Search results for: maternal health service
11792 Service Blueprinting: A New Application for Evaluating Service Provision in the Hospice Sector
Authors: L. Sudbury-Riley, P. Hunter-Jones, L. Menzies, M. Pyrah, H. Knight
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Just as manufacturing firms aim for zero defects, service providers strive to avoid service failures where customer expectations are not met. However, because services comprise unique human interactions, service failures are almost inevitable. Consequently, firms focus on service recovery strategies to fix problems and retain their customers for the future. Because a hospice offers care to terminally ill patients, it may not get the opportunity to correct a service failure. This situation makes the identification of what hospice users really need and want, and to ascertain perceptions of the hospice’s service delivery from the user’s perspective, even more important than for other service providers. A well-documented and fundamental barrier to improving end-of-life care is a lack of service quality measurement tools that capture the experiences of user’s from their own perspective. In palliative care, many quantitative measures are used and these focus on issues such as how quickly patients are assessed, whether they receive information leaflets, whether a discussion about their emotional needs is documented, and so on. Consequently, quality of service from the user’s perspective is overlooked. The current study was designed to overcome these limitations by adapting service blueprinting - never before used in the hospice sector - in order to undertake a ‘deep-dive’ to examine the impact of hospice services upon different users. Service blueprinting is a customer-focused approach for service innovation and improvement, where the ‘onstage’ visible service user and provider interactions must be supported by the ‘backstage’ employee actions and support processes. The study was conducted in conjunction with East Cheshire Hospice in England. The Hospice provides specialist palliative care for patients with progressive life-limiting illnesses, offering services to patients, carers and families via inpatient and outpatient units. Using service blueprinting to identify every service touchpoint, in-depth qualitative interviews with 38 in-patients, outpatients, visitors and bereaved families enabled a ‘deep-dive’ to uncover perceptions of the whole service experience among these diverse users. Interviews were recorded and transcribed, and thematic analysis of over 104,000 words of data revealed many excellent aspects of Hospice service. Staff frequently exceed people’s expectations. Striking gratifying comparisons to hospitals emerged. The Hospice makes people feel safe. Nevertheless, the technique uncovered many areas for improvement, including serendipity of referrals processes, the need for better communications with external agencies, improvements amid the daunting arrival and admissions process, a desperate need for more depression counselling, clarity of communication pertaining to actual end of life, and shortcomings in systems dealing with bereaved families. The study reveals that the adapted service blueprinting tool has major advantages of alternative quantitative evaluation techniques, including uncovering the complex nature of service user’s experiences in health-care service systems, highlighting more fully the interconnected configurations within the system and making greater sense of the impact of the service upon different service users. Unlike other tools, this in-depth examination reveals areas for improvement, many of which have already been implemented by the Hospice. The technique has potential to improve experiences of palliative and end-of-life care among patients and their families.Keywords: hospices, end-of-life-care, service blueprinting, service delivery
Procedia PDF Downloads 19411791 Evaluating the Impact of Early Maternal Incarceration on Male Delinquent Behavior during Emerging Adulthood through the Mediating Mechanism of Mastery
Authors: Richard Abel
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In the United States, increased incarceration rates have caused many adolescents to feel the strain of parental absence. This absence is then manifest through adolescent feelings of parental rejection. Additionally, upon reentry maternal incarceration may be related to adolescents experienced perceived excessive disciple. It is possible parents engage in this manner of discipline attempting to prevent the child from taking the same path to incarceration as the parent. According to General Strain Theory, adolescents encountering strain are likely to experience negative emotions. The emotion that is most likely to lead to delinquency is anger through reduced inhibitions and motivation to act. Additionally, males are more likely to engage in delinquent behavior, regardless of experiencing strain. This is not the case for every male who experiences maternal incarceration, parental rejection, excessive discipline, or anger. There are protective factors that enable agency within individuals. One such protective factor is mastery, or