVI , SRIVASTAVA DEEPIKA , SHARMA VIPUL
Published: December 2020

With continual advances in technology, wireless accessibility is being deployed increasingly in office and public environments, as it is having huge benefits. But it is also coupled with the security threats and risks that will adversely affect the performance of the organization. To get rid of these threats, firstly these threats need to be understood and then their solutions need to be finding out. This paper discusses major security threats and describes their solutions for securing wireless network.
WIRELESS EURYNOMUS A WIRELESS (802.11) PROBE REQUEST BASED ATTACK
Authors: CHOUDHARY HITESH , MOOLRAJANI PANKAJ
Published: December 2020

The 802.11 standard for wireless includes a procedure of sending a continuous probe request to find out if there is a nearby Access Point available or not. Most of wireless clients like laptops or smart phones are configured to auto-connect. Due to this auto connect feature any client can be compromised disregarding the fact that Access Point is nearby or not. Even if the client is connected to legal Access Point, a simple disassociation packet in 802.11 headers can be helpful for an attacker to leak your personal as well as company's top secret information.
Addressing Primary Care Inequities in Underserved Areas of the Philippines: A Review
Authors: Naria-Maritana Marianne Joy N. , Borlongan Gabriel R. , Zarsuelo Ma-Ann M. , Buan Ara Karizza G. , Nuestro Frances Karen A. , Dela Rosa Janvic A. , Silva Ma. Esmeralda C. , Mendoza Michael Antonio F. , Estacio Leonardo R.
Published: December 2020

Background. Inequities in health care exist in the Philippines due to various modifiable and non-modifiable determinants. Through the years, different interventions were undertaken by the government and various stakeholders to address these inequities in primary care. However, inequities still continue to persist. The enactment of the Universal Health Care (UHC) Act aims to ensure that every Filipino will have equitable access to comprehensive and quality health care services by strengthening primary care. As a step towards UHC, the government endeavors to guarantee equity by prioritizing assistance and support to underserved areas in the country. This paper aims to review different interventions to promote equity in the underserved areas that could aid in needs assessment.

Methods. A search through PUBMED and Google Scholar was conducted using the keywords, “inequity,” “primary care” and “Philippines.” The search yielded more than 10,000 articles which were further filtered to publication date, relevance to the topic, and credibility of source. A total of 58 full-text records were included in the review.

Results and Discussion. In the Philippines, inequities in primary care exist in the context of health programs, facilities, human health resources, finances, and training. These were recognized by various stakeholders, from government and private sector, and nongovernment organizations, taking actions to address inequities, applying different strategies and approaches but with a shared goal of improving primary care. On another end, social accountability must also be instilled among Filipinos to address identified social and behavioral barriers in seeking primary care. With political commitment, improvement in primary care towards health equity can be achieved.

Conclusion and Recommendation. To address inequities in primary care, there is a need to ensure adequate human resources for health, facilities, supplies such as medications, vaccination, clean water, and sources of funds. Moreover, regular conduct of training on healthcare services and delivery are needed. These will capacitate health workers and government leaders with continuous advancement in knowledge and skills, to be effective providers of primary care. Institutionalizing advocacy in equity through policies in healthcare provision would help realize the aims of the Universal Health Care Act.
Examining the Oral Health of Filipinos: Policy Analysis
Authors: Mendoza Michael Antonio F. , Zarsuelo Ma-Ann M. , Estacio Jr. Leonardo R. , Silva Ma. Esmeralda C.
Published: December 2020

Background. High prevalence of oral health problems persists across all age groups among Filipinos despite the continued endeavors of the government and professional societies. This position statement aimed to generate consensus policy recommendations to protect and promote oral health in the Philippines as an integral part of the healthcare service in light of the Universal Health Care (UHC) Act.

Methods. An evidence-based policy brief and presentations of dental and policy experts were used as discussion points in the roundtable discussion conducted by the UP Manila Health Policy Development Hub. Key stakeholders from various sectors were convened to generate inputs for policy actions and amendments to oral health related policies.

