Search results for: hospitals and outreach ophthalmic services

Authors: Sultan Aldaihani, Eiman Al-Fadhli

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Internet of Things (IoTs) expected to change the future of academic libraries operations. It enables academic libraries to be smart libraries through, for example, the connection of the physical objects with the Internet. The implementation of IoTs will improve library resources and services. Therefore, this research aims to investigate the applications of Internet of Things (IoTs) for information resources and services. Understanding perceptions of academic librarians toward IoTs before adopting of such applications will assist decision-makers in academic libraries in their strategic planning. An online questionnaire was administered to academic librarians at Kuwait University. The findings of this study showed that academic librarians have awareness for the IoTs. They have strongly believed that the IoTs contributes to the development of information resources, services, and understanding of the user's information behavior. Identifying new applications of the IoTs in libraries was the highest possible reason for future adoption. Academic librarians indicated that lack of privacy and data penetration were the greatest problem in their future adoption of IoTs. Academic libraries need to implement the IoTs for enhancing their information resources and services. One important step in the success of future adoption is to conduct awareness and training programs for academic librarians. They also need to maintain higher security and privacy measurements in their implementation for the IoTs. This study will assist academic libraries in accommodating this technology.

Keywords: academic libraries, internet of things, information resources, information services

Procedia PDF Downloads 144

Authors: Carlos Alves

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This research paper demonstrates how payments for environmental services (PES) can be an effective mechanism to combat food insecurity and reduce environmental degradation in developing countries. The paper begins by discussing how environmental services affect each one of the pillars of food security: availability, access, and utilization of food. However, due to numerous global environmental challenges, a new pillar of food security based on environmental sustainability is proposed and discussed. An argument is then made that PES can usefully combat food insecurity. It can provide an extra income to those who take on environmental service and help them to have a better access to food. In order to be successful in addressing food insecurity, PES schemes should target on the poor and redress issues that can prevent their effectiveness. Finally, the research presents a case study that discusses how several developing countries addressed problems and successfully developed PES programs.

Keywords: environmental sustainability, food security, nutrition, payments for environmental services

Procedia PDF Downloads 389

Authors: Yaner Yan, Ning Li, Yajun Qiao, Shuqing An

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Although most studies have focused on assessing and mapping terrestrial ecosystem services, there is still a knowledge gap on coastal ecosystem services and an urgent need to assess them. Lau (2013) clearly defined five types of costal ecosystem services: carbon sequestration, shoreline protection, fish nursery, biodiversity, and water quality. While high-resolution remote sensing can provide the more direct, spatially estimates of biophysical parameters, such as species distribution relating to biodiversity service, and Fluorescence information derived from remote sensing direct relate to photosynthesis, availing in estimation of carbon sequestration and the response to environmental changes in coastal wetland. Here, we review the capabilities of high-resolution and fluorescence remote sesing for describing biodiversity, vegetation condition, ecological processes and highlight how these prodicts may contribute to costal ecosystem service assessment. In so doing, we anticipate rapid progress to combine the high-resolution and fluorescence remote sesing to estimate the spatial pattern of costal ecosystem services.

Keywords: ecosystem services, high resolution, remote sensing, chlorophyll fluorescence

Procedia PDF Downloads 497

Authors: A. Alrasheed, I. Connerton

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Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

Procedia PDF Downloads 866

Authors: Mico Kenshee C. Samarista, John Harvey V. Miranda, Janne Audrae Q. Lebosada, Josef Anton R. Benitez, Juan Miguel C. Rubio

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This research paper presents the development and evaluation of a web-based application designed to simplify the process of car rental services in the Philippines. As the demand for convenient and efficient access to rental car information grows, the need for a user-friendly platform becomes increasingly crucial. The web-based application serves as a comprehensive central hub, aggregating and organizing rental car listings from various reputable websites across the Philippines. By collecting essential data through surveys and usability testing, we assess the platform's effectiveness in simplifying the rental car selection process.

