Search results for: national health insurance program
Commenced in January 2007
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Edition: International
Paper Count: 15482

Search results for: national health insurance program

12002 Design of Structural Health Monitoring System for a Damaged Reinforced Concrete Bridge

Authors: Muhammad Fawad

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Monitoring and structural health assessment are the primary requirements for the performance evaluation of damaged bridges. This paper highlights the case study of a damaged Reinforced Concrete (RC) bridge structure where the Finite element (FE) modelling of this structure was done using the material properties extracted by the in-situ testing. Analysis was carried out to evaluate the bridge damage. On the basis of FE analysis results, this study proposes a proper Structural Health Monitoring (SHM) system that will extend the life cycle of the bridge with minimal repair costs and reduced risk of failure. This system is based on the installation of three different types of sensors: Liquid Levelling sensors (LLS) for measurement of vertical displacement, Distributed Fiber Optic Sensors (DFOS) for crack monitoring, and Weigh in Motion (WIM) devices for monitoring of moving loads on the bridge.

Keywords: bridges, reinforced concrete, finite element method, structural health monitoring, sensors

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12001 Climate Trends, Variability, and Impacts of El Niño-Southern Oscillation on Rainfall Amount in Ethiopia

Authors: Zerihun Yohannes Amare, Belayneh Birku Geremew, Nigatu Melise Kebede, Sisaynew Getahun Amera

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In Ethiopia, agricultural production is predominantly rainfed. The El Niño Southern Oscillation (ENSO) is the driver of climate variability, which affects the agricultural production system in the country. This paper aims to study trends, variability of rainfall, and impacts of El Niño Southern Oscillation (ENSO) on rainfall amount. The study was carried out in Ethiopia's Western Amhara National Regional State, which features a variety of seasons that characterize the nation. Monthly rainfall data were collected from fifteen meteorological stations of Western Amhara. Selected El Niño and La Niña years were also extracted from National Oceanic and Atmospheric Administration (NOAA) from 1986 to 2015. Once the data quality was checked and inspected, the monthly rainfall data of the selected stations were arranged in Microsoft Excel Spreadsheet and analyzed using XLSTAT software. The coefficient of variation and the Mann-Kendall non-parametric statistical test was employed to analyze trends and variability of rainfall and temperature. The long-term recorded annual rainfall data indicated that there was an increasing trend from 1986 to 2015 insignificantly. The rainfall variability was less (Coefficient of Variation, CV = 8.6%); also, the mean monthly rainfall of Western Amhara decreased during El Niño years and increased during La Niña years, especially in the rainy season (JJAS) over 30 years. This finding will be useful to suggest possible adaptation strategies and efficient use of resources during planning and implementation.

Keywords: rainfall, Mann-Kendall test, El Niño, La Niña, Western Amhara, Ethiopia

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12000 Bee Keeping for Human-Elephant Conflict Mitigation: A Success Story for Sustainable Tourism in Kibale National Park, Western Uganda

Authors: Dorothy Kagazi

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The African elephant (Loxodonta africana) remains one of the most crop-damaging species around Kibale National Park, western Uganda. Elephant crop raiding deprives communities of food and incomes, consequently impacting livelihoods, attitude, and support for conservation. It also attracts an aggressive reaction from local communities including the retaliatory killing of a species that is already endangered and listed under Appendix I of the Convention on Endangered Species of Flora and Fauna (CITES). In order to mitigate against elephant crop raiding and minimize conflict, a number of interventions were devised by the government of Uganda such as physical guarding, scare-shooting, excavation of trenches, growing of unpalatable crops and fire lighting all of which have over the years been implemented around the park. These generated varying degrees of effectiveness but largely never solved the problem of elephants crossing into communities to destroy food and shelter which had a negative effect onto sustainable tourism of the communities who often resorted to killing these animals and hence contributing the falling numbers of these animals. It was until government discovered that there are far more effective ways of deterring these animals from crossing to communities that it commissioned a study to deploy the African honeybee (Apis mellifera scutellata) as a deterrent against elephant crop raiding and income enhancement for local people around the park. These efforts led to a number of projects around Kibale National Park where communities were facilitated to keep bees for human-elephant conflict mitigation and rural income enhancement through the sale of honey. These projects have registered tremendous success in reducing crop damage, enhance rural incomes, influence positive attitude change and ultimately secure community support for elephant and park conservation which is a clear manifestation of sustainable tourism development in the area. To address the issue of sustainability, the project was aligned with four major objectives that contributed to the overall goal of maintaining the areas around the parks and the national park itself in such a manner that it remains viable over an infinite period. Among these included determining deterrence effects of bees against elephant crop raiding, assessing the contribution of beekeeping towards rural income enhancement, determining the impact of community involvement of park conservation and management among others. The project deployed 500 improved hives by placing them at specific and previously identified and mapped out elephant crossing points along the park boundary. A control site was established without any intervention to facilitate comparison of findings and data was collected on elephant raiding frequency, patterns, honey harvested, and community attitude towards the park. A socio-economic assessment was also undertaken to ascertain the contribution of beekeeping to incomes and attitude change. In conclusion, human-wildlife conflicts have disturbed conservation and sustainable tourism development efforts. Such success stories like the beekeeping strategy should hence be extensively discussed and widely shared as a conservation technique for sustainable tourism.

