Search results for: rural healthcare settings

Authors: Avent Grange, Frederic Bertrand, Jean-Baptiste Droin, Amandine Marrel, Jean-Henry Ferrasse, Olivier Boutin

Abstract:

CEA and its industrial partners are designing a gas Power Conversion System (PCS) based on a Brayton cycle for the ASTRID Sodium-cooled Fast Reactor. Investigations of control and regulation requirements to operate this PCS during operating, incidental and accidental transients are necessary to adapt core heat removal. To this aim, we developed a methodology to optimize the thermal-hydraulic behavior of the reactor during normal operations, incidents and accidents. This methodology consists of a multi-objective optimization for a specific sequence, whose aim is to increase component lifetime by reducing simultaneously several thermal stresses and to bring the reactor into a stable state. Furthermore, the multi-objective optimization complies with safety and operating constraints. Operating, incidental and accidental sequences use specific regulations to control the thermal-hydraulic reactor behavior, each of them is defined by a setpoint, a controller and an actuator. In the multi-objective problem, the parameters used to solve the optimization are the setpoints and the settings of the controllers associated with the regulations included in the sequence. In this way, the methodology allows designers to define an optimized and specific control strategy of the plant for the studied sequence and hence to adapt PCS piloting at its best. The multi-objective optimization is performed by evolutionary algorithms coupled to surrogate models built on variables computed by the thermal-hydraulic system code, CATHARE2. The methodology is applied to a loss of off-site power sequence. Three variables are controlled: the sodium outlet temperature of the sodium-gas heat exchanger, turbomachine rotational speed and water flow through the heat sink. These regulations are chosen in order to minimize thermal stresses on the gas-gas heat exchanger, on the sodium-gas heat exchanger and on the vessel. The main results of this work are optimal setpoints for the three regulations. Moreover, Proportional-Integral-Derivative (PID) control setting is considered and efficient actuators used in controls are chosen through sensitivity analysis results. Finally, the optimized regulation system and the reactor control procedure, provided by the optimization process, are verified through a direct CATHARE2 calculation.

Keywords: gas power conversion system, loss of off-site power, multi-objective optimization, regulation, sodium fast reactor, surrogate model

Procedia PDF Downloads 294

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

Procedia PDF Downloads 504

Authors: David A. Scott, Michelle G. Scott

Abstract:

The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.

Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates

Procedia PDF Downloads 63

Authors: G. Gevorgyan, S. Khudaverdyan, A. Vaseashta

Abstract:

The Lake Sevan basin is situated in the eastern part of the Republic of Armenia (Gegharquniq marz/district). The heavy metal pollution of the some tributaries of Lake Sevan was investigated. Water sampling was performed in August and December, 2014 from the 4 observation sites: 1) Sotq river upstream (about 600 meters upstream from the Sotq gold mine); 2) Sotq river mouth; 3) Masrik river mouth; 4) Dzknaget river mouth. Heavy metal (V, Fe, Ni, Cu, As, Mo, Pb) concentrations in the water samples were determined by the standard methods using an atomic absorption spectrophotometer. The results of the study showed that heavy metal content mainly increased from the upstream of the Sotq river to the mouth of the Masrik river which may have been conditioned by the influence of gold mining activity as the Masrik and its tributary-Sotq rivers passing through the gold mining area were exposed to heavy metal pollution. The observation sites can be ranked by pollution degree as follows: №3> №2> №1> №4. The highest heavy metal pollution degree was observed in the Masrik river mouth which may have been conditioned by the direct impact of gold mining activity and the pressure of its tributary–the Sotq river which flows through the gold mining area. The lowest heavy metal pollution degree was registered in the Dzknaget river mouth which flowing through rural areas wasn’t subject to significant heavy metal pollution. According to the observation sites of the Sotq and Masrik rivers, high positive correlation was mainly observed between the concentrations of the investigated heavy metals (except nickel) which indicated that all the heavy metals except the nickel had the same anthropogenic pollution source which was the activity of the Sotq gold mine. In general, it is possible to state that the activity of the Sotq gold mine in the Lake Sevan basin caused the heavy metal pollution of the Sotq and Masrik rivers which may have posed environmental hazards. Heavy metals are nondegradable substances, and heavy metal pollution of freshwater systems may pose risks to the environment and human health through accumulation in the tissues of aquatic organisms, water-food chain as well as oral ingestion and dermal contact.

Keywords: Armenia, Lake Sevan basin, gold mining activity, river ecosystems, heavy metal pollution

Procedia PDF Downloads 578

Authors: Rubisha Adhikari, Rajani Shah

Abstract:

Introduction: Aging is a natural, global and inevitable phenomenon every single person has to go through, and nobody can escape the process. One of the emerging challenges to public health is to improve the quality of later years of life as life expectancy continues to increase. Quality of life (QoL) has grown to be a key goal for many public health initiatives. Population aging has become a global phenomenon as they are growing more quickly in emerging nations than they are in industrialized nations, leaving minimal opportunities to regulate the consequences of the demographic shift. Methods: A community-based descriptive analytical approach was used to examine the quality of life and associated factors among elderly people. A mixed method was chosen for the study. For the quantitative data collection, a household survey was conducted using the WHOQOL-OLD tool. In-depth interviews were conducted among twenty participants for qualitative data collection. Data generated through in-depth interviews were transcribed verbatim. In-depth interviews lasted about an hour and were audio recorded. The in-depth interview guide had been developed by the research team and pilot-tested before actual interviews. Results: This study result showed the association between quality of life and socio-demographic variables. Among all the variables under socio-demographic variable of this study, age (ꭓ2=14.445, p=0.001), gender (ꭓ2=14.323, p=<0.001), marital status (ꭓ2=10.816, p=0.001), education status (ꭓ2=23.948, p=<0.001), household income (ꭓ2=13.493, p=0.001), personal income (ꭓ2=14.129, p=0.001), source of personal income (ꭓ2=28.332,p=<0.001), social security allowance (ꭓ2=18.005,p=<0.001), alcohol consumption (ꭓ2=9.397,p=0.002) are significantly associated with quality of life of elderly. In addition, affordability (ꭓ2=12.088, p=0.001), physical activity (ꭓ2=9.314, p=0.002), emotional support (ꭓ2=9.122, p=0.003), and economic support (ꭓ2=8.104, p=0.004) are associated with quality of life of elderly people. Conclusion: In conclusion, this mixed method study provides insight into the attributes of the quality of life of elderly people in Nepal and similar settings. As the geriatric population is growing in full swing, maintaining a high quality of life has become a major challenge. This study showed that determinants such as age, gender, marital status, education status, household income, personal income, source of personal income, social security allowance and alcohol consumption, economic support, emotional support, affordability and physical activity have an association with quality of life of the elderly.