Keywords: web, application, car, services

Procedia PDF Downloads 82

Authors: Marziyeh Bahrami, Hamed Pahlevan Hsseini, Behnam Ghamami, Arman Alvanpour, Hamed Ezzati, Amir Salar Sadeghi

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One of the ways to increase the efficiency of services in the system of agents and, of course, in the world of cloud computing, is to use virtualization techniques. The aim of this research is to create changes in cloud computing services that will reduce as much as possible the energy consumption related to the migration of virtual machines and, in some way, the energy related to the allocation of resources and reduce the amount of pollution. So far, several methods have been proposed to increase the efficiency of cloud computing services in order to save energy in the cloud environment. The method presented in this article tries to prevent energy consumption by data centers and the subsequent production of carbon and biological pollutants as much as possible by increasing the efficiency of cloud computing services. The results show that the proposed algorithm, using the improvement in virtualization techniques and with the help of a genetic algorithm, improves the efficiency of cloud services in the matter of migrating virtual machines and finally saves consumption. becomes energy.

Keywords: consumption reduction, cloud computing, genetic algorithm, live migration, virtual Machine

Procedia PDF Downloads 55

Authors: Wanutchaya Duanginta, Napaporn Apiratmateekul, Tippawan Sangkaew, Sunaree Wekinhirun, Kunchit Kongros, Wanvisa Treebuphachatsakul

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Thailand has a tropical climate with an average outdoor ambient air temperature of over 30°C, which can exceed manufacturer recommendations for the storage of glucose test strips. This study monitored temperature and humidity at actual sites of five sub-district health promoting hospitals (HPH) in Phitsanulok Province for the storage of glucose test strips in refrigerated conditions. Five calibrated data loggers were placed at the actual sites for glucose test strip storage at five HPHs for 8 weeks between April and June. For the stress test, two lot numbers of glucose test strips, each with two glucose meters, were kept in a plastic box with desiccants and placed in a refrigerator with the temperature calibrated to 4°C and at room temperature (RT). Temperature and humidity in the refrigerator and at RT were measured every hour for 30 days. The mean temperature for storing test strips at the five HPHs ranged from 29°C to 33°C, and three of the five HPHs (60%) had a mean temperature above 30°C. The refrigerator temperatures were 3.8 ± 2.0°C (2.0°C to 6.5°C), and relative humidity was 51 ± 2% (42 to 54%). The maximum of blood glucose testing by glucose meters when the test strips were stored in a refrigerator were not significantly different (p > 0.05) from unstressed test strips for both glucose meters using amperometry-GDH-PQQ and amperometry-GDH-FAD principles. Opening the test strip vial daily resulted in higher variation than when refrigerated after a single-use. However, the variations were still within an acceptable range. This study concludes that glucose tested strips can be stored in plastic boxes in a refrigerator if it is well-controlled for temperature and humidity. Storage of glucose-tested strips in the refrigerator during hot and humid weather may be useful for HPHs with limited air conditioners.

Keywords: environmental stressed test, thermal stressed test, quality control, point-of-care testing

Procedia PDF Downloads 189

Authors: Grace Omowunmi Soyebi

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A computerized medical record system is a collection of medical information about a person that is stored on a computer. One principal problem of most hospitals in rural areas is using the file management system for keeping records. A lot of time is wasted when a patient visits the hospital, probably in an emergency, and the nurse or attendant has to search through voluminous files before the patient's file can be retrieved; this may cause an unexpected to happen to the patient. This data mining application is to be designed using a structured system analysis and design method which will help in a well-articulated analysis of the existing file management system, feasibility study, and proper documentation of the design and implementation of a computerized medical record system. This computerized system will replace the file management system and help to quickly retrieve a patient's record with increased data security, access clinical records for decision-making, and reduce the time range at which a patient gets attended to.

