Search results for: ethical decision making
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7617

Search results for: ethical decision making

4287 An Integrated Approach to Cultural Heritage Management in the Indian Context

Authors: T. Lakshmi Priya

Abstract:

With the widening definition of heritage, the challenges of heritage management has become more complex . Today heritage not only includes significant monuments but comprises historic areas / sites, historic cities, cultural landscapes, and living heritage sites. There is a need for a comprehensive understanding of the values associated with these heritage resources, which will enable their protection and management. These diverse cultural resources are managed by multiple agencies having their own way of operating in the heritage sites. An Integrated approach to management of these cultural resources ensures its sustainability for the future generation. This paper outlines the importance of an integrated approach for the management and protection of complex heritage sites in India by examining four case studies. The methodology for this study is based on secondary research and primary surveys conducted during the preparation of the conservation management plansfor the various sites. The primary survey included basic documentation, inventorying, and community surveys. Red Fort located in the city of Delhi is one of the most significant forts built in 1639 by the Mughal Emperor Shahjahan. This fort is a national icon and stands testimony to the various historical events . It is on the ramparts of Red Fort that the national flag was unfurled on 15th August 1947, when India became independent, which continues even today. Management of this complex fort necessitated the need for an integrated approach, where in the needs of the official and non official stakeholders were addressed. The understanding of the inherent values and significance of this site was arrived through a systematic methodology of inventorying and mapping of information. Hampi, located in southern part of India, is a living heritage site inscribed in the World Heritage list in 1986. The site comprises of settlements, built heritage structures, traditional water systems, forest, agricultural fields and the remains of the metropolis of the 16th century Vijayanagar empire. As Hampi is a living heritage site having traditional systems of management and practices, the aim has been to include these practices in the current management so that there is continuity in belief, thought and practice. The existing national, regional and local planning instruments have been examined and the local concerns have been addressed.A comprehensive understanding of the site, achieved through an integrated model, is being translated to an action plan which safeguards the inherent values of the site. This paper also examines the case of the 20th century heritage building of National Archives of India, Delhi and protection of a 12th century Tomb of Sultan Ghari located in south Delhi. A comprehensive understanding of the site, lead to the delineation of the Archaeological Park of Sultan Ghari, in the current Master Plan for Delhi, for the protection of the tomb and the settlement around it. Through this study it is concluded that the approach of Integrated Conservation has enabled decision making that sustains the values of these complex heritage sites in Indian context.

Keywords: conservation, integrated, management, approach

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4286 Exploring the Role of Private Commercial Banks in Increasing Small and Medium Size Enterprises’ Financial Accessibility in Developing Countries: A Study in Bangladesh

Authors: Khondokar Farid Ahmmed, Robin Bown

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It is widely recognized that the formal financing of Small and Medium Size Enterprises (SMEs) by Private Commercial Banks (PCBs) is restricted. Due to changing financial market competition, SMEs are now important customers to PCBs in the member countries of the Asian Development Bank (ADB). Various initiatives in enhancing the efficiency of risk assessment of PCBs have failed in increasing financing accessibility in the traditional financing system where information asymmetry is a key constraint. In this circumstance, PCBs need to undertake a holistic approach. Holistic approach refers to methods that attempt to fundamentally change established traditions. To undertake holistic approach, this study intends to find the entire established financing culture between PCBs and SMEs in a new lens beyond the tradition on the basis of two basic questions: “What is the traditional lending culture between PCBs and SMEs” and “What could be potential role of PCBs to develop that culture where focusing on SME financing to PCBs". This study considered formal SME financing in Bangladesh by focusing on SMEs applying for their first loan. Bangladesh is a member country of ADB. The data collection method is semi-structured and we utilized face-to-face interviews with in-depth branch managers, higher officials and owner-managers of SME customers of PCBs and higher officials of SME Foundation and the Bangladesh central bank. Discourse analysis method was used for data analysis on the frame of thematic discussion fully based on participants’ views. The research found that branch managers and loan officers have a high level of power in assessing and financing decision-making. There is a changing attitude in PCB sector in requiring flexible collateral assets. Branch managers (Loan Officers) consider value of business prospect of owner-mangers as complementary of collateral assets. However, the study found the assessment process of business prospect is entirely unstructured and linked with socio-cultural settings that does not support PCBs’ changing manner in terms of collateral requirement. The study redefined and classified collateral assets to include all financing constructs in a structure. The degree of value of the collateral assets determines the degree of business prospects. This study suggested applying an outside classroom-learning paradigm such as “knowledge tour” to enhance the value of the kinds of collateral assets. This is the scope of PCBs in increasing SMEs’ financing eligibility in win-win basis. The findings and proposition could be effective in other ADB member countries and audiences in the field.

