Search results for: public health surveillance
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13067

Search results for: public health surveillance

10097 Development of a Core Set of Clinical Indicators to Measure Quality of Care for Thyroid Cancer: A Modified-Delphi Approach

Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

Abstract:

BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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10096 The Challenges of Citizen Engagement in Urban Transformation: Key Learnings from Three European Cities

Authors: Idoia Landa Oregi, Itsaso Gonzalez Ochoantesana, Olatz Nicolas Buxens, Carlo Ferretti

Abstract:

The impact of citizens in urban transformations has become increasingly important in the pursuit of creating citizen-centered cities. Citizens at the forefront of the urban transformation process are key to establishing resilient, sustainable, and inclusive cities that cater to the needs of all residents. Therefore, collecting data and information directly from citizens is crucial for the sustainable development of cities. Within this context, public participation becomes a pillar for acquiring the necessary information from citizens. Public participation in urban transformation processes establishes a more responsive, equitable, and resilient urban environment. This approach cultivates a sense of shared responsibility and collective progress in building cities that truly serve the well-being of all residents. However, the implementation of public participation practices often overlooks strategies to effectively engage citizens in the processes, resulting in non-successful participatory outcomes. Therefore, this research focuses on identifying and analyzing the critical aspects of citizen engagement during the same participatory urban transformation process in different European contexts: Ermua (Spain), Elva (Estonia) and Matera (Italy). The participatory neighborhood regeneration process is divided into three main stages, to turn social districts into inclusive and smart neighborhoods: (i) the strategic level, (ii) the design level, and (iii) the implementation level. In the initial stage, the focus is on diagnosing the neighborhood and creating a shared vision with the community. The second stage centers around collaboratively designing various action plans to foster inclusivity and intelligence while pushing local economic development within the district. Finally, the third stage ensures the proper co-implementation of the designed actions in the neighborhood. To this date, the presented results critically analyze the key aspects of engagement in the first stage of the methodology, the strategic plan, in the three above-mentioned contexts. It is a multifaceted study that incorporates three case studies to shed light on the various perspectives and strategies adopted by each city. The results indicate that despite of the various cultural contexts, all cities face similar barriers when seeking to enhance engagement. Accordingly, the study identifies specific challenges within the participatory approach across the three cities such as the existence of discontented citizens, communication gaps, inconsistent participation, or administration resistance. Consequently, key learnings of the process indicate that a collaborative sphere needs to be cultivated, educating both citizens and administrations in the aspects of co-governance, giving these practices the appropriate space and their own communication channels. This study is part of the DROP project, funded by the European Union, which aims to develop a citizen-centered urban renewal methodology to transform the social districts into smart and inclusive neighborhoods.

Keywords: citizen-centred cities, engagement, public participation, urban transformation

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10095 Impact of Health Sector Economic Reforms in Underdeveloped Countries

Authors: Haga Abdelrahman Elimam

Abstract:

This paper investigates the connotation, and some of the realistic implications, of the economic reform of health sector in under developed countries. The paper investigates the issues that economic reforms have to address, and the policy targets they are considered to accomplish. The work argues that the development of economic reform is not connected only with understanding the priorities and refining them, furthermore with reformation and restructuring the organizations through which health policies are employed. Considering various organizational values, that are likely to be regular to all economic reform programs, a regulatory approach to institutional reform is unsuitable. The paper further investigates the selection of economic reform that may as well influence via technical suggestions and analysis, but the verdict to continue, and the consequent success of execution, eventually depends on the progressive political sustainability. The paper concludes by giving examples of institutional reforms from various underdeveloped countries and includes recommendation of the responsibility and control of donor organizations.

Keywords: economic reform, health sector, underdeveloped countries, technical suggestions

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10094 Distribution Urban Public Spaces Among Riyadh Residential Neighborhoods

Authors: Abdulwahab Alalyani, Mahbub Rashid

Abstract:

Urban Open Space (UOS) a central role to promotes community health, including daily activities, but these resources may not available, accessible enough, and or equitably be distributed. This paper measures and compares spatial equity of the availability and accessibility UOS among low, middle, and high-income neighborhoods in Riyadh city. The measurement mothdulgy for the UOSavailability was by calculating the total of UOS with respect to the population total (m2/inhabitant) and the accessibility indicted by using walking distance of a 0.25 mi (0.4 km) buffering streets network.All UOS were mapped and measured using geographical information systems. To evaluate the significant differences in UOS availability and accessibility across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences.The findings are as follows; finding, UOSavailability was lower than global standers. Riyadh has only 1.13 m2 per capita of UOS, and the coverage accessible area by walking distance to UOS was lower than 50%. The final finding, spatial equity of the availability and accessibility, were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of UOS should be focused on increasing Urban park availability and should be given priority to those low-income and unhealthy communities.

Keywords: distribution urban open space, urban open space accessibility, spatial equity, riyadh city

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10093 Healthcare Seeking Behaviors of Parents Who Have Children with Disabilities: A Case Study at the Effutu Municipality, Winneba-Central Region, Ghana-West Africa

Authors: Priscilla Deede Hammond

Abstract:

Healthcare seeking behaviour has emerged as a tool to tackle perceived ill-health by taking remedial actions. And currently, efforts are being directed towards encouraging people (especially parents) to learn and use health-promoting behaviours in seeking their children’s healthcare. Regardless of these efforts, most parents encounter challenges with raising a child with a disability. The purpose of the study was to explore the healthcare-seeking behaviours of parents of children with disabilities. In order to achieve the purpose of the study, a case study design was employed where the researcher used a qualitative approach such as semi-structured interview to gather the required data. Data from participants were analysed using a thematic analysis approach. It was revealed from the findings of the study that, some of the parents after the first diagnosis by health professionals consulted a spiritualist or a herbalist for help. Also, some parents stated that their response to their children’s healthcare depended on the severity of the sickness. The study recommends the Ministry of Gender, Children and Social Protection and other social agencies such as the Social Welfare Department to provide health assessment and financial support to families of children with disabilities.