Keywords: programming, data, software development, innovation

Procedia PDF Downloads 81

Authors: Lilian A. Okeke, I. Okeke, N. Waziri, S. Balogun, P. Nguku, O. Fawole

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Background: Access to ante-natal care services promotes safe motherhood and delivery with improved maternal and neonatal outcome. We conducted this study to identify factors influencing the utilization of antenatal care (ANC) and health delivery services. Methods: We conducted a cross sectional study. Households were numbered and a one in three sample was selected using a systematic sampling method. One hundred and ninety eight women who were either pregnant or had previous deliveries were interviewed using pretested structured questionnaires to obtain information on their socio-demographic characteristics, and reasons for non-utilization of ANC and health delivery services. We performed univariate and bivariate analysis using Epi info version 3.5.3. Results: The age of respondents ranged from (17-55 years) with a median age of 29 years. One hundred and ninety two (97%) utilized antenatal care services. Ninety three (47.9%) attended ANC at second trimester. More than half (58.6%) had ≥ 4 visits to ANC. One hundred and thirty one (66.2%) had their last delivery at home by a traditional birth attendant. Factors associated with ANC and health facility delivery services utilization were: age group 45-55 (OR 0.01; 95% CI: 0.00-0.16) and > 55 years (OR 0.03; 95% CI: 0.00-0.60), wife’s educational status (OR 3.17; 95% CI: 1.66-8.30), husband’s permission (OR 11.8; 95% CI 2.19-63.62), and distance ≥ 5km (OR 0.33; 95% CI: 0.16-0.60). Conclusion: ANC services were well utilized. Most women did not book early and had their last delivery at home. Predictors of ANC use and health facility delivery were age, wife’s educational status, husband's permission and long distance from health facility. A one-day health sensitization of the benefits of ANC utilization and the dangers of delivering at home was implemented.

Keywords: ante natal care, health facility, delivery services, rural area, Plateau state

Procedia PDF Downloads 370

Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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Authors: Oktay Nusratov, Ramin Rzaev, Aydin Goyushov

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Fuzzy inference method based approach to the forming of modular intellectual system of assessment the quality of communication services is proposed. Developed under this approach the basic fuzzy estimation model takes into account the recommendations of the International Telecommunication Union in respect of the operation of packet switching networks based on IP-protocol. To implement the main features and functions of the fuzzy control system of quality telecommunication services it is used multilayer feedforward neural network.

Keywords: quality of communication, IP-telephony, fuzzy set, fuzzy implication, neural network

Procedia PDF Downloads 466

Authors: M. Shaheed Hartley

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There has been increasing pressure on education researchers and practitioners at higher education institutions to focus on the development of South Africa’s rural and peri-urban communities and improving their quality of life. Many tertiary institutions are obliged to review their outreach interventions in schools. To ensure that the support provided to schools is still relevant, a systemic evaluation of science educator needs is central to this process. These prioritised needs will serve as guide not only for the outreach projects of tertiary institutions, but also to service providers in general so that the process of addressing educators needs become coordinated, organised and delivered in a systemic manner. This paper describes one area of a broader needs assessment exercise to collect data regarding the needs of educators in a district of 45 secondary schools in the Western Cape Province of South Africa. This research focuses on the needs and challenges faced by science educators at these schools as articulated by the relevant stakeholders. The objectives of this investigation are two-fold: (1) to create a data base that will capture the needs and challenges identified by science educators of the selected secondary schools; and (2) to develop a needs profile for each of the participating secondary schools that will serve as a strategic asset to be shared with the various service providers as part of a community of practice whose core business is to support science educators and science education at large. The data was collected by a means of a needs assessment questionnaire (NAQ) which was developed in both actual and preferred versions. An open-ended questionnaire was also administered which allowed teachers to express their views. The categories of the questionnaire were predetermined by participating researchers, educators and education department officials. Group interviews were also held with the science teachers at each of the schools. An analysis of the data revealed important trends in terms of science educator needs and identified schools that can be clustered around priority needs, logistic reasoning and educator profiles. The needs database also provides opportunity for the community of practice to strategise and coordinate their interventions.