the perception that one is in control of his or her own future. The model proposed in this research suggests maternal incarceration is associated with increased parental rejection and excessive discipline in males. Males experiencing parental rejection and excessive discipline are likely to experience increased anger, which is then associated with increases in delinquent behavior. This model explores whether agency, in the form of mastery, mediates the relationship between strains and negative emotions, or between negative emotions and delinquent behavior. The Kaplan Longitudinal and Multigenerational Study (KLAMS) dataset is uniquely situated to analyze this model providing longitudinal data collected from both parents and their offspring. Maternal incarceration is constructed using parental responses such that the mother was incarcerated after the child’s birth, and any incarceration that happened prior to birth is excluded. The remaining variables of the study are all constructed from varying waves of the adolescent survey. Parental rejection, along with control variables for age, race, parental socioeconomic status, neighborhood effects, delinquent peers, and prior delinquent behavior are all constructed using Wave I data. To increase causal inference, the negative emotion of anger and the mediating variable of mastery are measured during Wave II. Lastly, delinquent behavior is measured at Wave III. Results of the analysis show expected relationships such that adolescent males encountering maternal incarceration show increased perception of parental rejection and excessive discipline. Additionally, there is a positive relationship between parental rejection and excessive discipline at Wave I and feelings of anger at Wave II for males. For males experiencing either of these strains in Wave I, feelings of anger in Wave II are found to be associated with increased delinquent behavior in Wave III. Mastery was found to mediate the relationship between both parental rejection and excessive discipline and anger, but no such mediation occurs in the relationship between anger and delinquency, regardless of the strain being experienced. These findings suggest adolescent males who feel they are in control of their own lives are less likely to experience negative emotions produced by the occurrence of strain, thereby decreasing male engagement in delinquent behavior later in life.Keywords: delinquency, mastery, maternal incarceration, strain
Procedia PDF Downloads 13511790 Behaviors and Factors Affecting the Selection of Spa Services among Consumers in Amphawa, Samut Songkhram, Thailand
Authors: Chutima Klaysung
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This research aims to study the factors that influence the decision to choose the spa service of consumers in Amphawa, Samut Songkhram, Thailand. The research method will use quantitative research; data were collected by questionnaires distributed to spa consumers, both female and male, aged between 20 years and 70 years in the Amphawa, Samut Songkhram area for 400 samples by convenience sampling method. The data were analyzed using descriptive statistics including percentage, mean, standard deviation and inferential statistics, including Pearson correlation for hypothesis testing. The results showed that the demographic variables including age, education, occupation, income and frequency of access to service spa were related to the decision to choose the spa service of consumers in Amphawa, Samut Songkhram. In addition, the researchers found the marketing mixed factors such as products, prices, places, promotion, personnel selling, physical evidence and processes were associated with the decision to choose the spa service of consumers in Amphawa, Samut Songkhram, Thailand.Keywords: consumer in amphawa, samut songkhram, decision to choose the spa service, marketing mixed factor, spa service
Procedia PDF Downloads 23811789 Role of Maternal Astaxanthin Supplementation on Brain Derived Neurotrophic Factor and Spatial Learning Behavior in Wistar Rat Offspring’s
Authors: K. M. Damodara Gowda
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Background: Maternal health and nutrition are considered as the predominant factors influencing brain functional development. If the mother is free of illness and genetic defects, maternal nutrition would be one of the most critical factors affecting the brain development. Calorie restrictions cause significant impairment in spatial learning ability and the levels of Brain Derived Neurotrophic Factor (BDNF) in rats. But, the mechanism by which the prenatal under-nutrition leads to impairment in brain learning and memory function is still unclear. In the present study, prenatal Astaxanthin supplementation on BDNF level, spatial learning and memory performance in the offspring’s of normal, calorie restricted and Astaxanthin supplemented rats was investigated. Methodology: The rats were administered with 6mg and 12 mg of astaxanthin /kg bw for 21 days following which acquisition and retention of spatial memory was tested in a partially-baited eight arm radial maze. The BDNF level in different regions of the brain (cerebral