Search results for: health planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11955

Search results for: health planning

8355 The State of Herb Medicine in Oriental Morocco: Cases of Debdou, Taourirt and Guerssif Districts

Authors: Himer Khalid, Alami Ilyass, Kharchoufa Loubna, Elachouri Mostafa

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It has been estimated by the World Health Organization that 80% of the world's population relies on traditional medicine to meet their daily health requirements. In Morocco reliance on such medicine is partly owing to the high cost of conventional medicine and the inaccessibility of modern health care facilities. There was high agreement in the use of plants as medicine in Oriental Morocco. Our objective is to evaluate the informant’s knowledge on medicinal plants by the local population and to document the uses of medicinal plants by this community, for the treatment of different illnesses. Using an ethnopharmacological approach, we collected information concerning the traditional medicinal knowledge and the medicinal plants used, by interviewing successfully 458 informants living in oriental Morocco (from Debdou, Taourirt, Guersif a,d Laayoune districts). The data were analyzed by statistical methods (Component Analysis “CA”, Factorial Analysis “FA”) and other methods such as through Informant’s Consensus Factor (ICF) and Use Value (UV). Our results indicate that, more than 60% of the population in these regions relies on medicinal plants for the treatment of different ailments with predominance of women consumers. 135 plant species belonging to 61 families were documented. These plants were used by the population for the treatment of a group of illness (about 14 principal ailments). We conclude that, in oriental Morocco, till now, the population has some traditional knowledge commonly used as medical tradition. These wealthy heritage needs conservation and evaluation.

Keywords: Morocco, medicinal plants, traditional knowledge, wealthy heritage

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8354 Prescribed Organization of Nursing Work and Psychosocial Risks: A Cross-Sectional Study

Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

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To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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8353 Social Justice-Focused Mental Health Practice: An Integrative Model for Clinical Social Work

Authors: Hye-Kyung Kang

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Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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8352 Global Health, Humanitarian Medical Aid, and the Ethics of Rationing

Authors: N. W. Paul, S. Michl

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In our globalized world we need to appreciate the fact that questions of health and justice need to be addressed on a global scale, too. The way in which diverse governmental and non-governmental initiatives are trying to answer the need for humanitarian medical aid has long since been a visible result of globalized responsibility. While the intention of humanitarian medical aids seems to be evident, the allocation of resources has become more and more an ethical and societal challenge. With a rising number and growing dimension of humanitarian catastrophes around the globe the search for ethically justifiable ways to decide who might benefit from limited resources has become a pressing question. Rooted in theories of justice (Rawls) and concepts of social welfare (Sen) we developed and implemented a model for an ethically sound distribution of a limited annual budget for humanitarian care in one of the largest medical universities of Germany. Based on our long lasting experience with civil casualties of war (Afghanistan) and civil war (Libya) as well as with under- and uninsured and/or stateless patients we are now facing the on-going refugee crisis as our most recent challenge in terms of global health and justice. Against this background, the paper strives to a) explain key issues of humanitarian medical aid in the 21st century, b) explore the problem of rationing from an ethical point of view, c) suggest a tool for the rational allocation of scarce resources in humanitarian medical aid, d) present actual cases of humanitarian care that have been managed with our toolbox, and e) discuss the international applicability of our model beyond local contexts.

Keywords: humanitarian care, medical ethics, allocation, rationing

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8351 The Impact of Multiple Stressors on the Functioning and Resilience of Model Freshwater Ecosystems

Authors: Sajida Saqira, Anthony Chariton, Grant C. Hose

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The Anthropocene has seen dramatic environmental changes which are affecting every ecosystem on earth. Freshwater ecosystems are particularly vulnerable as they are at risk from the many activities that go on and contaminants that are released in catchments. They are thus subject to many stressors simultaneously. Freshwater ecosystems respond to stress at all levels of biological organization, from subcellular to community structure and ecosystem functioning. The aim of this study was to examine the resistance and resilience of freshwater ecosystems to multiple stressors. Here we explored the individual and combined effects of copper as a chemical stressor and common carp (Cyprinus carpio) as a biological stressor on the health, functioning, and recovery of outdoor experimental pond ecosystems in a long-term, controlled, factorial experiment. Primary productivity, decomposition, and water and sediment quality were analysed at regular intervals for one year to understand the health and functioning of the ecosystems. Changes to benthic biota were quantified using DNA-based and traditional microscopy-based counts of invertebrates. Carp were added to the ponds to copper contaminated sediments (with controls) to explore the combined effects of copper and carp and removed after six months to explore the resilience and recovery of the system. The outcomes of this study will advance our understanding of the impacts of multiple stressors on freshwater ecosystems, and the resilience of these systems to copper and C. carpio, which are both globally significant stressors in freshwater systems.