Keywords: CCA, financing, information asymmetry, PCA, PCB, financing

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4285 Exploring the Carer Gender Support Gap: Results from Freedom of Information Requests to Adult Social Services in England

Authors: Stephen Bahooshy

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Our understanding of gender inequality has advanced in recent years. Differences in pay and societal gendered behaviour expectations have been emphasized. It is acknowledged globally that gender shapes everyone’s experiences of health and social care, including access to care, use of services and products, and the interaction with care providers. NHS Digital in England collects data from local authorities on the number of carers and people with support needs and the services they access. This data does not provide a gender breakdown. Caring can have many positive and negative impacts on carers’ health and wellbeing. For example, caring can improve physical health, provide a sense of pride and purpose, and reduced stress levels for those who undertake a caring role by choice. Negatives of caring include financial concerns, social isolation, a reduction in earnings, and not being recognized as a carer or involved and consulted by health and social care professionals. Treating male and female carers differently is by definition unequitable and precludes one gender from receiving the benefits of caring whilst potentially overburdening the other with the negatives of caring. In order to explore the issue on a preliminary basis, five local authorities who provide statutory adult social care services in England were sent Freedom of Information requests in 2019. The authorities were selected to include county councils and London boroughs. The authorities were asked to provide data on the amount of money spent on care at home packages to people over 65 years, broken down by gender and carer gender for each financial year between 2013 and 2019. Results indicated that in each financial year, female carers supporting someone over 65 years received less financial support for care at home support packages than male carers. Over the six-year period, this difference equated to a £9.5k deficit in financial support received on average per female carer when compared to male carers. An example of a London borough with the highest disparity presented an average weekly spend on care at home for people over 65 with a carer of £261.35 for male carers and £165.46 for female carers. Consequently, female carers in this borough received on average £95.89 less per week in care at home support than male carers. This highlights a real and potentially detrimental disparity in the care support received to female carers in order to support them to continue to care in parts of England. More research should be undertaken in this area to better explore this issue and to understand if these findings are unique to these social care providers or part of a wider phenomenon. NHS Digital should request local authorities collect data on gender in the same way that large employers in the United Kingdom are required by law to provide data on staff salaries by gender. People who allocate social care packages of support should consider the impact of gender when allocating support packages to people with support needs and who have carers to reduce any potential impact of gender bias on their decision-making.

Keywords: caregivers, carers, gender equality, social care

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4284 The Efficacy of Video Education to Improve Treatment or Illness-Related Knowledge in Patients with a Long-Term Physical Health Condition: A Systematic Review

Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

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4283 Augmented Reality Enhanced Order Picking: The Potential for Gamification

Authors: Stavros T. Ponis, George D. Plakas-Koumadorakis, Sotiris P. Gayialis

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Augmented Reality (AR) can be defined as a technology, which takes the capabilities of computer-generated display, sound, text and effects to enhance the user's real-world experience by overlaying virtual objects into the real world. By doing that, AR is capable of providing a vast array of work support tools, which can significantly increase employee productivity, enhance existing job training programs by making them more realistic and in some cases introduce completely new forms of work and task executions. One of the most promising AR industrial applications, as literature shows, is the use of Head Worn, monocular or binocular Displays (HWD) to support logistics and production operations, such as order picking, part assembly and maintenance. This paper presents the initial results of an ongoing research project for the introduction of a dedicated AR-HWD solution to the picking process of a Distribution Center (DC) in Greece operated by a large Telecommunication Service Provider (TSP). In that context, the proposed research aims to determine whether gamification elements should be integrated in the functional requirements of the AR solution, such as providing points for reaching objectives and creating leaderboards and awards (e.g. badges) for general achievements. Up to now, there is a an ambiguity on the impact of gamification in logistics operations since gamification literature mostly focuses on non-industrial organizational contexts such as education and customer/citizen facing applications, such as tourism and health. To the contrary, the gamification efforts described in this study focus in one of the most labor- intensive and workflow dependent logistics processes, i.e. Customer Order Picking (COP). Although introducing AR in COP, undoubtedly, creates significant opportunities for workload reduction and increased process performance the added value of gamification is far from certain. This paper aims to provide insights on the suitability and usefulness of AR-enhanced gamification in the hard and very demanding environment of a logistics center. In doing so, it will utilize a review of the current state-of-the art regarding gamification of production and logistics processes coupled with the results of questionnaire guided interviews with industry experts, i.e. logisticians, warehouse workers (pickers) and AR software developers. The findings of the proposed research aim to contribute towards a better understanding of AR-enhanced gamification, the organizational change it entails and the consequences it potentially has for all implicated entities in the often highly standardized and structured work required in the logistics setting. The interpretation of these findings will support the decision of logisticians regarding the introduction of gamification in their logistics processes by providing them useful insights and guidelines originating from a real life case study of a large DC operating more than 300 retail outlets in Greece.

Keywords: augmented reality, technology acceptance, warehouse management, vision picking, new forms of work, gamification

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4282 The Role of ICTS in Improving the Quality of Public Spaces in Large Cities of the Third World

Authors: Ayat Ayman Abdelaziz Ibrahim Amayem, Hassan Abdel-Salam, Zeyad El-Sayad

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Nowadays, ICTs have spread extensively in everyday life in an unprecedented way. A great attention is paid to the ICTs while ignoring the social aspect. With the immersive invasion of internet as well as smart phones’ applications and digital social networking, people become more socially connected through virtual spaces instead of meeting in physical public spaces. Thus, this paper aims to find the ways of implementing ICTs in public spaces to regain their status as attractive places for people, incite meetings in real life and create sustainable lively city centers. One selected example of urban space in the city center of Alexandria is selected for the study. Alexandria represents a large metropolitan city subjected to rapid transformation. Improving the quality of its public spaces will have great effects on the whole well-being of the city. The major roles that ICTs can play in the public space are: culture and art, education, planning and design, games and entertainment, and information and communication. Based on this classification various examples and proposals of ICTs interventions in public spaces are presented and analyzed to encourage good old fashioned social interaction by creating the New Social Public Place of this Digital Era. The paper will adopt methods such as questionnaire for evaluating the people’s willingness to accept the idea of using ICTs in public spaces, their needs and their proposals for an attractive place; the technique of observation to understand the people behavior and their movement through the space and finally will present an experimental design proposal for the selected urban space. Accordingly, this study will help to find design principles that can be adopted in the design of future public spaces to meet the needs of the digital era’s users with the new concepts of social life respecting the rules of place-making.