Results. Thematic analysis of the discussion was organized using the WHO Building Blocks of Health Systems, which yielded practical, accessible, and population-wide interventions (2010). The following issues were highlighted: (a) health service delivery needs strong collaboration of LGUs; (b) insufficient workforce of dental professionals; (c) market availability of sufficiently fluoridated toothpaste per age group; and (d) health financing scheme on oral health services.

Conclusion and Recommendations. With the shift in the health system landscape brought by the UHC Act, timely and responsive inter-sectoral interventions, focusing on prevention, must be set to attain the target decrease in the prevalence of dental caries. It was also to recommend to (i) engage the academe and training institutions to increase the workforce, (ii) consider adopting international standards on sugar consumption as appropriate, and (iii) ensure sufficient funds for sustainability of oral health programs, particularly school-based caries prevention program starting in pre-schools.
Policy Analysis on Determining Hospital Bed Capacity in Light of Universal Health Care
Authors: Silva Ma. Esmeralda C. , Zarsuelo Ma-Ann M. , Naria-Maritana Marianne Joy N. , Zordilla Zenith D. , Lam Hilton Y. , Mendoza Michael Antonio F. , Buan Ara Karizza G. , Nuestro Frances Karen A. , Dela Rosa Janvic A. , Padilla Carmencita D.
Published: December 2020

Background. Through the years of improving quality health service delivery, hospital bed capacity in the Philippines has remained to be a persistent challenge. In light of the aim of the Universal Health Care Act to protect and promote the right to health of every Filipino, one metric used to identify areas that are in most need or are under served, is the number of public hospital beds vis a vis the catchment population.

Methods. The systematic review of literature was utilized to generate a policy brief presented to the invited stakeholders of the policy issue for the roundtable discussion participated by all key stakeholders of the policy issue. Evidence and insights were thematically analyzed to generate consensus policy recommendations.

Results. With the current hospital bed availability and maldistribution, the Philippines still faces compounded issues in addressing healthcare demands. Currently, the request for increasing bed capacity is done through legislation. In context, this request is also parallel in expanding service capacity through the allocation of more funds and personnel. The ratio of private and charity beds must ensure to have equity among all patients of varying segments of the population. Enjoining private hospitals to share bed capacity for public service was also explored given appropriate subsidies.

Conclusion and Recommendation. To ensure equity in health service delivery, it is imperative to assess, strategize, and conduct prioritization of the needs of government hospitals for increased bed capacity, considering the distribution, socio-demographic profile, and health needs of the catchment population.
Policy Analysis on Identifying Copayment Services for the Shift in Financing Scheme of Health Care Services
Authors: Lam Hilton Y. , Zarsuelo Ma-Ann M. , Rey Katrina Loren R. , Silva Ma. Esmeralda C. , Mendoza Michael Antonio F. , Padilla Carmencita D.
Published: December 2020

Background. As the Philippines moves toward universal health coverage, it is imperative to examine how to eliminate inefficiencies, particularly misuse, overutilization, and risks of fraudulent claims. This position statement aimed to identify health services requiring copayments for cost-efficient health financing for the Universal Health Care Act.

Methods. A qualitative study was employed using a systematic review of literature, and thematic analysis of policy roundtable discussion (RTD) was conducted. The systematic review of literature generated evidence for the policy brief and critical points for discussion in the stakeholders’ RTD forum. The RTD was organized by the UP Manila Health Policy Development Hub (UPM HPDH) with the Department of Health (DOH) and was participated by key stakeholders of the policy issue to attain consensus recommendations and develop criteria for identifying services requiring copayments.

Results. An algorithm is proposed by the UPM HPDH based on collective expertise as a guide for policymakers to assess each benefit package in terms of overutilization, the danger of depleting government funds, and the risk of fraud. The use of clinical pathways is suggested to assess the misuse and overutilization of health services. In addition to copayments, benefits packages prone to fraudulent activities should be subjected to fraud prevention processes. Copayment should be linked inversely to the preventability level of the disease or condition.