cortex, hippocampus and cerebellum) was estimated by ELISA method. Results: Calorie restricted animals treated with astaxanthin made significantly more correct choices (P < 0.05), and fewer reference memory errors (P < 0.05) on the tenth day of training compared to offsprings of calorie restricted animals. Calorie restricted animals treated with astaxanthin also made significantly higher correct choices (P < 0.001) than untreated calorie restricted animals in a retention test 10 days after the training period. The mean BDNF level in cerebral cortex, Hippocampus and cerebellum in Calorie restricted animals treated with astaxanthin didnot show significant variation from that of control animals. Conclusion: Findings of the study indicated that memory and learning was impaired in the offspring’s of calorie restricted rats which was effectively modulated by astaxanthin at the dosage of 12 mg/kg body weight. In the same way the BDNF level at cerebral cortex, Hippocampus and Cerebellum was also declined in the offspring’s of calorie restricted animals, which was also found to be effectively normalized by astaxanthin.Keywords: calorie restiction, learning, Memory, Cerebral cortex, Hippocampus, Cerebellum, BDNF, Astaxanthin
Procedia PDF Downloads 23311788 Health Care using Queuing Theory
Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj
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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis
Procedia PDF Downloads 30011787 Simulation of Pedestrian Service Time at Different Delay Times
Authors: Imran Badshah
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Pedestrian service time reflects the performance of the facility, and it’s a key parameter to analyze the capability of facilities provided to serve pedestrians. The level of service of pedestrians (LOS) mainly depends on pedestrian time and safety. The pedestrian time utilized by taking a service is mainly influenced by the number of available services and the time utilized by each pedestrian in receiving a service; that is called a delay time. In this paper, we analyzed the simulated pedestrian service time with different delay times. A simulation is performed in AnyLogic by developing a model that reflects the real scenario of pedestrian services such as ticket machine gates at rail stations, airports, shopping malls, and cinema halls. The simulated pedestrian time is determined for various delay values. The simulated result shows how pedestrian time changes with the delay pattern. The histogram and time plot graph of a model gives the mean, maximum and minimum values of the pedestrian time. This study helps us to check the behavior of pedestrian time at various services such as subway stations, airports, shopping malls, and cinema halls.Keywords: agent-based simulation, anylogic model, pedestrian behavior, time delay
Procedia PDF Downloads 21011786 Teaching for Change: Instructional Support in a Bilingual Setting
Authors: S. J. Hachar
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The goal of this paper is to provide educators an overview of international practices supporting young learners, arming us with adequate information to lead effective change. We will report on research and observations of Service Learning Projects conducted by one South Texas University. The intent of the paper is also to provide readers an overview of service learning in the preparation of teacher candidates pursuing a Bachelor of Science in Elementary Education. The objective of noting the efficiency and effectiveness of programs leading to literacy and oral fluency in a native language and second language will be discussed. This paper also highlights experiential learning for academic credit that combines community service with student learning. Six weeks of visits to a variety of community sites, making personal observations with faculty members, conducting extensive interviews with parents and key personnel at all sites will be discussed. The culminating Service Learning Expo will be reported as well.Keywords: elementary education, junior achievement, service learning
Procedia PDF Downloads 32311785 pscmsForecasting: A Python Web Service for Time Series Forecasting
Authors: Ioannis Andrianakis, Vasileios Gkatas, Nikos Eleftheriadis, Alexios Ellinidis, Ermioni Avramidou
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pscmsForecasting is an open-source web service that implements a variety of time series forecasting algorithms and exposes them to the user via the ubiquitous HTTP protocol. It allows developers to enhance their applications by adding time series forecasting functionalities through an intuitive and easy-to-use interface. This paper provides some background on time series forecasting and gives details about the implemented algorithms, aiming to enhance the end user’s understanding of the underlying methods before incorporating them into their applications. A detailed description of the web service’s interface and its various parameterizations is also provided. Being an open-source project, pcsmsForecasting can also be easily modified and tailored to the specific needs of each application.Keywords: time series, forecasting, web service, open source