Keywords: healthcare, health, parents, disabilities

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10092 AI In Health and Wellbeing - A Seven-Step Engineering Method

Authors: Denis Özdemir, Max Senges

Abstract:

There are many examples of AI-supported apps for better health and wellbeing. Generally, these applications help people to achieve their goals based on scientific research and input data. Still, they do not always explain how those three are related, e.g. by making implicit assumptions about goals that hold for many but not for all. We present a seven-step method for designing health and wellbeing AIs considering goal setting, measurable results, real-time indicators, analytics, visual representations, communication, and feedback. It can help engineers as guidance in developing apps, recommendation algorithms, and interfaces that support humans in their decision-making without patronization. To illustrate the method, we create a recommender AI for tiny wellbeing habits and run a small case study, including a survey. From the results, we infer how people perceive the relationship between them and the AI and to what extent it helps them to achieve their goals. We review our seven-step engineering method and suggest modifications for the next iteration.

Keywords: recommender systems, natural language processing, health apps, engineering methods

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10091 Issues and Influences in Academic Choices among Communication Students in Oman

Authors: Bernard Nnamdi Emenyeonu

Abstract:

The study of communication as a fully-fledged discipline in institutions of higher education in the Sultanate of Oman is relatively young. Its evolution is associated with Oman's Renaissance beginning from 1970, which ushered in an era of modernization in which education, industrialization, expansion, and liberalization of the mass media, provision of infrastructure, and promotion of multilateral commercial ventures were considered among the top priorities of national development plans. Communication studies were pioneered by the sole government university, Sultan Qaboos University, in the 1990s, but so far, the program is taught in Arabic only. In recognition of the need to produce professionals suitably equipped to fit into the expanding media establishments in the Sultanate as well as the widening global market, the government decided to establish programs in which communication would be taught in English language. Under the supervision of the Ministry of Higher Education, six Colleges of Applied Sciences were established in Oman in 2007. These colleges offer a 4-year Bachelor degree program in communication studies that comprises six areas of specialization: Advertising, Digital Media, International Communication, Journalism, Media Management and Public Relations. Over the years, a trend has emerged where students tend to flock to particular specializations such as Public Relations and Digital Media, while others, such as Advertising and Journalism, continue to draw the least number of students. In some instances, some specializations have had to be frozen due to the dire lack of interest among new students. It has also been observed that female students are more likely to be more biased in choice of specializations. It was therefore the task of this paper to establish, through a survey and focus group interviews, the factors that influence choice of communication studies as well as particular specializations, among Omani Communication Studies undergraduates. Results of the study show that prior to entering into the communication studies program, the majority of students had no idea of what the field entailed. Whatever information they had about communication studies was sourced from friends and relatives rather than more reliable sources such as career fairs or guidance counselors. For the most part, the choice of communication studies as a major was also influenced by factors such as family, friends and prospects for jobs. Another significant finding is the strong association between gender and choice of specializations within the program, with females flocking to digital media while males tended to prefer public relations. Reasons for specialization preferences dwelt strongly on expectations of a good GPA and the promise of a good salary after graduation. Regardless of gender, most students identified careers in news reporting, public relations and advertising as unsuitable for females. Teaching and program presentation were identified as the most suitable for females. Based on these and other results, the paper not only examined the social and cultural factors that are likely to have influenced the respondent's attitude to communication studies, but also discussed the implication for curriculum development and career development in a developing society such as Oman.

Keywords: career choice, communication specialization, media education, Oman

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10090 A Socio-Spatial Analysis of Financialization and the Formation of Oligopolies in Brazilian Basic Education

Authors: Gleyce Assis Da Silva Barbosa

Abstract:

In recent years, we have witnessed a vertiginous growth of large education companies. Daughters of national and world capital, these companies expand both through consolidated physical networks in the form of branches spread across the territory and through institutional networks such as business networks through mergers, acquisitions, creation of new companies and influence. They do this by incorporating small, medium and large schools and universities, teaching systems and other products and services. They are also able to weave their webs directly or indirectly in philanthropic circles, limited partnerships, family businesses and even in public education through various mechanisms of outsourcing, privatization and commercialization of products for the sector. Although the growth of these groups in basic education seems to us a recent phenomenon in peripheral countries such as Brazil, its diffusion is closely linked to higher education conglomerates and other sectors of the economy forming oligopolies, which began to expand in the 1990s with strong state support and through political reforms that redefined its role, transforming it into a fundamental agent in the formation of guidelines to boost the incorporation of neoliberal logic. This expansion occurred through the objectification of education, commodifying it and transforming students into consumer clients. Financial power combined with the neo-liberalization of state public policies allowed the profusion of social exclusion, the increase of individuals without access to basic services, deindustrialization, automation, capital volatility and the indetermination of the economy; in addition, this process causes capital to be valued and devalued at rates never seen before, which together generates various impacts such as the precariousness of work. Understanding the connection between these processes, which engender the economy, allows us to see their consequences in labor relations and in the territory. In this sense, it is necessary to analyze the geographic-economic context and the role of the facilitating agents of this process, which can give us clues about the ongoing transformations and the directions of education in the national and even international scenario since this process is linked to the multiple scales of financial globalization. Therefore, the present research has the general objective of analyzing the socio-spatial impacts of financialization and the formation of oligopolies in Brazilian basic education. For this, the survey of laws, data, and public policies on the subject in question was used as a methodology. As a methodology, the work was based on some data from these companies available on websites for investors. Survey of information from global and national companies that operate in Brazilian basic education. In addition to mapping the expansion of educational oligopolies using public data on the location of schools. With this, the research intends to provide information about the ongoing commodification process in the country. Discuss the consequences of the oligopolization of education, considering the impacts that financialization can bring to teaching work.