Keywords: ageing, chitwan, elderly, health status, quality of life

Procedia PDF Downloads 50

Authors: K. Frahtia, I. Mihoubi, S. Picot

Abstract:

Leishmaniasis is a group of parasitic disease with a varied clinical expression caused by flagellate protozoa of the Leishmania genus. These diseases are transmitted to humans and animals by the sting of a vector insect, the female sandfly. Among the groups of dipteral disease vectors, Phlebotominae occupy a prime position and play a significant role in human pathology, such as leishmaniasis that affects nearly 350 million people worldwide. The vector control operation launched by health services throughout the country proves to be effective since despite the prevalence of the disease remains high especially in rural areas, leishmaniasis appears to be declining in Algeria. In this context, this study mainly concerns molecular detection of Leishmania from the vector. Furthermore, a molecular diagnosis has also been made on skin samples taken from patients in the region of Constantine, located in the North-East of Algeria. Concerning the vector, 5858 sandflies were captured, including 4360 males and 1498 females. Male specimens were identified based on their morphological. The morphological identification highlighted the presence of the Phlebotomus genus with a prevalence of 93% against 7% represented by the Sergentomyia genus. About the identified species, P. perniciosus is the most abundant with 59.4% of the male identified population followed by P. longicuspis with 24.7% of the workforce. P. perfiliewi is poorly represented by 6.7% of specimens followed by P. papatasi with 2.2% and 1.5% S. dreyfussi. Concerning skin samples, 45/79 (56.96%) collected samples were found positive by real-time PCR. This rate appears to be in sharp decline compared to previous years (alert peak of 30,227 cases in 2005). Concerning the detection of Leishmania from sandflies by RT-PCR, the results show that 3/60 PCR performed genus are positive with melting temperatures corresponding to that of the reference strain (84.1 +/- 0.4 ° C for L. infantum). This proves that the vectors were parasitized. On the other side, identification by RT-PCR species did not give any results. This could be explained by the presence of an insufficient amount of leishmanian DNA in the vector, and therefore support the hypothesis of the regression of leishmaniasis in Constantine.

Keywords: Algeria, molecular diagnostic, phlebotomus, real time PCR

Procedia PDF Downloads 261

Authors: Hanna Kroczak

Abstract:

In Poland, the system of social and professional reintegration of people at risk of social exclusion is, in fact, based on the activity of social economy enterprises. Playing this significant role these entities have to cope with various problems, related to the necessity of being successful on the open market, location on the peripheral (especially rural) areas or the “socialist heritage” in social and economic relations, which is certainly not favorable for implementing the idea of activation policy. One of the main objectives of the project entitled “Innovation among people. The analysis of the innovations creation and implementation in companies and social economy enterprises operating in Poland”, was to investigate the innovativeness of Polish social economy entities as a possible way for them to be prosperous (the project was funded by the Polish National Science Centre grant on the decision DEC-2013/11/B/HS4/00691). The ethnographic research in this matter was conducted in 2015 in two parts: six three-day studies using participant observation and individual in-depth interview (IDI) techniques (in three social cooperatives and three social integration centres) and two one-month shadowings (in one social cooperative and one social integration centre). Enterprises were selected from various provinces in Poland on the basis of data from previous computer-assisted telephone interviewing (CATI) research, where they declared that innovation management is a central element of their strategy. The ethnographic study revealed that they, indeed, create innovations and the main types of them are social and organisational innovations – but not always and not all the employees are aware of that. Moreover, it turned out that wherever the research was conducted, researchers found some similar opportunities of innovations creating process, like a “charismatic leader”, true passion and commitment not depended on the earned money or building local institutional networks, and similar threats, e.g. under-staffed offices or the great bureaucracy of some institutions. The primary conclusion for the studied entities is that being innovative is not only their challenge and opportunity for well-being at the same time, but even a necessity, something deeply rooted in their specific organisational structures. Explanations and illustrations for the statements above will be presented in the proposed paper.

Keywords: ethnographic research, innovation, Polish social economy, professional reintegration, social economy enterprises, social reintegration

Procedia PDF Downloads 194

Authors: Mukondi Nethavhakone

Abstract:

The high prevalence of violence against women is a global public health problem. Our societies have become dangerous places for women. Women during their child-bearing ages are at a higher risk of experiencing emotional, physical, and sexual violence. What makes it more concerning is that these violent acts are perpetrated by family members or partners, or ex-partners. Intimate Partner Violence (IPV) is associated with long-lasting physical, reproductive, sexual, mental, and maternal health implications. Expectedly women’s mental health would dimmish as a result of experiencing IPV. The burden of violence against women is seen to be heavier in low- and middle-income countries (LMICs) compared to the rest of the world. Countries have committed to eliminating all forms of violence against women through the sustainable development goal, aiming to see changes by the year 2030. As such, various countries have implemented psychosocial interventions of different levels of impact. However, little is known, especially in low- and middle-income countries, with regard to the potential of psychosocial interventions for IPV to improve the mental health outcomes for the survivors and/or victims of IPV. Analysing the risk for IPV through a social-ecological theoretical approach, low- and middle-income countries still readdressing gender inequality which is the cause of intimate partner violence. That is why it is taking time for these countries to shift psychosocial interventions to focus more on the improvement of the mental health of the survivors. It is, therefore, against this backdrop that the researcher intends to undertake a scoping review to understand the nature and characteristics of psychosocial interventions that have been implemented in low- and middle-income countries. With the findings from the scoping review, the researcher aims to develop a conceptual framework that may be a useful resource for healthcare practitioners and researchers in low- and middle-income countries. As this area of research has not been thoroughly reviewed, the results from this scoping will determine whether a systematic review will be justifiable. Additionally, the researcher will identify gaps and opportunities for future research in this area.

