Search results for: public health burden
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13097

Search results for: public health burden

12767 WhatsApp as a Public Health Management Tool in India

Authors: Drishti Sharma, Mona Duggal

Abstract:

Background: WhatsApp can serve as a cost-effective, scalable, convenient, and popular medium for public health management related communication in the developing world where the existing system of communication is top-down and slow. The product supports sending and receiving a variety of media: text, photos, videos, documents, and location, as well as voice/video calls. With growing number of users of smartphones and improving access and penetration of internet, the scope of information technology remains immense in resolving the hurdles faced by traditional public health system. Poor infrastructure, gap in digital literacy, faulty documentation, strict organizational hierarchy and slow movement of information across desks and offices- all these, make WhatsApp an efficient prospect to complement the existing system for communication, feedback and leadership for public health system in India. Objective: This study investigates the benefits, challenges and limitations associated with WhatsApp usage as a public health management tool. Methods: The study was conducted within the Chandigarh Union Territory. We used a qualitative approach and conducted individual semi-structured interviews and group interviews (n = 10). Participants included medical officers (n 20), Program managers (n = 4), academicians (n=2) and administrators (n=2). Thematic and content qualitative analyses were conducted. Message log of the WhatsApp group of one of the health program was assessed. Results: Medical Officers said that WhatsApp helped them remain in touch with the program officer. They could easily give feedback and highlight those challenges which needed immediate intervention from the program managers, hence they felt supported. Also, the application helped them share pictures of their activities (meetings and field activities) with the group which they thought inspired others and gave themselves immense satisfaction. Also, it helped build stronger relationships and better coordination among themselves, the same being important in team events. For program managers, it had become a portal for coordinating large scale campaigns. Its reach and the fact that the feedback is real-time make WhatsApp ideal for district level events. Though the easy informal connectivity made them answerable to their staff but it also provided them with flexibility in operations. It turned out to be an important portal for sharing outcome and goals related feedback (both positive and negative) to the team. To be sure, using WhatsApp for the purpose of public health program presents considerable challenges, including technological barriers, organizational challenges, gender issues, confidentiality concerns and unplanned aftereffects. Nevertheless, its advantages in a low-cost setting make it an efficient alternative. Conclusion: WhatsApp has become an integral part of our lives. Use of this app for public health program management within closed groups looks promising and useful. At the same time, addressing the challenges involved would make its usage safer.

Keywords: communication, mobile technology, public health management, WhatsApp

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12766 Profitability and Productivity Performance of the Selected Public Sector Banks in India

Authors: Sudipto Jana

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Background and significance of the study: Banking industry performs as a catalyst for industrial growth and agricultural growth, however, as well involves the existence and welfare of the citizens. The banking system in India was described by unmatched growth and the recreation of bunch making in the pre-liberalization era. At the time of financial sector reforms Reserve Bank of India issued a regulatory norm concerning capital adequacy, income recognition, asset classification and provisioning that have increasingly precede meeting by means of the international paramount performs. Bank management ceaselessly manages the triumph, effectiveness, productivity and performance of the bank as good performance, high productivity and efficiency authorizes the triumph of the bank management targets as well as aims of bank. In a comparable move toward performance of any economy depends upon the expediency and effectiveness of its financial system of nation establishes its economic growth indicators. Profitability and productivity are the most important relevant parameters of any banking group. Keeping in view of this, this study examines the profitability and productivity performance of the selected public sector banks in India. Methodology: This study is based on secondary data obtained from Reserve Bank of India database for the periods between 2006 and 2015. This study purposively selects four types of commercial banks, namely, State Bank of India, United Bank of India, Punjab National Bank and Allahabad Bank. In order to analyze the performance with relation to profitability and productivity, productivity performance indicators in terms of capital adequacy ratio, burden ratio, business per employee, spread per employee and advances per employee and profitability performance indicators in terms of return on assets, return on equity, return on advances and return on branch have been considered. In the course of analysis, descriptive statistics, correlation statistics and multiple regression have been used. Major findings: Descriptive statistics indicate that productivity performance of State Bank of India is very satisfactory than other public sector banks in India. But management of productivity is unsatisfactory in case of all the public sector banks under study. Correlation statistics point out that profitability of the public sector banks are strongly positively related with productivity performance in case of all the public sector banks under study. Multiple regression test results show that when profitability increases profit per employee increases and net non-performing assets decreases. Concluding statements: Productivity and profitability performance of United Bank of India, Allahabad Bank and Punjab National Bank are unsatisfactory due to poor management of asset quality as well as management efficiency. It needs government’s interference so that profitability and productivity performance are increased in the near future.