Keywords: needs assessment, science and mathematics education, evaluation, teaching and learning, South Africa

Procedia PDF Downloads 180

Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

Procedia PDF Downloads 58

Authors: C. Sridawruang

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Young people today has sexual activities differing from those of earlier generations, in that teenagers are likely to have multiple partners, and are frequently in short-term relationships or with partners that are not well known to them. The proportion of teenage mothers in Thailand has increased. Young people were not specifically addressed during the overall very successful HIV-prevention campaigns. Because of this missed opportunity, they are still unaware of the risk of unsafe sexual behavior. Aims: To describe the reproductive health care services in perspectives of rural Thai teenagers Methods: This survey was one part of a mixed method approach taken using survey and focus groups with 439 teenagers aged 12-18 years in 5 villages, Udon Thani, Thailand. The standard questionnaire survey had been used for collecting data. The numeric data was checked and analyzed by using descriptive statistics. Results: Most teenager respondents stated that they do not know where sexual reproductive health services provided for them. Most teenagers felt difficult to access and talk with health staff about sexual related issues. They stated that discussing, or consulting with health providers might not be safe. Teenagers might lose opportunities to access and get advice from health care services. The mean knowledge score of contraception and condom reproductive was 6.34 from a total score 11. Most teenagers especially girls expressed a need for counseling services and reported a need for telephone services. Conclusions: The need of appropriate information focusing on sexual relationships and contraception should be designed to help young people make wise decisions and there should be set health care services for Thai teenagers to make sure that teenagers could access easily. Health care providers need to be trained to improve their knowledge, attitudes and skills in reproductive health care practices for Thai teenagers.

Keywords: youth friendly health services, rural, Thai, teenagers

Procedia PDF Downloads 339

Authors: Ida Bruheim Jensen, Hulda Mjöll Gunnarsdottir, Ingunn T. Ellingsen

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Digital government is often seen as an enabler or even driver of transformation of public administration, with the objective of creating public value. The increasing use of digital solutions in public services comes with great expectations of new and/or more efficient service provision. Digitalizing public sector services involve multi-level implementation. It involves national policy negotiations and decisions of digital government solutions. It involves co-creation/-production of ideas where planning, design, and implementation involves several groups of actors targeting end-users. Norway is among the most digitalised countries in the world, and Government spendings on digital technologies in public services are high compared to other OECD countries. This contribution studies an ongoing digital transformation in the Norwegian child welfare services. DigiBarnevern (Digi child welfare) is a nationwide project promising better and more efficient child welfare services through various digital technologies. The digitalization process, which is managed by the state and municipalities, is still in its early stages, and as of 2022, only a few services are operative. Digital technologies such as DigiBarnevern are implemented with promises of qualitatively improving child protection work, making the services more effective, foster user participation, and increase availability. There is limited research on the implications of using digital technologies in child protection work. We aim to present findings from an ongoing research project (2022-2024). Drawing on data from focus group interviews with social workers in 5 municipal child welfare services in Norway, we explore social workers’ experiences and expectations towards using digital technologies in child welfare services. Technological solutions may change the services and child protection work in numerous ways. Potential points of departure for discussion are how technologies may change the relationships between social workers, children, youth, and their families, how technologies can alter and obscure responsibilities, and how technologies may demand digital competence among social workers and service recipients.

Keywords: child welfare, social work, technology, digitalisation

Procedia PDF Downloads 87

Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie

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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.

Keywords: abortion, contraception, quality improvement, service provision

Procedia PDF Downloads 218

Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

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Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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Authors: Mandisi Matyana

