Search results for: medical services

Authors: Yu-Ching Liu

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Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

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Authors: Zohra Mhedhbi, Meheret Gaston, Sinda Haoues-Jouve, Julia Hidalgo, Pierre Mazzega

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In the current context of climate change, supporting national and local stakeholders to make climate-smart decisions is necessary but still underdeveloped in many countries. To overcome this problem, the Global Frameworks for Climate Services (GFCS), implemented under the aegis of the United Nations in 2012, has initiated many programs in different countries. The GFCS contributes to the development of Climate Services, an instrument based on the production and transfer of scientific climate knowledge for specific users such as citizens, urban planning actors, or agricultural professionals. As cities concentrate on economic, social and environmental issues that make them more vulnerable to climate change, the New Urban Agenda (NUA), adopted at Habitat III in October 2016, highlights the importance of paying particular attention to disaster risk management, climate and environmental sustainability and urban resilience. In order to support the implementation of the NUA, the World Meteorological Organization (WMO) has identified the urban dimension as one of its priorities and has proposed a new tool, the Integrated Urban Services (IUS), for more sustainable and resilient cities. In the southern countries, there’s a lack of development of climate services, which can be partially explained by problems related to their economic financing. In addition, it is often difficult to make climate change a priority in urban planning, given the more traditional urban challenges these countries face, such as massive poverty, high population growth, etc. Climate services and Integrated Urban Services, particularly in African cities, are expected to contribute to the sustainable development of cities. These tools will help promoting the acquisition of meteorological and socio-ecological data on their transformations, encouraging coordination between national or local institutions providing various sectoral urban services, and should contribute to the achievement of the objectives defined by the United Nations Framework Convention on Climate Change (UNFCCC) or the Paris Agreement, and the Sustainable Development Goals. To assess the state of the art on these various points, the Web of Science metadatabase is queried. With a query combining the keywords "climate*" and "urban*", more than 24,000 articles are identified, source of more than 40,000 distinct keywords (but including synonyms and acronyms) which finely mesh the conceptual field of research. The occurrence of one or more names of the 514 African cities of more than 100,000 inhabitants or countries, reduces this base to a smaller corpus of about 1410 articles (2990 keywords). 41 countries and 136 African cities are cited. The lexicometric analysis of the metadata of the articles and the analysis of the structural indicators (various centralities) of the networks induced by the co-occurrence of expressions related more specifically to climate services show the development potential of these services, identify the gaps which remain to be filled for their implementation and allow to compare the diversity of national and regional situations with regard to these services.

Keywords: African cities, climate change, climate services, integrated urban services, lexicometry, networks, urban planning, web of science

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Authors: Lucas B. Naves, Maria José Abreu

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Reprocessing single-use device has attracted interesting on the medical environment over the last decades. The reprocessing technique was sought in order to reduce the cost of purchasing the new medical device, which can achieve almost double of the price of the reprocessed product. In this manuscript, we have done a literature review, aiming the reuse of medical device that was firstly designed for single use only, but has become, more and more, effective on its reprocessing procedure. We also show the regulation, the countries which allows this procedure, the classification of these device and also the most important issue concerning the re-utilization of medical device, how to minimizing the risk of gram positive and negative bacteria, avoid cross-contamination, hepatitis B (HBV), and C (HCV) virus, and also human immunodeficiency virus (HIV).

Keywords: reusing, reprocessing, single-use medical device, HIV, hepatitis B and C

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Authors: Chidiebere Joy Nwankwo, Benjamin S. C. Uzochukwu, Florence T. Sibeudu