Conclusion. There were gaps in the current policies to identify services requiring copayment services. Copayment schemes should be carefully determined to prevent misuse, overuse, and fraud of appropriate and necessary health services, while at the same time not limit access to needed care.
Policy Analysis on the Mental Health Needs of Overseas Filipino Workers: Addressing Gaps through Evidence-based Policy Reform
Authors: Silva Ma. Esmeralda C. , Zarsuelo Ma-Ann M. , Zordilla Zenith D. , Estacio Jr. Leonardo R. , Mendoza Michael Antonio F. , Padilla Carmencita D.
Published: December 2020

Background. There is an increasing number of distressed Overseas Filipino Workers (OFWs) due to adverse working conditions and unresolved post-repatriation issues. The enactment of the Republic Act 11036 (Mental Health Act) in 2018 supports the commitment of the State in promoting and protecting the mental health of every Filipino.

Methods. A systematic review of literature was conducted to generate evidence-based policy tools for the round table discussion conducted by the UP Manila Health Policy Development Hub, engaging all major stakeholders from all sides of the policy issue. Strengths and challenges of the current government initiatives in the phases of predeployment, deployment, repatriation, and reintegration were discussed to attain consensus policy recommendations.

Results. Increased migration led to a cascade of distressed OFWs and their subsequent need for trained mental health professionals. In host countries, challenges in on-site services include (i) limited psychiatry practice as prescribed by law of the host countries, (ii) reciprocity of the host country in allowing more welfare officers, and (iii) budget to support more plantilla items of Assistance to Nationals (ATN) staff. The inter-agency collaboration and legal support for all phases of migration should be holistic and set.

Conclusions and Recommendations. From the literature review and policy discussion, consensus recommendations included strengthening pre-deployment preparation, curbing the trafficking of minors, improving psychiatry practice through the Bilateral Labor Agreement, developing psychosocial counseling competencies among front line host country personnel, enhancing telecounselling services and exploring telemedicine, among others.
Rationalizing Health Personnel Financing Schemes for Evidence-informed Policy Reforms: Policy Analysis
Authors: Lam Hilton Y. , Rey Katrina Loren R. , Zarsuelo Ma-Ann M. , Silva Ma. Esmeralda C. , Mendoza Michael Antonio F. , Padilla Carmencita D.
Published: December 2020

Background. The Universal Health Care Law seeks to optimize financing of personnel costs without compromising quality and equitable health care among the health care facilities. This position statement aimed to identify strategies and policy recommendations for the cost-effective financing of health personnel in public healthcare facilities.

Methods. A systematic review of literature was done to generate policy brief and key points for roundtable discussion in collaboration with the Department of Health (DOH). The discussion was guided by the three health financing options of DOH: (a) retain Personnel Services (PS) as DOH budget but shift Maintenance and Other Operating Expenses (MOOE) to PhilHealth; (b) shift PS and MOOE to PhilHealth, and (c) rationalize part-time status in government hospitals.

Results. The pros and cons of financing options were cross-examined. In Option 1, physicians in government hospitals would receive fixed salaries from DOH / Local Government Units. In Option 2, there would be a monopsony between PhilHealth and provincial power. Payment will be performance-driven, and balance billing will be eliminated. Option 3 would be a set up of retaining part-time positions for physicians.

Conclusion and Recommendation. Participants deduced that for Option 1, provision of salary augmentation sources and ensuring adequate plantilla items and level of remuneration in government hospitals should be considered, in order to sufficiently compete with physicians’ income from private practice. For Option 2, the PhilHealth reimbursement system should ensure timely reimbursement so as not to subject care providers to financial instabilities. For Option 3, rationalizing part-time status should be flexible and can be applied regardless of how physicians are paid, as this would incentivize caregivers to work harder and smarter.
Return Service Agreement in the Context of the Universal Health Care Act: Using International and Local Experiences to Guide Application of the RSA
Authors: Capeding Theo Prudencio Juhani Z. , Zarsuelo Ma-Ann M. , Mendoza Michael Antonio F. , Estacio Jr. Leonardo R. , Silva Ma. Esmeralda C.
Published: December 2020

Background. Philippines is in a constant struggle to address shortage and maldistribution of health professionals, affecting equity in service delivery. The government endeavors to generate adequate supply of health workforce through scholarship and training programs which have been further expanded with the enactment of the Universal Health Care (UHC) Act. This article aimed to give a background for discussion on the application of return service agreement (RSA) provisions in the light of attaining universal health care.