Procedia PDF Downloads 8411784 Effect of Group Prenatal Care on Adolescent Pregnancy Outcomes: A Randomized Controlled Trial
Authors: Parvin Abedi, Fatemeh Malchi, Mina Iravani, Elham Maraghi, Eesa Mohammadi, Najmieh Saadati
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Background: Adolescent pregnancy has major health and social consequences and can lead to adverse maternal and neonatal outcomes. Objectives: The objective of this study was to evaluate the impact of group prenatal care (GPNC) of adolescents on their maternal and neonatal outcomes. Methods: In this study, 294 adolescent pregnant women (aged 15-19) were randomly assigned into two groups of prenatal care (n=147) and individual prenatal care (IPNC) (n=147). Participants in the intervention group received GPNC at 16-20 weeks of gestational age, while the control group received (IPNC). The data were analyzed using the Chi-square test, independent t-test, and linear and logistic tests. Results: As far as weight gain was concerned, 91.7% and 62.1% of the participants in the GPNC and IPNC groups had an appropriate weight gain during pregnancy, respectively OR 6.72 (95% CI 3.40, 13.26). In the GPNC group, 79.2% of participants had exclusive breastfeeding in the first 6 weeks after childbirth and while this rate was 49.7% in the IPNC group, OR 3.92 (95% CI 2.36, 6.64). Preterm birth was observed in 3.4% of the participants in the GPNC group as opposed to 9.5% in the IPNC group OR 6.17 (95% CI 0.73, 51.93). Conclusion: Adolescent women in GPNC have more appropriate weight gain and a higher rate of exclusive breastfeeding compared to adolescent women in IPNC. Group prenatal care could be considered a viable method of care for adolescent pregnant women.Keywords: group prenatal car, adolescents pregnant women, pregnancy outcomes, neonatal outcomes
Procedia PDF Downloads 2111783 The Relationship among Exercise Participation, Job Stress and Job Satisfaction: A Study on Food Service Employees in Taiwan
Authors: Jui-Hsiu Chang
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As an increasing number of restaurants are growing, the demand for man force in the food service industry is dramatically increasing as well. However, food service workers often complete the heavy workload, infrequent breaks, long hours and shifts. With the overwhelming workload, many workers have experienced high injury rates. As a result, the restaurant industry reports a higher employee turnover rate compare to other service industries in Taiwan. Restaurant managers are seeing ways to retain good employees in order to provide good quality service for daily operation. The purpose of this study was to explore the relationship among exercise participation, job stress and job satisfaction on the food service employees. In addition, to examine how the job stress affected their job satisfaction. A survey using a self-reported questionnaire was conducted to collect data, and 269 questionnaires were collected for data analysis. The obtained materials were analyzed using descriptive statistic, independent t-test, one-way ANOVA, linear regression analysis. The results show that 1. Job stress had a significantly negative influence on employees’ job satisfaction. 2. Exercise participation had significantly positive influence on employees’ job satisfaction. 3. Job stress and job satisfaction varied among the groups of respondent with different level of exercise involvement. Furthermore, the practical implications were proposed for the food service company management when developing daily operational strategies.Keywords: exercise participation, food service employees, job satisfaction, job stress
Procedia PDF Downloads 26811782 Factors Associated with Self-Rated Health among Persons with Disabilities: A Korean National Survey
Authors: Won-Seok Kim, Hyung-Ik Shin
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Self-rated health (SRH) is a subjective assessment of individual health and has been identified as a strong predictor for mortality and morbidity. However few studies have been directed to the factors associated with SRH in persons with disabilities (PWD). We used data of 7th Korean national survey for 5307 PWD in 2008. Multiple logistic regression analysis was performed to find out independent risk factors for poor SRH in PWD. As a result, indicators of physical condition (poor instrumental ADL), socioeconomic disadvantages (poor education, economically inactive, low self-rated social class, medicaid in health insurance, presence of unmet need for hospital use) and social participation and networks (no use of internet service) were selected as independent risk factors for poor SRH in final model. Findings in the present study would be helpful in making a program to promote the health and narrow the gap of health status between the PWD.Keywords: disabilities, risk factors, self-rated health, socioeconomic disadvantages, social networks
Procedia PDF Downloads 39711781 Perceived Needs on Teaching-Learning Activities among Basic Education Teachers as Reflected in Their In-Service Teacher Training
Authors: Cristie Ann Jaca-Delfin, Felino Javines Jr.