Keywords: financialization, oligopolies, education, Brazil

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10089 Occupational Stress in Nurses of a Maternity Ward in Lubango, Angola

Authors: Lídia Chienda, Tchilissila A. Simoes

Abstract:

Angola is known for the low quality of maternal health services, registering one of the highest maternal and child mortality of Africa. Working in these health facilities may be of great challenge for health professionals. In this study, we aimed to identify the presence of occupational stress in 76 nurses working in a maternity ward in Lubango, Southern Angola. The participants completed the Health Professional Stress Questionnaire and reported a moderate and high level of stress. To these individuals, 'receiving a low salary,' 'inadequate/insufficient salary,' 'overwork or very demanding work' and 'working long hours in a row' seemed to be the main indicators of occupational stress. Moreover, there was an influence of the work overload, the remuneration earned, the career, and family conflicts in the occupational stress index. These results contributed to a better understanding of the difficulties Angolan nurses are facing and the need to implement policies that envisage the wellbeing of this population.

Keywords: Africa, maternity wards, nursing, occupational stress

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10088 Autonomous Flight Control for Multirotor by Alternative Input Output State Linearization with Nested Saturations

Authors: Yong Eun Yoon, Eric N. Johnson, Liling Ren

Abstract:

Multirotor is one of the most popular types of small unmanned aircraft systems and has already been used in many areas including transport, military, surveillance, and leisure. Together with its popularity, the needs for proper flight control is growing because in most applications it is required to conduct its missions autonomously, which is in many aspects based on autonomous flight control. There have been many studies about the flight control for multirotor, but there is still room for enhancements in terms of performance and efficiency. This paper presents an autonomous flight control method for multirotor based on alternative input output linearization coupled with nested saturations. With alternative choice of the output of the multirotor flight control system, we can reduce computational cost regarding Lie algebra, and the linearized system can be stabilized with the introduction of nested saturations with real poles of our own design. Stabilization of internal dynamics is also based on the nested saturations and accompanies the determination of part of desired states. In particular, outer control loops involving state variables which originally are not included in the output of the flight control system is naturally rendered through this internal dynamics stabilization. We can also observe that desired tilting angles are determined by error dynamics from outer loops. Simulation results show that in any tracking situations multirotor stabilizes itself with small time constants, preceded by tuning process for control parameters with relatively low degree of complexity. Future study includes control of piecewise linear behavior of multirotor with actuator saturations, and the optimal determination of desired states while tracking multiple waypoints.

Keywords: automatic flight control, input output linearization, multirotor, nested saturations

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10087 Cross-Sectional Analysis of the Health Product E-Commerce Market in Singapore

Authors: Andrew Green, Jiaming Liu, Kellathur Srinivasan, Raymond Chua

Abstract:

Introduction: The size of Singapore’s online health product (HP) market (e-commerce) is largely unknown. However, it is recognized that a large majority comes from overseas and thus, unregulated. As buying HP from unauthorized sources significantly compromises public health safety, understanding e-commerce users’ demographics and their perceptions on online HP purchasing becomes a pivotal first step to form a basis for recommendations in Singapore’s pharmacovigilance efforts. Objective: To assess the prevalence of online HP purchasing behaviour among Singaporean e-commerce users. Methodology: This is a cross-sectional study targeting Singaporean e-commerce users recruited from various local websites and online forums. Participants were not randomized into study arms but instead stratified by random sampling method based on participants’ age. A self-administered anonymous questionnaire was used to explore participants' demographics, online HP purchasing behaviour, knowledge and attitude. The association of different variables with online HP purchasing behaviour was analysed using logistic regression statistics. Main outcome measures: Prevalence of HP e-commerce users in Singapore (%) and variables that contribute to the prevalence (adjusted prevalent ratio). Results: The study recruited 372 complete and valid responses. The prevalence of online HP consumers among e-commerce users in Singapore is estimated to be 55.9% (1.7 million consumers). Online purchasing of complementary HP (46.9%) was the most prevalent, followed by medical devices (21.6%) and Western medicine (20.5%). Multivariate analysis showed that age is an independent variable that correlates with the likelihood of buying HP online. The prevalence of HP e-commerce users is highest in the 35-44 age group (64.1%) and lowest among the 16-24 age group (36.4%). The most bought HP through the internet are vitamins and minerals (21.5%), non-herbal (15.9%), herbal (13.9%), weight loss (8.7%) and sports (8.4%) supplements. While the top 3 products are distributed equally between the genders, there is a skew towards female respondents (12.4% in females vs. 4.9% in males) for weight loss supplements and towards males (13.2% in males vs. 3.7% in females) for sports supplements. Even though online consumers are in the younger age brackets, our study found that up to 72.0% of HP bought online are bought for others (buyer’s family and/or friends). Multivariate analysis showed a statistically significant association between purchasing HP through online means and the perceptions that 'internet is safe' (adjusted Prevalence Ratio=1.15, CI 1.03-1.28), 'buying HP online is time saving' (PR=1.17, CI 1.01-1.36), and 'recognition of HP brand' (PR=1.21 CI 1.06-1.40). Conclusions: This study has provided prevalence data for online HP market in Singapore, and has allowed the country’s regulatory body to formulate a targeted pharmacovigilance approach to this growing problem.