Methods. A modified systematic review of literature was conducted guided by the key issues determined by the Department of Health with focus on the extent of scholarship grants and on number of recipients.

Results. The Philippine government enacted policy reforms through implementing RSA in response to the progressive decline of the net flow of health professionals. However, the criticisms lie in that RSA is not a long-term solution. With the RSA provisions in the UHC Law, metrics on determining the under-produced and maldistributed professional cadre must be created. These should be responsive in addressing facility-level and health system-level gaps.

Conclusion and Recommendation. Paucity of current local literature impedes attaining a conclusive body of evidence, therefore, further research is needed. Operationalization of RSA should not be viewed as a singular means to solve the health workforce gaps, but as part of holistic assessment, taking into consideration epidemiological, geographical, political, and social determinants. Stakeholders must ingress in collaborative intersectoral policy actions to warrant bottom-up support. Activities related to mapping, monitoring, and incentivizing medical and health-related professionals must be established to support a system conducive for workforce retention.
Towards Universal Quality Health Care through an Independent Accreditation Agency: A Review
Authors: Borlongan Gabriel R. , Zarsuelo Ma-Ann M. , Mendoza Michael Antonio F. , Silva Ma. Esmeralda C. , Estacio Jr. Leonardo R.
Published: December 2020

Background. Guaranteeing quality of health care services is part of the objectives of Republic Act No. 11223 or the Universal Health Care (UHC) Act of 2019. In assuring that quality services are delivered by health care providers, they must be accredited to participate in the National Health Insurance Program. The UHC Act mandates the Philippine Health Insurance Corporation (PhilHealth) to recognize third party mechanisms as basis of granting incentives for health facilities that deliver services of higher quality. This review aimed to identify lessons and experiences from literature that can be adopted and contextualized in the Philippine setting, for strategic policies on strengthening the national health facility accreditation system.

Methods. A systematic review of literature was conducted to generate evidence-based recommendations from discussions on cross country experiences and local government initiatives towards improved accreditation system.

Results. By virtue of the UHC Act, a form of strategic purchasing is further institutionalized through a rating system that incentivizes health facilities that provide better services in terms of quality, efficiency, and equity. It is imperative to consider the country’s previous and current gaps and challenges in accreditation and adopt the best practices of other countries, as appropriate to Philippine's local settings. A tool is proposed in creating a national hospital accreditation system using the domains of leadership and governance, financing and sustainability, standards development, program management, and continuing quality improvement.

Conclusion and Recommendations. With the legitimacy of third party accreditation body mandated by the UHC Act, operationalization of the prescribed mechanisms and organizational structure must enjoin all pertinent stakeholders and be supported by sustainable funds and technical assistance by the government.
Identifying Possible Gaps and Gray Areas in the Draft Universal Health Care Act Implementing Rules and Regulations: a Thematic Analysis of a Roundtable Event on Local Health Systems
Authors: Capeding Theo Prudencio Juhani Z. , Zarsuelo Ma-Ann M. , Mendoza Michael Antonio F. , Silva Ma. Esmeralda C. , Estacio Jr. Leonardo R.
Published: December 2020

Background. The Universal Health Care (UHC) Act is a landmark legislation that seeks to improve provision ofcomprehensive health services through the integration of local health systems. The Department of Health (DOH)conducted a series of roundtable discussions to gather stakeholders' inputs and concerns to refine the initial draftof the Implementing Rules and Regulations (IRR) of UHC.

Methods. On April 4, 2019, the Department of Health led a roundtable discussion on the Local Health Systemssections of the UHC IRR in collaboration with University of the Philippines Manila. A total of 65 stakeholders fromdifferent sectors participated in a semi-structured roundtable event. The proceedings were audio recorded andtranscribed. A thematic analysis was done using NVivo 12 software to document gaps and gray areas identifiedby the participants.