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Teachers especially those who are teaching elementary and high school students need to upgrade their teaching practices in order to become effective and efficient facilitators of learning. It is in this context that this study is conducted in order to present the perceived teaching-learning activities needs among basic education teachers in the three campuses of the University of San Carlos, Cebu City, the Philippines as expressed during their In-Service Teacher Training. The study employed the quantitative-qualitative research design and used the researcher-made survey questionnaire to look into the ten items under Teaching-Learning Activities to determine which item teachers need to be trained and retrained on. The data were solicited during the teachers’ In-Service Teacher Training period conducted in May 2015. It was found out that designing interesting and meaningful classroom activities, strategies in teaching and assessment procedures were identified as the most needed areas teachers want to be included in their in-service training. As these expressed needs were identified, the teachers’ in-service training must a venue for teachers’ instructional development needs to be addressed so as to maximize the students’ learning outcomesKeywords: in-service teacher training, perceived needs, teaching-learning activities, teaching practices
Procedia PDF Downloads 32511780 Longitudinal Examination of Depressive Symptoms among U.S. Parents who Gave Birth During the COVID-19 Pandemic
Authors: Amy Claridge, Tishra Beeson
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Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic
Procedia PDF Downloads 7811779 Mental Health Literacy in the Arabic Community
Authors: Yamam Abuzinadah
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Mental health literacy has become a very influential topic around the world due to the increase of mental health issues that have been reported through national research and surveys. Mental health literacy refers to the awareness, attitudes, beliefs, knowledge and skills when dealing with mental illness. This research explores mental health literacy in the Arabic and the ways culture informs perceptions of mental health in general. Also, the impact of mental health literacy on: help-seeking attitudes, relationships and community interactions. The outcomes of this research will contribute to raising mental health awareness among the Arabic community, develop and enhance mental health service provision and explore new ideas in regards to elevating mental health literacy in the Arabic community. This research aims to explore attitudes, beliefs, perspective, values and perceptions toward mental health in general among the Arabic community. It will also aim to highlight the factors contributing to theses beliefs, perspective, value and perception and accordingly the role these factors play in regards to awareness, services access, recovery and care provided from the family and the community. This thesis will aim to reflect a detailed theorisation and exploration of: (1) The impact of cultural factors on mental health literacy ie. attitudes, beliefs, knowledge and skills. (2) The ways culture informs perceptions of mental health literacy. (3) The impact of mental health literacy on: help-seeking behaviors, and relationships and community interactions.Keywords: Arab, mental health, literacy, awareness
Procedia PDF Downloads 43411778 Research on Spatial Distribution of Service Facilities Based on Innovation Function: A Case Study of Zhejiang University Zijin Co-Maker Town
Authors: Zhang Yuqi
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Service facilities are the boosters for the cultivation and development of innovative functions in innovative cluster areas. At the same time, reasonable service facilities planning can better link the internal functional blocks. This paper takes Zhejiang University Zijin Co-Maker Town as the research object, based on the combination of network data mining and field research and verification, combined with the needs of its internal innovative groups. It studies the distribution characteristics and existing problems of service facilities and then proposes a targeted planning suggestion. The main conclusions are as follows: (1) From the perspective of view, the town is rich in general life-supporting services, but lacking of provision targeted and distinctive service facilities for innovative groups; (2) From the perspective of scale structure, small-scale street shops are the main business form, lack of large-scale service center; (3) From the perspective of spatial structure, service facilities layout of each functional block is too fragile to fit the characteristics of 2aggregation- distribution' of innovation and entrepreneurial activities; (4) The goal of optimizing service facilities planning should be guided for fostering function of innovation and entrepreneurship and meet the actual needs of the innovation and entrepreneurial groups.Keywords: the cultivation of innovative function, Zhejiang University Zijin Co-Maker Town, service facilities, network data mining, space optimization advice