Keywords: e-commerce, pharmaceuticals, pharmacovigilance, Singapore

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10086 Health Promotion Programs for Fifteen Years Decreased Loneliness and Increased Happiness for Elementary School Children in Yuzawa Town, Japan

Authors: Takeo Shibata, Arihito Endo, Chika Hiraga, Akemi Kunimatsu, Yoko Shimizu

Abstract:

Introduction: A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. Yuzawa Town is famous with hot springs and ski resorts. We evaluated the changes in mental status in elementary school children. Methods: questionnaires survey had been held every five years. 196 questionnaires were corrected (94 boys and 102 girls). Changes for their anxieties, loneliness, confiding, problem-solving, risk breaching, communications, happiness, and life satisfaction were evaluated by chi-square test. Results: The rate of loneliness and life dissatisfactions decreased. The rates of happiness, confiding in grandparents, and risk breaching, increased. Especially, happiness rates increased for boys, loneliness rate decreased for girls, confiding in grandparents and risk breaching rate increased for girls. Conclusion: Our health promotion programs could increase mental health status in elementary school children.

Keywords: health promotion, mental status, elementary school, loneliness, happiness

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10085 Health Behaviours of Patients Qualified for Bariatric Surgery

Authors: A. Gazdzinska, P. Jagielski, E. Kaniewska, S. P. Gazdzinski, M. Wylezol

Abstract:

Background: In the multi-factor etiology of obesity, an increasing degree of importance is attributed to behavioral factors. Lifestyle and health-oriented behaviors heavily influence the treatment of multiple diseases, including obesity. However, only a few studies evaluated health-related behaviors exhibited by patients qualified for bariatric surgery. None of them was performed in Polish population. Aim: Assessment of health behaviors of obese patients according to the degree of mood disorders. Method: The study involved 93 patients (66 females) who were qualified for bariatric surgery in the Department of Surgery of the Military Institute of Aviation Medicine in Warsaw. Diagnostic instrument was the Juczynski’s Inventory of Health Behavior (HBI), which evaluates health behavior in four categories, i.e. proper nutrition habits (PNH), preventive behavior (PH), health practices (HP) and positive mental attitude (PMA). The average HBI falls in the range between 24 and 120 points, for each category of health behaviors fall between 1 and 5 (higher score means higher severity declared healthy behaviors). The depressive symptoms in patients were assessed with Beck Depression Inventory (BDI). All analyses were conducted using STATISTICA 12. Results: The average age was 44.2 ± 11.5 years, mean BMI was 44.3 ± 10.5 kg/m2 and 46.8 ± 7.6 kg/m2, in females and males respectively. According to BDI, 32% patients had mild level of depression, 10% moderate and 14% severe depression. BDI scores were not different between females and males. Low results with regard to the health behaviors declared were obtained by 35.5 % of patients, medium by 44.0%, while high ones by only 20.5%. On average, patients gained 3.28 points in PNH, 3.37 points in PH, 3.29 points in HP, while 3.42 in the PMA category, showing average intensity of these behaviors. These health behaviors were practiced significantly more often by women (p = 0.04). The average HBI was 80.2; with average score of 81.5 for females and 76.6 for males, respectively (p = 0.03). Women were better in the PNH category (p = 0.02). A positive correlation was found between age and all categories of health behaviors, in particular PNH (R = 0.38; p = 0.001), PH (R = 0.26; p = 0.01), HP (R = 0.27; p = 0.01) and PMA (R = 0.24; p = 0.02), independent of gender. The severity of depression had a significant impact only on the behaviors associated with proper eating habits, which saw a negative correlation between BDI scores and the PNH (R = -0.21; p = 0.04). Conclusions: Majority of morbidly obese patients qualified for bariatric surgery obtained low to average scores in health behavior questionnaire. However, these results are similar in comparison with the Polish adult population. In accordance to these results, it seems that healthy behaviors, among them eating behaviors, do not appear to be a cause of obesity epidemic or they might be acquired when the disease is already underway. Female gender and age had a positive effect, and depression had a negative effect on the level of health behaviors among patients qualified for bariatric surgery.

Keywords: depression, habits, health behaviours, obesity

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10084 The Interaction of Country-of-Manufacturing with Country-of-Design within Different Consumption Context

Authors: Ebru Genc, Shih-Ching Wang

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In today’s globalized world, while companies move their production centers to developing countries in order to gain cost advantage, they receive negative responses from consumers because of the weak image of those countries. In this study, we looked at this tradeoff faced by multinational companies. Some companies that have headquarters in developed countries have devised a strategy of manipulating country-of-origin (COO) information by introducing the concept of country of design (COD). We analyzed the impact of country-of-manufacturing (COM) information on consumers’ product evaluation and purchase intention in the presence of different levels of COD information, namely, in terms of developed and developing countries. We found that it is not advantageous for a firm to publish a design location with a strong image if the firm is producing in a country that has a weak image. On the other hand, revealing COD information has a reinforcing effect on consumers’ product evaluation and purchase intention if the firm is producing in a country with a strong image. Second, we studied the impact of consumption context on this relationship (in terms of public or private use) and found that for products that are typically used in public, COM has significantly shown higher importance on product evaluation and purchase intention, compared to products typically used in private. However, our results show that consumption context shows no effect of an impact resulting from COD information.