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Although the South African local government is doing all the best in ensuring improved service delivery for the citizens, service delivery disparity still remains the real challenge for other municipalities. The unequal distribution of services within municipal wards is causing unequal happiness among the citizens; hence others do enjoy different provided municipal services, while others do not. It is acknowledged that less access to municipal services infringes one’s rights, such as the right to human dignity and the right to life. Some of the municipal services are basic services and they are the mainstay of human survival, such as water, housing, etc. It is quite evident that the service delivery disparity could be caused by the various factors within the local municipality affairs, including both administrative and political factors. Therefore, this study is undertaken to check and evaluate the main foundations of service delivery disparity in ensuring equal development of the state, particularly for local communities. The study used the qualitative method to collect the data from the citizens of Winnie Madikizela Mandela Local Municipality. An extensive literature was also conducted in understanding the causes of service delivery disparity. Study findings prove that the service delivery disparity could be caused by factors such as political interference in administration, corruption and fraud, elevated unemployment levels, inadequate institutional capacity, etc. Therefore, the study recommends strong community participation and constant external supervision in the local government so as to encourage openness in local government to ensure fair administration towards services to be provided.

Keywords: administration, development, municipal services, service delivery disparity, Winnie Madikizela Mandela local municipality

Procedia PDF Downloads 106

Authors: Takalani Tshitangano

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Background: In Limpopo province the rate of new tuberculosis (TB) cases increase daily. The Infection Control (IC) plan is one of the essential actions for TB IC. This study aimed to establish the availability of these plans at health care facilities. Objectives: The objectives were to explore and describe the awareness and knowledge of health care workers (HCWs) of the availability and content of TB IC plan; and to identity the role of infection control committees from the perspective of HCWs. Method: A qualitative approach using a cross-sectional descriptive design was adopted. The target population was all HCWs from the seven hospitals of Vhembe district. A purposive sampling approach was used to select 57 participants. The approval to conduct this study was obtained from the relevant authorities and participants. Data were collected through seven focus group discussions comprising five to 10 members. An unstructured discussion guide was used to collect data, and an open-coding method was used to analyse the data. Lincoln and Guba’s criteria ensured trustworthiness of the study findings. Results: Findings revealed that HCWs were not aware of the availability and the information contained in the TB IC plans. No person was designated as TB IC officer at hospital level. There was lack of a TB IC Committee and teams as well as ineffective utilisation of those that did exist. Conclusions: It was concluded that if the TB IC plans are not available at health care facilities, then the TB IC practices implemented by HCWs vary, resulting in TB nosocomial infection transmission. It was recommended that the World Health Organisation’s TB IC plans be adopted and implemented in Vhembe district.

Keywords: health care workers' awareness, health care workers' knowledge, availability of TB infection control plans, rural hospitals

Procedia PDF Downloads 217

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

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Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Safeer Ahmad, Pratheek Sudhakran, M. Arif Kamal, Tarique Anwar

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In Healthcare facility designing, Efficient MEP services are very crucial because the built environment not only affects patients and family but also Healthcare staff and their outcomes. This paper shall cover the basics of Value engineering and its different phases that can be implemented to the MEP Designing stage for Healthcare facility optimization, also VE can improve the product cost the unnecessary costs associated with healthcare services. This paper explores Healthcare facility services and their Value engineering Job plan for the successful application of the VE technique by conducting a Workshop with end-users, designing team and associate experts shall be carried out using certain concepts, tools, methods and mechanism developed to achieve the purpose of selecting what is actually appropriate and ideal among many value engineering processes and tools that have long proven their ability to enhance the value by following the concept of Total quality management while achieving the most efficient resources allocation to satisfy the key functions and requirements of the project without sacrificing the targeted level of service for all design metrics. Detail study has been discussed with analysis been carried out by this process to achieve a better outcome, Various tools are used for the Analysis of the product at different phases used, at the end the results obtained after implementation of techniques are discussed.