Keywords: India, productivity, profitability, public sector banks

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12765 Hepatitis B Vaccination Status and Its Determinants among Primary Health Care Workers in Northwest Pakistan

Authors: Mohammad Tahir Yousafzai, Rubina Qasim

Abstract:

We assessed Hepatitis B vaccination and its determinants among health care workers (HCW) in Northwest Pakistan. HCWs from both public and private clinics were interviewed about hepatitis B vaccination, socio-demographic, hepatitis B virus transmission modes, disease threat and benefits of vaccination. Logistic regression was performed. Hepatitis B vaccination was 40% (Qualified Physicians: 86% and non-qualified Dispensers:16%). Being Qualified Physician (Adj. OR 26.6; 95%CI 9.3-73.2), Non-qualified Physician (Adj.OR 1.9; 95%CI 0.8-4.6), qualified Dispensers (Adj. OR 3.6; 95%CI 1.3-9.5) compared to non-qualified Dispensers, working in public clinics (Adj. OR 2.5; 95%CI 1.1-5.7) compared to private, perceived disease threat after exposure to blood and body fluids (Adj. OR 1.1; 95%CI 1.1-1.2) and perceived benefits of vaccination (Adj. OR 1.1; 95%CI 1.1-1.2) were significant predictors of hepatitis B vaccination. Improved perception of disease threat and benefits of vaccination and qualification of HCWs are associated with hepatitis B vaccination.

Keywords: Hepatitis B vaccine, immunization, healthcare workers, primary health

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12764 Rapid Detection of the Etiology of Infection as Bacterial or Viral Using Infrared Spectroscopy of White Blood Cells

Authors: Uraib Sharaha, Guy Beck, Joseph Kapelushnik, Adam H. Agbaria, Itshak Lapidot, Shaul Mordechai, Ahmad Salman, Mahmoud Huleihel

Abstract:

Infectious diseases cause a significant burden on the public health and the economic stability of societies all over the world for several centuries. A reliable detection of the causative agent of infection is not possible based on clinical features, since some of these infections have similar symptoms, including fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Moreover, physicians usually encounter difficulties in distinguishing between viral and bacterial infections based on symptoms. Therefore, there is an ongoing need for sensitive, specific, and rapid methods for identification of the etiology of the infection. This intricate issue perplex doctors and researchers since it has serious repercussions. In this study, we evaluated the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. Fourier transform infrared (FTIR) spectroscopy is considered a successful diagnostic method in the biological and medical fields. Many studies confirmed the great potential of the combination of FTIR spectroscopy and machine learning as a powerful diagnostic tool in medicine since it is a very sensitive method, which can detect and monitor the molecular and biochemical changes in biological samples. We believed that this method would play a major role in improving the health situation, raising the level of health in the community, and reducing the economic burdens in the health sector resulting from the indiscriminate use of antibiotics. We collected peripheral blood samples from young 364 patients, of which 93 were controls, 126 had bacterial infections, and 145 had viral infections, with ages lower than18 years old, limited to those who were diagnosed with fever-producing illness. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.

Keywords: infectious diseases, (FTIR) spectroscopy, viral infections, bacterial infections.