Keywords: carp, copper, ecosystem health, freshwater ecosystem, multiple stressors

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8350 A Green Hydrogen Route for Electromobility in Brazil and Its Impact in Climate Change

Authors: Milena França Marques

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Due to the climate crisis, several countries such as Brazil began to look for energy alternatives, finding green hydrogen as a possible solution. In addition to not emitting polluting gasses, it also has a large energy capacity, being an excellent alternative for the transport sector, the third sector that emits the most Greenhouse Gases (GHG) in Brazil. Therefore, this work aims to suggest a route for using green hydrogen, through the analysis of plans implemented in other countries, the Brazilian situation, and its difficulties in the development of hydrogen and electromobility, aiming to understand how its value chain works, as well as how to make the Brazilian fleet more efficient and decarbonize. As a result, 68 structuring measures were suggested for the first 5 axes of the National Hydrogen Program (PNH2) using the Three-Year Plan as a basis. Categorizations of measures were also made, definitions of those responsible for their development and implementation, as well as deadlines for them to be met. It is concluded that the study has the potential to promote national energy-environmental mobility transition planning realistically, capable of developing hydrogen and electromobility in Brazil, in addition to contributing to achieving the goals established by its Nationally Determined Contribution (NDC).

Keywords: climate change, electromobility, hydrogen, roadmap

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8349 Assessment of Soil Salinity through Remote Sensing Technique in the Coastal Region of Bangladesh

Authors: B. Hossen, Y. Helmut

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Soil salinity is a major problem for the coastal region of Bangladesh, which has been increasing for the last four decades. Determination of soil salinity is essential for proper land use planning for agricultural crop production. The aim of the research is to estimate and monitor the soil salinity in the study area. Remote sensing can be an effective tool for detecting soil salinity in data-scarce conditions. In the research, Landsat 8 is used, which required atmospheric and radiometric correction, and nine soil salinity indices are applied to develop a soil salinity map. Ground soil salinity data, i.e., EC value, is collected as a printed map which is then scanned and digitized to develop a point shapefile. Linear regression is made between satellite-based generated map and ground soil salinity data, i.e., EC value. The results show that maximum R² value is found for salinity index SI 7 = G*R/B representing 0.022. This minimal R² value refers that there is a negligible relationship between ground EC value and salinity index generated value. Hence, these indices are not appropriate to assess soil salinity though many studies used those soil salinity indices successfully. Therefore, further research is necessary to formulate a model for determining the soil salinity in the coastal of Bangladesh.

Keywords: soil salinity, EC, Landsat 8, salinity indices, linear regression, remote sensing

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8348 The Advancement of Smart Cushion Product and System Design Enhancing Public Health and Well-Being at Workplace

Authors: Dosun Shin, Assegid Kidane, Pavan Turaga

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According to the National Institute of Health, living a sedentary lifestyle leads to a number of health issues, including increased risk of cardiovascular dis-ease, type 2 diabetes, obesity, and certain types of cancers. This project brings together experts in multiple disciplines to bring product design, sensor design, algorithms, and health intervention studies to develop a product and system that helps reduce the amount of time sitting at the workplace. This paper illustrates ongoing improvements to prototypes the research team developed in initial research; including working prototypes with a software application, which were developed and demonstrated for users. Additional modifications were made to improve functionality, aesthetics, and ease of use, which will be discussed in this paper. Extending on the foundations created in the initial phase, our approach sought to further improve the product by conducting additional human factor research, studying deficiencies in competitive products, testing various materials/forms, developing working prototypes, and obtaining feedback from additional potential users. The solution consisted of an aesthetically pleasing seat cover cushion that easily attaches to common office chairs found in most workplaces, ensuring a wide variety of people can use the product. The product discreetly contains sensors that track when the user sits on their chair, sending information to a phone app that triggers reminders for users to stand up and move around after sitting for a set amount of time. This paper also presents the analyzed typical office aesthetics and selected materials, colors, and forms that complimented the working environment. Comfort and ease of use remained a high priority as the design team sought to provide a product and system that integrated into the workplace. As the research team continues to test, improve, and implement this solution for the sedentary workplace, the team seeks to create a viable product that acts as an impetus for a more active workday and lifestyle, further decreasing the proliferation of chronic disease and health issues for sedentary working people. This paper illustrates in detail the processes of engineering, product design, methodology, and testing results.