Keywords: mental health improvement, psychosocial interventions, intimate partner violence, LMICs

Procedia PDF Downloads 120

Authors: Saad Bin Ismail, Muhammad Ateeq Qureshi, Rao Muhammad Zahid Khalil

Abstract:

In the last few decades, urbanization worldwide has been sprawled manifold, which is denunciated in the growth of urban infrastructure and transportation. Urban Heat Island (UHI) can induce deterioration of the living environment, disabilities, and rises in energy usages. In this study, the prevalence/presence of Surface Urban Heat Island (SUHI) effect in major cities of Pakistan, including Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar has been investigated. Landsat and SPOT satellite images were acquired for the assessment of urban sprawl. MODIS Land Surface Temperature product MOD11A2 was acquired between 1000-1200 hours (local time) for assessment of urban heat island. The results of urban sprawl informed that the extent of Islamabad and Rawalpindi urban area increased from 240 km2 to 624 km2 between 2000 and 2016, accounted 24 km2 per year, Lahore 29 km2, accounted 1.6 km2 per year, Karachi 261 km2, accounted for 16 km2/ per year, Peshawar 63 km2, accounted 4 km2/per year, and Quetta 76 km2/per year, accounted 5 km2/per year approximately. The average Surface Urban Heat Island (SUHI) magnitude is observed at a scale of 0.63 ᵒC for Islamabad and Rawalpindi, 1.25 ᵒC for Lahore, and 1.16 ᵒC for Karachi, which is 0.89 ᵒC for Quetta, and 1.08 ᵒC for Peshawar from 2000 to 2016. The pixel-based maximum SUHI intensity reaches up to about 11.40 ᵒC for Islamabad and Rawalpindi, 15.66 ᵒC for Lahore, 11.20 ᵒC for Karachi, 14.61 ᵒC for Quetta, and 15.22 ᵒC for Peshawar from the baseline of zero degrees Centigrade (ᵒC). The overall trend of SUHI in planned cities (e.g., Islamabad) is not found to increase significantly. Spatial and temporal patterns of SUHI for selected cities reveal heterogeneity and a unique pattern for each city. It is well recognized that SUHI intensity is modulated by land use/land cover patterns (due to their different surface properties and cooling rates), meteorological conditions, and anthropogenic activities. The study concluded that the selected cities (Islamabad, Rawalpindi, Lahore, Karachi, Quetta, and Peshawar) are examples where dense urban pockets observed about 15 ᵒC warmer than a nearby rural area.

Keywords: urban heat island , surface urban heat island , urbanization, anthropogenic source

Procedia PDF Downloads 308

Authors: Peter Boyes, Sarah Sharples, Paul Tennent, Gary Priestnall, Jeremy Morley

Abstract:

Significant long-term investment projects can involve complex decisions. These are often described as capital projects, and the factors that contribute to their complexity include budgets, motivating reasons for investment, stakeholder involvement, interdependent projects, and the delivery phases required. The complexity of these projects often requires management groups to be established involving stakeholder representatives; these teams are inherently multidisciplinary. This study uses two university campus capital projects as case studies for this type of management group. Due to the interaction of projects with wider campus infrastructure and users, decisions are made at varying spatial granularity throughout the project lifespan. This spatial-related context brings complexity to the group decisions. Sensemaking is the process used to achieve group situational awareness of a complex situation, enabling the team to arrive at a consensus and make a decision. The purpose of this study is to understand the role of people and data in the complex spatial related long-term decision and sensemaking processes. The paper aims to identify and present issues experienced in practical settings of these types of decision. A series of exploratory semi-structured interviews with members of the two projects elicit an understanding of their operation. From two stages of thematic analysis, inductive and deductive, emergent themes are identified around the group structure, the data usage, and the decision making within these groups. When data were made available to the group, there were commonly issues with the perception of veracity and validity of the data presented; this impacted the ability of group to reach consensus and, therefore, for decisions to be made. Similarly, there were different responses to forecasted or modelled data, shaped by the experience and occupation of the individuals within the multidisciplinary management group. This paper provides an understanding of further support required for team sensemaking and decision making in complex capital projects. The paper also discusses the barriers found to effective decision making in this setting and suggests opportunities to develop decision support systems in this team strategic decision-making process. Recommendations are made for further research into the sensemaking and decision-making process of this complex spatial-related setting.

Keywords: decision making, decisions under uncertainty, real decisions, sensemaking, spatial, team decision making

Procedia PDF Downloads 122

Authors: Keshav Raj Acharya, Prabina Sharma

Abstract:

Sugandhakokila (Cinnamomum glaucescens Nees. Dury) is a large evergreen native tree species; mostly confined naturally in mid-hills of Rapti Zone of Nepal. The species is identified as prioritized for agro-technology development as well as for research and development by a department of plant resources. This species is band for export outside the country without processing by the government of Nepal to encourage the value addition within the country. The present study was carried out in Chillikot village of Dang district to find out the economic contribution of C. glaucescens in the local economy and to document the major conservation threats for this species. Participatory Rural Appraisal (PRA) tools such as Household survey, key informants interviews and focus group discussions were carried out to collect the data. The present study reveals that about 1.7 million Nepalese rupees (NPR) have been contributed annually in the local economy of 29 households from the collection of C. glaucescens berries in the study area. The average annual income of each family was around NPR 67,165.38 (US$ 569.19) from the sale of the berries which contributes about 53% of the total household income. Six different value chain actors are involved in C. glaucescens business. Maximum profit margin was taken by collector followed by producer, exporter and processor. The profit margin was found minimum to regional and village traders. The total profit margin for producers was NPR 138.86/kg, and regional traders have gained NPR 17/kg. However, there is a possibility to increase the profit of producers by NPR 8.00 more for each kg of berries through the initiation of community forest user group and village cooperatives in the area. Open access resource, infestation by an insect to over matured trees and browsing by goats were identified as major conservation threats for this species. Handing over the national forest as a community forest, linking the producers with the processor through organized market channel and replacing the old tree through new plantation has been recommended for future.