Keywords: bees, communities, conservation, elephants

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11999 Impact of Blended Learning in Interior Architecture Programs in Academia: A Case Study of Arcora Garage Academy from Turkey

Authors: Arzu Firlarer, Duygu Gocmen, Gokhan Uysal

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There is currently a growing trend among universities towards blended learning. Blended learning is becoming increasingly important in higher education, with the aims of better accomplishing course learning objectives, meeting students’ changing needs and promoting effective learning both in a theoretical and practical dimension like interior architecture discipline. However, the practical dimension of the discipline cannot be supported in the university environment. During the undergraduate program, the practical training which is tried to be supported by two different internship programs cannot fully meet the requirements of the blended learning. The lack of education program frequently expressed by our graduates and employers is revealed in the practical knowledge and skills dimension of the profession. After a series of meetings for curriculum studies, interviews with the chambers of profession, meetings with interior architects, a gap between the theoretical and practical training modules is seen as a problem in all interior architecture departments. It is thought that this gap can be solved by a new education model which is formed by the cooperation of University-Industry in the concept of blended learning. In this context, it is considered that theoretical and applied knowledge accumulation can be provided by the creation of industry-supported educational environments at the university. In the application process of the Interior Architecture discipline, the use of materials and technical competence will only be possible with the cooperation of industry and participation of students in the production/manufacture processes as observers and practitioners. Wood manufacturing is an important part of interior architecture applications. Wood productions is a sustainable structural process where production details, material knowledge, and process details can be observed in the most effective way. From this point of view, after theoretical training about wooden materials, wood applications and production processes are given to the students, practical training for production/manufacture planning is supported by active participation and observation in the processes. With this blended model, we aimed to develop a training model in which theoretical and practical knowledge related to the production of wood works will be conveyed in a meaningful, lasting way by means of university-industry cooperation. The project is carried out in Ankara with Arcora Architecture and Furniture Company and Başkent University Department of Interior Design where university-industry cooperation is realized. Within the scope of the project, every week the video of that week’s lecture is recorded and prepared to be disseminated by digital medias such as Udemy. In this sense, the program is not only developed by the project participants, but also other institutions and people who are trained and practiced in the field of design. Both academicians from University and at least 15-year experienced craftsmen in the wood metal and dye sectors are preparing new training reference documents for interior architecture undergraduate programs. These reference documents will be a model for other Interior Architecture departments of the universities and will be used for creating an online education module.

Keywords: blended learning, interior design, sustainable training, effective learning.

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11998 Yoga Offers Protection for Premenstrual Syndrome

Authors: Katalin Gocze, Vanda A Nemes, Charlotte Briest

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Introduction: Premenstrual syndrome (PMS) is a psychoneuroendocrinological disorder adversely affecting life-quality for over 80% of hormonally active women. PMS has a negative impact on women’s daily life in terms of work, interpersonal relationships and leisure time activities. The aim of our study was to evaluate the effects of a yoga intervention focusing on the female pelvic area. Materials and methods: 34 women (ages 18-40) with PMS (Premenstrual Syndrome Screening Tool) and no previous experience in yoga were recruited and randomly assigned to either the yoga or the control group. The intervention consisted of 90’ yoga sessions twice a week and a daily 15’ self-practice module with carefully chosen yogic exercises addressing the reproductive organs by toning the pelvic floor and opening the hips as well as relieving stress and improving concentration. Severity of symptoms of PMS was assessed at the beginning and after the 8-week-long intervention. Pre- and post-program data collection included physical and psychological parameters and the evaluation of ACOQ PMS questionnaire and daily symptom diary. Results: Age and educational background were similar in the control and intervention group with an overall mean age of 29.11±4.78 years. PSST scores significantly improved in the yoga group (p=0.002), while difference in the control group’s pre and post-program values were non-significant (p=0.38). Perception and tolerance of anxiety and stress was significantly better after the intervention (p=0.008). As for changes in physical symptoms distinct improvement was registered for breast tenderness (p=0.028) and for meteorism (p=0.015). Discussion: Yoga’s success originates from the synergic positive effects of stress relief and regular physical activity. Benefits (both mental and physical) of strategically planned, focused yoga practice are apparent even after shorter time periods and can help women with PMS manage or eliminate symptoms in order to improve their life-quality.

Keywords: life-quality, physical symptoms, premenstrual syndrome, psychological impact, yoga

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11997 Research on Users' Obesity and Office Tower Core-Tube Design from the Perspective of Physical Activities

Authors: Ming Ma, Zhenyu Cai, Rui Li

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People are more vulnerable to health problems than ever before, such as overweight and obesity due to the change of built environment. In the high-rise buildings, the core-tube layout is closely associated with user’s physical activities which will affect human’s health in a long-term. As for the white-collars who spends the amount of time working in the office tower, using staircase seems to provide an opportunity for them to increase the physical activities in the workplaces. This paper is aiming to find out the specific relationship between health and core-tube in the office tower through analyzing the correlation between staircase’s layout and user’s health. The variables of staircase’s layout are consisted of two indicators: plan layout and space design, including nine factors while health variable is applying BIM as the only main factor. 14 office towers in downtown Shanghai are selected as the research samples because of its typical users’ pattern and similar core-tube layout. In the result, it is obvious that the users from these 14 cases have higher BMI than average partly because that the staircases are mainly designed for emergency and fire instead of daily use. After the regression and correlation analysis of the variables of health and staircases, it’s found that users’ BMI is significantly associated with the factors of floor guide-signs and distance from lobby to the staircase. In addition, the factors of comfort level of staircase such as width and daylighting have a certain correlation with users’ BMI.