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Background: Family planning is one of the most cost-effective ways to prevent maternal, infant, and child mortality. It can decrease maternal mortality by reducing the number of unintended pregnancies, the number of abortions, and the proportion of births at high risk. It has been seen to improve the health and economic well-being of families and communities and ensures women’s planned childbearing in order to achieve education and career goals which could raise family income thereby reducing poverty. The choice and use of a particular family planning method and their sources vary globally. Rural Communities often face significant challenges in accessing and utilizing family planning services. Aim: This study set out to assess Access and Utilization of Family Planning Services among Women of Reproductive Age in a Rural Community of Enugu state, Nigeria. Rural communities were chosen for this study because past demographic surveys have shown that women in urban areas are more likely to accept and practice family planning compared to those in rural areas. Method: A Descriptive Cross-sectional Research design was employed to achieve the aim and objectives of the study. Data collected from 177 consenting participants using interviewer-administered questionnaires was analysed using Descriptive statistics to summarize the Socio-demographic characteristics of the participants and Access and Utilization of Family Planning Services among the participants including Reasons for using different Family Planning Methods and Barriers encountered in Access and Utilization of these services. A Cross-tabulation between Socio-demographic Characteristics of respondents and the use of Family Planning services was carried out. Result: The findings of this study revealed that majority of the participants (72.9%) have not utilized any family planning service. Out of those (27.1%) that have used any family planning service, majority of them are still currently using a form of family planning service and have access to them in health facilities, patent medicine vendors and others based on multiple responses. Male condoms were the most utilized modern family planning service. Based on multiple responses, inaccessibility, personal beliefs and partner’s objection were the most identified barriers encountered in accessing family planning services. Conclusion: Access and uptake of family planning services in rural communities is lower than the national average. Increasing access to family planning is an urgent priority for rural areas Interventions that will scale up Access and Utilization of family planning services in rural communities should be intensified.

Keywords: access, family planning, rural community, utilization

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Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

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This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

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Authors: Md. S. Sabuz

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Bangladesh, a South Asian developing country, has achieved a remarkable breakthrough in health indicators during the last four decades despite immense income inequality. This phenomenon results in the mystical exclusion of marginalized people from obtaining health care facilities. However, the persistence of exclusion of the disadvantaged remains troubling. Exclusion occurs from occupational inferiority, pay and wage differences, educational backwardness, gender disparity to urban-rural complexity and eliminate the unprivileged from seeking and availing the health services. Evidence from Bangladesh shows that many sick people prefer to die at home without securing medical services because in previous times they were not treated well, not because the medical facilities were inadequate or antediluvian but the socio-economic class allows them to receive obdurate treatment. Furthermore, government and policymakers have given enormous emphasis on infrastructural development and achieving health indicators instead of ensuring quality services and inclusiveness of people from all spheres. Therefore, it is high time to address the issues concerning this and highlight the impact of economic status on health status in a sociological perspective. The objective of this study is to consider ways of assessing and exploring the impact of economic status for instance: occupational status, pay and wage variable, on health status in the context of Bangladesh. The hypotheses are that there are a significant number of factors affecting economic status which are impactful for health status eventually, but acute income inequality is a prominent factor. Illiteracy, gender disparity, remoteness, incredibility on services, superior costs, superstition etc. are the dominant indicators behind the economic factors influencing the health status. The chosen methodologies are a qualitative and quantitative approaches to accomplish the research objectives. Secondary sources of data will be used to conduct the study. Surveys will be conducted on the people who have ever been through the health care facilities and people from the different socio-economic and cultural backgrounds. Focus group discussions will be conducted to acquire the data from different cultural and regional citizens. The findings show that 48% of people who are from disadvantaged communities have been deprived of proper health care facilities. The general reasons behind this are the higher cost of medicines and other equipment. A significant number of people are unaware of the appropriate facilities. It was found that the socio-economic variables are the main influential factors that work as the driving force for both economic dimension and health status. Above all regional variables and gender, dimensions have an enormous effect on determining the health status of an individual or community. Amidst many positive achievements for example decrease in the child mortality rate, an increase in the immunization programs of the child etc., the inclusiveness of all classes of people in health care facilities has been overshadowed in Bangladesh. However, this phenomenon along with the socio-economic and cultural phenomena significantly demolishes the quality and inclusiveness of the health status of people.