Keywords: community forest, conservation threats, C. glaucescens, value chain analysis

Procedia PDF Downloads 127

Authors: Alex Eldo Simon, Abhishek Yadav

Abstract:

This study aimed to evaluate the utility of postmortem computed tomography (CT) and heart weight measurements in the assessment of cardiomegaly in cases of sudden death due to cardiac origin by comparing the results of these two diagnostic methods. The study retrospectively analyzed postmortem computed tomography (PMCT) data from 54 cases of sudden natural death and compared the findings with those of the autopsy. The study involved measuring the cardiothoracic ratio (CTR) from coronal computed tomography (CT) images and determining the actual cardiac weight by weighing the heart during the autopsy. The inclusion criteria for the study were cases of sudden death suspected to be caused by cardiac pathology, while exclusion criteria included death due to unnatural causes such as trauma or poisoning, diagnosed natural causes of death related to organs other than the heart, and cases of decomposition. Sensitivity, specificity, and diagnostic accuracy were calculated, and to evaluate the accuracy of using the cardiothoracic ratio (CTR) to detect an enlarged heart, the study generated receiver operating characteristic (ROC) curves. The cardiothoracic ratio (CTR) is a radiological tool used to assess cardiomegaly by measuring the maximum cardiac diameter in relation to the maximum transverse diameter of the chest wall. The clinically used criteria for CTR have been modified from 0.50 to 0.57 for use in postmortem settings, where abnormalities can be detected by comparing CTR values to this threshold. A CTR value of 0.57 or higher is suggestive of hypertrophy but not conclusive. Similarly, heart weight is measured during the traditional autopsy, and a cardiac weight greater than 450 grams is defined as hypertrophy. Of the 54 cases evaluated, 22 (40.7%) had a cardiothoracic ratio (CTR) ranging from > 0.50 to equal 0.57, and 12 cases (22.2%) had a CTR greater than 0.57, which was defined as hypertrophy. The mean CTR was calculated as 0.52 ± 0.06. Among the 54 cases evaluated, the weight of the heart was measured, and the mean was calculated as 369.4 ± 99.9 grams. Out of the 54 cases evaluated, 12 were found to have hypertrophy as defined by PMCT, while only 9 cases were identified with hypertrophy in traditional autopsy. The sensitivity and specificity of the test were calculated as 55.56% and 84.44%, respectively. The sensitivity of the hypertrophy test was found to be 55.56% (95% CI: 26.66, 81.12¹), the specificity was 84.44% (95% CI: 71.22, 92.25¹), and the diagnostic accuracy was 79.63% (95% CI: 67.1, 88.23¹). The limitation of the study was a low sample size of only 54 cases, which may limit the generalizability of the findings. The comparison of the cardiothoracic ratio with heart weight in this study suggests that PMCT may serve as a screening tool for medico-legal autopsies when performed by forensic pathologists. However, it should be noted that the low sensitivity of the test (55.5%) may limit its diagnostic accuracy, and therefore, further studies with larger sample sizes and more diverse populations are needed to validate these findings.

Keywords: PMCT, virtopsy, CTR, cardiothoracic ratio

Procedia PDF Downloads 73

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

Abstract:

Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

Procedia PDF Downloads 77

Authors: Constanza Monterrubio-Solis, Jose Tomas Ibarra

Abstract:

The fertile interdependence of social-ecological systems reveals itself in the interactions between native forests and seeds, home gardens, kitchens, foraging activities, local knowledge, and food practices, creating particular flavors and food meanings as part of cultural identities within territories. Resilience in local-food systems, from a relational perspective, can be understood as the balance between persistence and adaptability to change. Food growing, preparation, and consumption are constantly changing and adapting as expressions of agency of female and male indigenous peoples and peasants. This paper explores local food systems’ expressions of resilience in the la Araucanía region of Chile, namely: diversity, redundancy, buffer capacity, modularity, self-organization, governance, learning, equity, and decision-making. Applying ethnographic research methods (participant observation, focus groups, and semi-structured interviews), this work reflects on the experience developed through work with Mapuche women cultivating home gardens in the region since 2012; it looks to material and symbolic elements of resilience in the local indigenous food systems. Local food systems show indeed indicators of social-ecological resilience. The biocultural memory is expressed in affection to particular flavors and recipes, the cultural importance of seeds and reciprocity networks, as well as an accurate knowledge about the indicators of the seasons and weather, which have allowed local food systems to thrive with a strong cultural foundation. Furthermore, these elements turn into biocultural resistance in the face of the current institutional pressures for rural specialization, processes of cultural assimilation such as agroecosystems and diet homogenization, as well as structural threats towards the diversity and freedom of native seeds. Thus, the resilience-resistance dynamic shown by the social-ecological systems of the southern Andes is daily expressed in the local food systems and flavors and is key for diverse and culturally sound social-ecological health.

Keywords: biocultural heritage, indigenous food systems, social-ecological resilience, southern Andes

Procedia PDF Downloads 125

Authors: Zachary Pan

Abstract:

Our general mission is to solve the problem of classifying images into different body part types and deciding if each of them is healthy or not. However, for now, we will determine healthiness for only one-sixth of the body parts, specifically the chest. We will detect pneumonia in X-ray scans of those chest images. With this type of AI, doctors can use it as a second opinion when they are taking CT or X-ray scans of their patients. Another ad-vantage of using this machine learning classifier is that it has no human weaknesses like fatigue. The overall ap-proach to this problem is to split the problem into two parts: first, classify the image, then determine if it is healthy. In order to classify the image into a specific body part class, the body parts dataset must be split into test and training sets. We can then use many models, like neural networks or logistic regression models, and fit them using the training set. Now, using the test set, we can obtain a realistic accuracy the models will have on images in the real world since these testing images have never been seen by the models before. In order to increase this testing accuracy, we can also apply many complex algorithms to the models, like multiplicative weight update. For the second part of the problem, to determine if the body part is healthy, we can have another dataset consisting of healthy and non-healthy images of the specific body part and once again split that into the test and training sets. We then use another neural network to train on those training set images and use the testing set to figure out its accuracy. We will do this process only for the chest images. A major conclusion reached is that convolutional neural networks are the most reliable and accurate at image classification. In classifying the images, the logistic regression model, the neural network, neural networks with multiplicative weight update, neural networks with the black box algorithm, and the convolutional neural network achieved 96.83 percent accuracy, 97.33 percent accuracy, 97.83 percent accuracy, 96.67 percent accuracy, and 98.83 percent accuracy, respectively. On the other hand, the overall accuracy of the model that de-termines if the images are healthy or not is around 78.37 percent accuracy.