Keywords: office tower, staircase, design, obesity, physical activity

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11996 Data Integrity: Challenges in Health Information Systems in South Africa

Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: data integrity, data integrity challenges, hospital information systems, South Africa

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11995 Rural to Urban Migration and Mental Health Consequences in Urbanizing China

Authors: Jie Li, Nick Manning

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The mass rural-urban migrants in China associated with the urbanization processes bear significant implications on public health, which is an important yet under-researched area. Urban social and built environment, such as noise, air pollution, high population density, and social segregation, has the potential to contribute to mental illness. In China, rural-urban migrants are also faced with institutional discrimination tied to the hukou (household registration) system, through which they are denied of full citizenship to basic social welfare and services, which may elevate the stress of urban living and exacerbate the risks to mental illness. This paper aims to link the sociospatial exclusion, everyday life experiences and its mental health consequences on rural to urban migrants living in the mega-city of Shanghai. More specifically, it asks what the daily experience of being a migrant in Shanghai is actually like, particularly regarding sources of stress from housing, displacement, service accessibility, and cultural conflict, and whether these stresses affect mental health? Secondary data from literature review on migration, urban studies, and epidemiology research, as well as primary data from preliminary field trip observations and interviews are used in the analysis.

Keywords: migration, urbanisation, mental health, China

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11994 Evaluation of Vitamin D Levels in Obese and Morbid Obese Children

Authors: Orkide Donma, Mustafa M. Donma

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Obesity may lead to growing serious health problems throughout the world. Vitamin D appears to play a role in cardiovascular and metabolic health. Vitamin D deficiency may add to derangements in human metabolic systems, particularly those of children. Childhood obesity is associated with an increased risk of chronic and sophisticated diseases. The aim of this study is to investigate associations as well as possible differences related to parameters affected by obesity and their relations with vitamin D status in obese (OB) and morbid obese (MO) children. This study included a total of 78 children. Of them, 41 and 37 were OB and MO, respectively. WHO BMI-for age percentiles were used for the classification of obesity. The values above 99 percentile were defined as MO. Those between 95 and 99 percentiles were included into OB group. Anthropometric measurements were recorded. Basal metabolic rates (BMRs) were measured. Vitamin D status is determined by the measurement of 25-hydroxy cholecalciferol [25- hydroxyvitamin D3, 25(OH)D] using high-performance liquid chromatography. Vitamin D status was evaluated as deficient, insufficient and sufficient. Values < 20.0 ng/ml, values between 20-30 ng/ml and values > 30.0 ng/ml were defined as vitamin D deficient, insufficient and sufficient, respectively. Optimal 25(OH)D level was defined as ≥ 30 ng/ml. SPSSx statistical package program was used for the evaluation of the data. The statistical significance degree was accepted as p < 0.05. Mean ages did not differ between the groups. Significantly increased body mass index (BMI), waist circumference (C) and neck C as well as significantly decreased fasting blood glucose (FBG) and vitamin D values were observed in MO group (p < 0.05). In OB group, 37.5% of the children were vitamin D deficient, and in MO group the corresponding value was 53.6%. No difference between the groups in terms of lipid profile, systolic blood pressure (SBP), diastolic blood pressure (DBP) and insulin values was noted. There was a severe statistical significance between FBG values of the groups (p < 0.001). Important correlations between BMI, waist C, hip C, neck C and both SBP as well as DBP were found in OB group. In MO group, correlations only with SBP were obtained. In a similar manner, in OB group, correlations were detected between SBP-BMR and DBP-BMR. However, in MO children, BMR correlated only with SBP. The associations of vitamin D with anthropometric indices as well as some lipid parameters were defined. In OB group BMI, waist C, hip C and triglycerides (TRG) were negatively correlated with vitamin D concentrations whereas none of them were detected in MO group. Vitamin D deficiency may contribute to the complications associated with childhood obesity. Loss of correlations between obesity indices-DBP, vitamin D-TRG, as well as relatively lower FBG values, observed in MO group point out that the emergence of MetS components starts during obesity state just before the transition to morbid obesity. Aside from its deficiency state, associations of vitamin D with anthropometric measurements, blood pressures and TRG should also be evaluated before the development of morbid obesity.

Keywords: children, morbid obesity, obesity, vitamin D

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11993 Impact of Mammographic Screening on Ethnic Inequalities in Breast Cancer Stage at Diagnosis and Survival in New Zealand

Authors: Sanjeewa Seneviratne, Ian Campbell, Nina Scott, Ross Lawrenson

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Introduction: Indigenous Māori women experience a 60% higher breast cancer mortality rate compared with European women in New Zealand. We explored the impact of difference in the rate of screen detected breast cancer between Māori and European women on more advanced disease at diagnosis and lower survival in Māori women. Methods: All primary in-situ and invasive breast cancers diagnosed in screening age women (as defined by the New Zealand National Breast Cancer Screening Programme) between 1999 and 2012 in the Waikato area were identified from the Waikato Breast Cancer Register and the national screening database. Association between screen versus non-screen detection and cancer stage at diagnosis and survival were compared by ethnicity and socioeconomic deprivation. Results: Māori women had 50% higher odds of being diagnosed with more advance staged cancer compared with NZ European women, a half of which was explained by the lower rate of screen detected cancer in Māori women. Significantly lower breast cancer survival rates were observed for Māori compared with NZ European and most deprived compared with most affluent socioeconomic groups for symptomatically detected breast cancer. No significant survival differences by ethnicity or socioeconomic deprivation were observed for screen detected breast cancer. Conclusions: Low rate of screen detected breast cancer appears to be a major contributor for more advanced stage disease at diagnosis and lower breast cancer survival in Māori compared with NZ European women. Increasing screening participation for Māori has the potential to substantially reduce breast cancer mortality inequity between Māori and NZ European women.