Keywords: consumption context, country of design, country of manufacturing, country of origin

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10083 Assessment of Implementation of the Health and Safety Contents of the Nigerian Factories Act by Small and Medium Scale Industries in Anambra State, Nigeria

Authors: Vivian Uchechi Okpala

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Background: Millions of workers die every year as a result of occupational hazards, accidents and injuries, which are as a result of non- compliance to the laws or legislations guiding the health, safety and welfare of workers in the industries. This and many more lead to the assessment of implementation of the health and safety contents of the Nigerian Factories Act (NFA) by small and medium scale industries in Anambra State. Objectives: The study is aimed at achieving the following specific objectives; to assess the extent of implementation of Part-II Health and Part -III Safety (General Provisions), implementation of Part II Health and Part -III Safety (General Provisions Nigerian Factories Acts based on the age of the industries, locations of the industries and level of education of the workers of the small and medium scale industries Methods: the research design that was used for this study was descriptive survey research design, Area of this study was Anambra state, The population for this study comprised 180 chairmen/presidents of union workers of manufacturing industries in Anambra State, The instrument used for this study was structured questionnaire titled ‘assessment of implementation of NFA health and safety contents by small and medium scale industries, results: From the analysis, the following findings were made: Results: The medium scale industries implemented the Part-II Health and Part III Safety (General provisions) better than the small scale industries in Anambra state, the age of the industries, location of the industries and the level of education of the workers in the industries significantly influenced the implementation of the Part III Safety (General Provisions) of NFA, the location of the industries significantly influenced the implementation of the Part II-Health (General Provisions) of NFA. Conclusion: there was generally a certain level of implementation of the factories Act, there is need for more improvement, strict inspection by the regulatory agencies. Implications of the study were highlighted and several suggestions for further studies were made. Based on the findings, several recommendations were made including that the Ministry of Labour and Productivity and the Ministry of Health should strengthen planned information, strict policies to sanction the offenders. Keywords: Occupational Health and Safety, Nigerian Factories Act

Keywords: occupational health and safety, Nigerian factories act, workers, welfare

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10082 Food Insecurity and Mental Health among Adolescents in Southwest Ethiopia: Structural Equation Modeling Analysis

Authors: Mulusew G. Jebena, David Lindstrom, Tefera Belachew, Craig Hadley, Carl Lachat, Patrick Kolsteren

Abstract:

Background: The biological and psychosocial consequence of food insecurity on physical health and nutritional status has been reported. But, its effect on mental health during adolescence remains unexplored. Thus, the main aim of this analysis is to examine the mechanism by which food insecurity is linked to mental health among adolescents living in Jimma, Southwest Ethiopia. Methods: We used data from third round observation of Jimma Longitudinal Family and Youth Survey (JLFSY). A total of 1,521 adolescents included for the main analysis. Food insecurity was measured using 5-items scale and The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress. Structural equation modeling analysis was done using maximum likelihood estimation method. Model diagnostics test was reported. All p values were two tailed and P value ≤ 0.05 was used to determine statistical significance. Results: The prevalence of mental distress was 20.8%, 95% CI: (18.8, 22.9). After adjusted for covariates, the final model depicts food insecurity was associated with adolescent mental distress (β=.324). This analysis showed 94.1% of the effect of food insecurity on mental distress is direct. By contrast, 5.9% of the food insecurity effect is mediated by physical health. In addition, Self-rated health (β=.356), socioeconomic status (β=-.078) parental educational (β= .170), living in urban (β= .193) and female headed household (β=.205) were associated with adolescent mental distress. Conclusions: This finding highlights the direct effect of food insecurity on adolescent mental distress. Therefore, any intervention aimed to improve mental distress of adolescents should consider strategies to improve access to sufficient, safe, and nutritious food. Beside this, prevention of underlying factors such as psychosomatic health illness and improving socio economic status is also very critical. Furthermore longitudinal relationship of the long term effect of food insecurity on mental health should be investigated.

Keywords: adolescent, Ethiopia, food insecurity, mental health

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10081 The Islamic Administrative Morals among Criminal Investigators in the Investigation and Prosecution Bureau in Kingdom of Saudi Arabia: A Practical Study on the Investigation and Prosecution Bureau in the Kingdom of Saudi Arabia

Authors: Majed Aldusaimani

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Introduction: The researcher aims to verify the extent of the criminal investigator's commitment to the Islamic morals set out in the Holy Quran, their application in his work, and to understand the point of view of police officers, clerks and suspects regarding the investigator's commitment to moral and ethics in practice. Research question: Are the criminal investigators at the Bureau of Investigation and Public Prosecution in the Kingdom of Saudi Arabia committed to the application of the practical morals set out in the Holy Quran in the view of the police officers, clerks and suspects with whom they work? Objectives of the study: 1. Identifying the standing of morality in Islam. 2. Identifying the practical morals outlined in the Holy Quran. 3. Identifying the most important practical morals in the Holy Quran that must be met by the criminal investigator from the viewpoint of the investigator himself. 4. Identifying the criminal investigator's commitment to the practical morals set out in the Holy Quran as perceived from the perspectives of police officers, clerks and suspects. Methodology: This study will use a descriptive methodology through quantitative and qualitative analysis of the data from respondents, who will be asked to answer questions about the extent of the commitment to the practical morals set out in the Holy Quran of the criminal investigators at the Bureau of Investigation and Public Prosecution that they have encountered.

Keywords: Islamic, investigator, Morals, Quran

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10080 Serological Assay and Genotyping of Hepatitis C Virus in Infected Patients in Zanjan Province

Authors: Abdolreza Esmaeilzadeh, Maryam Erfanmanesh, Sousan Ghasemi, Farzaneh Mohammadi

Abstract:

Background: Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies. Materials and Methods: Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA). Results: Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%. Conclusions: According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.