Keywords: anti-sedentary work behavior, new product development, sensor design, health intervention studies

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8347 Practices Supporting the Wellbeing of Healthcare Staff: Findings From a Narrative Inquiry

Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham, Sue Cutmore, Chris Degeling, Kristine Falzon, Summer Finlay

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Effective local responses to community needs are grounded in contextual knowledge and built on existing resources. The SEED Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW, Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

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8346 Distributed Manufacturing (DM)- Smart Units and Collaborative Processes

Authors: Hermann Kuehnle

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Developments in ICT totally reshape manufacturing as machines, objects and equipment on the shop floors will be smart and online. Interactions with virtualizations and models of a manufacturing unit will appear exactly as interactions with the unit itself. These virtualizations may be driven by providers with novel ICT services on demand that might jeopardize even well established business models. Context aware equipment, autonomous orders, scalable machine capacity or networkable manufacturing unit will be the terminology to get familiar with in manufacturing and manufacturing management. Such newly appearing smart abilities with impact on network behavior, collaboration procedures and human resource development will make distributed manufacturing a preferred model to produce. Computing miniaturization and smart devices revolutionize manufacturing set ups, as virtualizations and atomization of resources unwrap novel manufacturing principles. Processes and resources obey novel specific laws and have strategic impact on manufacturing and major operational implications. Mechanisms from distributed manufacturing engaging interacting smart manufacturing units and decentralized planning and decision procedures already demonstrate important effects from this shift of focus towards collaboration and interoperability.

Keywords: autonomous unit, networkability, smart manufacturing unit, virtualization

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8345 Relationship between Effective Classroom Management with Students’ Academic Achievement of EFL of STKIP YPUP

Authors: Eny Syatriana

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The purpose of this study is to find out the effective instruction for classroom management, with the main identification of organizing and managing effective learning environments, to identify characteristics of effective lesson planning, identify resources and materials dealing with positive and effective classroom management. Knowing the effective instruction management is one of the characteristics of well managed teacher. The study was carried out in three randomly selected classes of STKIP YPUP in South Sulawesi. The design adopted for the study was a descriptive survey approach. Simple descriptive analysis was used. The major instrument used in this study were student questionnaire, teacher questionnaire, data were gathered with the research instrument and were analyzed, the research question were investigated and two hypothesis were duly tested using t-test statistics. Based on the findings of this research, it was concluded that effective classroom management skills or techniques have strong and positive influence on student achievement.

Keywords: effective classroom management skills, students’ achievement, students academic, effective learning environments

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8344 2016 Taiwan's 'Health and Physical Education Field of 12-Year Basic Education Curriculum Outline (Draft)' Reform and Its Implications

Authors: Hai Zeng, Yisheng Li, Jincheng Huang, Chenghui Huang, Ying Zhang

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Children are strong; the country strong, the development of children Basketball is a strategic advantage. Common forms of basketball equipment has been difficult to meet the needs of young children teaching the game of basketball, basketball development for 3-6 years old children in the form of appropriate teaching aids is a breakthrough basketball game teaching children bottlenecks, improve teaching critical path pleasure, but also the development of early childhood basketball a necessary requirement. In this study, literature, questionnaires, focus group interviews, comparative analysis, for domestic and foreign use of 12 kinds of basketball teaching aids (cloud computing MINI basketball, adjustable basketball MINI, MINI basketball court, shooting assist paw print ball, dribble goggles, dribbling machine, machine cartoon shooting, rebounding machine, against the mat, elastic belt, ladder, fitness ball), from fun and improve early childhood shooting technique, dribbling technology, as well as offensive and defensive rebounding against technology conduct research on conversion technology. The results show that by using appropriate forms of teaching children basketball aids, can effectively improve children's fun basketball game, targeted to improve a technology, different types of aids from different perspectives enrich the connotation of children basketball game. Recommended for children of color psychology, cartoon and environmentally friendly material production aids, and increase research efforts basketball aids children, encourage children to sports teachers aids applications.