Procedia PDF Downloads 11711777 Earphone Style Wearable Device for Automatic Guidance Service with Position Sensing
Authors: Dawei Cai
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This paper describes a design of earphone style wearable device that may provide an automatic guidance service for visitors. With both position information and orientation information obtained from NFC and terrestrial magnetism sensor, a high level automatic guide service may be realized. To realize the service, a algorithm for position detection using the packet from NFC tags, and developed an algorithm to calculate the device orientation based on the data from acceleration and terrestrial magnetism sensors called as MEMS. If visitors want to know some explanation about an exhibit in front of him, what he has to do is only move to the object and stands for a moment. The identification program will automatically recognize the status based on the information from NFC and MEMS, and start playing explanation content about the exhibit. This service should be useful for improving the understanding of the exhibition items and bring more satisfactory visiting experience without less burden.Keywords: wearable device, MEMS sensor, ubiquitous computing, NFC
Procedia PDF Downloads 24111776 Factors Adversely Associated with Breastfeeding among Obese Mothers in Malaysia
Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih
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The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity
Procedia PDF Downloads 19511775 Maternal Mind-Mindedness and Its Association with Attachment: The Case of Arab Infants and Mothers in Israel
Authors: Gubair Tarabeh, Ghadir Zriek, David Oppenheim, Avi Sagi-Schwartz, Nina Koren-Karie
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Introduction: Mind-Mindedness (MM) focuses on mothers' attunement to their infant's mental states as reflected in their speech to the infant. Appropriate MM comments are associated with attachment security in individualistic Western societies where parents value their children’s autonomy and independence, and may therefore be more likely to engage in mind-related discourse with their children that highlights individual thoughts, preferences, emotions, and motivations. Such discourse may begin in early infancy, even before infants are likely to understand the semantic meaning of parental speech. Parents in collectivistic societies, by contrast, are thought to emphasize conforming to social norms more than individual goals, and this may lead to parent-child discourse that emphasizes appropriate behavior and compliance with social norms rather than internal mental states of the self and the other. Therefore, the examination of maternal MM and its relationship with attachment in Arab collectivistic culture in Israel was of particular interest. Aims of the study: The goal of the study was to examine whether the associations between MM and attachment in the Arab culture in Israel are the same as in Western samples. An additional goal was to examine whether appropriate and non-attuned MM comments could, together, distinguish among mothers of children in the different attachment classifications. Material and Methods: 76 Arab mothers and their infants between the ages of 12 and 18 months were observed in the Strange Situation Procedure (49 secure (B), 11 ambivalent (C), 14 disorganized (D), and 2 avoidant (A) infants). MM was coded from an 8-minute free-play sequence. Results: Mothers of B infants used more appropriate and less non-attuned MM comments than mothers of D infants, with no significant differences with mothers of C infants. Also, mothers of B infants used less non-attuned MM comments than both mothers of D infants and mothers of C infants. In addition, Mothers of B infants were most likely to show the combination of high appropriate and low non-attuned MM comments; Mothers of D infants were most likely to show the combination of high non-attuned and low appropriate MM comments; and a non-significant trend indicated that mothers of C infants were most likely to show a combination of high appropriate and high non-attuned MM comments. Conclusion: Maternal MM was associated with attachment in the Arab culture in Israel with combinations of appropriate and non-attuned MM comments distinguishing between different attachment classifications.Keywords: attachment, maternal mind-mindedness, Arab culture, collectivistic culture
Procedia PDF Downloads 15511774 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana
Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei
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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality
Procedia PDF Downloads 8111773 Information Technology Service Management System Measurement Using ISO20000-1 and ISO15504-8
Authors: Imam Asrowardi, Septafiansyah Dwi Putra, Eko Subyantoro