Keywords: breast cancer, screening, ethnicity, inequity

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11992 Community Re-Integrated Soldiers’ Perceptions of Barriers and Facilitators to A Home-Based Physical Rehabilitation Programme Following Lower-Limb Amputation

Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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11991 Timing and Probability of Presurgical Teledermatology: Survival Analysis

Authors: Felipa de Mello-Sampayo

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The aim of this study is to undertake, from patient’s perspective, the timing and probability of using teledermatology, comparing it with a conventional referral system. The dynamic stochastic model’s main value-added consists of the concrete application to patients waiting for dermatology surgical intervention. Patients with low health level uncertainty must use teledermatology treatment as soon as possible, which is precisely when the teledermatology is least valuable. The results of the model were then tested empirically with the teledermatology network covering the area served by the Hospital Garcia da Horta, Portugal, links the primary care centers of 24 health districts with the hospital’s dermatology department via the corporate intranet of the Portuguese healthcare system. Health level volatility can be understood as the hazard of developing skin cancer and the trend of health level as the bias of developing skin lesions. The results of the survival analysis suggest that the theoretical model can explain the use of teledermatology. It depends negatively on the volatility of patients' health, and positively on the trend of health, i.e., the lower the risk of developing skin cancer and the younger the patients, the more presurgical teledermatology one expects to occur. Presurgical teledermatology also depends positively on out-of-pocket expenses and negatively on the opportunity costs of teledermatology, i.e., the lower the benefit missed by using teledermatology, the more presurgical teledermatology one expects to occur.

Keywords: teledermatology, wait time, uncertainty, opportunity cost, survival analysis

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11990 Health Risk Assessment of Heavy Metals in Clarias gariepinus (Burchell, 1822) from Fish Mongers within Akure Metropolis, Ondo State, Nigeria

Authors: O. O. Olawusi-Peters, K. I. Adejugbagbe

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The concentration of heavy metal (Cd, Pb, Fe, Zn, Cu) in Clarias gariepinus collected from fish markets; Fanibi (Station I) and Fiwasaye (Station II) in Akure metropolis, Ondo state, Nigeria were investigated to ascertain the safety for the consumers. 60 samples were collected from the two markets in three batches (I, II, III) for a period of six months and analyzed for heavy metals in the gills and muscles of the fish. Also, the Health Risk Index (HRI) was used to determine the health risk of these metals to the consumer. The results showed that the investigated metal concentration was higher in station I than station II, except Pb having higher concentration in station II than station I. In both stations, the highest concentration of Fe was recorded in the gills (12.60 ± 1.51; 6.94 ± 1.38) and muscles (3.72 ± 0.09; 3.86 ± 0.33) of samples in batch I. Also, the HRI revealed that consumption of Clarias gariepinus from these study areas did not pose any health risk (HRI < 1). In addition, concentrations of the heavy metals were all below the permissible limits recommended by FAO/WHO.

Keywords: health risk index, heavy metals, clarias gariepinus, akure metropolis, fish monger

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11989 Prevalence and Hypertension Management among the Nomadic Migratory Community of Marsabit County, Kenya: Lessons Learned and Wayforward

Authors: Wesley Too, Christine Chesiror

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Hypertension is a public health challenge that globally, with the World Health Organization estimating that by 2025, more than 1.5 billion people would have been diagnosed with it. Kenya’s prevalence of hypertension is estimated at 24.6 percent; however, 55% of the affected have uncontrolled blood pressure, which is worst in some parts of the country with different lifestyle: nomads and migratory communities. Kenyan pastoralists comprise 20% of the nation's population and are constantly on the move for search of water, pasture for their herd, and desertification have driven nomadic populations to the brink, given their unique and dynamic challenges. Nomads face myriad of challenges and barriers towards the management of their health care problems. Nomadic area is predominantly rural, with a low population density and a nomadic population. Health care access and quality are further hampered by poor telecommunications, infrastructure, and security. In Kenya, nomadic communities experience the worst health outcomes, disproportionate health disparities, and inequalities due to unresponsive, culturally sensitive health care system to nomad’s lifestyle and their health care needs. Marsabit covering a surface area of 66,923.1 km2, is the second largest county in Kenya, constituting about 2.3 million people of North-Eastern region, with only 2.3 percent and 1.9 percent of Kenya's total number of doctors and nurses in the country. In Kenya, there are scanty research on hypertension managementin this region and, at best, non-existent study on hypertension among nomads-migratory communities of Northern Kenya. Therefore, the purpose seeks to determine the prevalence of hypertension among nomads and document nomads' practices regarding early detections, management, and levels of control of hypertension in one of the Counties in Kenya with high- hypertensive case load per year. Methods: A cross-sectional study design was used to collect data from multiple sites and health facilities. A total of 260 participants were enrolled into the study. The study is currently ongoing. It is anticipated that by September, we will have initial findings & recommendations to share for conference

