Circular frames without x-ray – lessons learned regarding radiation exposure during tibial deformity correction from Low & Middle Income Countries?

Circular frames are a successful way of treating difficult fractures and non-unions. At our institution (CSC) in Phnom Penh, Cambodia, our method differs from developed healthcare systems in that we do not use x-ray to site the frames. A retrospective cohort study was performed between CSC and a UK LRS unit. Demographics, diagnosis, frame type, pre- and post-op deformity, proximal and distal construct alignment comparative to the tibia, and time to union or failure. 70 patients in total were identified and were randomly selected from a hospital in UK. Demographics & deformity were similar and failed to reach significant difference on testing: union rate 70% v. 82%, time to union 9.8 v. 8.5 months, and radiation exposure mean 0 v. 74 cGy/cm2 (range 6.4–326.7). These are startlingly homogenous results considering the differing resources available. We believe that ring fixators are a viable treatment method in austere environments where image intensifiers are unavailable, and demand no unnecessary radiation exposure.

Cambodia will go easy on Myanmar junta

Headline CAMBODIA: Phnom Penh will go easy on Myanmar junta

Climate Sadness: The Fragile Beauty of Tonlé Sap

Tonlé Sap is the large fresh water lake-river near the geographic center of Cambodia. Visiting Tonlé Sap, following an academic conference in Phnom Penh, demanded a response at a personal and more visceral human level. Writing this poem attempted to express disquiet beyond academic examination of the biophysical dimensions of Tonlé Sap. The poem is sad for Tonlé Sap, for Cambodia, and implicitly for all of us on this planet. For thousands of years people have lived around Tonlé Sap, adapting to weather, the flow of water from mountain to sea, and the changing ebb and flow of civilizations. Anthropogenic sea level rise challenges all of this human history, unnecessarily.

Estimation of Traffic Delay Due to U-Turns at Uncontrolled Medians: Case Study in Phnom Penh, Cambodia

Lack of infrastructure capacity to the demand in mobility results in delays in traffic. U-turns restrict the movement of the opposing through-traffic during the maneuver, hence triggering delays. Significant delays can be observed, especially in high volume traffic, where U-turning is not restricted. Hence, it is imperative to study the delays incurred by the U-turning vehicles to assess their impacts on traffic congestion. This study thus proposes a quantitative method to estimate the aggregate and average delay per vehicle caused by U-turns at uncontrolled medians of urban roads. Traffic data were collected at a corridor where vehicles were allowed to U-turn on a four-lane divided mixed traffic urban road in Phnom Penh, Cambodia. The delay in the opposing lane of traffic was calculated by analyzing the data using a novel analytical method; a derivative of the Webster’s delay model. The results reveal that the suggested technique evaluates the caused delay with good accuracy. Excessive traffic delay and about three seconds delay per vehicle in the through-traffic of the opposite lane align well with the experienced delay at the site. The method can be used to assess the delay at straight corridor sections where U-turns are not restricted, understand the causes of the delay, and develop control measures for improved traffic performance.

Estado nutricional e cáries dentárias em crianças e adolescentes cambojanas vulneráveis que vivem em Phnom Penh

A investigação tem demonstrado que durante a infância, a malnutrição está relacionada com a doença da cavidade oral mais prevalente no Camboja, a cárie dentária. Este estudo transversal avaliou o estado nutricional e a cárie dentária de 344 crianças e adolescentes cambojanos vulneráveis com idade entre os 6 e os 18 anos. O estado nutricional (peso corporal, estatura e índice de massa corporal para idade e sexo) e o índice CPOD (dentes cariados sem obturação) foram medidos e calculados. A maioria apresentava peso normal (56,7%), 36,6% com baixo peso, 6,7% com excesso de peso e 45,1% com baixa estatura para a idade e sexo. A prevalência de cárie dentária foi notavelmente alta (94,9%). Crianças de 6-11 anos apresentaram índice CPOD significativamente maior (6,7 ± 4,0) do que os adolescentes (4,0 ± 2,9 para 12-14 anos e 4,1 ± 1,6 para 15-18 anos, P <0,01). Além disso, os participantes com baixo peso apresentaram o maior índice CPOD (6,6 ± 3,8). Crianças vulneráveis e em situação de risco, na faixa etária dos 6 aos 11 anos e com baixo peso foram as mais afetadas, pelo que, a prevenção é urgente, principalmente nos dias de hoje. A literacia em alimentação e em saúde oral deve ser incentivada.

Conflict and satisfaction in distribution channels: Hotel operators' perspectives in Cambodia