Keywords: cultural context of health, economic status, gender and health, rural health care

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Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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Authors: Rosemary I. Eneji, Stephen Adi Odey, Edem Carole, Eucharia Nwagbara

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Sexual and reproductive health behaviors are the main causes of death, disability, and disease among adolescents in Nigeria. In this study, we determined the accessibility of youth-friendly sexual and reproductive health services to secondary school adolescents in southern Cross River state, Nigeria. Nineteen randomly selected public secondary schools across the seven local government areas in the zone were used. The respondents were four hundred senior secondary (classes SSI - SS3) students aged 15-19 years, comprising 63.7% females and 36.3% males. A 50-item structured questionnaire was used for the study. There was a strong influence of age and sex of adolescents, income and occupation of parents, knowledge and awareness of adolescents, and tradition on the accessibility and use of youth-friendly sexual and reproductive health services (YFSRHS) to the adolescents. The attitude of health workers towards accessibility was of little effect. Overall, youth-friendly sexual and reproductive health services were not easily accessible to adolescents in the study area. Thus, there is need to enforce adolescent reproductive health policies in the area. Training and use of trained caregivers and peer educators to attend to adolescents and the inclusion of adolescent reproductive health as a subject in the curriculum are strongly recommended.

Keywords: youth, reproductive health, cross river state, secondary schools, Nigeria

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Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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Authors: Vedat Coskun, Fahri Soylemezgiller, Busra Ozdenizci, Kerem Ok

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In recent years, several smart card solutions for transportation services of cities with different technical infrastructures and business models has emerged considerably, which triggers new business and technical opportunities. In order to create a unique system, we present a novel, promising system called Multifunctional City Smart Card System to be used in all cities that provides transportation and loyalty services based on the MasterCard M/Chip Advance standards. The proposed system provides a unique solution for transportation services of large cities over the world, aiming to answer all transportation needs of citizens. In this paper, development of the Multifunctional City Smart Card System and system requirements are briefly described. Moreover, performance analysis results of M/Chip Advance Compatible Validators which is the system's most important component are presented.

Keywords: smart card, m/chip advance standard, city transportation, performance analysis

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Authors: Jaroslav Belás, Anna Chochoľáková, Lenka Gabčová

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The aim of this article was to examine and quantify the dependence of additional purchases of banking products from customer loyalty and dependence of bank clients’ loyalty on the customers’ satisfaction. In this context, in our research from 2014, the respondents were divided into satisfied (loyal) and dissatisfied (disloyal) banking clients and their attitudes in the area of loyalty and additional purchases of banking products were compared. The differences in attitudes were examined by means of Pearson statistics. It was found out that satisfied customers compared with those dissatisfied clients significantly more advise their bank to their friends, also they often consider that they would use their bank in the future, they are more resistant to the offers from the other banks as well. Loyal customers are more interested in the services of their own banks when considering investments in the financial market, keep their savings in their own bank, take out a mortgage loan from their own bank and use other banking products and services offered by their own bank as well. According to the results of our research, with the different intensities the loyalty of customers is transforming into a potential purchase of additional banking products. The greatest potential interest of the bank customers was in keeping their own savings in the bank and mortgage loans. The intensity of interest in the purchase of financial investments and other products was relatively low.

Keywords: commercial bank, bank customers’ satisfaction, loyalty of bank clients, additional purchases of banking products and services

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Authors: Sandra Cecilia Bautista-Rodríguez, Vladimir Melgarejo

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Climate change, loss of ecosystems, increasing poverty, increasing marginalization of rural communities and declining food security are global issues that require urgent attention. In this regard, a great deal of research has focused on how agroecosystems respond to these challenges as they provide ecosystem services (ES) that lead to higher levels of resilience, adaptation, productivity and self-sufficiency. Hence, the valuing of ecosystem services plays an important role in the decision-making process for the design and management of agroecosystems. This paper aims to define the link between ecosystem service valuation methods and ES value dimensions in agroecosystems from ecological economics and agroecology. The method used to identify valuation methodologies was a literature review in the fields of Agroecology and Ecological Economics, based on a strategy of information search and classification. The conceptual framework of the work is based on the multidimensionality of value, considering the social, ecological, political, technological and economic dimensions. Likewise, the valuation process requires consideration of the ecosystem function associated with ES, such as regulation, habitat, production and information functions. In this way, valuation methods for ES in agroecosystems can integrate more than one value dimension and at least one ecosystem function. The results allow correlating the ecosystem functions with the ecosystem services valued, and the specific tools or models used, the dimensions and valuation methods. The main methodologies identified are multi-criteria valuation (1), deliberative - consultative valuation (2), valuation based on system dynamics modeling (3), valuation through energy or biophysical balances (4), valuation through fuzzy logic modeling (5), valuation based on agent-based modeling (6). Amongst the main conclusions, it is highlighted that the system dynamics modeling approach has a high potential for development in valuation processes, due to its ability to integrate other methods, especially multi-criteria valuation and energy and biophysical balances, to describe through causal cycles the interrelationships between ecosystem services, the dimensions of value in agroecosystems, thus showing the relationships between the value of ecosystem services and the welfare of communities. As for methodological challenges, it is relevant to achieve the integration of tools and models provided by different methods, to incorporate the characteristics of a complex system such as the agroecosystem, which allows reducing the limitations in the processes of valuation of ES.