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12763 Prevention of Corruption in Public Purchases

Authors: Anatoly Krivinsh

Abstract:

The results of dissertation research "Preventing and combating corruption in public procurement" are presented in this publication. The study was conducted 2011 till 2013 in a Member State of the European Union, in the Republic of Latvia. Goal of the thesis is to explore corruption prevention and combating issues in public procurement sphere, to identify the prevalence rates, determinants and contributing factors and prevention opportunities in Latvia. In the first chapter the author analyses theoretical aspects of understanding corruption in public procurement, with particular emphasis on corruption definition problem, its nature, causes and consequences. A separate section is dedicated to the public procurement concept, mechanism and legal framework. In the first part of this work the author presents cognitive methodology of corruption in public procurement field, based on which the author has carried out an analysis of corruption situation in public procurement in Republic of Latvia. In the second chapter of the thesis, the author analyzes the problem of corruption in public procurement, including its historical aspects, typology and classification of corruption subjects involved, corruption risk elements in public procurement and their identification. During the development of the second chapter author's practical experience in public procurements was widely used. The third and fourth chapter deals with issues related to the prevention and combating corruption in public procurement, namely the operation of the concept, principles, methods and techniques, subjects in Republic of Latvia, as well as an analysis of foreign experience in preventing and combating corruption. The fifth chapter is devoted to the corruption prevention and combating perspectives and their assessment. In this chapter the author has made the evaluation of corruption prevention and combating measures efficiency in Republic of Latvia, assessment of anti-corruption legislation development stage in public procurement field in Latvia.

Keywords: prevention of corruption, public purchases, good governance, human rights

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12762 Urban Slum Communities Engage in the Fight Against TB in Karnataka, South India

Authors: N. Rambabu, H. Gururaj, Reynold Washington, Oommen George

Abstract:

Motivation: Under the USAID Strengthening Health Outcomes through Private Sector (SHOPS-TB) initiative, Karnataka Health Promotion Trust (KHPT) with technical support of Abt associates is implementing a TB prevention and care model in Karnataka State, South India. KHPT is the interface agency between the public and private sectors, and providers and the target community facilitating early TB case detection and enhancing treatment compliance through private health care providers (pHCP) engagement in RNTCP. The project coverage is 0.84 million urban poor from 663 slums in 12 districts of Karnataka. Problem Statement: India with the highest burden of global TB (26%) and two million cases annually, accounts for approximately one fifth of the global incidence. WHO estimates 300,000 people die from TB annually in India. India expanded the coverage of Directly Observed Treatment, Short-course chemotherapy (DOTS) to the entire country as early as 2006. However, the performance of RNTCP has not been uniform across states. While the national annual new smear-positive (NSP) case notification rate is 53, it is much lower at 47 in Karnataka. A third of TB patients in India reside in urban slums. Approach: Under SHOPS, KHPT actively engages with communities through key opinion leaders and community structures. Interpersonal communication, by Outreach workers through house-to-house visits and at aggregation points, is the primary method used for communication about TB and its management and to increase demand for sputum examination and DOTS. pHCP are mapped, trained and mentored by KHPT. ORWs also provide patient and family counseling on TB treatment, side effects and adherence, screen close contacts of index patients especially children under 6 years of age and screen co-morbidities including HIV, diabetes and malnutrition and risk factors including alcoholism, tobacco use, occupational hazards making appropriate accompanied or documented referrals. A treatment ‘buddy’ system for the patients involving close friends or family members, ICT-based support, DOTS Prerana (inspiration) groups of TB patients, family members and community, DOTS Mitra (friend) helpline services are also used for care and support services. Results: The intervention educated 39988 slum dwellers, referred 1731 chest symptomatics, tested 1061 patients and initiated 248 patients on anti-TB treatment within three months of intervention through continuous community engagement. Conclusions: The intervention’s potential to increase access to preferred health care providers, reduce patient and health system delays in diagnosis and initiation of treatment, improve health seeking behaviour and enhance compliance of pHCPs to standard treatment protocols is being monitored. Initial results are promising.

Keywords: DOTS, KHPT, health outcomes, public and private sector

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12761 Governance and Public Policy: The Perception of Efficiency and Equility in Brazil and South Africa