Keywords: Alexandria sustainable city center, digital place-making, ICTs, social interaction, social networking, urban places

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4281 The Representations of Protesters in the UK National Daily Press: Pro- And Anti- Brexit Demonstrations 2016-2019

Authors: Charlotte-Rose Kennedy

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In a political climate divided by Brexit, it is crucial to be critical of the press, as it is the apparatus which political authorities use to impose their laws and shape public opinion. Although large protests have the power to shake and disrupt policy-making by making it difficult for governments to ignore their goals, the British press historically constructs protesters as delegitimate, deviant, and criminal, which could limit protests’ credibility and democratic power. This paper explores how the remain supporting daily UK press (The Mirror, Financial Times, The Independent, The Guardian) and the leave supporting daily UK press (The Daily Mail, The Daily Star, The Sun, The Express, The Telegraph) discursively constructed every pro- and anti-Brexit demonstration from 2016 to 2019. 702 instances of the terms ‘protester’, ‘protesters’, ‘protestor’ and ‘protestors’ were analyzed through both transitivity analysis and critical discourse analysis. This mixed-methods approach allowed for the analysis of how the UK press perpetuated and upheld social ideologies about protests through their specific grammatical and language choices. The results of this analysis found that both remain and leave supporting press utilized the same discourses to report on protests they oppose and protests they support. For example, the remain backing The Mirror used water metaphors regularly associated with influxes of refugees and asylum seekers to support the protesters on the remain protest ‘Final Say’, and oppose the protesters on the leave protest ‘March to Leave’. Discourses of war, violence, and victimhood are also taken on by both sides of the press Brexit debate and are again used to support and oppose the same arguments. Finally, the paper concludes that these analogous discourses do nothing to help the already marginalized social positions of protesters in the UK and could potentially lead to reduced public support for demonstrations. This could, in turn, facilitate the government in introducing increasingly restrictive legislation in relation to freedom of assembly rights, which could be detrimental to British democracy.

Keywords: Brexit, critical discourse analysis, protests, transitivity analysis, UK press

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4280 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

Abstract:

Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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4279 Developing a Framework for Assessing and Fostering the Sustainability of Manufacturing Companies

Authors: Ilaria Barletta, Mahesh Mani, Björn Johansson

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The concept of sustainability encompasses economic, environmental, social and institutional considerations. Sustainable manufacturing (SM) is, therefore, a multi-faceted concept. It broadly implies the development and implementation of technologies, projects and initiatives that are concerned with the life cycle of products and services, and are able to bring positive impacts to the environment, company stakeholders and profitability. Because of this, achieving SM-related goals requires a holistic, life-cycle-thinking approach from manufacturing companies. Further, such an approach must rely on a logic of continuous improvement and ease of implementation in order to be effective. Currently, there exists in the academic literature no comprehensively structured frameworks that support manufacturing companies in the identification of the issues and the capabilities that can either hinder or foster sustainability. This scarcity of support extends to difficulties in obtaining quantifiable measurements in order to objectively evaluate solutions and programs and identify improvement areas within SM for standards conformance. To bridge this gap, this paper proposes the concept of a framework for assessing and continuously improving the sustainability of manufacturing companies. The framework addresses strategies and projects for SM and operates in three sequential phases: analysis of the issues, design of solutions and continuous improvement. A set of interviews, observations and questionnaires are the research methods to be used for the implementation of the framework. Different decision-support methods - either already-existing or novel ones - can be 'plugged into' each of the phases. These methods can assess anything from business capabilities to process maturity. In particular, the authors are working on the development of a sustainable manufacturing maturity model (SMMM) as decision support within the phase of 'continuous improvement'. The SMMM, inspired by previous maturity models, is made up of four maturity levels stemming from 'non-existing' to 'thriving'. Aggregate findings from the use of the framework should ultimately reveal to managers and CEOs the roadmap for achieving SM goals and identify the maturity of their companies’ processes and capabilities. Two cases from two manufacturing companies in Australia are currently being employed to develop and test the framework. The use of this framework will bring two main benefits: enable visual, intuitive internal sustainability benchmarking and raise awareness of improvement areas that lead companies towards an increasingly developed SM.

Keywords: life cycle management, continuous improvement, maturity model, sustainable manufacturing

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4278 Unfair Labour Practice on Staff in Primary Health Care Facilities, Northwest Province, South Africa: A Qualitative Study

Authors: Maserapelo Gladys Serapelwane, Eva Mofatiki Manyedi

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Background: Unfair labour practices on staff is a worldwide concern, which creates conflicts and disharmony among health workers. It is found that nursing staff members are unfairly treated without a valid reason in primary health care (PHC) facilities and predominantly in developing countries, and South Africa is not excluded. Objectives: The purpose of the study was to explore and describe the experiences of operational managers regarding unfair labour practices on staff by their local area managers and describe the perceptions of operational managers towards such treatment. Methods: A qualitative, descriptive, exploratory, and contextual research approach was considered appropriate for the study. In this study, the population comprised operational managers working in the PHC facilities of Northwest Province, South Africa. Purposive sampling was used to select participants for the study and focus group interviews were used to interview 23 operational managers. Ethical measures were applied throughout the study. Findings: The six phases of thematic analysis were used to analyze data collected for the study. Two themes that emerged are experiences of factors related to unfair labour practices in the PHC facilities and perceptions regarding how to improve their working conditions. The categories that were found in the first themes were favouritism and discrimination. In the second theme, in-service training and transparency regarding staff training and development emerged. Recommendations comprised, among others, training on the concepts of quality in the workplace and reinforcement of transparency regarding granting of study leave and attending workshops. Conclusion: Operational managers in the PHC facilities experienced unfair labour practices as evidenced by favouritism.