Keywords: ecological economics, agroecosystems, ecosystem services, valuation of ecosystem services

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Authors: Mohammed Sghir Taleb

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Located at the northwest corner of the African continent between 21 ° and 36 ° north latitude and between the 1st and the 17th degree of west longitude, Morocco, with a total area of 715,000 km2, enjoys a privileged position with a coastline of 3 446 km long opening to the Mediterranean and the Atlantic Ocean. Its privileged location with a double coastline and its diverse mountain with four major mountain ranges: the Rif, Middle Atlas, High Atlas and Anti Atlas, with altitudes exceeding 2000 m in the Rif, 3000 m in the Middle Atlas and 4000 m in the High Atlas. Morocco is characterized by an important forest genetic diversity represented by a rich and varied flora and many ecosystems: forest, preforest, presteppe, steppe, Sahara that spans a range of bioclimatic zones: arid, semiarid, subhumid, and humid. The vascular flora of Morocco is rich and highly diversified, with a very significant degree of endemism. Natural flora and ecosystems provide important services to populations represented by grazing, timber harvest, harvesting of medicinal and aromatic plants. This work will be focused on the Moroccan biodiversity and natural ecosystem services and on the interaction between local populations and ecosystems and on the strategies developed by Morocco for restoring and conserving biodiversity and ecosystem services.

Keywords: morocco, biodiversity, forest ecosystems, local population

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Authors: Medani Prasad Rijal

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Forest itself is a factory as well as product. It supplies tangible and intangible goods and services. It supplies timber, fuel wood, fodder, grass leaf litter as well as non timber edible goods and medicinal and aromatic products additionally provides environmental services. These environmental services are of local, national or even global importance. In Nepal, more than 19 thousands community forests are providing environmental service in less economic benefit than actual efficiency. There is a risk of cost of management of those forest exceeds benefits and forests get converted to open access resources in future. Most of the environmental goods and services do not have markets which mean no prices at which they are available to the consumers, therefore the valuation of these services goods and services establishment of paying mechanism for such services and insure the benefit to community is more relevant in local as well as global scale. There are few examples of carbon trading in domestic level to meet the country wide emission goal. In this contest, the study aims to explore the public attitude towards carbon offsetting and their responsibility over service providers. This study helps in promotion of environment service awareness among general people, service provider and community forest. The research helps to unveil the carbon pool scenario in community forest and willingness to pay for carbon offsetting of people who are consuming more energy than general people and emitting relatively more carbon in atmosphere. The study has assessed the carbon pool status in two community forest and valuated carbon service from community forest through willingness to pay in Dharan municipality situated in eastern. In the study, in two community forests carbon pools were assessed following the guideline “Forest Carbon Inventory Guideline 2010” prescribed by Ministry of Forest and soil Conservation, Nepal. Final outcomes of analysis in intensively managed area of Hokse CF recorded as 103.58 tons C /ha with 6173.30 tons carbon stock. Similarly in Hariyali CF carbon density was recorded 251.72 mg C /ha. The total carbon stock of intensively managed blocks in Hariyali CF is 35839.62 tons carbon.