Keywords: anti-HCV antibody, Hepatitis C Virus (HCV), genotype, RT-PCR, AS-PCR

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10079 Jan’s Life-History: Changing Faces of Managerial Masculinities and Consequences for Health

Authors: Susanne Gustafsson

Abstract:

Life-history research is an extraordinarily fruitful method to use for social analysis and gendered health analysis in particular. Its potential is illustrated through a case study drawn from a Swedish project. It reveals an old type of masculinity that faces difficulties when carrying out two sets of demands simultaneously, as a worker/manager and as a father/husband. The paper illuminates the historical transformation of masculinity and the consequences of this for health. We draw on the idea of the “changing faces of masculinity” to explore the dynamism and complexity of gendered health. An empirical case is used for its illustrative abilities. Jan, a middle-level manager and father employed in the energy sector in urban Sweden is the subject of this paper. Jan’s story is one of 32 semi-structured interviews included in an extended study focusing on well-being at work. The results reveal a face of masculinity conceived of in middle-level management as tacitly linked to the neoliberal doctrine. Over a couple of decades, the idea of “flexibility” was turned into a valuable characteristic that everyone was supposed to strive for. This resulted in increased workloads. Quite a few employees, and managers, in particular, find themselves working both day and night. This may explain why not having enough time to spend with children and family members is a recurring theme in the data. Can this way of doing be linked to masculinity and health? The first author’s research has revealed that the use of gender in health science is not sufficiently or critically questioned. This lack of critical questioning is a serious problem, especially since ways of doing gender affect health. We suggest that gender reproduction and gender transformation are interconnected, regardless of how they affect health. They are recognized as two sides of the same phenomenon, and minor movements in one direction or the other become crucial for understanding its relation to health. More or less, at the same time, as Jan’s masculinity was reproduced in response to workplace practices, Jan’s family position was transformed—not totally but by a degree or two, and these degrees became significant for the family’s health and well-being. By moving back and forth between varied events in Jan’s biographical history and his sociohistorical life span, it becomes possible to show that in a time of gender transformations, power relations can be renegotiated, leading to consequences for health.

Keywords: changing faces of masculinity, gendered health, life-history research method, subverter

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10078 Religio-Cultural Ethos and Mental Health

Authors: Haveesha Buddhdev

Abstract:

The most important right for a human being in a society is the freedom of expression as stated by Article 18 and 19 of the Universal Declaration of Human rights pledged by member states of United Nations. Will it be fair to expect him/her to be of sound mental health if this right is taken away? Religion as a primary social institution controls many rights, freedoms and duties of people in a society. It does so by imposing certain values and beliefs on people which would either enhance quality of life or curb their freedom adversely thus affecting individual mental health. This paper aims to study the positive and negative role that religion plays in influencing one’s freedom of expression. This paper will focus on reviewing existing studies on the positive and negative impacts of religion on mental health. It will also contain data collected by the researcher about the impacts of religion on freedom of expression which will be obtained by surveying a sample of 30 adolescents and young adults. The researcher will use a Likert scale for these purpose, with response options ranging from strongly disagree to strongly agree and quantify it accordingly. Descriptive statistics would be used to analyse the data. Such research would help to identify possible problems faced by adolescents and young adults when it comes to religio-cultural ethos and also facilitate further researches to study the role that religion plays in mental health.

Keywords: cultural Ethos, freedom of expression, adolescent mental health, social science

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10077 Preliminary Experience in Multiple Green Health Hospital Construction

Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

Abstract:

Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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10076 Adverse Impacts of Poor Wastewater Management Practices on Water Quality in Gebeng Industrial Area, Pahang, Malaysia

Authors: I. M. Sujaul, M. A. Sobahan, A. A. Edriyana, F. M. Yahaya, R. M. Yunus

Abstract:

This study was carried out to investigate the adverse effect of industrial waste water on surface water quality in Gebeng industrial estate, Pahang, Malaysia. Surface water was collected from 6 sampling stations. Physico-chemical parameters were characterized based on in-situ and ex-situ analysis according to standard methods by American Public Health Association (APHA). Selected heavy metals were determined by using Inductively Coupled Plasma Mass Spectrometry (ICP MS). The result reveled that the concentration of heavy metals such as Pb, Cu, Cd, Cr and Hg were high in samples. The result showed that the value of Pb and Hg were higher in the wet season in comparison to dry season. According to Malaysia National Water Quality Standard (NWQS) and Water Quality Index (WQI) all the sampling station were categorized as class IV (highly polluted). The present study reveled that the adverse effects of careless disposal of wastes and directly discharge of effluents affected on surface water quality. Therefore, the authorities should implement the laws to ensure the proper practices of waste water management for environmental sustainability around the study area.

Keywords: water, heavy metals, water quality index, Gebeng

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10075 Analysing Representations of ‘Leftover’ Women in Chinese Media: Taking the Film ‘The Last Woman Standing’ and ‘I Do’ as Examples

Authors: Ting Li Liu

Abstract:

‘Leftover woman’ or ‘3S’ woman is the term used to describe a well-educated, high income, independent woman who is single and never married around 30 years in Chinese society. With the naming of this demographic of ‘leftover women’, their family, dating culture, mate selection and marriage attract public concern. Massive media representations of ‘leftover women’ occur daily; the research aims to present several media representations of women’s anxiety about their singlehood and related marital issues around thirty. The research triangulates two areas of media representation of ‘leftover women’: films and audience reviews on ‘Douban Movie’ website. Drawing on traditional media studies, Fairclough’s critical discourse analysis combined with multimodal techniques is applied to the research to analyze the representations of ‘leftover women’ and their implications for marital culture in China, in conjunction with a feminist perspective. The conference paper will discuss two case studies: the film ‘The last woman standing’ and ‘I Do’. Paying attention to different aspects of ‘leftover women’, the research aims to re-examine the representations of ‘leftover women’ in selected scenes, such as their age anxiety, family, marriage, dating process, careers, etc. The paper also includes public beliefs about ‘leftover women’ from online audience reviews. In conclusion, the emergence of ‘leftover women’ is a reflection of Chinese tradition’s impact on people’s lives and new changes in Chinese families and their attitude to marriage.