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Process assessments can improve IT service management system (IT SMS) processes but the assessment method is not always transparent. This paper outlines a project to develop a solution- mediated process assessment tool to enable transparent and objective SMS process assessment. Using the international standards for SMS and process assessment, the tool is being developed following the International standard approach in collaboration and evaluate by expert judgment from committee members and ITSM practitioners.Keywords: SMS, tools evaluation, ITIL, ISO service
Procedia PDF Downloads 48211772 Rapid-Access Multispecialty Nurse-Led Tongue Tie Service: A Retrospective Evaluation of Cost-Effectiveness
Authors: Jia Yin Tan, Daniel Rambei, Kate Mann, Samuel price, Ahmed Aboelela
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Introduction: Breastfeeding is a complex process, influenced by various factors. Tongue-tie may lead to breastfeeding difficulties due to an inability to suck effectively, causing sore nipples and poor infant weight gain. In the UK, most frenotomies on infants are performed by doctors, nurses, health visitors or midwives. Objectives: Evaluation of safety and efficacy of a multispecialty nurse-led rapid access tongue-tie service at Sheffield Children’s Hospital, run jointly by the ENT and paediatric surgery departments. Methodology: A retrospective observational study, including all patients attending the ENT and paediatric surgery nurse-led tongue tie clinics between 1/10/2021 and 30/09/2022. Results: During the study period there were 1135 referrals for frenotomy, with a mean of 15 days between referral to clinic episode. 86.8% of referred patients underwent frenotomy, with a complication rate of 0.1% and revision rate of 5.4%. Conclusions: Our findings suggest that our rapid access nurse-led outpatient tongue tie service is safe and efficacious, with low complication and revision rates. This suggests a potential for developing a community-based service, allowing safe and effective care closer to home.Keywords: tongue tie, frenotomy, cost, nurse-led
Procedia PDF Downloads 11111771 Successful Cesarean Delivery with Veno-Venous Extracorporeal Membrane Oxygenation Support in a Pregnant Woman with Severe Acute Respiratory Distress Syndrome and Heart Failure Complicated by a Rare Condition of Pre-B Cell Acute Lymphoblastic Leukemia in P
Authors: Kristel Dame Bañez Sumagaysay, Marie Victoria Cruz-javier
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The current subject is a case of a 21 year-old woman at 29 1/7 weeks of gestation with Pre-B cell Acute Lymphoblastic Leukemia who was admitted to the coronary care unit (CCU) of the St. Luke’s Medical Center-Global City for Severe Acute Respiratory Distress Syndrome (ARDS) secondary to hospital-acquired pneumonia secondary to pneumocystis jiroveci; central line-associated bloodstream infection (E. aerogenes). She presented with chronic hypoxemia caused by Pulmonary edema, probably secondary to heart failure secondary to cardiomyopathy chemotherapy-induced. Due to worsening feto-maternal status, extracorporeal membrane oxygenation (ECMO) for respiratory support was instituted, and an elective cesarean section was done due to multiple maternal factors and deteriorating health status under total intravenous anesthesia assisted by veno-venous extracorporeal membrane oxygenation. She delivered a live preterm newborn male, APGAR Score: 1, 0, 0, birth weight 985 grams, birth length: 40.5cm, small for gestational age.Keywords: extracorporeal membrane oxygenation, pre-b cell acute lymphoblastic leukemia, severe acute respiratory distress syndrome, ethical dilemmas
Procedia PDF Downloads 7611770 Evaluating the Factors Influencing the Efficiency and Usage of Public Sports Services in a Chinese Province
Authors: Zhankun Wang, Timothy Makubuya
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The efficiency of public sports service of prefecture-level cities in Zhejiang from 2008 to 2012 was evaluated by applying the DEA method, then its influencing factors were also analyzed through Tobit model. Upon analysis, the results revealed the following; (i) the change in average efficiency of public sports service in Zhejiang present a smooth uptrend and at a relatively high level from 2008 to 2012 (ii) generally, the productivity of public sports service in Zhejiang improved from 2008 to 2012, the productivity efficiency varied greatly in different years, and the regional difference of production efficiency increased. (iii) The correlations for urbanization rate, aging rate, per capita GDP and the population density were significantly positive with the public sports service efficiency in Zhejiang, of which the most significant was the aging rate. However, the population density and per capita GDP had less impact on the efficiency of public sports service in Zhejiang. In addition, whether the efficiency of public sports services in different areas in Zhejiang reciprocates to overall benefits in public wellbeing in both rural and urban settings is still arguable.Keywords: DEA model, public sports service, efficiency, Tobit model, Malmquist productivity index, Zhejiang