Keywords: carbon, offsetting, sequestration, valuation, willingness to pay

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Authors: Pariwat Somnuek

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This study focused on tourism logistic services in the border areas of Thailand by an analysis and comparison of the opinions of tourists, villagers, and entrepreneurs of these services. Sample representatives of this study were a total of 600 villagers and 15 entrepreneurs in the three border areas consisting of Chong Anma, Chong Sa-Ngam, and Chong Jom checkpoints. For methodology, survey questionnaires, situation analysis, TOWS matrix, and focus group discussions were used for data collection, as well as descriptive analysis and statistics such as arithmetic means and standard deviations, were employed for data analysis. The findings revealed that business potential was at the medium level and entrepreneurs were satisfied with their turnovers. However, perspectives of transportation and tourism services provided for tourists need to be immediately improved. Recommendations for the potential development included promotion of border tourism destinations and foreign investments into accommodation, restaurants, and transport, as well as the establishment of business networks between Thailand and Cambodia, along with the introduction of new tourism destinations by co-operation between entrepreneurs in both countries. These initiatives may lead to increased visitors, collaboration of security offices, and an improved image of tourism security.

Keywords: business potential, potential development, tourism logistics, services

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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Authors: Victoriano Valencia García, Luis Usero Aragonés, Eugenio J. Fernández Vicente

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Nowadays, the successful implementation of ICTs is vital for almost any kind of organization. Good governance and ICT management are essential for delivering value, managing technological risks, managing resources and performance measurement. In addition, outsourcing is a strategic IT service solution which complements IT services provided internally in organizations. This paper proposes the measurement tools of a new holistic maturity model based on standards ISO/IEC 20000 and ISO/IEC 38500, and the frameworks and best practices of ITIL and COBIT, with a specific focus on IT outsourcing. These measurement tools allow independent validation and practical application in the field of higher education, using a questionnaire, metrics tables, and continuous improvement plan tables as part of the measurement process. Guidelines and standards are proposed in the model for facilitating adaptation to universities and achieving excellence in the outsourcing of IT services.

Keywords: IT governance, IT management, IT services, outsourcing, maturity model, measurement tools

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Authors: Simon Mwima, Evans Jennifer Mann, Agnes Nzomene, Edson Chipalo, Eusebius Small, Moses Okumu, Bosco Mukuba

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Introduction: In Uganda, sexual minorities experience exacerbated intersectional stigma and discrimination that exposes them to elevated HIV infections and impedes access to HIV testing and PrEP with low treatment adherence. We contribute to the lack of information about sexual minorities living with HIV in Uganda by using modified social-ecological theory to explore social influences impacting HIV services engagement. Findings from focused group discussion (FGD) involving 31 sexual minorities, ages 18-25, recruited through urban HIV clinics in Kampala reveal the protective and promotive social influence within the individual and interpersonal relationships (sexual partners and peers). Further, inhibitive social influences were found within family, community, societal, and healthcare settings. During the COVID-19 pandemic, these adolescents strategically used promotive social influences to increase their engagement with HIV care services. Interviews were recorded in English, transcribed verbatim, and analyzed using Dedoose. Conclusions: The findings revealed that young people (identified as sexual minorities) strategically used promotive social influences and supported each other to improve engagement with HIV care in the context of restrictive laws in Uganda during the COVID-19-Pandemic. Future HIV prevention, treatment, and care responses could draw on how peers support each other to navigate the heavily criminalized and stigmatized settings to access healthcare services.

Keywords: HIV/AIDS services, intersectional stigma, discrimination, adolescents, sexual minorities, COVID-19 pandemic Uganda

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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During the recent years, demand for healthcare services has dramatically increased. As the demand for healthcare services increases, so does the necessity of constructing new healthcare buildings and redesigning and renovating existing ones. Increasing demands necessitate the use of optimization techniques to improve the overall service efficiency in healthcare settings. However, high complexity of care processes remains the major challenge to accomplish this goal. This study proposes a method based on process mining results to address the high complexity of care processes and to find the optimal layout of the various medical centers in an emergency department. ProM framework is used to discover clinical pathway patterns and relationship between activities. Sequence clustering plug-in is used to remove infrequent events and to derive the process model in the form of Markov chain. The process mining results served as an input for the next phase which consists of the development of the optimization model. Comparison of the current ED design with the one obtained from the proposed method indicated that a carefully designed layout can significantly decrease the distances that patients must travel.