Keywords: health and physical education field of curriculum outline, health fitness, sports and health curriculum reform, Taiwan, twelve years basic education

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8343 Municipalities as Enablers of Citizen-Led Urban Initiatives: Possibilities and Constraints

Authors: Rosa Nadine Danenberg

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In recent years, bottom-up urban development has started growing as an alternative to conventional top-down planning. In large proportions, citizens and communities initiate small-scale interventions; suddenly seeming to form a trend. As a result, more and more cities are witnessing not only the growth of but also an interest in these initiatives, as they bear the potential to reshape urban spaces. Such alternative city-making efforts cause new dynamics in urban governance, with inevitable consequences for the controlled city planning and its administration. The emergence of enabling relationships between top-down and bottom-up actors signals an increasingly common urban practice. Various case studies show that an enabling relationship is possible, yet, how it can be optimally realized stays rather underexamined. Therefore, the seemingly growing worldwide phenomenon of ‘municipal bottom-up urban development’ necessitates an adequate governance structure. As such, the aim of this research is to contribute knowledge to how municipalities can enable citizen-led urban initiatives from a governance innovation perspective. Empirical case-study research in Stockholm and Istanbul, derived from interviews with founders of four citizen-led urban initiatives and one municipal representative in each city, provided valuable insights to possibilities and constraints for enabling practices. On the one hand, diverging outcomes emphasize the extreme oppositional features of both cases (Stockholm and Istanbul). Firstly, both cities’ characteristics are drastically different. Secondly, the ideologies and motifs for the initiatives to emerge vary widely. Thirdly, the major constraints for citizen-led urban initiatives to relate to the municipality are considerably different. Two types of municipality’s organizational structures produce different underlying mechanisms which demonstrate the constraints. The first municipal organizational structure is steered by bureaucracy (Stockholm). It produces an administrative division that brings up constraints such as the lack of responsibility, transparency and continuity by municipal representatives. The second structure is dominated by municipal politics and governmental hierarchy (Istanbul). It produces informality, lack of transparency and a fragmented civil society. In order to cope with the constraints produced by both types of organizational structures, the initiatives have adjusted their organization to the municipality’s underlying structures. On the other hand, this paper has in fact also come to a rather unifying conclusion. Interestingly, the suggested possibilities for an enabling relationship underline converging new urban governance arrangements. This could imply that for the two varying types of municipality’s organizational structures there is an accurate governance structure. Namely, the combination of a neighborhood council with a municipal guide, with allowance for the initiatives to adopt a politicizing attitude is found as coinciding. Especially its combination appears key to redeem varying constraints. A municipal guide steers the initiatives through bureaucratic struggles, is supported by coproduction methods, while it balances out municipal politics. Next, a neighborhood council, that is politically neutral and run by local citizens, can function as an umbrella for citizen-led urban initiatives. What is crucial is that it should cater for a more entangled relationship between municipalities and initiatives with enhanced involvement of the initiatives in decision-making processes and limited involvement of prevailing constraints pointed out in this research.