Keywords: value engineering, healthcare facility, design, services

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Authors: Minhae Shim Roth

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The “Deinstitutionalization movement” refers to the spatial transition in the United States during the mid-20th century when the treatment of mental illness purportedly moved from long-term psychiatric institutions to community integrated care. Contrary to the accepted narrative of mental health care in the U.S., asylums did not close or empty. Some remained psychiatric hospitals, which came to be called forensic hospitals or state hospitals; others were converted into prisons or carceral institutions. During Deinstitutionalization, the asylum system became an appendage of the carceral system, with state hospitals becoming little more than holding centers for prisoners who were civilly committed, those incompetent to stand trial, offenders with mental health issues, and those found not guilty by reason of insanity. Psychiatric patients who became prisoners and prisoners who became patients became entangled in the phenomenon called transinstitutionalization. This paper investigates the relationship between psychiatric and criminal incarceration in 20th century California and focuses particularly on the case of Korean-American Chol Soo Lee, who fought detention in the psychiatric-prison system through the writ of habeas corpus. This study uses methodologies like critical theory, close reading, and archival research. This paper argues that during his psychiatric hospitalization at Napa State Hospital and incarceration in the California Department of Corrections, Lee underwent what sociologist Erving Goffman coined in his 1960 text Asylums as the process of “mortification.” After a burst of Asian American solidarity and legal aid that resulted in Lee’s triumphant release from Death Row in 1983 through a writ of habeas corpus, Lee struggled in the free world due to the long-lasting consequences of institutionalization, which led to alienation, recidivism, and an early death at the age of 62. This paper examines the trajectory of Lee’s trial and the legal activism behind it within the context of Goffman’s theory of total institutions and offer a nuanced reading of Lee’s case both during and after his incarceration.

Keywords: criminal justice, criminal law, law and mental capacity, habeas corpus, deinstitutionalization, mental health

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Authors: Anupam Sibal

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Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

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Authors: Usman Ahmed Adam, Umar Ibrahim, Ezra S. Gbaje

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This study is posed to explore the practice of Public Access Computers (PACs) in academic libraries in Kaduna State, Nigeria. The study aimed to determine the computers and other tools available, their services and challenges of the practices. Three questions were framed to identify number of public computers and tools available, their services and problems faced during the practice. The study used qualitative research design along with semi-constructed interview and observation as tools for data collection. Descriptive analysis was employed to analyze the data. The sample size of the study comprises 52 librarian and IT staff from the seven academic institutions in Kaduna State. The findings revealed that, PACs were provided for access to the Internet, digital resources, library catalogue and training services. The study further explored that, despite the limit number of the computers, users were not allowed to enjoy many services. The study recommends that libraries in Kaduna state should provide more public computers to be able to cover the population of their users; libraries should allow users to use the computers without limitations and restrictions.

Keywords: academic libraries, computers in library, digital libraries, public computers

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Authors: William Coburn, Dylan Hauchard, Amel Naouali

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Background: The nature of the HIV epidemic in Puerto Rico (PR) is less understood than in the continental U.S. There is evidence to suggest that there are differences in health care access based on geographical location, such that rural areas are less underserved and have less immediate access to HIV prevention resources. Methods: The current study consists of a cross-sectional online survey of self-reporting HIV-negative sexual minority men (SMM) residing in PR. Results: In this sample, there were no differences between urban and rural-based services for SMM. However, more than half of the sample reported that they have never disclosed their gender identity and sexual practices to a physician. Conclusion: HIV is a significant public health concern affecting Latinos/Hispanics in the U.S. Findings in this paper can have implications for HIV prevention services in PR specifically, as few studies have directly focused on the impact of HIV and health care services in PR outside of the continental U.S.

Keywords: HIV, Puerto Rico, infectious diseases , public health

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Authors: I Putu Yuda Hananta, Inke Kusumastuti

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The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