Keywords: pastoralists, hypertension, health, kenya

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11988 Optimization of Machine Learning Regression Results: An Application on Health Expenditures

Authors: Songul Cinaroglu

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Machine learning regression methods are recommended as an alternative to classical regression methods in the existence of variables which are difficult to model. Data for health expenditure is typically non-normal and have a heavily skewed distribution. This study aims to compare machine learning regression methods by hyperparameter tuning to predict health expenditure per capita. A multiple regression model was conducted and performance results of Lasso Regression, Random Forest Regression and Support Vector Machine Regression recorded when different hyperparameters are assigned. Lambda (λ) value for Lasso Regression, number of trees for Random Forest Regression, epsilon (ε) value for Support Vector Regression was determined as hyperparameters. Study results performed by using 'k' fold cross validation changed from 5 to 50, indicate the difference between machine learning regression results in terms of R², RMSE and MAE values that are statistically significant (p < 0.001). Study results reveal that Random Forest Regression (R² ˃ 0.7500, RMSE ≤ 0.6000 ve MAE ≤ 0.4000) outperforms other machine learning regression methods. It is highly advisable to use machine learning regression methods for modelling health expenditures.

Keywords: machine learning, lasso regression, random forest regression, support vector regression, hyperparameter tuning, health expenditure

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11987 Humanising Digital Healthcare to Build Capacity by Harnessing the Power of Patient Data

Authors: Durhane Wong-Rieger, Kawaldip Sehmi, Nicola Bedlington, Nicole Boice, Tamás Bereczky

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Patient-generated health data should be seen as the expression of the experience of patients, including the outcomes reflecting the impact a treatment or service had on their physical health and wellness. We discuss how the healthcare system can reach a place where digital is a determinant of health - where data is generated by patients and is respected and which acknowledges their contribution to science. We explore the biggest barriers facing this. The International Experience Exchange with Patient Organisation’s Position Paper is based on a global patient survey conducted in Q3 2021 that received 304 responses. Results were discussed and validated by the 15 patient experts and supplemented with literature research. Results are a subset of this. Our research showed patient communities want to influence how their data is generated, shared, and used. Our study concludes that a reasonable framework is needed to protect the integrity of patient data and minimise abuse, and build trust. Results also demonstrated a need for patient communities to have more influence and control over how health data is generated, shared, and used. The results clearly highlight that the community feels there is a lack of clear policies on sharing data.

Keywords: digital health, equitable access, humanise healthcare, patient data

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11986 Motivational Profiles of Choice of Medical Studies: Cross-Sectional Study

Authors: Rajae Tahri, Omar Chokairi, Asmae Saadi, Souad Chaouir

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Background: The factors motivating students to choose a medical career is a long-standing topic of publication and discussion. To our knowledge, no national study on the motivation for choosing medical studies has been published to date. Population and methods: This is an observational, descriptive, and cross-sectional study of first-year medical students at the Faculty of Medicine and Pharmacy of Rabat. An anonymous questionnaire comprising 16 questions was developed and distributed to students during Embryology tutorials. The students were free to fill it in or not. The number of students who consented to participate in the survey was 266. The variables studied are the socio-demographic variables of the students and the reasons for choosing medical studies. Results: The most strongly and frequently chosen reasons for choice by our students were saving lives (64.9%), helping others (62.1%), love of medicine (57%), and reducing suffering (56.5%). The comparison of the results according to gender showed a significant difference between the degree of self-motivation of girls compared to that of boys (p <0.001). The reason that stood out the most for them was teamwork. The presence of a health professional in the family was associated with strong extrinsic motivation (p = 0.005). Conclusion: Understanding medical student career choices would improve our knowledge of the factors that influence medical student learning and performance. This knowledge will make it possible to adapt the educational strategies to maintain the motivation of the students throughout their course as well as during their exercise.

Keywords: motivation, motivational profiles, medical studies, Morocco

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11985 Comparative Study to Evaluate the Efficacy of Control Criterion in Determining Consolidation Scope in the Public Sector

Authors: Batool Zarei

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This study aims to answer this question whether control criterion with two elements of power and benefit which is introduced as 'control criterion of consolidation scope' in national and international standards of accounting in public sector (and also private sector) is efficient enough or not. The methodology of this study is comparative and the results of this research are significantly generalizable, due to the given importance to the sample of countries which were studied. Findings of this study states that in spite of pervasive use of control criterion (including 2 elements of power and benefit), criteria for determining the existence of control in public sector accounting standards, are not efficient enough to determine the consolidation scope of whole of government financial statements in a way that meet decision making and accountability needs of managers, policy makers and supervisors; specially parliament. Therefore, the researcher believes that for determining consolidation scope in public sector, in addition to economic view, it is better to pay attention to budgetary, legal and statistical concepts and also to practical and financial risk and define indicators for proving the existence of control (power and benefit) which include accountability relationships (budgetary relation, legal form and nature of activity). these findings also reveals the necessity of passing a comprehensive public financial management (PFM) legislation in order to redefine the characteristics of public sector entities and whole of government financial statements scope and review Statistics organizations and central banks duties for preparing government financial statistics and national accounts in order to achieve sustainable development and resilient economy goals.