Keywords: unfair labour practices, primary health care facilities, operational managers, North West Province

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4277 The Role of Leader, Member Exchange on Psychological Capital, Mediated by Person-Organisational Fit

Authors: Sonja Grobler

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Background: Leadership and specifically Leader, member exchange has a definite impact on employee behaviour and attitudes, and specifically their state of psychological capital. The interactionist construct of person-organisational fit (P-O fit), consisting of a combination of supplementary fit (indirect fit or value congruence) and complementary fit (direct or person-job fit, as well as needs-supply fit) may, however, impact on the relationship between LMX and psychological capital. The unique permutations of these relationships are important not only for conceptualisation purposes but also for intervention design to enhance the employees’ psychological capital; this would contribute to positive employee behaviour and attitudes. Aim: The purpose of this study was to determine whether a relationship exists between Leader, Member Exchange (LMX) and psychological capital, with possible mediation by P-O fit. Setting: The research was conducted with ± 60 employees from each of 43 private sectors and four public sector organisations in South Africa. Method: This study utilised a positivist methodology based on an empirical approach while using a cross-sectional design and quantitative analysis. The sample is relatively representative (in terms of race, gender, and the South African work force), as it consisted of 60 employees from each of the 43 South African organisations that participated in the study, with 2 486 respondents in total. Results: Significant, positive relationships were found between LMX, P-O fit, and psychological capital. Additionally, it was found that P-O fit partially mediates the relationship between ethical leadership and supervisory trust, confirming the proposed model. Conclusion: A strong, positive relationship exists between LMX (consisting of Affect, Loyalty, Contribution, and Professional Respect) and psychological capital (consisting of Self-efficacy, Hope, Resilience and Optimism) which is partially mediated by P-O fit (consisting of supplementary fit and complementary fit).

Keywords: leader and member exchange, person-organisational fit, psychological capital, positive psychology, interactionist approach

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4276 Developing a Model – an Application of Fuzzy Analytic Network Process Techniques for Hostels

Authors: Pin-Ju Juan, Peng-Yu Juan, Yi-Shan Chen

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The main purpose of this paper is to present a fuzzy Analytic Network Process (ANP) model for the hostel organizational performance selection. In this article, we created 39 criteria for selecting hostel organizational performance acquired from literature's review and experts method practical investigations, and the methods of fuzzy analytic network process are used to consolidate decision-makers’ assessments about criteria weightings. Finally, we selected organizational performance of a hostel in Taiwan to determine the effectiveness of the proposed evaluation model in this paper.

Keywords: Fuzzy ANP, hostel, organizational performance, strategy management

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4275 A Case Report on Cognitive-Communication Intervention in Traumatic Brain Injury

Authors: Nikitha Francis, Anjana Hoode, Vinitha George, Jayashree S. Bhat

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The interaction between cognition and language, referred as cognitive-communication, is very intricate, involving several mental processes such as perception, memory, attention, lexical retrieval, decision making, motor planning, self-monitoring and knowledge. Cognitive-communication disorders are difficulties in communicative competencies that result from underlying cognitive impairments of attention, memory, organization, information processing, problem solving, and executive functions. Traumatic brain injury (TBI) is an acquired, non - progressive condition, resulting in distinct deficits of cognitive communication abilities such as naming, word-finding, self-monitoring, auditory recognition, attention, perception and memory. Cognitive-communication intervention in TBI is individualized, in order to enhance the person’s ability to process and interpret information for better functioning in their family and community life. The present case report illustrates the cognitive-communicative behaviors and the intervention outcomes of an adult with TBI, who was brought to the Department of Audiology and Speech Language Pathology, with cognitive and communicative disturbances, consequent to road traffic accident. On a detailed assessment, she showed naming deficits along with perseverations and had severe difficulty in recalling the details of the accident, her house address, places she had visited earlier, names of people known to her, as well as the activities she did each day, leading to severe breakdowns in her communicative abilities. She had difficulty in initiating, maintaining and following a conversation. She also lacked orientation to time and place. On administration of the Manipal Manual of Cognitive Linguistic Abilities (MMCLA), she exhibited poor performance on tasks related to visual and auditory perception, short term memory, working memory and executive functions. She attended 20 sessions of cognitive-communication intervention which followed a domain-general, adaptive training paradigm, with tasks relevant to everyday cognitive-communication skills. Compensatory strategies such as maintaining a dairy with reminders of her daily routine, names of people, date, time and place was also recommended. MMCLA was re-administered and her performance in the tasks showed significant improvements. Occurrence of perseverations and word retrieval difficulties reduced. She developed interests to initiate her day-to-day activities at home independently, as well as involve herself in conversations with her family members. Though she lacked awareness about her deficits, she actively involved herself in all the therapy activities. Rehabilitation of moderate to severe head injury patients can be done effectively through a holistic cognitive retraining with a focus on different cognitive-linguistic domains. Selection of goals and activities should have relevance to the functional needs of each individual with TBI, as highlighted in the present case report.