Authors: Paulino V. Tavares, Ana L. Romao

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Public governance represents an articulated arrangement, dynamic and interactive, present in the exercise of authority aimed at strengthening the decision-making procedure in public administration with transparency, accountability, responsiveness and capable of to emerge control and social empowerment, to pursue and achieve the objectives efficiently and with the effectiveness desired by the collective, respecting laws and providing social, institutional and economic equility in society. With this, using a multidimensional approach with the application of three questionnaires to a universe of twenty Counselors of the Courts of Auditors (Brazil), twenty professionals of public administration (Brazil), twenty Government/Provincial Counselors (South Africa), and twenty South African professionals of public administration, the present work aims to capture what is the perception about the efficiency and equility of public policies in Brazil and South Africa. With this, up until now, 30 responses have been obtained, and the results indicate that, in Brazil, 65% affirm due to the inefficiency of public policies, 70% point out that they do not believe in the equility of these same policies. In South Africa, the results indicate that 45% believe in government efficiency, and, with regard to the equility of public policies, 65% do not believe. In Brazil, the research reveals at least three reasons for this result, that is, lack of planning, lack of clear objectives of public policies, and lack of information on the part of society, while in South Africa, so far, research has not identified a specific reason for this result.

Keywords: efficiency, equility, governance, public policy

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12760 Balancing Rule of Law, Human Rights and Governance

Authors: Torkan Jabbariraad

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This study explores the role of private regulation as a mode of governance that engages non-state actors in establishing and implementing rules or standards for public goods or services. It examines the various forms, functions, and effects of private regulation on the rule of law and human rights and considers the role and duties of public authorities in monitoring and supporting private regulation. It contends that private regulation should be regarded as a beneficial supplement to public regulation rather than a substitute or rival and that public authorities should find a balance between acknowledging the independence and variety of private actors and securing their accountability and legitimacy. It also recommends that applying the principles and values of good governance to private regulation can improve its quality and efficiency. The study relies on various sources and viewpoints from the literature on governance theory, public law, and human rights and suggests further research and discussion on the topic of private regulation and its consequences for society.

Keywords: private regulation, public authority, governance theory, rule of law, human rights

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12759 Inclusivity in Public Spaces through Architecture: A Case of Transgender Community in India

Authors: Sakshi Dhruve, Ar. Sarang Barbarwar

Abstract:

Public spaces are the locus of activity and interaction in any urban area. Such spaces provide identity to cities, towns or neighborhoods and define the people and culture over there. Inclusiveness is one of the core aspects of public or community spaces. With its humongous population and rapidly expanding urban areas, India needs more inclusivity in public spaces to attain true equitable development. The aim of the paper is to discuss the sensitivity of public spaces in India to the transgender community. The study shows how this community was legally included as ‘Third Gender’ in country’s legislation yet lacks social acceptance and security. It shows the challenges and issues faced by them at public spaces. The community was studied on ethnographic basis to understand their culture, lifestyle, requirements, etc. The findings have indicated towards a social stigma from people and insensitivity in designing of civic spaces. The larger objective of the study is also to provide recommendations on the design aspects and interventions in public places to increase their inclusiveness towards the transgender society.

Keywords: community spaces, ethnographic, stigma, Third Gender community

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12758 Chinese “Wolf Warrior” Diplomacy And Foreign Public Opinion

Authors: Chaohong Pan

Abstract:

Through public diplomacy on social media, governments have attempted to influence foreign public opinion. What is the impact of digital public diplomacy? Public diplomacy research often relies on content analysis to study the strategies employed by communicators but has rarely examined its actual impact on the audience. In addition, we do not know if giving a communicator an explicit label, as Twitter does with “government account”, would change the effects of the messages. Can the government label reduce the percussiveness of public diplomacy messages by sending a warning signal? Using a 2 × 2 survey experiment, the present paper contributes to the study of public diplomacy by randomly exposing American participants to four types of tweets from Chinese diplomats. The stimulus materials vary in terms of the tweets’ content (“positive-china” vs. “negative-US) and Twitter government labels (with vs. without the labels). I found that positive tweets about China have a significant positive effect on Americans’ attitudes toward China, whereas negative tweets about the US have little effect on their opinions. Furthermore, positive-China tweets are effective only on China-related issues, which indicates that Chinese diplomats’ tweets have limited effects on shaping a foreign audience’s attitudes toward their own country. Lastly, I find that labels largely have no impact on a diplomatic tweet’s effect. These results contribute to our understanding of the effects of public diplomacy in the digital age.