Keywords: control, consolidation scope, public sector accounting, government financial statistics, resilient economy

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11984 Health Communication and the Diabetes Narratives of Key Social Media Influencers in the UK

Authors: Z. Sun

Abstract:

Health communication is essential in promoting healthy lifestyles, managing disease conditions, and eventually reducing health disparities. The key elements of successful health communication always include the development of communication strategies to engage people in thinking about their health, inform them about healthy choices, persuade them to adopt safe and healthy behaviours, and eventually achieve public health objectives. The use of 'Narrative' is recognised as a kind of health communication strategy to enhance personal and public health due to its potential persuasive effect in motivating and supporting individuals change their beliefs and behaviours by inviting them into a narrative world, breaking down their cognitive and emotional resistance and enhance their acceptance of the ideas portrayed in narratives. Meanwhile, the popularity of social media has provided a novel means of communication for both healthcare stakeholders, and a special group of active social media users (influencers) have started playing a pivotal role in providing health ‘solutions’. Such individuals are often referred to as ‘influencers’ because of their central position in the online communication system and the persuasive effect their actions may have on audiences. They may have established a positive rapport with their audience, earned trust and credibility in a specific area, and thus, their audience considers the information they delivered to be authentic and influential. To our best knowledge, to date, there is no published research that examines the effect of diabetes narratives presented by social media influencers and their impacts on health-related outcomes. The primary aim of this study is to investigate the diabetes narratives presented by social media influencers in the UK because of the new dimension they bring to health communication and the potential impact they may have on audiences' health outcomes. This study is situated within the interpretivist and narrative paradigms. A mixed methodology combining both quantitative and qualitative approaches has been adopted. Qualitative data has been derived to provide a better understanding of influencers’ personal experiences and how they construct meanings and make sense of their world, while quantitative data has been accumulated to identify key social media influencers in the UK and measure the impact of diabetes narratives on audiences. Twitter has been chosen as the social media platform to initially identify key influencers. Two groups of participants are the top 10 key social media influencers in the UK and 100 audiences of each influencer, which means a total of 1000 audiences have been invited. This paper is going to discuss, first of all, the background of the research under the context of health communication; Secondly, the necessity and contribution of this research; then, the major research questions being explored; and finally, the methods to be used.

Keywords: diabetes, health communication, narratives, social media influencers

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11983 The Report of Co-Construction into a Trans-National Education Teaching Team

Authors: Juliette MacDonald, Jun Li, Wenji Xiang, Mingwei Zhao

Abstract:

Shanghai International College of Fashion and Innovation (SCF) was created as a result of a collaborative partnership agreement between the University of Edinburgh and Donghua University. The College provides two programmes: Fashion Innovation and Fashion Interior Design and the overarching curriculum has the intention of developing innovation and creativity within an international learning, teaching, knowledge exchange and research context. The research problem presented here focuses on the multi-national/cultural faculty in the team, the challenges arising from difficulties in communication and the associated limitations of management frameworks. The teaching faculty at SCF are drawn from China, Finland, Korea, Singapore and the UK with input from Flying Faculty from Fashion and Interior Design, Edinburgh College of Art (ECA), for 5 weeks each semester. Rather than fully replicating the administrative and pedagogical style of one or other of the institutions within this joint partnership the aim from the outset was to create a third way which acknowledges the quality assurance requirements of both Donghua and Edinburgh, the academic and technical needs of the students and provides relevant development and support for all the SCF-based staff and Flying Academics. It has been well acknowledged by those who are involved in teaching across cultures that there is often a culture shock associated with transnational education but that the experience of being involved in the delivery of a curriculum at a Joint Institution can also be very rewarding for staff and students. It became clear at SCF that if a third way might be achieved which encourages innovative approaches to fashion education whilst balancing the expectations of Chinese and western concepts of education and the aims of two institutions, then it was going to be necessary to construct a framework which developed close working relationships for the entire teaching team, so not only between academics and students but also between technicians and administrators at ECA and SCF. The attempts at co-construction and integration are built on the sharing of cultural and educational experiences and knowledge as well as provision of opportunities for reflection on the pedagogical purpose of the curriculum and its delivery. Methods on evaluating the effectiveness of these aims include a series of surveys and interviews and analysis of data drawn from teaching projects delivered to the students along with graduate successes from the last five years, since SCF first opened its doors. This paper will provide examples of best practice developed by SCF which have helped guide the faculty and embed common core values and aims of co-construction regulations and management, whilst building a pro-active TNE (Trans-National Education) team which enhances the learning experience for staff and students alike.

Keywords: cultural co-construction, educational team management, multi-cultural challenges, TNE integration for teaching teams

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11982 Do the Health Benefits of Oil-Led Economic Development Outweigh the Potential Health Harms from Environmental Pollution in Nigeria?

Authors: Marian Emmanuel Okon

Abstract:

Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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11981 Daily Stress, Family Functioning, and Mental Health among Palestinian Couples in Israel During COVID-19: A Moderated Mediation Model

Authors: Niveen M. Hassan-Abbas

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The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann’s systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion, and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 heterosexual married Palestinians from Israel who completed self-report questionnaires. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic and suggested that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.