<p>This study examines hoteliers’ perceptions of the level of satisfaction and sources of conflict with both traditional and online intermediaries (TI and OI) in Cambodia. It unveils the overall level of satisfaction of hoteliers with intermediaries in Cambodia, discusses the sources of conflict, and assesses whether there are differences in terms of the levels of satisfaction as well as sources of conflict between TI and OI. This study is focussed on the supply side, which is hoteliers. A mixed methods approach is used for this study and 42 hoteliers in Cambodia were interviewed in three different regions in Cambodia: Siem Reap, Phnom Penh, and Sihanoukville. The study found that the overall level of satisfaction of hoteliers with intermediaries is very positive. The overall level of satisfaction of hoteliers with TI such as travel agencies and tour operators is perceived as satisfactory between "Somewhat good" and "Extremely good". Similarly, the overall level of satisfaction of hoteliers with OI such as Booking.com, Expedia, Agoda, and Ctrip is also perceived as satisfactory ranging from "Somewhat good" to "Extremely good". The results also reveal that the most common sources of conflict with TI are price level-related conflict, payment-related conflict, and price-quality ratio-related conflict. The least common sources of conflict for TI were booking details-related conflict, commission-related conflict, and overbooking-related conflict. Likewise, the most frequent sources of conflict with OI are price level-related conflict, overbooking-related conflict, and complaint handling-related conflict and commission-related conflict, booking details-related conflict, and fulfillment of contract conditions-related conflict were the least frequent sources of conflict. Some differences were found for the level of satisfaction and sources of conflict in terms of hotel attributes and respondents' backgrounds. Regarding the level of satisfaction, differences were found in the case of hotel size and hotel age with TI. Concerning the sources of conflict, differences were found in terms of respondents’ nationalities, hotel category, hotel size, and hotel age. It is surprising to note that no statistical differences were found in the case of hotel location, ownership, and respondents’ job titles.</p>

Factors influencing physicochemical characteristics of faecal sludge in Phnom Penh, Cambodia

Comprehensive knowledge of faecal sludge characteristics is needed for sludge management planning, but it is lacking for the city of Phnom Penh, Cambodia. Thus, this study characterised physicochemical properties of faecal sludge from households in Phnom Penh and related these to sludge containment unit type, unit age, connectedness to the urban drainage network, type of wastewater captured, watertight containment units, number of users, and emptying practices. In total, 194 faecal sludge samples collected during containment unit emptying were analysed for physicochemical parameters. Information on containment units was collected in a survey of emptiers and users. Mean values of faecal sludge chemical parameters were found to be slightly lower than previously reported values for low-/middle-income countries, whereas physicochemical properties were within similar ranges. The main factor influencing organic matter content in faecal sludge was containment unit connection to the urban drainage network, whereas emptying practice and capture of only blackwater affected nutrient levels. The concentrations of nutrients and organic pollutants greatly exceeded Cambodian discharge standards for wastewater. This causes environmental impacts, so treatment is needed before discharge. The faecal sludge characteristics and influencing factors identified here can serve as a baseline for sanitation stakeholders planning faecal sludge management systems in Phnom Penh and similar cities.

Conflict and satisfaction in distribution channels: Hotel operators' perspectives in Cambodia

<p>This study examines hoteliers’ perceptions of the level of satisfaction and sources of conflict with both traditional and online intermediaries (TI and OI) in Cambodia. It unveils the overall level of satisfaction of hoteliers with intermediaries in Cambodia, discusses the sources of conflict, and assesses whether there are differences in terms of the levels of satisfaction as well as sources of conflict between TI and OI. This study is focussed on the supply side, which is hoteliers. A mixed methods approach is used for this study and 42 hoteliers in Cambodia were interviewed in three different regions in Cambodia: Siem Reap, Phnom Penh, and Sihanoukville. The study found that the overall level of satisfaction of hoteliers with intermediaries is very positive. The overall level of satisfaction of hoteliers with TI such as travel agencies and tour operators is perceived as satisfactory between "Somewhat good" and "Extremely good". Similarly, the overall level of satisfaction of hoteliers with OI such as Booking.com, Expedia, Agoda, and Ctrip is also perceived as satisfactory ranging from "Somewhat good" to "Extremely good". The results also reveal that the most common sources of conflict with TI are price level-related conflict, payment-related conflict, and price-quality ratio-related conflict. The least common sources of conflict for TI were booking details-related conflict, commission-related conflict, and overbooking-related conflict. Likewise, the most frequent sources of conflict with OI are price level-related conflict, overbooking-related conflict, and complaint handling-related conflict and commission-related conflict, booking details-related conflict, and fulfillment of contract conditions-related conflict were the least frequent sources of conflict. Some differences were found for the level of satisfaction and sources of conflict in terms of hotel attributes and respondents' backgrounds. Regarding the level of satisfaction, differences were found in the case of hotel size and hotel age with TI. Concerning the sources of conflict, differences were found in terms of respondents’ nationalities, hotel category, hotel size, and hotel age. It is surprising to note that no statistical differences were found in the case of hotel location, ownership, and respondents’ job titles.</p>

Child-Friendly Urban Development: Smile Village Community Development Initiative in Phnom Penh

Since urban children’s populations have been rapidly increasing, there is a growing interest in promoting child-friendly cities and communities. UNICEF has accordingly developed a framework for action to build child-friendly cities and communities. This framework outlines the steps to build a governance system committed to realizing the rights of children and translated implementation processes in relation to the Convention on the Rights of the Child. Particularly, UNICEF produced a guidebook that outlines building blocks to developing child-friendly cities and communities. This guidebook provides good practices and consolidates common challenges and lessons learned to guide the city governments and relevant stakeholders. Likewise, Cambodia developed a national child-friendly community framework aimed to further improve conducive environments for children where their rights are recognized and supported. Following these international and national trends on child-friendly urban development, many organizations and relevant stakeholders in Cambodia have come together to build urban communities focused on children. Similarly, the Smile Village community in Phnom Penh city was developed. Although its main vision is to build a residential community for underprivileged families to achieve social and financial mobility, various facilities and programs were developed for children. This study explores this community on its child-friendly dimensions and examines whether this urban community is child-friendly based on the national child-friendly community development’s core dimensions.