Keywords: Mixed Integer programming, Facility layout problem, Process Mining, Healthcare Operation Management

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Authors: Shah Muhammad Butt, Ahmed Masaud Ansair

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Present financial crisis in Higher Educational Institutes (HEIs) is causing lots of problems such as considerable budget cuts, which makes it difficult to meet the ever growing IT based research and learning needs. Institutions are rapidly planning and promoting cloud based approaches for their academic and research needs. A cost-effective hybrid cloud framework for HEIs will provide educational services for campus or intercampus communication. Hybrid cloud framework comprises private and public cloud approaches. This paper will propose the framework based on the Open Source Cloud (OpenNebula for Virtualization, Eucalyptus for Infrastructure and Aneka for programming development environment) combined with CSPs services which are delivered to the end-user via the internet from public clouds such as Google, Microsoft, Zoho, and Salesforce.

Keywords: educational services, hybrid campus cloud, open source, higher educational institutes

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Umamaheswari Shanmugam, Silvia Ronchi

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that can use the large amount and variety of data generated during healthcare services every day; one of the significant advantages of these new technologies is the ability to get experience and knowledge from real-world use and to improve their performance continuously. Healthcare systems and institutions can significantly benefit because the use of advanced technologies improves the efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and protect patients' safety. The evolution and the continuous improvement of software used in healthcare must consider the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device's approval. Still, they are necessary to ensure performance, quality, and safety. At the same time, they can be a business opportunity if the manufacturer can define the appropriate regulatory strategy in advance. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems

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Authors: Yenisleidy Martinez Martinez, Yannay Casas-Ledon, Jo Dewulf

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The ecosystem services (ES) concept has contributed to draw attention to the benefits ecosystems generate for people and how necessary natural resources are for human well-being. The identification and prioritization of the ES constitute the first steps to undertake conservation and valuation initiatives on behalf of people. Additionally, mapping the supply of ES is a powerful tool to support decision making regarding the sustainable management of landscape and natural resources. In this context, the present study aimed to identify, prioritize and map the primary ES in Biobio and Nuble regions using a methodology that combines expert judgment, multi-attribute evaluation methods, and Geographic Information Systems (GIS). Firstly, scores about the capacity of different land use/cover types to supply ES and the importance attributed to each service were obtained from experts and stakeholders via an online survey. Afterward, the ES assessment matrix was constructed, and the weighted linear combination (WLC) method was applied to mapping the overall capacity of supply of provisioning, regulating and maintenance, and cultural services. Finally, prioritized ES for the study area were selected and mapped. The results suggest that native forests, wetlands, and water bodies have the highest supply capacities of ES, while urban and industrial areas and bare areas have a very low supply of services. On the other hand, fourteen out of twenty-nine services were selected by experts and stakeholders as the most relevant for the regions. The spatial distribution of ES has shown that the Andean Range and part of the Coastal Range have the highest ES supply capacity, mostly regulation and maintenance and cultural ES. This performance is related to the presence of native forests, water bodies, and wetlands in those zones. This study provides specific information about the most relevant ES in Biobio and Nuble according to the opinion of local stakeholders and the spatial identification of areas with a high capacity to provide services. These findings could be helpful as a reference by planners and policymakers to develop landscape management strategies oriented to preserve the supply of services in both regions.

Keywords: ecosystem services, expert judgment, mapping, multi-criteria decision making, prioritization

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Authors: Tanya L. Patimeteeporn, Murali D. Nair

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There is a wide range of literature that suggests the factors that prevent Asian American families from utilizing mental health services. These factors arise from a combination of cultural perceptions of mental illness, and methods of treating them without the use of a mental health professional. Due to the increased awareness of Asian Americans’ stigmatization to mental health, there has been an effort to create culturally competent interventions for Asian American families that would reduce opposition to mental health services. Assessment of the effectiveness of these interventions reveals practices that integrate traditional healing methods with psychoeducation are more likely to promote receptiveness of mental health services by Asian American families. The documentary in this review, demonstrates these traditional healing methods from various ethnic enclaves in Los Angeles. In addition, mental health professionals who provide these interventions to Asian American families need to consider culture-bound syndromes and the various Asian health philosophies and belief systems in order to provide a culturally sensitive holistic treatment for their clients. However, because the literature on these interventions is limited, there is a need for a larger body of evidence to accurately assess the effectiveness of these culturally competent psychoeducation interventions.