Keywords: leftover women, marriage, family, media culture, China

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10074 Popular Modern Devotional Prints: The Construction of Identity between the Visual and Viewer in Public Interaction Spaces

Authors: Muhammad Asghar, Muhammad Ali, Farwah Batool

Abstract:

Despite the general belief in Islam that figural representations should be avoided, particularly propagated by the Deobandis, a religious group influenced by Salafi and Wahhabi ideas, nevertheless the public interaction spaces such as Shops and offices are decorated with popular, mass-produced, modern devotional prints. This study seeks to focus on popular visual culture, its display in public interaction places such as shops and discusses how people establish relationships with images. The method adopted was basically ethnographic: to describe as precisely and completely as possible the phenomena to be studied, using the language and conceptual categories of the interlocutors themselves. This study has been enriched by ethnographic field research conducted during the months from October to December 2015 in the major cities of Punjab and their brief forays and surroundings where we explored how seeing upon images performs religious identity within the public space. The study examines the pattern of aesthetics and taste in the shops of especially common people whose sensibilities have not been refined or influenced by being exposed to any narrative or fine arts. Furthermore, it is our intention to question the general beliefs and opinions in the context of popular practices, the way in which people relate to these prints. The interpretations and analyses presented in this study illuminate how people create meaning through the display of such items of material culture in the immediate settings of their spaces. This study also seeks to demonstrate how popular Islam is practiced, transformed and understood through the display of popular representations of popular figures of piety like Sufi saints or their shrines are important to many believers and thus occupy important places in their shops. The findings are supported with empirical evidence and based on interviews with the shopkeepers, owners and office employees. Looking upon those popular modern devotional prints keeps people’s reverence of the personages alive. Because of their sacred themes they affect a relationship between the saint and the beholders as well as serve to symbolize and reinforce their belief since they become powerful loci of emotional attachment. Collectively such devotional prints satisfy a local taste to help people establish contact with God through the saints’ intercession in order to receive protection and benediction, and help in spiritual, mental and material problems. By putting all these facets of belief together we gain an insight into both the subjective and cognizant role that icons’ of saints play in the lives of believers. Their veneration through ingeniously contrived modern means of production makes a significant contribution to an understanding of how such imagery promotes a powerful belief in Sufi saints, which ultimately gives indications of how popular Islam is practiced and understood at its gross roots level.

Keywords: ethnographic field research, popular visual culture, protected space, religious identity

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10073 A Negotiation Model for Understanding the Role of International Law in Foreign Policy Crises

Authors: William Casto

Abstract:

Studies that consider the actual impact of international law upon foreign affairs crises are flawed by an unrealistic model of decision making. The common, unexamined assumption is that a nation has a unitary executive or ruler who considers a wide variety of considerations, including international law, in attempting to resolve a crisis. To the extent that negotiation theory is considered, the focus is on negotiations between or among nations. The unsettling result is a shallow focus that concentrates on each country’s public posturing about international law. The country-to-country model ignores governments’ internal negotiations that lead to their formal position in a crisis. The model for foreign policy crises needs to be supplemented to include a model of internal negotiations. Important foreign policy decisions come from groups within a government committee, advisers, etc. Within these groups, participants may have differing agendas and resort to international law to bolster their positions. To understand the influence of international law in international crises, these internal negotiations must be considered. These negotiations are crucial to creating a foreign policy agenda or recommendations. External negotiations between the two nations are significant, but the internal negotiations provide a better understanding of the actual influence of international law upon international crises. Discovering the details of specific internal negotiations is quite difficult but not necessarily impossible. The present proposal will use a specific crisis to illustrate the role of international law. In 1861 during the American Civil War, a United States navy captain stopped a British mail ship and removed two ambassadors of the rebelling southern states. The result was what is commonly called the Trent Affair. In the wake of the captain’s unauthorized and rash action, Great Britain seriously considered going to war against the United States. A detailed analysis of the Trent Affair is possible using the available and extensive internal British correspondence and memoranda to reach an understanding of the effect of international law upon decision making. The extensive trove of internal British documents is particularly valuable because in 1861, the only effective means of communication was face-to-face or through letters. Telephones did not exist, and travel by horse and carriage was tedious. The British documents tell us how individual participants viewed the process. We can approach an accurate understanding of what actually happened as the British government strove to resolve the crisis. For example, British law officers initially concluded that the American captain’s rash act was permissible under international law. Later, the law officers revised their opinion. A model of internal negotiation is particularly valuable because it strips away nations’ public posturing about disputed international law principles. In internal decision making, there is room for meaningful debate over the relevant principles. This fluid debate tells how international law is used to develop a hard, public bargaining position. The Trent Affair indicates that international law had an actual influence upon the crisis and that law was not mere window dressing for the government’s public position.

Keywords: foreign affairs crises, negotiation, international law, Trent affair

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10072 The Effects of Irregular Immigration Originating from Syria on Turkey's Security Issues

Authors: Muzaffer Topgul, Hasan Atac

Abstract:

After the September 11 attacks, fight against terrorism has risen to higher levels in security concepts of the countries. The following reactions of some nation states have led to the formation of unstable areas in different parts of the World. Especially, in Iraq and Syria, the influences of radical groups have risen with the weakening of the central governments. Turkey (with the geographical proximity to the current crisis) has become a stop on the movement of people who were displaced because of terrorism. In the process, the policies of the Syrian regime resulted in a civil war which is still going on since 2011, and remain as an unresolved crisis. With the extension of the problem, changes occurred in foreign policies of the World Powers; moreover, the ongoing effects of the riots, conflicts of interests of foreign powers, conflicts in the region because of the activities of radical groups increased instability within the country. This case continues to affect the security of Turkey, particularly illegal immigration. It has exceeded the number of two million Syrians who took refuge in Turkey due to the civil war, while continuing uncertainty about the legal status of asylum seekers, besides the security problems of asylum-seekers themselves, there are problems in education, health and communication (language) as well. In this study, we will evaluate the term of immigration through the eyes of national and international law, place the disorganized and illegal immigration in security sphere, and define the elements/components of irregular migration within the changing security concept. Ultimately, this article will assess the effects of the Syrian refuges to Turkey’s short-term, mid-term, and long-term security in the light of the national and international data flows and solutions will be presented to the ongoing problem. While explaining the security problems the data and the donnees obtained from the nation and international corporations will be examined thorough the human security dimensions such as living conditions of the immigrants, the ratio of the genders, especially birth rate occasions, the education circumstances of the immigrant children, the effects of the illegal passing on the public order. In addition, the demographic change caused by the immigrants will be analyzed, the changing economical conditions where the immigrants mostly accumulate, and their participation in public life will be worked on and the economical obstacles sourcing due to irregular immigration will be clarified. By the entire datum gathered from the educational, cultural, social, economic, demographical extents, the regional factors affecting the migration and the role of irregular migration in Turkey’s future security will be revealed by implication to current knowledge sources.

Keywords: displaced people, human security, irregular migration, refugees

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10071 Knowledge regarding Sexual and Reproductive Health among Adolescents in Higher Secondary School

Authors: Kopila Shrestha

Abstract:

Adolescent sexual reproductive health is one of the most important issues in the world. Reproductive ability is taking place at an earlier age and adolescents are indulging in risk taking behaviors day by day. A descriptive cross-sectional study was conducted in Kathmandu valley to assess the knowledge regarding sexual and reproductive health among adolescent. Total of 200 respondents were selected through non-probability convenient sampling technique. Self-administered written questionnaires using semi-structured questions were used. The collected data were analyzed by using descriptive statistics such as frequency, percentage, mean, standard deviation and inferential statistics such as Chi-square test. The findings revealed that most of the respondents had adequate knowledge regarding transmission and protection of HIV/AIDs and STIs but still some respondents had a misconception regarding it. Few respondents had knowledge regarding legal age for marriage and the minimum age for first child bearing. The statistical analysis revealed that the total mean knowledge score with standard deviation was 45.02±8.674. Nearly half of the respondents (49.5%) had a moderate level of knowledge, followed by an inadequate level of knowledge 29.5% and adequate level of knowledge 21.0% regarding sexual and reproductive health. There was significant association of level of knowledge with area of residence (p-value .002) but no association with age (p-value .067), sex (p-value .999), religion (p-value .082) and ethnicity (p-value .114). Nearly half of the participants possess some knowledge about sexual and reproductive health but still effective educational intervention is required in higher secondary school to encourage more sensible and healthy behaviour.

Keywords: adolescents, higher secondary school, knowledge, sexual and reproductive health

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10070 Corporate Collapses and (Legal) Ethics

Authors: Elizabeth Snyman-Van Deventer

Abstract:

Numerous corporate scandals, which included investment scams, corporate malfeasance, unethical conduct and conflicts of interest, contributed to the collapse of WorldCom, Global Crossing, Xerox, Tyco, Enron, Sprint, AbbVie and Imclone and led to alarmed investors abandoning public securities markets and the tumbling of U.S stock markets. These companies suffered significant financial losses due to substantial and fraudulent misstatements and other illegal, corrupt or unethical practices. Executives were convicted of fraud and sentenced to prison. The corporate financial scandals, governance failures, and the ensuing public outcries led to mandatory legislation, e.g. the Sarbanes-Oxley Act in the USA. In European corporate scandals such as Parmalat, Royal Dutch Ahold, Vivendi, Adecco and Elan, the boards missed financial misrepresentations. In South Africa, Steinhoff is the most well-known example of corporate collapse, but now we can also add Tongaat Hulett. It seems as if fraud and corruption may be the major sources of these corporate collapses. In most instances, there is either the active involvement of the directors and managers in these fraudulent or corrupt practices, or there is a negligent or even intentional failure to act by directors to prevent these activities. However, besides directors and managers, auditors and lawyers failed in most of these companies to fulfil their professional duties. In most of these major collapses, the ethics of especially auditors and directors could be questioned. This paper will first provide a brief overview of corporate collapses. Secondly, the reasons for these collapses, with a focus on unethical conduct, will be discussed.

Keywords: professional duties, corporate collapses, ethical conduct, legal ethics, directors, auditors

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10069 Variation in Youth and Family Experiences of System of Care Principles in Community Mental Health

Authors: James D. Beauchemin

Abstract:

This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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10068 A Study on Micro-Renewal of Mountainous Urban Communities Based on Child-Friendliness

Authors: Zipei Yin

Abstract:

Community space is the main place for children's daily outdoor activities. The mountain community space has the typical characteristics of a closed natural environment, a scattered population layout with height differences, and a relatively independent group structure. This has resulted in special limitations on children's outdoor activities in terms of safety, accessibility, and appropriateness, which urgently makes it necessary to explore how to construct children's activity spaces in mountainous societies under the special limitations. This study investigated the activity spaces for children aged 3-11 years old in typical old communities in Chongqing and evaluated them based on the dimensions of spatial characteristics, environmental safety, and connectivity to summarise three typical patterns of children's outdoor activity spaces in old communities in mountainous cities. Then, under the framework of the appeal of the child-friendly urban environment, taking advantage of the characteristics of the old community in mountain cities compared with the plain urban community, such as complex social form, diversified functional positioning, and good foundation of autonomy, this paper explores the micro-renewal path and strategy of the compound utilization of community public space from the two levels of design and governance, so as to further promote the research and practice of the healthy development of mountain urban community environment.

Keywords: child-friendly, healthy community, community public space, mountainous urban community, community renewal

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