Keywords: bottom-up urban development, governance innovation, Istanbul, Stockholm

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8342 Factors for Success in Eco-Industrial Town Development in Thailand

Authors: Jirarat Teeravaraprug, Tarathorn Podcharathitikull

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Nowadays, Ministry of Industry has given an attention to develop Eco-industrial towns in Thailand. Eco-industrial towns are a way of demonstrating the application of industrial ecology and are subjects of increased interest as government, business and society. This concept of Eco-industrial town is quite new in Thailand. It is used as a way of achieving more sustainable industrial development. However, many firms or organizations have misunderstood the concept and treated with suspicion. The planning and development of Eco-industrial towns is a significant challenge for the developers and public agencies. This research then gives an attempt to determine current problems of being Eco-Industrial towns and determine success factors for developing Eco-Industrial towns in Thailand. The research starts with giving knowledge about Eco-industrial towns to stakeholders and conducting public hearing in order to acquire the problems of being Eco-industrial towns. Then, factors effecting the development of Eco-Industrial town are collected. The obtained factors are analyzed by using the concept of IOC. Then, the remained factors are categorized and structured based on the concept of AHP. A questionnaire is constructed and distributed to the experts who are involved in the Eco-industrial town project. The result shows that the most significant success criterion is management teams of industrial parks or groups and the second most significant goes to governmental policies.

Keywords: AHP, Eco-Industrial town, success factors, Thailand

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8341 Development of Ready Reckoner Charts for Easy, Convenient, and Widespread Use of Horrock’s Apparatus by Field Level Health Functionaries in India

Authors: Gumashta Raghvendra, Gumashta Jyotsna

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Aim and Objective of Study : The use of Horrock’s Apparatus by health care worker requires onsite mathematical calculations for estimation of ‘volume of water’ and ‘amount of bleaching powder’ necessary as per the serial number of first cup showing blue coloration after adding freshly prepared starch-iodide indicator solution. In view of the difficulties of two simultaneous calculations required to be done, the use of Horrock’s Apparatus is not routinely done by health care workers because it is impractical and inconvenient Material and Methods: Arbitrary use of bleaching powder in wells results in hyper-chlorination or hypo-chlorination of well defying the purpose of adequate chlorination or non-usage of well water due to hyper-chlorination. Keeping this in mind two nomograms have been developed, one to assess the volume of well using depth and diameter of well and the other to know the quantity of bleaching powder to b added using the number of the cup of Horrock’s apparatus which shows the colour indication. Result & Conclusion: Out of thus developed two self-speaking interlinked easy charts, first chart will facilitate bypassing requirement of formulae ‘πr2h’ for water volume (ready reckoner table with depth of water shown on ‘X’ axis and ‘diameter of well’ on ‘Y’ axis) and second chart will facilitate bypassing requirement formulae ‘2ab/455’ (where ‘a’ is for ‘serial number of cup’ and ‘b’ is for ‘water volume’, while ready reckoner table showing ‘water volume’ shown on ‘X’ axis and ‘serial number of cup’ on ‘Y’ axis). The use of these two charts will help health care worker to immediately known, by referring the two charts, about the exact requirement of bleaching powder. Thus, developed ready reckoner charts will be easy and convenient to use for ensuring prevention of water-borne diseases occurring due to hypo-chlorination, especially in rural India and other developing countries.

Keywords: apparatus, bleaching, chlorination, Horrock’s, nomogram

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8340 Navigating States of Emergency: A Preliminary Comparison of Online Public Reaction to COVID-19 and Monkeypox on Twitter