Keywords: Palestinian families in Israel, COVID-19 pandemic, family cohesion and flexibility, extra-dyadic stress, intra-dyadic stress, mental health

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11980 Phylogenetic Analysis Based On the Internal Transcribed Spacer-2 (ITS2) Sequences of Diadegma semiclausum (Hymenoptera: Ichneumonidae) Populations Reveals Significant Adaptive Evolution

Authors: Ebraheem Al-Jouri, Youssef Abu-Ahmad, Ramasamy Srinivasan

Abstract:

The parasitoid, Diadegma semiclausum (Hymenoptera: Ichneumonidae) is one of the most effective exotic parasitoids of diamondback moth (DBM), Plutella xylostella in the lowland areas of Homs, Syria. Molecular evolution studies are useful tools to shed light on the molecular bases of insect geographical spread and adaptation to new hosts and environment and for designing better control strategies. In this study, molecular evolution analysis was performed based on the 42 nuclear internal transcribed spacer-2 (ITS2) sequences representing the D. semiclausum and eight other Diadegma spp. from Syria and worldwide. Possible recombination events were identified by RDP4 program. Four potential recombinants of the American D. insulare and D. fenestrale (Jeju) were detected. After detecting and removing recombinant sequences, the ratio of non-synonymous (dN) to synonymous (dS) substitutions per site (dN/dS=ɷ) has been used to identify codon positions involved in adaptive processes. Bayesian techniques were applied to detect selective pressures at a codon level by using five different approaches including: fixed effects likelihood (FEL), internal fixed effects likelihood (IFEL), random effects method (REL), mixed effects model of evolution (MEME) and Program analysis of maximum liklehood (PAML). Among the 40 positively selected amino acids (aa) that differed significantly between clades of Diadegma species, three aa under positive selection were only identified in D. semiclausum. Additionally, all D. semiclausum branches tree were highly found under episodic diversifying selection (EDS) at p≤0.05. Our study provide evidence that both recombination and positive selection have contributed to the molecular diversity of Diadegma spp. and highlights the significant contribution of D. semiclausum in adaptive evolution and influence the fitness in the DBM parasitoid.

Keywords: diadegma sp, DBM, ITS2, phylogeny, recombination, dN/dS, evolution, positive selection

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11979 H. P. Grice’s Cooperative Principle in a Reproductive Health Clinic in Kenya

Authors: Melvin Ouma

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Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

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11978 Development of Electronic Services in Georgia: Analysis of Current Situation

Authors: Dato Surmanidze, Dato Antadze, Tornike Partenadze

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Public online services in Georgia are concentrated on main target segments: public administration, business, population, non-governmental and other interested organizations. Therefore, the strategy of digital Georgia is focused on providing G2C, G2B/B2G, G2NGO and G2G services. In G2C framework sophisticated and high-technological online services have been developed in order to provide passports, identity cards, documentations concerning residence and civil acts (birth, marriage, divorce, child adoption, change of name and surname, death, etc) as well as other services. Websites like my.gov.ge and sda.gov.ge have distance services like electronic application, processing and decision making. In line with international standards automatic services like electronic tenders, product catalogues, invoices and payment have been developed. This creates better investment climate for foreign companies in Georgia in the framework of G2B politics. The website mybusiness.gov.ge creates better conditions for local business. Among electronic services is e-NRMS (electronic system for national resource management) which was introduced by the Ministry of Finance of Georgia. The system was created in order to ensure management of national resources by state and business organizations. It is integrated with bank services and provides G2C, G2B and B2G representatives with electronic services. Also a portal meteo.gov.ge was created which gives electronic services concerning air, geological, environmental and pollution issues. Also worknet.gov.ge should be mentioned which is an electronic hub of information management for employers and employees. The information portal of labor market will facilitate receipt of information, its analysis and delivery to interested people like employers and employees. However, nowadays it’s been two years that only employees portal is activated. Therefore, awareness about the portal, its competitiveness and success is undermined.

Keywords: electronic services, public administration, information technology, information society

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11977 Use of Satellite Altimetry and Moderate Resolution Imaging Technology of Flood Extent to Support Seasonal Outlooks of Nuisance Flood Risk along United States Coastlines and Managed Areas

Authors: Varis Ransibrahmanakul, Doug Pirhalla, Scott Sheridan, Cameron Lee

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U.S. coastal areas and ecosystems are facing multiple sea level rise threats and effects: heavy rain events, cyclones, and changing wind and weather patterns all influence coastal flooding, sedimentation, and erosion along critical barrier islands and can strongly impact habitat resiliency and water quality in protected habitats. These impacts are increasing over time and have accelerated the need for new tracking techniques, models and tools of flood risk to support enhanced preparedness for coastal management and mitigation. To address this issue, NOAA National Ocean Service (NOS) evaluated new metrics from satellite altimetry AVISO/Copernicus and MODIS IR flood extents to isolate nodes atmospheric variability indicative of elevated sea level and nuisance flood events. Using de-trended time series of cross-shelf sea surface heights (SSH), we identified specific Self Organizing Maps (SOM) nodes and transitions having a strongest regional association with oceanic spatial patterns (e.g., heightened downwelling favorable wind-stress and enhanced southward coastal transport) indicative of elevated coastal sea levels. Results show the impacts of the inverted barometer effect as well as the effects of surface wind forcing; Ekman-induced transport along broad expanses of the U.S. eastern coastline. Higher sea levels and corresponding localized flooding are associated with either pattern indicative of enhanced on-shore flow, deepening cyclones, or local- scale winds, generally coupled with an increased local to regional precipitation. These findings will support an integration of satellite products and will inform seasonal outlook model development supported through NOAAs Climate Program Office and NOS office of Center for Operational Oceanographic Products and Services (CO-OPS). Overall results will prioritize ecological areas and coastal lab facilities at risk based on numbers of nuisance flood projected and inform coastal management of flood risk around low lying areas subjected to bank erosion.