Keywords: public diplomacy, china, foreign public opinion, twitter

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12757 Exploring Key Elements of Successful Distance Learning Programs: A Case Study in Palau

Authors: Maiya Smith, Tyler Thorne

Abstract:

Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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12756 Modeling Karachi Dengue Outbreak and Exploration of Climate Structure

Authors: Syed Afrozuddin Ahmed, Junaid Saghir Siddiqi, Sabah Quaiser

Abstract:

Various studies have reported that global warming causes unstable climate and many serious impact to physical environment and public health. The increasing incidence of dengue incidence is now a priority health issue and become a health burden of Pakistan. In this study it has been investigated that spatial pattern of environment causes the emergence or increasing rate of dengue fever incidence that effects the population and its health. The climatic or environmental structure data and the Dengue Fever (DF) data was processed by coding, editing, tabulating, recoding, restructuring in terms of re-tabulating was carried out, and finally applying different statistical methods, techniques, and procedures for the evaluation. Five climatic variables which we have studied are precipitation (P), Maximum temperature (Mx), Minimum temperature (Mn), Humidity (H) and Wind speed (W) collected from 1980-2012. The dengue cases in Karachi from 2010 to 2012 are reported on weekly basis. Principal component analysis is applied to explore the climatic variables and/or the climatic (structure) which may influence in the increase or decrease in the number of dengue fever cases in Karachi. PC1 for all the period is General atmospheric condition. PC2 for dengue period is contrast between precipitation and wind speed. PC3 is the weighted difference between maximum temperature and wind speed. PC4 for dengue period contrast between maximum and wind speed. Negative binomial and Poisson regression model are used to correlate the dengue fever incidence to climatic variable and principal component score. Relative humidity is estimated to positively influence on the chances of dengue occurrence by 1.71% times. Maximum temperature positively influence on the chances dengue occurrence by 19.48% times. Minimum temperature affects positively on the chances of dengue occurrence by 11.51% times. Wind speed is effecting negatively on the weekly occurrence of dengue fever by 7.41% times.

Keywords: principal component analysis, dengue fever, negative binomial regression model, poisson regression model

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12755 Dynamic Transmission Modes of Network Public Opinion on Subevents Clusters of an Emergent Event

Authors: Yuan Xu, Xun Liang, Meina Zhang

Abstract:

The rise and attenuation of the public opinion broadcast of an emergent accident, in the social network, has a close relationship with the dynamic development of its subevents cluster. In this article, we take Tianjin Port explosion's subevents as an example to research the dynamic propagation discipline of Internet public opinion in a sudden accident, and analyze the overall structure of dynamic propagation to propose four different routes for subevents clusters propagation. We also generate network diagrams for the dynamic public opinion propagation, analyze each propagation type specifically. Based on this, suggestions on the supervision and guidance of Internet public opinion broadcast can be made.

Keywords: network dynamic transmission modes, emergent subevents clusters, Tianjin Port explosion, public opinion supervision

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12754 Implementing a Mobility Platform to Connect Hubs in Rural Areas

Authors: E. Neidhardt

Abstract:

Mobility is not only an aspect of personal freedom, but for many people mobility is also a requirement to be able to satisfy the needs of daily life. They must buy food, get to work, or go to the doctor. Many people are dependent on public transport to satisfy their needs. Especially in rural areas with a low population density this is difficult. In these areas it is often not cost-effective to provide public transport with sufficient coverage and frequency. Therefore, the available public transport is unattractive. As a result, people use their own car, which is not desirable from a sustainable point of view. Children and some elderly people also do not have this option. Sometimes people organize themselves and volunteer transport services are created, which function similarly to the demand-oriented taxis. With a platform for demand-oriented transport, we want to make the available public transport more usable and attractive by linking scheduled transport with voluntary transport services.

Keywords: demand-oriented, HubChain, living lab, public transport

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12753 Public Preferences and Willingness to Pay for Social Health Insurance in Iran: A Discrete Choice Experiment

Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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12752 Assessing Undergraduate Students' Awareness and Utilization of University Mental Health Services and Programs for Depression: A Case Study