Authors: Antonia Egli, Theo Lynn, Pierangelo Rosati, Gary Sinclair

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The World Health Organization (WHO) defines vaccine hesitancy as the postponement or complete denial of vaccines and estimates a direct linkage to approximately 1.5 million avoidable deaths annually. This figure is not immune to public health developments, as has become evident since the global spread of COVID-19 from Wuhan, China in early 2020. Since then, the proliferation of influential, but oftentimes inaccurate, outdated, incomplete, or false vaccine-related information on social media has impacted hesitancy levels to a degree described by the WHO as an infodemic. The COVID-19 pandemic and related vaccine hesitancy levels have in 2022 resulted in the largest drop in childhood vaccinations of the 21st century, while the prevalence of online stigma towards vaccine hesitant consumers continues to grow. Simultaneously, a second disease has risen to global importance: Monkeypox is an infection originating from west and central Africa and, due to racially motivated online hate, was in August 2022 set to be renamed by the WHO. To better understand public reactions towards two viral infections that became global threats to public health no two years apart, this research examines user replies to threads published by the WHO on Twitter. Replies to two Tweets from the @WHO account declaring COVID-19 and Monkeypox as ‘public health emergencies of international concern’ on January 30, 2020, and July 23, 2022, are gathered using the Twitter application programming interface and user mention timeline endpoint. Research methodology is unique in its analysis of stigmatizing, racist, and hateful content shared on social media within the vaccine discourse over the course of two disease outbreaks. Three distinct analyses are conducted to provide insight into (i) the most prevalent topics and sub-topics among user reactions, (ii) changes in sentiment towards the spread of the two diseases, and (iii) the presence of stigma, racism, and online hate. Findings indicate an increase in hesitancy to accept further vaccines and social distancing measures, the presence of stigmatizing content aimed primarily at anti-vaccine cohorts and racially motivated abusive messages, and a prevalent fatigue towards disease-related news overall. This research provides value to non-profit organizations or government agencies associated with vaccines and vaccination programs in emphasizing the need for public health communication fitted to consumers' vaccine sentiments, levels of health information literacy, and degrees of trust towards public health institutions. Considering the importance of addressing fears among the vaccine hesitant, findings also illustrate the risk of alienation through stigmatization, lead future research in probing the relatively underexamined field of online, vaccine-related stigma, and discuss the potential effects of stigma towards vaccine hesitant Twitter users in their decisions to vaccinate.

Keywords: social marketing, social media, public health communication, vaccines

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8339 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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8338 Educational Attainment Inequalities in Depressive Symptoms in More Than 100 000 Individuals in Europe

Authors: Adam Chlapecka, Anna Kagstrom, Pavla Cermakova

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Background: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. Methods: We studied 108 315 Europeans (54 % women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (7 educational levels based on ISCED classification); and depressive symptoms (≥ 4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions. Results: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe. Conclusion: The level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to the decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.

Keywords: depression, education, epidemiology, Europe

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8337 Dynamic Evaluation of Shallow Lake Habitat Quality Based on InVEST Model: A Case in Baiyangdian Lake

Authors: Shengjun Yan, Xuan Wang

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Water level changes in a shallow lake always introduce dramatic land pattern changes. To achieve sustainable ecosystem service, it is necessary to evaluate habitat quality dynamic and its spatio-temporal variation resulted from water level changes, which can provide a scientific basis for protection of biodiversity and planning of wetland ecological system. Landsat data in the spring was chosen to obtain landscape data at different times based on the high, moderate and low water level of Baiyangdian Shallow Lake. We used the InVEST to evaluate the habitat quality, habitat degradation, and habitat scarcity. The result showed that: 1) the water level of shallow lake changes from high to low lead to an obvious landscape pattern changes and habitat degradation, 2) the most change area occurred in northwestward and southwest of Baiyangdian Shallow Lake, which there was a 21 percent of suitable habitat and 42 percent of moderately suitable habitat lost. Our findings show that the changes of water level in the shallow lake would have a strong relationship with the habitat quality.

Keywords: habitat quality, habitat degradation, water level changes, shallow lake

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8336 Investigate the Movement of Salt-Wedge at Co Chien Estuary, Vietnam in the Context of Climate Change and Reduce Upstream Flow Using 3D Model

Authors: Hieu Duy Nguyen, Chitsan Lin Jr., Dung Duc Tran

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Nowadays, drought and salinity intrusion becomes a severe problem in the Lower Mekong region due to climate change, especially in coastal provinces. Freshwater resources are decreased due to sea-level rise and the decline in water flow from upstream in the dry season. The combination of the above issues can lead to many effects on the environment and human health in affected areas such as the pathological of digestive or decreased the immune system. Tidal cycle and upstream flows are the two main factors affecting the saline intrusion process and the former salt-wedge in the estuary. Under suitable conditions, salt-wedge can be going further upstream under the water surface and affected groundwater. In order to have a proper plan for the mitigation of the above adverse effects, we need to understand the characteristics of this process. In this study, 3D model is used to investigate the movement of salt-wedge under different conditions of tidal and flow discharge. The salinity in the vertical profile is also measured in the dry season of 2017 and 2018 for model calibrating. The data has proved that there is the presence of salt-wedge in the study area. The obtained results will help strategic planners to use and preserve water resources more effectively and serve as a basis for new research directions on saline intrusion and human health.