Keywords: cognitive-communication, executive functions, memory, traumatic brain injury

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4274 Effect of Halo Protection Device on the Aerodynamic Performance of Formula Racecar

Authors: Mark Lin, Periklis Papadopoulos

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This paper explores the aerodynamics of the formula racecar when a ‘halo’ driver-protection device is added to the chassis. The halo protection device was introduced at the start of the 2018 racing season as a safety measure against foreign object impacts that a driver may encounter when driving an open-wheel racecar. In the one-year since its introduction, the device has received wide acclaim for protecting the driver on two separate occasions. The benefit of such a safety device certainly cannot be disputed. However, by adding the halo device to a car, it changes the airflow around the vehicle, and most notably, to the engine air-intake and the rear wing. These negative effects in the air supply to the engine, and equally to the downforce created by the rear wing are studied in this paper using numerical technique, and the resulting CFD outputs are presented and discussed. Comparing racecar design prior to and after the introduction of the halo device, it is shown that the design of the air intake and the rear wing has not followed suit since the addition of the halo device. The reduction of engine intake mass flow due to the halo device is computed and presented for various speeds the car may be going. Because of the location of the halo device in relation to the air intake, airflow is directed away from the engine, making the engine perform less than optimal. The reduction is quantified in this paper to show the correspondence to reduce the engine output when compared to a similar car without the halo device. This paper shows that through aerodynamic arguments, the engine in a halo car will not receive unobstructed, clean airflow that a non-halo car does. Another negative effect is on the downforce created by the rear wing. Because the amount of downforce created by the rear wing is influenced by every component that comes before it, when a halo device is added upstream to the rear wing, airflow is obstructed, and less is available for making downforce. This reduction in downforce is especially dramatic as the speed is increased. This paper presents a graph of downforce over a range of speeds for a car with and without the halo device. Acknowledging that although driver safety is paramount, the negative effect of this safety device on the performance of the car should still be well understood so that any possible redesign to mitigate these negative effects can be taken into account in next year’s rules regulation.

Keywords: automotive aerodynamics, halo device, downforce. engine intake

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4273 Healthcare Utilization and Costs of Specific Obesity Related Health Conditions in Alberta, Canada

Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

Abstract:

Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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4272 The Influence of Fashion Bloggers on the Pre-Purchase Decision for Online Fashion Products among Generation Y Female Malaysian Consumers

Authors: Mohd Zaimmudin Mohd Zain, Patsy Perry, Lee Quinn

Abstract:

This study explores how fashion consumers are influenced by fashion bloggers towards pre-purchase decision for online fashion products in a non-Western context. Malaysians rank among the world’s most avid online shoppers, with apparel the third most popular purchase category. However, extant research on fashion blogging focuses on the developed Western market context. Numerous international fashion retailers have entered the Malaysian market from luxury to fast fashion segments of the market; however Malaysian fashion consumers must balance religious and social norms for modesty with their dress style and adoption of fashion trends. Consumers increasingly mix and match Islamic and Western elements of dress to create new styles enabling them to follow Western fashion trends whilst paying respect to social and religious norms. Social media have revolutionised the way that consumers can search for and find information about fashion products. For online fashion brands with no physical presence, social media provide a means of discovery for consumers. By allowing the creation and exchange of user-generated content (UGC) online, they provide a public forum that gives individual consumers their own voices, as well as access to product information that facilitates their purchase decisions. Social media empower consumers and brands have important roles in facilitating conversations among consumers and themselves, to help consumers connect with them and one another. Fashion blogs have become an important fashion information sources. By sharing their personal style and inspiring their followers with what they wear on popular social media platforms such as Instagram, fashion bloggers have become fashion opinion leaders. By creating UGC to spread useful information to their followers, they influence the pre-purchase decision. Hence, successful Western fashion bloggers such as Chiara Ferragni may earn millions of US dollars every year, and some have created their own fashion ranges and beauty products, become judges in fashion reality shows, won awards, and collaborated with high street and luxury brands. As fashion blogging has become more established worldwide, increasing numbers of fashion bloggers have emerged from non-Western backgrounds to promote Islamic fashion styles, such as Hassanah El-Yacoubi and Dian Pelangi. This study adopts a qualitative approach using netnographic content analysis of consumer comments on two famous Malaysian fashion bloggers’ Instagram accounts during January-March 2016 and qualitative interviews with 16 Malaysian Generation Y fashion consumers during September-October 2016. Netnography adapts ethnographic techniques to the study of online communities or computer-mediated communications. Template analysis of the data involved coding comments according to the theoretical framework, which was developed from the literature review. Initial data analysis shows the strong influence of Malaysian fashion bloggers on their followers in terms of lifestyle and morals as well as fashion style. Followers were guided towards the mix and match trend of dress with Western and Islamic elements, for example, showing how vivid colours or accessories could be worked into an outfit whilst still respecting social and religious norms. The blogger’s Instagram account is a form of online community where followers can communicate and gain guidance and support from other followers, as well as from the blogger.