Keywords: body part, healthcare, machine learning, neural networks

Procedia PDF Downloads 86

Authors: Bernard Kumi-Boateng, Issaka Yakubu

Abstract:

Forest fire, which is, an uncontrolled fire occurring in nature has become a major concern for the Forestry Commission of Ghana (FCG). The forest fires in Ghana usually result in massive destruction and take a long time for the firefighting crews to gain control over the situation. In order to assess the effect of forest fire at local scale, it is important to consider the role fire plays in vegetation composition, biodiversity, soil erosion, and the hydrological cycle. The occurrence, frequency and behaviour of forest fires vary over time and space, primarily as a result of the complicated influences of changes in land use, vegetation composition, fire suppression efforts, and other indigenous factors. One of the forest zones in Ghana with a high level of vegetation stress is the Goaso forest area. The area has experienced changes in its traditional land use such as hunting, charcoal production, inefficient logging practices and rural abandonment patterns. These factors which were identified as major causes of forest fire, have recently modified the incidence of fire in the Goaso area. In spite of the incidence of forest fires in the Goaso forest area, most of the forest services do not provide a cartographic representation of the burned areas. This has resulted in significant amount of information being required by the firefighting unit of the FCG to understand fire risk factors and its spatial effects. This study uses Remote Sensing and Geographic Information System techniques to develop a fire risk hazard model using the Goaso Forest Area (GFA) as a case study. From the results of the study, natural forest, agricultural lands and plantation cover types were identified as the major fuel contributing loads. However, water bodies, roads and settlements were identified as minor fuel contributing loads. Based on the major and minor fuel contributing loads, a forest fire risk hazard model with a reasonable accuracy has been developed for the GFA to assist decision making.

Keywords: forest, GIS, remote sensing, Goaso

Procedia PDF Downloads 441

Authors: Pratima Poudel, Austin Himes, Heidi Renninger, Eric McConnel

Abstract:

Populus spp. (poplar) are the fastest-growing trees in North America, making them ideal for a range of applications as they can achieve high yields on short rotations and regenerate by coppice. Furthermore, poplar undergoes biochemical conversion to fuels without complexity, making it one of the most promising, purpose-grown, woody perennial energy sources. Employing wood-based biomass for bioenergy offers numerous benefits, including reducing greenhouse gas (GHG) emissions compared to non-renewable traditional fuels, the preservation of robust forest ecosystems, and creating economic prospects for rural communities.In order to gain a better understanding of the potential use of poplar as a biomass feedstock for biofuel in the southeastern US, the conducted a techno-economic assessment (TEA). This assessment is an analytical approach that integrates technical and economic factors of a production system to evaluate its economic viability. the TEA specifically focused on a short rotation coppice system employing a single-pass cut-and-chip harvesting method for poplar. It encompassed all the costs associated with establishing dedicated poplar plantations, including land rent, site preparation, planting, fertilizers, and herbicides. Additionally, we performed a sensitivity analysis to evaluate how different costs can affect the economic performance of the poplar cropping system. This analysis aimed to determine the minimum average delivered selling price for one metric ton of biomass necessary to achieve a desired rate of return over the cropping period. To inform the TEA, data on the establishment, crop care activities, and crop yields were derived from a field study conducted at the Mississippi Agricultural and Forestry Experiment Station's Bearden Dairy Research Center in Oktibbeha County and Pontotoc Ridge-Flatwood Branch Experiment Station in Pontotoc County.

Keywords: biomass, populus species, sensitivity analysis, technoeconomic analysis

Procedia PDF Downloads 71

Authors: Phalla Miech, William Leung, Ty Chhay, Sina Vor, Arata Hidano

Abstract:

Smallholder pig farms (SPFs) are prevalent in Cambodia but are vulnerable to disease impacts, as evidenced by the recent incursion of African swine fever into the region. As part of the ‘PigFluCam+’ project, we sought to provide an updated picture of pig husbandry and biosecurity practices among SPFs in south-central Cambodia. A multi-stage sampling design was adopted to select study districts and villages within four provinces: Phnom Penh, Kandal, Takeo, and Kampong Speu. Structured interviews were conductedbetween October 2020 - May 2021 among all consenting households keeping pigs in 16 target villages. Recruited SPFs (n=176) kept 6.8 pigs on average (s.d.=7.7), with most (88%) keeping cross-bred varieties of sows (77%), growers/finishers (39%), piglets/weaners (22%), and few keeping boars (5%). Chickens (83%) and waterfowl (56%) were commonly raised and could usually contact pigs directly (79%). Pigs were the primary source of household income for 28% of participants. While pigs tended to be housed individually (40%) or in groups (33%), 13% kept pigs free-ranging/tethered. Pigs were commonly fed agricultural by-products (80%), commercial feed (60%), and, notably, household waste (59%). Under half of SPFs vaccinated their pigs (e.g., against classical swine fever, Aujesky’s, and pasteurellosis, although the target disease was often unknown). Among 20 SPFs who experienced pig morbidities/mortalities within the past 6 months, only 3 (15%) reported to animal health workers, and disease etiology was rarely known. Common biosecurity measures included nets covering pig pens (62%) and restricting access to the site/pens (46%). Boot dips (0.6%) and PPE (1.2%) were rarely used. Pig smallholdings remain an important contributor to rural livelihoods. Current practices and biosecurity challenges increase risk pathways for a range of disease threats of both local and global concern. Ethnographic studies are needed to better understand local determinants and develop context-appropriate strategies.