Results. Concerns of the participants revolved around the following: role of the private sector in local health systems;the integration of different municipal and other component health systems into a province-wide health system;organizational design of the health systems; pooling and utilization of the Special Health Fund (SHF). Gaps andgray areas were concentrated on the transfer of personnel and other health resources to the province-wide system,the composition of the Provincial Health Board, and the utilization and management of the SHF.

Conclusion. The roundtable event acquired various perspectives from stakeholders that could help the DOH identifypriority action points that could be resolved at the agency level. The identified themes from the study analysis couldbe of value to decision makers to clarify issues, address policy gaps, and to prioritize future research directions.
Çocuk Edebiyatına Yönelik Tutum Ölçeği Geliştirilmesi: Geçerlik ve Güvenirlik Çalışması
Authors: KARAGÜL Sedat
Published: December 2020

Bu çalışmanın amacı, çocuk edebiyatına yönelik tutumu belirlemeye olanak tanıyan bir ölçek geliştirmektir. 30 maddelik taslak ölçek; ilgili alanyazın taraması, uzman görüşleri ve gerçekleştirilen ön deneme doğrultusunda oluşturulmuş, ardından 2018-2019 eğitim-öğretim yılında Burdur Mehmet Akif Ersoy Üniversitesi Eğitim Fakültesinin farklı bölümlerinde öğrenim gören 314 öğretmen adayına uygulanarak geçerlik ve güvenirlik çalışmaları yapılmıştır. Ölçeğin kapsam geçerliği, uzman görüşlerine başvurma ve ön deneme uygulaması yoluyla sağlanmaya çalışılmıştır. Yapı geçerliği için ise faktör analizi yapılmıştır. Faktör analizi sonucunda ölçeğin 3 faktörlü bir yapıya sahip olduğu belirlenmiş; iki madde yük değerleri düşük olduğundan, iki madde de içinde bulundukları faktörle ilişkili bulunmadığından ölçekten çıkarılmıştır. Böylece ölçek, 26 madde ve 3 faktörden oluşan bir yapıya sahip olmuştur. Ölçekte yer alan maddelerin toplamı ile faktörler arasındaki ilişkiyi belirlemek için Pearson korelasyon katsayısına ilişkin istatistik tekniğinden yararlanılmıştır. Yapılan çözümleme sonucunda ölçeği oluşturan faktörlerin birbirleri ile olumlu ve anlamlı ilişki içinde olduğu görülmüştür. Ölçeğin Cronbach Alpha güvenirlik katsayısı 0,88 bulunmuştur. Çalışmada elde edilen bulgular doğrultusunda geliştirilen ölçeğin geçerli ve güvenilir bir ölçme aracı niteliği taşıdığı söylenebilir.
PERCEIVED SOCIAL SUPPORT, STRESS, COPING ATTITUDES OF PARENTS WITH SPECIAL NEEDS CHILDREN
Authors: AYDIN Eren , YÜKSEL Begümhan
Published: December 2020

This study aimed to investigate the capacity of the perceived social support of parents of special needs children to predict their family stress and stress coping attitudes. The sample consisted of 120 parents of special needs children aged between 3 and 6 years who were attending special education and rehabilitation centres. Parents’ perceived social support, stress levels, and coping attitudes were determined using a “Personal Information Form”, the “Revised Parental Social Support Scale”, the “Questionnaire on Resources and Stress”, and the “Inventory of Coping With Stress Attitudes”. Stepwise linear regression analysis was used to analyse the variables. The study found that the family stress of parents of special needs children was predicted by their level of perceived social support and their level of satisfaction with the perceived social support; however, the level of perceived social support and the level of satisfaction with the perceived social support had no predictive effect on coping attitudes. The findings of the study were discussed in line with the relevant literature and suggestions were offered for further research and practices.
SOSYAL BİLGİLER ÖĞRETMEN ADAYLARININ 21. YÜZYIL ÖĞRETEN VE ÖĞRENEN BECERİLERİNİN İNCELENMESİ
Authors: AYDEMİR Hasan , KARALI Yalçın , COŞANAY Gökhan
Published: December 2020