Keywords: fashion bloggers, Malaysia, qualitative, social media

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4271 Gender Considerations and Entrepreneurship Development in Nigeria

Authors: Tirimisiyu Olaide Gbadamosi

Abstract:

Individuals go into business for the sake of obtaining regular income, becoming self-employed. Although, there different kinds of business enterprises that female and male can go into, often times, some businesses are regarded more suitable for a particular sex and not the other. This means that there is some gender discrimination in the choice of business one goes into and by extension in entrepreneurship development. Apparently, gender attitudes and behaviors will have positive or negative effects on entrepreneurship development in a society or economy. This research work therefore intends to take a critical look at gender discrimination as they affect entrepreneurship development with particular reference to northern Nigeria in general, using Exceptional Production Services Limited Kaduna, Kaduna North Local Government area as a case study, and also to suggest the possible solution to unidentified problems and give recommendation where necessary. Statement of research problem: Entrepreneurship has generally been recognised as a good medium or strategy for economic development of an individual, a community and a nation. It is also a known a known fact that some gender discrimination are often used in the choice of business or even the decision to go into business. For example, some businesses are regarded as more suitable to men than women. The question here is, is this the right approach to economic development through entrepreneurship? Of what effect is this approach to entrepreneurship development? These and the other questions are what this research intends to find answers to and if possible make recommendations. Significance of the study: The findings of this study will provide a guide for anyone for the establishment of a business in Nigeria. The study will help any prospective entrepreneur to make the right decision of which business to go into and how to contend with gender related issues that might influence its success in business. Furthermore, it is hoped that the study will assist the government and her agencies in the process in developing entrepreneurship development programs. Conclusion: There has been growing recognition that various types of discrimination do not always affect women and men in the same way. Moreover, gender discrimination may be intensified and facilitated by all other forms of discrimination. It has been increasingly recognized that without gender analysis of all forms of discrimination in business, including multiple forms of discrimination, and, in particular, in this context, related intolerance, violations of the human rights of women might escape detection and remedies to address racism may also fail to meet the needs of women and girls. It is also important that efforts to address gender discrimination incorporate approaches to the elimination of all forms of discrimination. Recommendation: Campaigning and raising awareness among young men and women, parents, teachers and employers about gender stereotypical attitudes towards academic performances and the likely consequences of overall educational choices for employment and entrepreneurship opportunities, career progression and earnings.

Keywords: entrepreneurship, economic development, small medium enterprises, gender discrimination

Procedia PDF Downloads 385
4270 Social Impact Bonds in the US Context

Authors: Paula M. Lantz

Abstract:

In the United States, significant socioeconomic and racial inequalities exist in many population-based indicators of health and social welfare. Although a number of effective prevention programs and interventions are available, local and state governments often do not pursue prevention in the face of budgetary constraints and more acute problems. There is growing interest in and excitement about Pay for Success” (PFS) strategies, also referred to as social impact bonds, as an approach to financing and implementing promising prevention programs and services that help the public sector either save money or achieve greater value for an investment. The PFS finance model implements evidence-based interventions using capital from investors who only receive a return on their investment from the government if agreed-upon, measurable outcomes are achieved. This paper discusses the current landscape regarding social impact bonds in the U.S., and their potential and challenges in addressing serious health and social problems. The paper presents an analysis of a number of social science issues that are fundamental to the potential for social impact bonds to successfully address social inequalities in health and social welfare. This includes: a) the economics of the intervention and a potential public payout; b) organizational and management issues in intervention implementation; c) evaluation research design and methods; d) legal/regulatory issues in public payouts to investors; e) ethical issues in the design of social impact bond deals and their evaluation; and f) political issues. Despite significant challenges in the U.S. context, there is great potential for social impact bonds as a type of social impact investing to encourage private investments in evidence-based interventions that address important public health and social problems in underserved populations and provide a return on investment.

Keywords: pay for success, public/private partnerships, social impact bonds, social impact investing

Procedia PDF Downloads 300
4269 Anthropometric Analysis for the Design of Workstations in the Interior Spaces of the Manufacturing Industry in Tijuana, Mexico

Authors: J. A. López, J. E. Olguín, C. W. Camargo, G. A. Quijano, R. Martínez

Abstract:

This paper presents an anthropometric study conducted to 300 employees in a maquiladora industry that belongs to the cluster of medical products as part of a research project to pretend simulate workplace conditions under which operators conduct their activities. This project is relevant because traditionally performed a study to design ergonomic workspaces according to anthropometric profile of users, however, this paper demonstrates the importance of making decisions when the infrastructure cannot be adapted for economic whichever put emphasis on user activity.

Keywords: anthropometry, biomechanics, design, ergonomics, productivity

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4268 Purpose in Procurement: Much Discussed, Less Conceptualized – An Exploratory Study of CPO Perceptions Based on the Gioia Methodology

Authors: Laurin Zemmrich, Nicolai Stickler

Abstract:

With the ongoing debate over how to incorporate sustainability, resilience, and value creation into business strategies, many procurement departments are put under pressure by governments, consumers, non-governmental organizations, and other stakeholders to disclose more information about their supply chains. According to practitioners and experts, procurement benefits the supply chain by increasing transparency and accountability, recruiting new suppliers, and supporting sustainable and ethical sourcing strategies. While most procurement departments establish these objectives, the bulk of activities are not carried out or are not regularly monitored. With the full potential of targeted sourcing still to be realized, procurement executives, in particular, are seeking for short-term cost-cutting impacts to appease external shareholders. We overcome this limitation by using an abductive approach to research and integrating empirical data from a Gioia methodology study design with relevant literature. Our analysis demonstrates that the procurement department has six essential levers aligned with sustainability, resilience, and value creation objectives and contributes to developing a new intra- and interorganizational purpose within the supply chain. Three enablers are identified as having a value-creating effect on supply chain interactions. Additionally, we discovered two impacts that alter the power balance between buyers and suppliers during transactions and have a cost-cutting or cost-avoiding effect. While cost-cutting, cost-avoidance, and dependency-reduction impacts are desirable, redistributing power may also have negative consequences. The article establishes a first strategy framework for evaluating the influence of the procurement department on supply chain transactions, allowing managers to understand better and apply the sourcing function inside a supply chain and embed it throughout the business.