Keywords: AVISO satellite altimetry SSHA, MODIS IR flood map, nuisance flood, remote sensing of flood

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11976 Finding the English Competency for Developing Public Health Village Volunteers at Ban Prasukchai in Chumpuang District, Nakhon Ratchasima Province in Thailand

Authors: Kittivate Boonyopakorn

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The purposes of this study were to find the English competence of the public health volunteers and to develop the use of their English. The samples for the study were 41 public health village volunteers at Ban Prasukchai, in Thailand. The findings showed that the sum of all scores for the pre-test was 452, while the score for the post-test was 1,080. Therefore, the results of the experiment confirm that the post-test scores (1,080) significantly are higher than the pre-test (452). The mean score (N=41) for the pre-test was 11.02 while the mean score (N=41) for the post-test was 18.10. The standard deviation for the pre-test was 2.734; however, for the post-test it was 1.934. In addition to the experts-evaluated research tools, the results of the evaluation for the structured interviews (IOC) were 1 in value. The evaluation of congruence for the content with learning objectives (IOC) were 0.66 to 1.00 in value. The evaluation of congruence for the pre and post-test with learning objectives (IOC) are 1 in value.

Keywords: finding the English competency, developing public health, village volunteers

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11975 Mental Health of Childless Couples: A Psychosocial Study

Authors: Digambar J. Darekar, Sharvari D. Darekar

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Childlessness is a universal problem. It particularly affects the mental health of childless couple. It leads to anxiety, frustration, nervousness, depression, loneliness, helplessness, hopelessness, etc. After reviewing the literature, it is found that mental health of married couples is negatively related to childlessness. To understand emotional and psychological problems of a childless couple, researcher surveyed and interviewed 50 childless couples with the help of medical practitioner and gynecologist. Personal adjustment and mental health inventory and marital adjustment inventory along with semi-structured interview questionnaire was used. On the basis of responses from the subject, distinction is made between the problems of male subjects and female subjects and common problem separately. The researcher found that childlessness leads to the conflict between in-laws, harassment, hopelessness, feeling of emptiness and vacuumed, frustration, lack of hope and desire for life, restlessness, loss of sleep, ideas of committing suicide, increased emotional distance and disturbed marital life. The childlessness leads to sorrow for women and anger for men. Men turns towards addiction and women tend to avoid social contact and face problems of social adjustments. Childless couples are sufferers of personal and marital adjustment problems which in turn affect their mental health adversely.

Keywords: childlessness, marital adjustments, mental health, social adjustment

Procedia PDF Downloads 193
11974 Readiness of Estonian Working and Non-working Older Adults to Benefit from eHealth

Authors: Marianne Paimre

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Estonia is heralded as the most successful digital country in the world with the highly acclaimed eHealth system. Yet 40% of the 65–74-year-olds do not use the Internet at all, and digital divide between young and elderly people's use of ICT is larger than in many advanced countries. Poor access to ICT resource and insufficient digital skills can lead to detachment from digital health resources, delayed diagnoses, and increased rates of hospitalization. To reveal digital divide within the elderly population itself, the presentation focuses on the health information behavior of Estonian seniors who either continue or have stopped working after retirement to use digital health applications. The author's main interest is on access, trust, and skills to use the Internet for medical purposes. Fifteen in-depth interviews with 65+ working persons, as well as 15 interviews with full-time retirees, were conducted. Also, six think-aloud protocols were conducted. The results indicate that older adults, who due to the nature of their work, have regular access to computers, often search for health-related information online. They exposed high source criticism and were successful in solving the given tasks. Conversely, most of the fully retired older adults claimed not using computers or other digital devices and cited lack of skills as the main reason for their inactivity. Thus, when developing health applications, it should be borne in mind that the ability and willingness of older adults to use e-solutions are very different.

Keywords: digital divide, digital healthcare, health information behavior, older adults

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11973 Research of Actuators of Common Rail Injection Systems with the Use of LabVIEW on a Specially Designed Test Bench

Authors: G. Baranski, A. Majczak, M. Wendeker

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Currently, the most commonly used solution to provide fuel to the diesel engines is the Common Rail system. Compared to previous designs, as a due to relatively simple construction and electronic control systems, these systems allow achieving favourable engine operation parameters with particular emphasis on low emission of toxic compounds into the atmosphere. In this system, the amount of injected fuel dose is strictly dependent on the course of parameters of the electrical impulse sent by the power amplifier power supply system injector from the engine controller. The article presents the construction of a laboratory test bench to examine the course of the injection process and the expense in storage injection systems. The test bench enables testing of injection systems with electromagnetically controlled injectors with the use of scientific engineering tools. The developed system is based on LabView software and CompactRIO family controller using FPGA systems and a real time microcontroller. The results of experimental research on electromagnetic injectors of common rail system, controlled by a dedicated National Instruments card, confirm the effectiveness of the presented approach. The results of the research described in the article present the influence of basic parameters of the electric impulse opening the electromagnetic injector on the value of the injected fuel dose. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK ‘PZL-KALISZ’ S.A.’ and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: fuel injector, combustion engine, fuel pressure, compression ignition engine, power supply system, controller, LabVIEW

Procedia PDF Downloads 131