Keywords: smallholder production, swine, biosecurity practices, Cambodia, African swine fever

Procedia PDF Downloads 169

Authors: Kalimah Ibrahiim, Israa Elmousa

Abstract:

This study employed the world café method alongside semi-structured interviews within a 'conversation café' setting to engage stakeholders from the public health and primary care sectors. The objective was to collaboratively explore strategies to improve outcomes for young people not in education, employment, or training (NEET). The discussions were aimed at identifying the underlying causes of disparities faced by NEET individuals, exchanging experiences, and formulating community-driven solutions to bolster preventive efforts and shape policy initiatives. A thematic analysis of the qualitative data gathered emphasized the importance of community problem-solving through the exchange of ideas and reflective discussions. Healthcare professionals reflected on their potential roles, pinpointing a significant gap in understanding the specific needs of the NEET population and the unclear distribution of responsibilities among stakeholders. The results underscore the necessity for a unified approach in primary care and the fostering of multi-agency collaborations that focus on addressing social determinants of health. Such strategies are critical not only for the immediate improvement of health outcomes for NEET individuals but also for informing broader policy decisions that can have long-term benefits. Further research is ongoing, delving deeper into the unique challenges faced by this demographic and striving to develop more effective interventions. The study advocates for continued efforts to integrate insights from various sectors to create a more holistic and effective response to the needs of the NEET population, ensuring that future strategies are informed by a comprehensive understanding of their circumstances and challenges.

Keywords: multi-agency working, primary care, public health, social inequalities

Procedia PDF Downloads 17

Authors: Evrim Genc Kumtepe, Elif Toprak, Aylin Ozturk, Gamze Tuna, Hakan Kilinc, Irem Aydin Menderis

Abstract:

Support services are very significant elements for all educational institutions in general; however, for distance learners, these services are more essential than traditional (face-to-face) counterparts. One of the most important reasons for this is that learners and instructors do not share the same physical environment and that distance learning settings generally require intrapersonal interactions rather than interpersonal ones. Some learners in distance learning programs feel isolated. Furthermore, some fail to feel a sense of belonging to the institution because of lack of self-management skills, lack of motivation levels, and the need of being socialized, so that they are more likely to fail or drop out of an online class. In order to overcome all these problems, support services have emerged as a critical element for an effective and sustainable distance education system. Within the context of distance education support services, it is natural to include technology-based and web-based services and also the related materials. Moreover, institutions in education sector are expected to use information and communication technologies effectively in order to be successful in educational activities and programs. In terms of the sustainability of the system, an institution should provide distance education services through ICT enabled processes to support all stakeholders in the system, particularly distance learners. In this study, it is envisaged to develop a model based on the current support services literature in the field of open and distance learning and the applications of the distance higher education institutions. Specifically, content analysis technique is used to evaluate the existing literature in the distance education support services, the information published on websites, and applications of distance higher education institutions across the world. A total of 60 institutions met the inclusion criteria which are language option (English) and availability of materials in the websites. The six field experts contributed to brainstorming process to develop and extract codes for the coding scheme. During the coding process, these preset and emergent codes are used to conduct analyses. Two coders independently reviewed and coded each assigned website to ensure that all coders are interpreting the data the same way and to establish inter-coder reliability. Once each web page is included in descriptive and relational analysis, a model of support services is developed by examining the generated codes and themes. It is believed that such a model would serve as a quality guide for future institutions, as well as the current ones.

Keywords: support services, open education, distance learning, support model

Procedia PDF Downloads 187

Authors: Fabian Nde Fon

Abstract:

Decolonisation is one of the hottest topics in most African Universities; this is because many researchers focus on research that does not speak to their immediate community. This research looked at postgraduate research projects that can take students to the community to apply the knowledge that they have learned as an attempt to transform their community. In regards to this, an honours project was designed to try and provide a cheaper and continuous source of protein (egg) using amber-link layers and to investigate the potential of the project to promote postgraduate student development and entrepreneurship. Two ban layer production systems were created: (1) Production system one on a Hill (PS-I) and (2) Production system two in a valley, closer to a dam (PS-II) at Nqutshini, Gingindlovu, KwaZulu-Natal Province. Forty point-of-lay (18 weeks old) amber links were bought at Inverness Rearers and divided into PS-I (20), and PS-II (20), and each of the production systems was further divided into two groups of ten (PS-I-1 and PS-II-1 (partially supplemented) and PS-I-2 and PS-II-2 (supplemented with layer mash)) by a random selection. Birds' weights were balanced in each group to avoid bias. The two groups in each production system were caged separately (1.5x1.5m² for ten birds) and in close proximity. Partially supplemented birds received 0.6 kg of layer mash (60g/per bird/day) and kitchen leftovers daily, and supplemented birds were fed 1.2 kg of layer mash (120g/per bird/day). Egg collection was daily after feeding in the morning while was given ad libitium. The eggs were assessed for internal and external quality after weighing before recording. Egg production from fully supplemented birds (PS-I-2 and PS-II-2) was generally higher (P<0.05) than those of PS-I-1 and PS-II-1. The difference in production was only 6% in the valley while on the Hill, it was only 3%. However, some of the birds in the valley showed signs of respiratory infections, which was not observed with those on the Hill. There are no differences in the internal and external qualities of eggs (york colour and egg shell) determined. This implies that both systems were sustainable. It was suggested members in the community living at the valley or Hill can use these hardy layers as a cheaper source of protein and preferable to the partially supplemented systems because it is relatively cheaper. The smallholder farmers are still pursuing the project long after the students graduate; hence the benefit of the project is reciprocal for both the university and the community (entrepreneurship).

Keywords: animal nutrition, ban layer, production, postgraduate curricula, entrepreneurship

Procedia PDF Downloads 103

Authors: Rahmi Kafadar, Levent Genc

Abstract:

In present study, it was aimed to determine potential agricultural lands (PALs) in Gokceada (Imroz) Island of Canakkale province, Turkey. Seven-band Landsat 8 OLI images acquired on July 12 and August 13, 2013, and their 14-band combination image were used to identify current Land Use Land Cover (LULC) status. Principal Component Analysis (PCA) was applied to three Landsat datasets in order to reduce the correlation between the bands. A total of six Original and PCA images were classified using supervised classification method to obtain the LULC maps including 6 main classes (“Forest”, “Agriculture”, “Water Surface”, “Residential Area-Bare Soil”, “Reforestation” and “Other”). Accuracy assessment was performed by checking the accuracy of 120 randomized points for each LULC maps. The best overall accuracy and Kappa statistic values (90.83%, 0.8791% respectively) were found for PCA images which were generated from 14-bands combined images called 3-B/JA. Digital Elevation Model (DEM) with 15 m spatial resolution (ASTER) was used to consider topographical characteristics. Soil properties were obtained by digitizing 1:25000 scaled soil maps of rural services directorate general. Potential Agricultural Lands (PALs) were determined using Geographic information Systems (GIS). Procedure was applied considering that “Other” class of LULC map may be used for agricultural purposes in the future properties. Overlaying analysis was conducted using Slope (S), Land Use Capability Class (LUCC), Other Soil Properties (OSP) and Land Use Capability Sub-Class (SUBC) properties. A total of 901.62 ha areas within “Other” class (15798.2 ha) of LULC map were determined as PALs. These lands were ranked as “Very Suitable”, “Suitable”, “Moderate Suitable” and “Low Suitable”. It was determined that the 8.03 ha were classified as “Very Suitable” while 18.59 ha as suitable and 11.44 ha as “Moderate Suitable” for PALs. In addition, 756.56 ha were found to be “Low Suitable”. The results obtained from this preliminary study can serve as basis for further studies.