Keywords: salt-wedge, salinity intrusion, human health, 3D model

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8335 Leveraging Artificial Intelligence to Analyze the Interplay between Social Vulnerability Index and Mobility Dynamics in Pandemics

Authors: Joshua Harrell, Gideon Osei Bonsu, Susan Garza, Clarence Conner, Da’Neisha Harris, Emma Bukoswki, Zohreh Safari

Abstract:

The Social Vulnerability Index (SVI) stands as a pivotal tool for gauging community resilience amidst diverse stressors, including pandemics like COVID-19. This paper synthesizes recent research and underscores the significance of SVI in elucidating the differential impacts of crises on communities. Drawing on studies by Fox et al. (2023) and Mah et al. (2023), we delve into the application of SVI alongside emerging data sources to uncover nuanced insights into community vulnerability. Specifically, we explore the utilization of SVI in conjunction with mobility data from platforms like SafeGraph to probe the intricate relationship between social vulnerability and mobility dynamics during the COVID-19 pandemic. By leveraging 16 community variables derived from the American Community Survey, including socioeconomic status and demographic characteristics, SVI offers actionable intelligence for guiding targeted interventions and resource allocation. Building upon recent advancements, this paper contributes to the discourse on harnessing AI techniques to mitigate health disparities and fortify public health resilience in the face of pandemics and other crises.

Keywords: social vulnerability index, mobility dynamics, data analytics, health equity, pandemic preparedness, targeted interventions, data integration

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8334 Factors Constraining the Utilization of Risk Management Strategies in the Execution of Public Construction Projects in North East Nigeria

Authors: S. U. Kunya, S. A. Mohammad

Abstract:

Construction projects in Nigeria are characterized with risks emanating from delays and accompanying cost-overruns. The aim of the study was to identify and assess factors constraining the utilization of risk management strategies in the execution of public construction project in North-East Nigeria. Data was collected with the aid of a well-structured questionnaire administered to three identified projects in the North-east. Data collected were analysed using the severity index. Findings revealed political involvement, selection of inexperienced contractors and lack of coordinated public sector strategy as the most severe factors constraining the utilization of risk management strategies. The study recommended that: formulation of laws to prevent negative political meddling in construction projects; selection of experienced, risk-informed contractors; and comprehensive risk assessment and planning on all public construction projects.

Keywords: factors, Nigeria, north-east, public projects, risk management, strategies, utilization

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8333 Depression in Non Hospitalized Jordanian Patients with Coronary Artery Disease

Authors: Ibtisam Al-Zaru

Abstract:

Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

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8332 Unified Public Transportation System for Mumbai Using Radio Frequency Identification

Authors: Saurabh Parkhedkar, Rajanikant Tenguria

Abstract:

The paper proposes revamping the public transportation system in Mumbai with the use of Radio Frequency Identification (RFID) technology in order to provide better integration and compatibility across various modes of transport. In Mumbai, mass transport system suffers from poor inter-compatible ticketing system, subpar money collection techniques, and lack of planning for optimum utilization of resources. Development of suburbs and growth in population will result in growing demand for mass transportation networks. Hence, the growing demand for the already overburdened public transportation system is only going to worsen the scenario. Thus, a superior system is essential in order to regulate, manage and supervise future transportation needs. The proposed RFID based system integrates Mumbai Suburban Railway, BEST (Brihanmumbai Electric Supply and Transport Undertaking transport wing) Bus, Mumbai Monorail and Mumbai Metro systems into a Unified Public Transportation System (UPTS). The UTPS takes into account various drawbacks of the present day system and offers solution, suitable for the modern age Mumbai.

Keywords: urbanization, transportation, RFID, Mumbai, public transportation, smart city.