Keywords: supply chain management, resilience, sustainability, value creation, purpose

Procedia PDF Downloads 118
4267 Logistical Optimization of Nuclear Waste Flows during Decommissioning

Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. Ladier, S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

Abstract:

An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: nuclear decommissioning, logistical optimization, decision-support framework, waste management

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4266 Is School Misbehavior a Decision: Implications for School Guidance

Authors: Rachel C. F. Sun

Abstract:

This study examined the predictive effects of moral competence, prosocial norms and positive behavior recognition on school misbehavior among Chinese junior secondary school students. Results of multiple regression analysis showed that students were more likely to misbehave in school when they had lower levels of moral competence and prosocial norms, and when they perceived their positive behavior being less likely recognized. Practical implications were discussed on how to guide students to make the right choices to behave appropriately in school. Implications for future research were also discussed.

Keywords: moral competence, positive behavior recognition, prosocial norms, school misbehavior

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4265 Autobiographical Memory Functions and Perceived Control in Depressive Symptoms among Young Adults

Authors: Meenu S. Babu, K. Jayasankara Reddy

Abstract:

Depression is a serious mental health concern that leads to significant distress and dysfunction in an individual. Due to the high physical, psychological, social, and economic burden it causes, it is important to study various bio-psycho-social factors that influence the onset, course, duration, intensity of depressive symptoms. The study aims to explore relationship between autobiographical memory (AM) functions, perceived control over stressful events and depressive symptoms. AM functions and perceived control were both found to be protective factors for individuals against depression and were both modifiable to predict better behavioral and affective outcomes. An extensive review of literatur, with a systematic search on Google Scholar, JSTOR, Science Direct and Springer Journals database, was conducted for the purpose of this review paper. These were used for all the aforementioned databases. The time frame used for the search was 2010-2021. An additional search was conducted with no time bar to map the development of the theoretical concepts. The relevant studies with quantitative, qualitative, experimental, and quasi- experimental research designs were included for the review. Studies including a sample with a DSM- 5 or ICD-10 diagnosis of depressive disorders were excluded from the study to focus on the behavioral patterns in a non-clinical population. The synthesis of the findings that were obtained from the review indicates there is a significant relationship between cognitive variables of AM functions and perceived control and depressive symptoms. AM functions were found to be have significant effects on once sense of self, interpersonal relationships, decision making, self- continuity and were related to better emotion regulation and lower depressive symptoms. Not all the components of AM function were equally significant in their relationships with various depressive symptoms. While self and directive functions were more related to emotion regulation, anhedonia, motivation and hence mood and affect, the social function was related to perceived social support and social engagement. Perceived control was found to be another protective cognitive factor that provides individuals a sense of agency and control over one’s life outcomes which was found to be low in individuals with depression. This was also associated to the locus of control, competency beliefs, contingency beliefs and subjective well being in individuals and acted as protective factors against depressive symptoms. AM and perceived control over stressful events serve adaptive functions, hence it is imperative to study these variables more extensively. They can be imperative in planning and implementing therapeutic interventions to foster these cognitive protective factors to mitigate or alleviate depressive symptoms. Exploring AM as a determining factor in depressive symptoms along with perceived control over stress creates a bridge between biological and cognitive factors underlying depression and increases the scope of developing a more eclectic and effective treatment plan for individuals. As culture plays a crucial role in AM functions as well as certain aspects of control such as locus of control, it is necessary to study these variables keeping in mind the cultural context to tailor culture/community specific interventions for depression.

Keywords: autobiographical memories, autobiographical memory functions, perceived control, depressive symptoms, depression, young adults

Procedia PDF Downloads 104
4264 Beyond Personal Evidence: Using Learning Analytics and Student Feedback to Improve Learning Experiences

Authors: Shawndra Bowers, Allie Brandriet, Betsy Gilbertson

Abstract:

This paper will highlight how Auburn Online’s instructional designers leveraged student and faculty data to update and improve online course design and instructional materials. When designing and revising online courses, it can be difficult for faculty to know what strategies are most likely to engage learners and improve educational outcomes in a specific discipline. It can also be difficult to identify which metrics are most useful for understanding and improving teaching, learning, and course design. At Auburn Online, the instructional designers use a suite of data based student’s performance, participation, satisfaction, and engagement, as well as faculty perceptions, to inform sound learning and design principles that guide growth-mindset consultations with faculty. The consultations allow the instructional designer, along with the faculty member, to co-create an actionable course improvement plan. Auburn Online gathers learning analytics from a variety of sources that any instructor or instructional design team may have access to at their own institutions. Participation and performance data, such as page: views, assignment submissions, and aggregate grade distributions, are collected from the learning management system. Engagement data is pulled from the video hosting platform, which includes unique viewers, views and downloads, the minutes delivered, and the average duration each video is viewed. Student satisfaction is also obtained through a short survey that is embedded at the end of each instructional module. This survey is included in each course every time it is taught. The survey data is then analyzed by an instructional designer for trends and pain points in order to identify areas that can be modified, such as course content and instructional strategies, to better support student learning. This analysis, along with the instructional designer’s recommendations, is presented in a comprehensive report to instructors in an hour-long consultation where instructional designers collaborate with the faculty member on how and when to implement improvements. Auburn Online has developed a triage strategy of priority 1 or 2 level changes that will be implemented in future course iterations. This data-informed decision-making process helps instructors focus on what will best work in their teaching environment while addressing which areas need additional attention. As a student-centered process, it has created improved learning environments for students and has been well received by faculty. It has also shown to be effective in addressing the need for improvement while removing the feeling the faculty’s teaching is being personally attacked. The process that Auburn Online uses is laid out, along with the three-tier maintenance and revision guide that will be used over a three-year implementation plan. This information can help others determine what components of the maintenance and revision plan they want to utilize, as well as guide them on how to create a similar approach. The data will be used to analyze, revise, and improve courses by providing recommendations and models of good practices through determining and disseminating best practices that demonstrate an impact on student success.