Keywords: digital elevation model (DEM), geographic information systems (GIS), gokceada (Imroz), lANDSAT 8 OLI-TIRS, land use land cover (LULC)

Procedia PDF Downloads 345

Authors: Saad Algharib, Jay Lee

Abstract:

Urbanization is a complex phenomenon that occurs during the city’s development from one form to another. In other words, it is the process when the activities in the land use/land cover change from rural to urban. Since the oil exploration, Kuwait City has been growing rapidly due to its urbanization and population growth by both natural growth and inward immigration. The main objective of this study is to detect changes in urban land use/land cover and to examine the changing spatial patterns of urban growth in and around Kuwait City between 1989 and 2001. In addition, this study also evaluates the spatial patterns of the changes detected and how they can be related to the spatial configuration of the city. Recently, the use of remote sensing and geographic information systems became very useful and important tools in urban studies because of the integration of them can allow and provide the analysts and planners to detect, monitor and analyze the urban growth in a region effectively. Moreover, both planners and users can predict the trends of the growth in urban areas in the future with remotely sensed and GIS data because they can be effectively updated with required precision levels. In order to identify the new urban areas between 1989 and 2001, the study uses satellite images of the study area and remote sensing technology for classifying these images. Unsupervised classification method was applied to classify images to land use and land cover data layers. After finishing the unsupervised classification method, GIS overlay function was applied to the classified images for detecting the locations and patterns of the new urban areas that developed during the study period. GIS was also utilized to evaluate the distribution of the spatial patterns. For example, Moran’s index was applied for all data inputs to examine the urban growth distribution. Furthermore, this study assesses if the spatial patterns and process of these changes take place in a random fashion or with certain identifiable trends. During the study period, the result of this study indicates that the urban growth has occurred and expanded 10% from 32.4% in 1989 to 42.4% in 2001. Also, the results revealed that the largest increase of the urban area occurred between the major highways after the forth ring road from the center of Kuwait City. Moreover, the spatial distribution of urban growth occurred in cluster manners.

Keywords: geographic information systems, remote sensing, urbanization, urban growth

Procedia PDF Downloads 164

Authors: Muhammed Ordu, Eren Demir, Chris Tofallis

Abstract:

The number of inpatient admissions in the UK has been significantly increasing over the past decade. These increases cause bed occupancy rates to exceed the target level (85%) set by the Department of Health in England. Therefore, hospital service managers are struggling to better manage key resource such as beds. On the other hand, this severe demand pressure might lead to confusion in wards. For example, patients can be admitted to the ward of another inpatient specialty due to lack of resources (i.e., bed). This study aims to develop a simulation-optimization model to reallocate the available number of beds in a mid-sized hospital in the UK. A hospital simulation model was developed to capture the stochastic behaviours of the hospital by taking into account the accident and emergency department, all outpatient and inpatient services, and the interactions between each other. A couple of outputs of the simulation model (e.g., average length of stay and revenue) were generated as inputs to be used in the optimization model. An integer linear programming was developed under a number of constraints (financial, demand, target level of bed occupancy rate and staffing level) with the aims of maximizing number of admitted patients. In addition, a sensitivity analysis was carried out by taking into account unexpected increases on inpatient demand over the next 12 months. As a result, the major findings of the approach proposed in this study optimally reallocate the available number of beds for each inpatient speciality and reveal that 74 beds are idle. In addition, the findings of the study indicate that the hospital wards will be able to cope with 14% demand increase at most in the projected year. In conclusion, this paper sheds a new light on how best to reallocate beds in order to cope with current and future demand for healthcare services.

Keywords: bed occupancy rate, bed reallocation, discrete event simulation, inpatient admissions, integer linear programming, projected usage

Procedia PDF Downloads 133

Authors: Suja Karkada, Jayanthi Radhakrishnan, Jansi Natarajan, Gerald, Amandu Matua, Sujatha Shanmugasundaram

Abstract:

Simulation-based learning is an educational strategy designed to simulate actual clinical situations in a safe environment. Globally, simulation is recognized by several landmark studies as an effective teaching-learning method. A systematic review of the literature on simulation revealed simulation as a useful strategy in creating a learning environment which contributes to knowledge, skills, safety, and confidence. However, to the best of the author's knowledge, there are no studies on assessing the anxiety of the students undergoing simulation. Hence the researchers undertook a study with the aim to evaluate the effectiveness of simulation on anxiety and knowledge among novice nursing students. This quasi-experimental study had a total sample of 69 students (35- Intervention group with simulation and 34- Control group with case scenario) consisting of all the students enrolled in the Fundamentals of Nursing Laboratory course during Spring 2016 and Fall 2016 semesters at a college of nursing in Oman. Ethical clearance was obtained from the Institutional Review Board (IRB) of the college of nursing. Informed consent was obtained from every participant. Study received the Dean’s fund for research. The data were collected regarding the demographic information, knowledge and anxiety levels before and after the use of simulation and case scenario for the procedure nasogastric tube feeding in intervention and control group respectively. The intervention was performed by four faculties who were the core team members of the course. Results were analyzed in SPSS using descriptive and inferential statistics. Majority of the students’ in intervention (82.9%) and control (89.9%) groups were equal to or below the age of 20 years, were females (71%), 76.8% of them were from rural areas and 65.2% had a GPA of more than 2.5. The selection of the samples to either the experimental or the control group was from a homogenous population (p > 0.05). There was a significant reduction of anxiety among the students of control group (t (67) = 2.418, p = 0.018) comparing to the experimental group, indicating that simulation creates anxiety among Novice nursing students. However, there was no significant difference in the mean scores of knowledge. In conclusion, the study was useful in that it will help the investigators better understand the implications of using simulation in teaching skills to novice students. Since previous studies with students indicate better knowledge acquisition; this study revealed that simulation can increase anxiety among novice students possibly it is the first time they are introduced to this method of teaching.