Authors: Calvin Odhiambo

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Depression among young adults is a common health problem and a growing public health concern. Of the young adult population, college students are particularly vulnerable to depression as they find themselves grappling with the stress and anxiety of college life while at the same navigating the demands of separation and independence from familial ties. To deal with the resultant mental health challenges affecting this population, most colleges offer counseling services to their student population. What is not known, however, is the extent to which students are aware of or even utilize such mental health services. Our study set out to assess the level of student awareness and utilization of counseling services and programs at a southeastern public university in the United States. Data were collected through self-administered questionnaires given to a convenience sample of 508 undergraduate students voluntarily recruited from 38 classes representing five colleges. Data analysis was done using the Statistical Package of Social Sciences (SPSS) version 25. Results showed that even though a majority of students were aware of the mental health services offered by the university, an overwhelming majority of these students did not utilize any of these services or participate in any mental health programs offered by the university. Significant gender and racial differences were observed. Reasons for the lack of awareness and utilization of mental health services are explored. Recommendations are made on how to increase student awareness and utilization of mental health services, and the implications of the findings are discussed. The findings of this study help to fill an academic lacuna on this issue and provides an important basis for developing policies to help mitigate the growing problem of depression and attendant mental health problems among undergraduate students.

Keywords: depression, counseling services, undergraduate college students, utilization of mental health services, perceptions and awareness

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12751 Policy and System Research for Health of Ageing Population

Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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12750 The Lopsided Burden of Non-Communicable Diseases in India: Evidences from the Decade 2004-2014

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

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India is a part of the ongoing globalization, contemporary convergence, industrialization and technical advancement that is taking place world-wide. Some of the manifestations of this evolution is rapid demographic, socio-economic, epidemiological and health transition. There has been a considerable increase in non-communicable diseases due to change in lifestyle. This study aims to assess the direction of burden of disease and compare the pressure of infectious diseases against cardio-vascular, endocrine, metabolic and nutritional diseases. The change in prevalence in a ten-year period (2004-2014) is further decomposed to determine the net contribution of various socio-economic and demographic covariates. The present study uses the recent 71st (2014) and 60th (2004) rounds of National Sample Survey. The pressure of infectious diseases against cardio-vascular (CVD), endocrine, metabolic and nutritional (EMN) diseases during 2004-2014 is calculated by Prevalence Rates (PR), Hospitalization Rates (HR) and Case Fatality Rates (CFR). The prevalence of non-communicable diseases are further used as a dependent variable in a logit regression to find the effect of various social, economic and demographic factors on the chances of suffering from the particular disease. Multivariate decomposition technique further assists in determining the net contribution of socio-economic and demographic covariates. This paper upholds evidences of stagnation of the burden of communicable diseases (CD) and rapid increase in the burden of non-communicable diseases (NCD) uniformly for all population sub-groups in India. CFR for CVD has increased drastically in 2004-2014. Logit regression indicates the chances of suffering from CVD and EMN is significantly higher among the urban residents, older ages, females, widowed/ divorced and separated individuals. Decomposition displays ample proof that improvement in quality of life markers like education, urbanization, longevity of life has positively contributed in increasing the NCD prevalence rate. In India’s current epidemiological phase, compression theory of morbidity is in action as a significant rise in the probability of contracting the NCDs over the time period among older ages is observed. Age is found to play a vital contributor in increasing the probability of having CVD and EMN over the study decade 2004-2014 in the nationally representative sample of National Sample Survey.

Keywords: cardio-vascular disease, case-fatality rate, communicable diseases, hospitalization rate, multivariate decomposition, non-communicable diseases, prevalence rate

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12749 Evaluation and Selection of Construction Contractors by Polish Public Clients

Authors: Kozik Renata, Leśniak Agnieszka, Plebankiewicz Edyta

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Contracting authorities in the public sector are obligated to apply the principles provided for in the Polish law for the evaluation and selection of contractors. To analyze the methods of contractors, applied in practice by public clients, the notices of contract award results for construction works were analyzed. The analysis shows that the procedure selected more and more often is open to competitive bidding, where the assessment of the competence of contractors is not very precise, as well as non-competitive bidding, i.e. single source procurement. The share of procurement procedures, where the only criterion is price, is increasing. The solution to the problems existing here might be the introduction of one of the forms of pre-selection of contractors. The article also briefly discusses verification systems for companies applying for public contracts used in EU countries.