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8331 Potential Risk Assessment Due to Groundwater Quality Deterioration and Quantifying the Major Influencing Factors Using Geographical Detectors in the Gunabay Watershed of Ethiopia

Authors: Asnakew Mulualem Tegegne, Tarun Kumar Lohani, , Abunu Atlabachew Eshete

Abstract:

Groundwater quality has become deteriorated due to natural and anthropogenic activities. Poor water quality has a potential risk to human health and the environment. Therefore, the study aimed to assess the potential risk of groundwater quality contamination levels and public health risks in the Gunabay watershed. For this task, seventy-eight groundwater samples were collected from thirty-nine locations in the dry and wet seasons during 2022. The ground water contamination index was applied to assess the overall quality of groundwater. Six major driving forces (temperature, population density, soil, land cover, recharge, and geology) and their quantitative impact of each factor on groundwater quality deterioration were demonstrated using Geodetector. The results showed that low groundwater quality was detected in urban and agricultural land. Especially nitrate contamination was highly linked to groundwater quality deterioration and public health risks, and a medium contamination level was observed in the area. This indicates that the inappropriate application of fertilizer on agricultural land and wastewater from urban areas has a great impact on shallow aquifers in the study area. Furthermore, the major influencing factors are ranked as soil type (0.33–0.31)>recharge (0.17–0.15)>temperature (0.13–0.08)>population density (0.1–0.08)>land cover types (0.07– 0.04)>lithology (0.05–0.04). The interaction detector revealed that the interaction between soil ∩ recharge, soil ∩ temperature, and soil ∩ land cover, temperature ∩ recharge is more influential to deteriorate groundwater quality in both seasons. Identification and quantification of the major influencing factors may provide new insight into groundwater resource management.

Keywords: groundwater contamination index, geographical detectors, public health · influencing factors, and water resources management

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8330 Durability of Reinforced Concrete Structure on Very High Aggressive Environment: A Case Study

Authors: Karla Peitl Miller, Leomar Bravin Porto, Kaitto Correa Fraga, Nataniele Eler Mendes

Abstract:

This paper presents the evaluation and study of a real reinforced concrete structure of a fertilizer storage building, constructed on a Vale’s Port at Brazil, which has been recently under refurbishment. Data that will be shared and commented aim to show how wrong choices in project concepts allied to a very high aggressive environment lead to a fast track degradation, incurring on a hazardous condition associated with huge and expensive treatment for repair and guarantee of minimum performance conditions and service life. It will be also shown and discussed all the covered steps since pathological manifestations first signs were observed until the complete revitalization and reparation planning would be drawn. The conclusions of the work easily explicit the importance of professional technical qualification, the importance of minimum requirements for design and structural reforms, and mainly, the importance of good inspection and diagnostic engineering continuous work.

Keywords: durability, reinforced concrete repair, structural inspection, diagnostic engineering

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8329 Preparing Undergraduate Nursing and Midwifery Students for Culturally Competent Health Care: A Qualitative Study

Authors: Olayide Ogunsiji, Glenda McDonald

Abstract:

Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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8328 Identifying Knowledge Gaps in Incorporating Toxicity of Particulate Matter Constituents for Developing Regulatory Limits on Particulate Matter

Authors: Ananya Das, Arun Kumar, Gazala Habib, Vivekanandan Perumal

Abstract:

Regulatory bodies has proposed limits on Particulate Matter (PM) concentration in air; however, it does not explicitly indicate the incorporation of effects of toxicities of constituents of PM in developing regulatory limits. This study aimed to provide a structured approach to incorporate toxic effects of components in developing regulatory limits on PM. A four-step human health risk assessment framework consists of - (1) hazard identification (parameters: PM and its constituents and their associated toxic effects on health), (2) exposure assessment (parameters: concentrations of PM and constituents, information on size and shape of PM; fate and transport of PM and constituents in respiratory system), (3) dose-response assessment (parameters: reference dose or target toxicity dose of PM and its constituents), and (4) risk estimation (metric: hazard quotient and/or lifetime incremental risk of cancer as applicable). Then parameters required at every step were obtained from literature. Using this information, an attempt has been made to determine limits on PM using component-specific information. An example calculation was conducted for exposures of PM2.5 and its metal constituents from Indian ambient environment to determine limit on PM values. Identified data gaps were: (1) concentrations of PM and its constituents and their relationship with sampling regions, (2) relationship of toxicity of PM with its components.

Keywords: air, component-specific toxicity, human health risks, particulate matter

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8327 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

Abstract:

Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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8326 Assessing the Impact of Frailty in Elderly Patients Undergoing Emergency Laparotomies in Singapore

Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

Abstract:

Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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