Keywords: Asian American, cultural boundaries, intervention, mental health stigma, psychoeducation, traditional healing

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Authors: Odufu Ifakachukwu Clifford

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Developing country governments are struggling to meet the basic needs and demands of citizens, especially so for the rural poor. With tightly constrained budgets, these governments have followed the lead of developed countries that have sought to restructure public service delivery through privatization, contracting out, public-private partnerships, and similar reforms. Such reforms in service delivery are generally welcomed when it is believed that private sector partners are better equipped to provide certain services than are governments. With respect to basic and essential services, however, a higher degree of uncertainty and apprehension exists as the focus shifts from simply minimizing the costs of delivering services to broadening access to all citizens. The constitution stipulates that everyone has the right to have access to sufficient food and water. Affordable and/or subsidized water, then, is not a privilege but a basic right of all citizens. Citizens elect political representatives to serve in office, with their sole mandate being to provide for the needs of the citizenry. As governments pass on some amount of responsibility for service delivery to private businesses, these governments must be able to exercise control in order to account to the people for the work done by private partners. This paper examines the legislative and policy frameworks as well as the environment within which PPPs take place in South Africa and the extent to which accountability can be strengthened in this environment. Within the aforementioned backdrop of PPPs and accountability, the constricted focus area of the paper aims to assess the extent to which the provision of clean and safe consumable water in South Africa is sustainable, cost-effective in terms of provision, and affordable to all.

Keywords: privatisation, accountability, essential services, government

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Authors: Marica Pidor-Quingco, Francis Cabatingan

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Background: One of the essential roles of a physician is to assess a patient’s worth and support them in making decisions regarding their future preferences when it comes to medical care. Advance Directives is a patient-centered approach which is liked to a better-quality treatment at the end of life. General Objective: To assess and describe the knowledge, attitudes and practices of resident physicians regarding advance directive among the resident physicians in Vicente Sotto Memorial Medical Study. Methods: An analytical cross-sectional study was conducted at Vicente Sotto Memorial Medical Center. There was a total of 129 respondents who gave their consent and was given survey questionnaire containing the demographic profile, knowledge, attitude and practices. Categorical variables were presented as frequency and percentage. Chi Square Test was used to determine the association of demographic profile with knowledge and attitude. Man-Whitney U test was utilized for the association of age with knowledge and attitude. Results: Out of 129 respondents, 36.59% were in favor towards self-determination and autonomy. Majority of the revealed an adequate knowledge and positive attitude regarding advance directives. Based on the results, there were no significant correlations between sociodemographic of the residents towards to knowledge and attitude. Over 66.7% of the respondents had used Advance Directives to their patients but 25% were not comfortable about it. Though most of the respondents was able to discuss AD with their patients, 7.0% of them are not willing to open the topic to the family. Conclusion: VSMMC is a tertiary hospital which also caters Hospice, Palliative and Supportive care to the patients. One of the services offered is initiating Advance Directives which may be a factor for a positive knowledge, attitude and practices towards this topic.

Keywords: advance directives, philippines, physicians, palliative

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Authors: Sandesh Achar

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The cloud computing industry has set new goals for better service delivery and deployment, so anyone can access services such as computation, application, and storage anytime. Cloud computing promises new possibilities for approaching sustainable solutions to deploy and advance their services in this distributed environment. This work explores energy-efficient approaches and how cloud-based architecture can reduce energy consumption levels amongst enterprises leveraging cloud computing services. Adopting cloud-based networking, database, and server machines provide a comprehensive means of achieving the potential gains in energy efficiency that cloud computing offers. In energy-efficient cloud computing, virtualization is one aspect that can integrate several technologies to achieve consolidation and better resource utilization. Moreover, the Green Cloud Architecture for cloud data centers is discussed in terms of cost, performance, and energy consumption, and appropriate solutions for various application areas are provided.