Bilginin hızla çoğaldığı ve değiştiği 21. yüzyılda toplumsal düzen ve bireysel ihtiyaçlar da hızla değişim göstermektedir. Bununla birlikte yeni iş alanları ve meslekler ortaya çıkmaktadır. Ülkelerin bu yeni oluşuma ayak uydurabilmeleri sahip oldukları insan potansiyelini yeni yüzyılın mesleki ihtiyaçlarını karşılayabilecek bireyler olarak yetiştirmelerine bağlıdır. Bu da yeni yüzyıl ihtiyaçlarına cevap vereceği öngörülen 21. yüzyıl becerileri eğitim programlarının uygulanmasıyla mümkün olacaktır. Burada en önemli görev bu eğitim programlarını uygulayacak olan öğretmenlere düşmektedir. Bu nedenle 21. yüzyıl becerilerinin öğrencilere kazandırılabilmesi için öncelikle bu becerilere sahip öğretmenlerin yetiştirilmesi gerekir. Bu doğrultuda araştırmanın amacı 21. yüzyılın hem öğreneni hem de öğreteni olacak olan öğretmen adaylarının bu becerilere ne düzeyde sahip olduklarını incelemek ve bu becerilere sahip olma düzeylerinin cinsiyet ve sınıf değişkenlerine göre farklılaşıp farklılaşmadığını saptamaktır. Araştırma ilişkisel tarama modeli ile yapılmıştır. Araştırmanın evreni 2019-2020 Eğitim Öğretim yılında İnönü Üniversitesi Eğitim Fakültesi Sosyal Bilgiler Öğretmenliği 2., 3. ve 4. sınıf öğrencilerinden oluşmaktadır. Evrenin tümüne ulaşılması amaçlanmıştır. Veri analizinde Mann Whitney U ve Kruskal-Wallis H Test kullanılmıştır. Araştırmada veri toplama aracı olarak Göksün (2016) tarafından geliştirilen 21. yüzyıl öğreten becerileri ölçeği ile 21. yüzyıl öğrenen becerileri ölçeği kullanılmıştır. Araştırma sonucunda öğretmen adaylarının öğrenen becerilerinde otonom, öğreten becerilerinde ise esnek öğretme becerilerinin sınıf düzeyine göre anlamlı düzeyde farklılaştığı görülmüştür.
Retratos da pandemia no bairro da levada: infância e crise em um “bairro de periferia”
Authors: Santos Alana Barros
Published: December 2020

A partir da atuação em ações de solidariedade da Casa do Congresso do Povo no bairro da Levada, Maceió-AL, me interessei pelos modos de vivenciar a infância de crianças da comunidade. O bairro, situado entre os canais da Lagoa Mundaú e o Centro histórico da capital Alagoana, possui um dos menores índices de desenvolvimento humano do estado e é marcado por processos de degradação infraestrutural e zoneamento de desprestígio moral. A disseminação do vírus vem intensificando situações de vulnerabilidade cotidiana dessa população como o desemprego, a fome e a paralisação das escolas públicas. As crianças têm permanecido mais no espaço da casa e da rua. Os relatos e registros compartilhados, são frutos dessa imersão onde tenho buscado encontrar as crianças que povoam esse bairro e observado como suas infâncias têm sido produzidas e reinventadas no contexto de crise que vivemos. De modo que este ensaio tem como objetivo retratar a vivência de crianças moradoras de um “bairro de periferia” durante o período de pandemia do covid-19.
"A vida não é útil": sonhar e suspender o céu
Authors: Canavieira Fabiana Oliveira
Published: December 2020