Keywords: certification, contractors selection, open tendering, public investors

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12748 Public Economic Efficiency and Case-Based Reasoning: A Theoretical Framework to Police Performance

Authors: Javier Parra-Domínguez, Juan Manuel Corchado

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At present, public efficiency is a concept that intends to maximize return on public investment focus on minimizing the use of resources and maximizing the outputs. The concept takes into account statistical criteria drawn up according to techniques such as DEA (Data Envelopment Analysis). The purpose of the current work is to consider, more precisely, the theoretical application of CBR (Case-Based Reasoning) from economics and computer science, as a preliminary step to improving the efficiency of law enforcement agencies (public sector). With the aim of increasing the efficiency of the public sector, we have entered into a phase whose main objective is the implementation of new technologies. Our main conclusion is that the application of computer techniques, such as CBR, has become key to the efficiency of the public sector, which continues to require economic valuation based on methodologies such as DEA. As a theoretical result and conclusion, the incorporation of CBR systems will reduce the number of inputs and increase, theoretically, the number of outputs generated based on previous computer knowledge.

Keywords: case-based reasoning, knowledge, police, public efficiency

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12747 Need of Medicines Information OPD in Tertiary Health Care Settings: A Cross Sectional Study

Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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12746 On the Path of the Ottoman Modernization Period Mesire: As a Women Place in 19th Century

Authors: Merve Kurt

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How women should behave in public spaces and how they should be dressed was a loaded issues in the Ottoman Empire. They pointed to what kind of state the Ottoman State was. One of such public space was Mesires, promenades. Women's visibility and invisibility, their morals were reflected and linked to the society as a whole. How the public space and private space is defined, what were the lines that separates them, how much blurred these lines were discussed in this paper. Moreover, all these points were strengthened by the primary sources from archives dating to the end of the 19th century.

Keywords: Mesire, Ottoman Empire, Ottoman women, public spaces

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12745 Creating a Digital Map to Monitor the Care of People Living with HIV/Aids in Porto Alegre, Brazil: An Experience Report

Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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12744 The Potential of Shifting Urban Village to Public Housing through Sharing Economy: Case Study of Shenzhen

Authors: Xinrui Gao

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This research aims to explore the potential of shifting urban villages to public housing in China. In common practice, the central and local governments established two divided systems of urban redevelopment and public housing, including aims, design ideas, policy, headquarters, and branch offices. In most cases, the urban regeneration and public housing projects satisfy only the selected part of the society who can afford it (urban regeneration) or meet the requirements (public housing), which fail to cover the housing demand. However, there are many similarities between these two types of housing under the background of a shared economy, especially in target groups, affordable prices, and efficient use of spaces. Shenzhen always takes the lead in China’s urban regeneration and housing reformation. There are some top-down approaches to transforming housing in the urban village into public housing at present. These new approaches will provide a good chance to evaluate existing practices and explore the future development path of urban villages; while at the same time it could positively influence the housing problem in China.

Keywords: urban village, public housing, sharing economy, urban redevelopment

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12743 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi

Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

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12742 Working at the Interface of Health and Criminal Justice: An Interpretative Phenomenological Analysis Exploration of the Experiences of Liaison and Diversion Nurses – Emerging Findings