Keywords: greener cloud, cloud computing, energy efficiency, energy consumption, metadata tags, green cloud advisor

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Authors: Zorana Jurinjak, Christos Alexopoulos

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The aim of this paper is to examine the effectiveness of using a medical bilingual dictionary in teaching English in a vocational college. More precisely, to what extent the use of bilingual medical dictionary in relation to the use of Standard English bilingual dictionaries influences the results on tests, and thus the acquisition of better competence of students mastering the subject terminology. Secondary interest in this paper would be to raise awareness among students and teachers about the advantages of dictionary use. The experiment was conducted at College of Applied Health Sciences in Ćuprija on a sample of 90 students. The respondents translated three medical texts with 42 target terms. Statistical analyses of the data obtained show that the differences in average time and correct answers favor the students who used medical dictionary.

Keywords: bilingual medical dictionary, standard english bilingual dictionary, medical terminology, EOS, ESP

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Authors: Sohayla Khaled El Fakahany

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Cultural and structural limitations and conservative social norms have direct effects on the availability of sources of sexual and reproductive health and rights (SRHR) in the Arab Region. Nevertheless, SRHR advocates, healthcare providers, and organizations have created online spaces like websites, blogs, and social media platforms to increase people’s access and ability to share information, experiences, and services. While these efforts help increase the accessibility to information and services, they also create and reflect inequalities based on limited internet access. Furthermore, these emergent ways of sharing and raising awareness online cannot be seen as a substitute for the urgent need for public healthcare systems and services to address SRHR issues in Arab states. This research aims to analyze the impact of the increasing importance of the role of social media platforms and technologies in the dissemination of SRHR-related information online to the youth as well as the associated inequalities of access. It also seeks to assess the effects and inequalities of the dependence on online platforms, which should be complementary to public and private SRHR services. The theoretical framework adopts Asef Bayat’s concept of social non-movements to analyze how collective mobilization around SRHR issues is exercised in repressive and conservative settings in the Arab region. Using digital ethnography of four prominent digital platforms and a qualitative survey of people aged 18-30 years, the research draws attention to the urgent need for better access to knowledge and services around gender, bodily autonomy, and sexual and reproductive health in the Arab region.

Keywords: sexual and reproductive health and rights, social non-movements, digital platforms, Arab region

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Authors: Ibrahim Aliyu Isah, Mohd Mansor Ismail, Salim Hassan, Norsida Bint Man

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Global and National contributions of Extension Agents in income derive through stingless beekeeping production as acknowledged globally as a new source of wealth creation, which contributes significantly to the positive, sustainable economic growth of Malaysia. A common specie, Trigona itama, production through effective utilization of highly competent agents of extension services led to high increase of output that guaranteed high income and sustainability to farmers throughout the study areas. A study on impacts of extension services on stingless bee production and its profitability and sustainability in both Peninsular Malaysia and East (Sarawak) Malaysia was conducted with the following objectives: (i) to examined various impacts of extension services on sustainability as variables in enhancing stingless beekeeping production for positive profitability. (ii) to determine the profitability and sustainability of stingless beekeeping production in the study area through transfer of technology and human resources development. The study covers a sample of beekeepers in ten states of Peninsular Malaysia and Sarawak. The sample size of 87 respondents were selected out of the population and 54 of filled questionnaires were retrieved. Capital budgeting analysis was carried out and economic performance was evaluated. Data collected was analysed using SPSS version 23.0. Correlation and Regression analyses were used. The capital budgeting analysis and government incentive schemes was incorporated in the applied projection of stingless bee farms. The result of Net Present Value (NPV) is determined as an accepted projection to the financial appraisal. The NPV in the study indicated positive outcome of production that can generate positive income and indicated efficient yield of investment and Profitability index (PI). In summary, it is possible for the extension services to increase output and hence increase profit which is sustainable for growth and development of agricultural sector in Malaysia.

Keywords: extension services, impacts, profitability and sustainability, Sarawak and peninsular Malaysia, trigona itama production

Procedia PDF Downloads 84