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Authors: Natsuko D'Aprile

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The construction of Nation-States is a historical process that produces a type of national identity and culture that States nowadays mobilise for global outreach. National culture, as a set of norms and values influencing individuals’ actions and decisions, produces a type of policy making of various strategies that impact how a Nation is promoted overseas. The 1990s were marked by a resurgence of the debates on national identity. This period is believed to have paved the way for nationalism and witnessed increased attention to analytical approaches to identity. Public diplomacy is a concrete example of how national culture is mobilised to project a favourable image of a Nation abroad, especially in the narratives on national identity mobilised by diplomatic actors. Public diplomacy is understood as providing tools for States to build and project strategic narratives that represent events and identities in an attempt to influence domestic and foreign audiences, be they domestic or foreign. France and Japan received little attention on the matter. This research hence aims to investigate how France and Japan have mobilised narratives on national identity since the 1990s in the context of their public diplomacy. To understand how identities are framed, qualitative and quantitative discourse analysis has been performed on a corpus of various speeches held by French and Japanese political actors in which they present their diplomacy goals, as well as official documents provided by both Ministries of Foreign Affairs. This analysis showed that the French discourse integrates a narrative on France’s universal vocation, relying on the expression of a Nation whose model is worldly applicable and has the legitimacy to influence international decisions. The Japanese discourse does not concretely emphasise Japanese or Asian values, except for some narratives integrating Confucian and Shintō values. It rather revolves around the need for Japan to ensure its citizens’ security and prosperity, hence the need for the Government to contribute to peace in the Asia-Pacific region and the world.

Keywords: comparative politics, culture, discourse analysis, narratives, public diplomacy

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Authors: Rubina Jahan, Mohammad Zayeed Bin Alam, Sazzad Chowdhury, Sadia Chowdhury

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Access to mental health services in Bangladesh is a tale of urban privilege and rural struggle. Mental health services in the country are primarily centered in urban medical hospitals, with only 260 psychiatrists for a population of more than 162 million, while rural populations face far more severe and daunting challenges. In alignment with the World Health Organization's perspective on mental health as a basic human right and a crucial component for personal, community, and socioeconomic development; SAJIDA Foundation a value driven non-government organization in Bangladesh has introduced a Community Based Mental Health (CMHI) program to fill critical gaps in mental health care, providing accessible and affordable community-based services to protect and promote mental health, offering support for those grappling with mental health conditions. The CMHI programme is being implemented in 3 districts in Bangladesh, 2 of them are remote and most climate vulnerable areas targeting total 6,797 individual. The intervention plan involves a screening of all participants using a 10-point vulnerability assessment tool to identify vulnerable individuals. The assumption underlying this is that individuals assessed as vulnerable is primarily due to biological, psychological, social and economic factors and they are at an increased risk of developing common mental health issues. Those identified as vulnerable with high risk and emergency conditions will receive Mental Health First Aid (MHFA) and undergo further screening with GHQ-12 to be identified as cases and non-cases. The identified cases are then referred to community lay counsellors with basic training and knowledge in providing 4-6 sessions on problem solving or behavior activation. In situations where no improvement occurs post lay counselling or for individuals with severe mental health conditions, a referral process will be initiated, directing individuals to ensure appropriate mental health care. In our presentation, it will present the findings from 6-month pilot implementation focusing on the community-based screening versus outcome of the lay counseling session and barriers and facilitators of implementing community based mental health care in a resource constraint country like Bangladesh.

Keywords: community-based mental health, lay counseling, rural bangladesh, treatment gap

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Authors: Weera Chotithammaporn, Bannasorn Santhan

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The purpose of this study was to investigate the students’ satisfaction towards the counseling services of the Faculty of Industrial Technology, Suan Sunandha Rajabhat University. The sample group consisted of 311 students coming for counseling services during September to October 2012 BE to complete the questionnaires developed by the researcher. The data were analyzed to find percentage, arithmetic mean, and SD, from which it can be concluded that: 1) Personal information including gender, GPA, department, year of the study, and hometown revealed that most of the students in the Faculty of Industrial Technology, Suan Sunandha Rajabhat University were female with the GPA between 2.01 and 2.50 and studied in the Department of Interior and Exhibition Design and Graphic and Multimedia Design. Most of them were in the first year of the study and came from the southern part of Thailand. 2) The level of students’ satisfaction towards the counseling services of the Faculty of Industrial Technology, Suan Sunandha Rajabhat University was in overall at high level with the highest aspect on IT services followed by follow-up and evaluation service, counseling service, individual personal data collecting service, and personal placement service respectively.

Keywords: satisfaction, students, counseling service, Faculty of Industrial Technology

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