Keywords: data-driven, improvement, online courses, faculty development, analytics, course design

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4263 Capacity Optimization in Cooperative Cognitive Radio Networks

Authors: Mahdi Pirmoradian, Olayinka Adigun, Christos Politis

Abstract:

Cooperative spectrum sensing is a crucial challenge in cognitive radio networks. Cooperative sensing can increase the reliability of spectrum hole detection, optimize sensing time and reduce delay in cooperative networks. In this paper, an efficient central capacity optimization algorithm is proposed to minimize cooperative sensing time in a homogenous sensor network using OR decision rule subject to the detection and false alarm probabilities constraints. The evaluation results reveal significant improvement in the sensing time and normalized capacity of the cognitive sensors.

Keywords: cooperative networks, normalized capacity, sensing time

Procedia PDF Downloads 634
4262 Assessment of Maternal Satisfaction Regarding Quality of Care during Labor

Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

Abstract:

Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

Procedia PDF Downloads 190
4261 Impact of Transportation on Access to Reproductive and Maternal Health Services in Northeast Cambodia: A Policy Brief

Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

Abstract:

Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

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4260 Need for Contemporization of Craft for Sustenance: A Study on Solapur Wall Hanging

Authors: Reena Aggarwal

Abstract:

Wall art is a manifestation of the human mind and an absorbing form of cultural expression. Solapur wall hanging making art reflects cultural values, regional sensibilities, beliefs, and identity and helps to preserve the many different communities. The tango of warp and weft in many ways than one tells the story of civilization itself. Solapur wall hanging is a poem in multicolor, written with the warp and weft having long, rich, and complex history with indigenous design vocabularies made by the Padmasali communities. The wall-hanging weaving of Solapur has remained unaltered for years, from being very basic and monochrome having landscapes and portraits catering only to the local market, thereby becoming a potential family income generation tool. The study focuses on the need for contemporization of the Solapur wall hanging and also deliberates on the fact that wherever the culture of native people has been aided by intervention, in nearly every case, the quality of their craft has began to be enhanced. The study also found the underlying reason for diminishing sales to a declining market, low sales, lack of innovation in design, and product development. Keeping in mind that the artisans of Solapur have heroically always hold on to their ancient beliefs and practices, which give them strength and identity, and a sense of pride, an intervention program was developed with an objective of widening the market and help artisans have a sustaining income which include urban consumers and create designs suitable for the urban market. The process of defining and measuring the advantages of design intervention was achieved by using qualitative research methods. An ethnographic research methodology was adopted, which includes six months of close interface with artisans from ten families engaged in making of wall hanging in Solapur. Design solutions were proposed in terms of product diversification and design extensions of the existing product line for increased variety. A collection of contemporary wall arts (wall decor) and room dividers were designed and developed.

Keywords: wall hanging, Solapur, contemporization, traditional, sustainable

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4259 Exploring Coexisting Opportunity of Earthquake Risk and Urban Growth

Authors: Chang Hsueh-Sheng, Chen Tzu-Ling

Abstract:

Earthquake is an unpredictable natural disaster and intensive earthquakes have caused serious impacts on social-economic system, environmental and social resilience, and further increase vulnerability. Due to earthquakes do not kill people, buildings do. When buildings located nearby earthquake-prone areas and constructed upon poorer soil areas might result in earthquake-induced ground damage. In addition, many existing buildings built before any improved seismic provisions began to be required in building codes and inappropriate land usage with highly dense population might result in much serious earthquake disaster. Indeed, not only do earthquake disaster impact seriously on urban environment, but urban growth might increase the vulnerability. Since 1980s, ‘Cutting down risks and vulnerability’ has been brought up in both urban planning and architecture and such concept has way beyond retrofitting of seismic damages, seismic resistance, and better anti-seismic structures, and become the key action on disaster mitigation. Land use planning and zoning are two critical non-structural measures on controlling physical development while it is difficult for zoning boards and governing bodies restrict development of questionable lands to uses compatible with the hazard without credible earthquake loss projection. Therefore, identifying potential earthquake exposure, vulnerability people and places, and urban development areas might become strongly supported information for decision makers. Taiwan locates on the Pacific Ring of Fire where a seismically active zone is. Some of the active faults have been found close by densely populated and highly developed built environment in the cities. Therefore, this study attempts to base on the perspective of carrying capacity and draft out micro-zonation according to both vulnerability index and urban growth index while considering spatial variances of multi factors via geographical weighted principle components (GWPCA). The purpose in this study is to construct supported information for decision makers on revising existing zoning in high-risk areas for a more compatible use and the public on managing risks.

Keywords: earthquake disaster, vulnerability, urban growth, carrying capacity, /geographical weighted principle components (GWPCA), bivariate spatial association statistic

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4258 A Study of the Disorders of Sexual Functioning in Women with Type 2 Diabetes Mellitus in a Tertiary Care Hospital in India

Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

Abstract:

Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

Procedia PDF Downloads 329