Authors: Sithandazile Masuku

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Introduction: Public health approaches to offender mental health are driven by international policies and frameworks in response to the disproportionately large representation of people with mental health problems within the offender pathway compared to the general population. Public health service innovations include mental health courts in the US, restorative models in Singapore and, liaison and diversion services in Australia, the UK, and some other European countries. Mental health nurses are at the forefront of offender health service innovations. In the U.K. context, police custody has been identified as an early point within the offender pathway where nurses can improve outcomes by offering assessments and share information with criminal justice partners. This scope of nursing practice has introduced challenges related to skills and support required for nurses working at the interface of health and the criminal justice system. Parallel literature exploring experiences of nurses working in forensic settings suggests the presence of compassion fatigue, burnout and vicarious trauma that may impede risk harm to the nurses in these settings. Published research explores mainly service-level outcomes including monitoring of figures indicative of a reduction in offending behavior. There is minimal research exploring the experiences of liaison and diversion nurses who are situated away from a supportive clinical environment and engaged in complex autonomous decision-making. Aim: This paper will share qualitative findings (in progress) from a PhD study that aims to explore the experiences of liaison and diversion nurses in one service in the U.K. Methodology: This is a qualitative interview study conducted using an Interpretative Phenomenological Analysis to gain an in-depth analysis of lived experiences. Methods: A purposive sampling technique was used to recruit n=8 mental health nurses registered with the UK professional body, Nursing and Midwifery Council, from one UK Liaison and Diversion service. All participants were interviewed online via video call using semi-structured interview topic guide. Data were recorded and transcribed verbatim. Data were analysed using the seven steps of the Interpretative Phenomenological Analysis data analysis method. Emerging Findings Analysis to date has identified pertinent themes: • Difficulties of meaning-making for nurses because of the complexity of their boundary spanning role. • Emotional burden experienced in a highly emotive and fast-changing environment. • Stress and difficulties with role identity impacting on individual nurses’ ability to be resilient. • Challenges to wellbeing related to a sense of isolation when making complex decisions. Conclusion Emerging findings have highlighted the lived experiences of nurses working in liaison and diversion as challenging. The nature of the custody environment has an impact on role identity and decision making. Nurses left feeling isolated and unsupported are less resilient and may go on to experience compassion fatigue. The findings from this study thus far point to a need to connect nurses working in these boundary spanning roles with a supportive infrastructure where the complexity of their role is acknowledged, and they can be connected with a health agenda. In doing this, the nurses would be protected from harm and the likelihood of sustained positive outcomes for service users is optimised.

Keywords: liaison and diversion, nurse experiences, offender health, staff wellbeing

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12741 Organizing Diabetes Care in a Resource Constrained Country: Bangladesh as an Example

Authors: Liaquat Ali, Khurshid Natasha

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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.

Keywords: Bangladesh, self sustain, health care, constrain

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12740 A Comparative Analysis of the Role, Representations and Architectural Identity of Public Space in Medieval and Contemporary Cairo

Authors: Muhammad Feteha

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The socio-political Middle East scene has radically changed over the last decade, and one major contributor to this change was the Egyptian revolution of 2011. The massive impact of this revolution that originally started as a small protest in the Tahrir square has attracted more scholars to study the public space in Egypt, where it has become a necessity in order to understand and improve the socio-political conditions. The status of public space in Egypt has been deteriorating due to many reasons, including privatization and neglect. This paper studies one of the major problems of the contemporary public space in Cairo, which is the lack of identity. This takes place through a comparative analysis between selected case studies from both medieval and contemporary Cairo. The theoretical framework upon which the analysis is based views public space as a ‘container of social action’ and a ‘product of spatial practice’. Through the ‘deciphering of space’, differences in the socio-political role, symbolism, and identity of public spaces between both eras are shown. The paper aims to extract some lessons from public space in medieval Cairo, which was truly the ‘centerpiece of the public realm’ and a ‘fundamental expressions’ of the unique trans-dynastic architectural identity of Cairo. In addition, it suggests some strategies to revive the Cairene identity of public space instead of constructing new ones to be only ‘utilitarian spaces used for circulation’ and lack any identity.

Keywords: architectural identity, Cairene public space, Islamic architectural history, production of space

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12739 Job Satisfaction and Associated factors of Urban Health Extension Professionals in Addis Ababa City, Ethiopia

Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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12738 The Implementation of Information Security Audits in Public Sector: Perspective from Indonesia

Authors: Nur Imroatun Sholihat, Gresika Bunga Sylvana

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Currently, cyber attack became an incredibly serious problem due to its increasing trend all over the world. Therefore, information security becomes prominent for every organization including public sector organization. In Indonesia, unfortunately, Ministry of Finance (MoF) is the only public sector organization that has already formally established procedure to assess its information security adequacy by performing information security audits (November 2017). We assess the implementation of information security audits in the MoF using qualitative data obtained by interviewing IT auditors and by analysis of related documents. For this reason, information security audit practice in the MoF could become the acceptable benchmark for all other public sector organizations in Indonesia. This study is important because, to the best of the author’s knowledge, our research into information security audits practice in Indonesia’s public sector have not been found yet. Results showed that information security audits performed mostly by doing pentest (penetration testing) to MoF’s critical applications.

Keywords: information security audit, information technology, Ministry of Finance of Indonesia, public sector organization

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