Keywords: anxiety, knowledge, novice students, simulation

Procedia PDF Downloads 150

Authors: Efleda Preclaro Tolentino

Abstract:

Research indicates that an educator’s belief system is reflected in the way they structure the learning environment. Their values and belief system have the potential to positively impact school readiness through an understanding of children’s development and the creation of a stable, motivating environment. Based on the premise that the social environment influences the development of social skills, knowledge construct, and shared values of young children, this study examined verbal and nonverbal exchanges between early childhood teachers and their preschool students within the context of remote learning. Using the qualitative method of data collection, the study determined the nature of interactions between preschoolers and their teachers within a remote learning environment at a preschool in Southeast Asia that utilized the Mother Tongue-based Multilingual Education (MTBMLE) Approach. From the lens of sociocultural theory, the study investigated preschoolers’ use of literacies to convey meaning and to interact within a remote learning environment. Using a Strengths Perspective, the study revealed the creativity and resourcefulness of preschoolers in expressing themselves through trans-literacies that were made possible by the use of online mode of learning within cultural and subcultural norms. The study likewise examined how social skills acquired by young children were transmitted (verbally or nonverbally) in their interactions with peers during Zoom meetings. By examining the dynamics of social exchanges between teachers and children, the findings of the study underscore the importance of providing support for preschool students as they apply acquired values and shared practices within a remote learning environment. The potential of distance learning in the early years will be explored, specifically in supporting young children’s language and literacy development. At the same time, the study examines the role of teachers as cultivators of trans-literacies. The teachers’ skillful use of technology in facilitating young children’s learning, as well as in supporting interactions with families, will be examined. The findings of this study will explore the potential of distance learning in early childhood education to establish continuity in learning, supporting young children’s social and emotional transitions, and nurturing trans-literacies that transcend prevailing definitions of learning contexts. The implications of teachers and parents working collaboratively to support student learning will be examined. The importance of preparing teachers to be resourceful, adaptable, and innovative to ensure that learning takes place across a variety of modes and settings will be discussed.

Keywords: transliteracy, preschoolers, remote learning, strengths perspective

Procedia PDF Downloads 76

Authors: Ying-Lun Tseng Chiu-Ying Chen

Abstract:

Taiwan's Mental Health Act was amended at the end of 2022; they added regulations regarding refusing compulsory treatment by patients with mental illnesses. In addition, not only by an examination committee, the judge must also assess the patient's need for compulsory treatment. Additionally, the maximum of compulsory hospitalization has been reduced from an unlimited period to a maximum of 60 days. They aim to promote the healthcare autonomy of individuals with mental illnesses in Taiwan and prevent their silenced voice in medical decision-making while they still possess rationality. Furthermore, they plan to use community support and social care networks to replace the current practice of compulsory treatment in Taiwan. This study uses qualitative research methodology, utilizing interview guidelines to inquire about the experiences of Taiwanese who have undergone compulsory hospitalization, compulsory community treatment, and compulsory medical care. The interviews aimed to explore their feelings when they were subjected to compulsory medical intervention, the inside of their illness, their opinions after treatments, and whether alternative medical interventions proposed by them were considered. Additionally, participants also asked about their personal life history and their support networks in their lives. We collected 12 Taiwanese who had experienced compulsory medical interventions and were interviewed 14 times. The findings indicated that participants still possessed rationality during the onset of their illness. However, when they have other treatments to replace compulsory medical, they sometimes diverge from those of the doctors and their families. Finally, doctors prefer their professional judgment and patients' families' option. Therefore, Taiwanese mental health patients' power of decision-making still needs to improve. Because this research uses qualitative research, so difficult to find participants, and the sample size rate was smaller than Taiwan's population, it may have biases in the analysis. So, Taiwan still has significant progress in enhancing the decision-making rights of participants in the study.

Keywords: medical decision making, compulsory treatment, medical ethics, mental health act

Procedia PDF Downloads 67

Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

Abstract:

Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

Procedia PDF Downloads 118

Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

Abstract:

Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

Procedia PDF Downloads 401

Authors: Kaushal Jha

Abstract:

India is one of the major producers of pineapple contributing a significant part in terms of total world production of pineapple. It has spread throughout tropical and subtropical regions as a commercial fruit crop. In India, the cultivation of pineapple is confined to high rainfall and humid coastal region in the peninsular India and hilly areas of Northeastern region of India. Nagaland, one of the potential states of North-East India is basically an agrarian state having been endowed with favourable agro climatic conditions and a rich bio-diversity of flora and fauna. Agriculture contributes significantly to the state’s economy. Pineapple is an important fruit crop grown in Nagaland and has a very high potential for doubling the income of farmers in comparison to the traditional practices of rice cultivation. This requires improved farm management practices as well as a genre of entrepreneurial intentions and capabilities. The present study aimed at analysing the dimensions of entrepreneurial skill development among the pineapple growers of Nagaland. Medziphema block under Dimapur district is considered as the pineapple valley of Nagaland. Pineapple grown in this area is considered as one of the best in Nagaland in terms of its sweetness as well as quality. A multistage sampling was undertaken for conducting the present study. Medziphema rural development block was selected purposively for this purpose. The sample was drawn from three leading pineapple producing villages under Medziphema block. The respondents were selected based on random sampling procedure. Data were collected from the respondents using a pre-tested structured schedule. Major findings revealed that entrepreneurial skill development was one of the important factors to augment the increase in the sustained flow of income among the target farmers. Development of farm leadership, improving self esteem, innovativeness, economic motivation, orientation towards management of farm resources and value addition were identified as important dimensions for promoting entrepreneurial skill development and bringing prosperity to the farmers.

Keywords: skill development, entrepreneurial attributes, pineapple growers, Nagaland

Procedia PDF Downloads 148