Esta resenha tem o objetivo apresentar não só último livro do líder indígena, jornalista e ambientalista Ailton Krenak intitulado A vida não é útil (2020b), mas, sua cosmovisão sobre a dualidade vida e morte, como também, sobre nossa relação com a Terra, desnudando a ficção do modelo econômico no qual nos inserimos. Sua linguagem objetiva, sensível e irônica são marcas de um pensamento anticolonial, anticapitalista e intensamente crítico do modelo de vida predatório que a alta casta que se autodenomina humanidade vive, a qual ele tece críticas contundentes. O autor expõe, a partir de seus saberes tradicionais ancestrais, sua forma de conexão com a Terra como organismo vivo inteligente. Tece considerações sobre as diferentes percepções de vida e morte, para os indígenas e os não-indígenas, situando essa discussão no contexto da pandemia do novo Coronavirus – Covid19. Aborda o fetiche pelas tecnologias e faz a defesa da conexão ente sonhos e a vida cotidiana, ao mesmo tempo que defende menos desenvolvimento e mais envolvimento. O convite à leitura desta obra dar-se tanto por seu conteúdo crítico de defesa de uma política de vida, mas também, pela estética sensível da sua cosmopolítica realista microesperançosa.
Attention-based Convolutional Neural Network for MRI Gibbs-ringing Artifact Suppression
Authors: Penkin Maksim , Krylov Andrey , Khvostikov Alexander
Published: December 2020

Gibbs-ringing artifact is a common artifact in MRI image processing. As MRI raw data is taken in a frequency domain, 2D in- verse discrete Fourier transform is applied to visualize data. Inability to take inverse Fourier transform of full spectrum (full k-space) leads to the insufficient sampling of the high frequency data and results in a well-known Gibbs phenomenon. It is worth to notice that truncation of high frequency information generates a significant blur, thus some techniques from other image restoration problems (for example, image deblur task) can be successfully used. We propose attention-based convolutional neural network for Gibbs-ringing reduction which is the extension of recently proposed GAS-CNN (Gibbs-ringing Artifact Suppression Convolutional Neural Network). Proposed method includes simplified non-linear mapping, amended by LRNN (Layer Recurrent Neural Network) refinement block with feature attention module, controlling the correlation between input and output tensors of the refinement unit. The research shows that the proposed post-processing refinement construction considerably simplifies the non-linear mapping.
The Model of Distance Education of the Designer in the Frames of Computer Project Graphics
Authors: Zaeva-Burdonskaya Elena , Kardashenko Daria
Published: December 2020

The article considers the potential of computer graphic modeling based on the experience of distance learning in design and art disciplines at the Department of Environmental design of the Stroganov Academy. An analysis of both practical and theoretical work of the Department during the semester made it possible to conclude that the model for the integration of full-time and distance learning, the individual and interactive approaches to the student is optimal for schools of creative arts. The experiment revealed the greatest flexibility and adaptability to the online format of the methodological material of the disciplines of graphic tools, its maximum openness to self-study, its role in innovative forms of design work, of the creative search for student’s own learning style.
Description Models, Methods, Algorithms, and Technology for Processing Poorly tructured Raster Graphic Documents
Authors: Vasin Dmitry
Published: December 2020

The original, highly effective technology for processing large format, complex structured graphic documents with a poorly formalized description of objects based on the original low-level raster and vector representation models is described in the paper, as part of the further development of the combinatorial geometric approach to processing geographically distributed data. We propose the original data structures and algorithms developed on the basis for solving actual problems of preprocessing, compression, and raster images recognition of graphic documents of the type
Deep Neural Networks Capabilities for Semantic Segmentation of Noisy Aerial Images
Authors: Markelov Aleksandr , Krivorotov Ivan , Gorbachev Vadim
Published: December 2020

Semantic segmentation is one of the important ways of extracting information about objects in images. State of the art neural network algorithms allow to perform highly accurate semantic segmentation of images, including aerial photos. However, in most of the works authors use high-quality low-noise images. In this work, we study the ability of neural networks to correctly segment images with intensive uncorrelated Gaussian noise. The study brings us three main conclusions. Firstly, it demonstrates that neural network algorithms are capable of working with extreme image distortions without using additional filtration or image recovery techniques. Secondly, the experiments quantitatively show that distortion intensity can be negated with increased training set size. Such process is similar to model’s quality improvement and generalization due to training dataset enlargement. Finally, we quantitatively demonstrate how image aggregation techniques affect training with noised data.