Procedia PDF Downloads 29211769 Cloud Computing Architecture Based on SOA
Authors: Negin Mohammadrezaee Larki
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Cloud Computing is a popular solution that has been used in recent years to cooperate and collaborate among distributed applications over networks. Moving successfully into cloud computing requires an architecture that will support the new cloud capabilities. Many business leaders and analysts agree that moving to cloud requires having a solid, service-oriented architecture to provide the infrastructure needed for successful cloud implementation.Keywords: Service Oriented Architecture (SOA), Service Oriented Cloud Computing Architecture (SOCCA), cloud computing, cloud computing architecture
Procedia PDF Downloads 38911768 Examination of Public Hospital Unions Technical Efficiencies Using Data Envelopment Analysis and Machine Learning Techniques
Authors: Songul Cinaroglu
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Regional planning in health has gained speed for developing countries in recent years. In Turkey, 89 different Public Hospital Unions (PHUs) were conducted based on provincial levels. In this study technical efficiencies of 89 PHUs were examined by using Data Envelopment Analysis (DEA) and machine learning techniques by dividing them into two clusters in terms of similarities of input and output indicators. Number of beds, physicians and nurses determined as input variables and number of outpatients, inpatients and surgical operations determined as output indicators. Before performing DEA, PHUs were grouped into two clusters. It is seen that the first cluster represents PHUs which have higher population, demand and service density than the others. The difference between clusters was statistically significant in terms of all study variables (p ˂ 0.001). After clustering, DEA was performed for general and for two clusters separately. It was found that 11% of PHUs were efficient in general, additionally 21% and 17% of them were efficient for the first and second clusters respectively. It is seen that PHUs, which are representing urban parts of the country and have higher population and service density, are more efficient than others. Random forest decision tree graph shows that number of inpatients is a determinative factor of efficiency of PHUs, which is a measure of service density. It is advisable for public health policy makers to use statistical learning methods in resource planning decisions to improve efficiency in health care.Keywords: public hospital unions, efficiency, data envelopment analysis, random forest
Procedia PDF Downloads 12711767 Integrating Sexual Reproductive Health and Rights in Promoting Gender Equality, Equity, and Empowerment of Women
Authors: Danielle G. Saique
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Introduction: Promoting Gender Equality, Equity and Empowerment of Women (GEE&EW) can be attained by practicing thereby exercising Sexual and Reproductive Health and Rights (SRHR). Gender Inequality is manifested thru Violence Against Women (VAW). Objectives: This study presents causes, prevalence, effects of Gender Inequality for not practicing and violating SRHR. This proposes Action Plan by promoting, integrating SRHR in the “holistic approach” of Social Work education, practice and service-delivery in any work-set-ups. Limitations: VAW cases showed victim and violator are known, related and living together. Cases transpired at home, reported, investigated in the police and filed in the legal court of law for the year 2013. Methods: Data from blotters, reports, filed cases, case studies gathered by the Social Worker (SWr). Qualitative analysis identified cause, prevalence of VAW related in violating SRHR. SWr serves innovative interventions in any work settings by applying SRHR background, skills in educating, counseling client-victims. Results: 65 VAW cases on non-negotiation or refusal of practicing SRHR. Non-acceptance of Family Planning yielded unwanted, unplanned pregnancies, abandoned children, battered women. Neglected pre-post natal maternal care caused complications or death. Rape, incest led trauma or death. Unsafe, unprotected sex transmitted STDs. Conclusions: Non-availing SRHR from health facilities, from Medical Health SWr concluded to non-practicing or violating rights to life, health care, protection, rights to information, education, rights to plan family, rights from torture, ill-treatment. VAW brings undesirable effects to the well-being, wellness and humaneness of the victim. Recommendations: The innovative intervention services on SRHR of a SWr and the findings, results in violating SRHR are recommendations in Action Planning by adding “The SRHR Concepts” in Social Work thereby preventing VAW; empowering women’s rights to development, gender equality, equity liberty, security, freedom; resilience and involvement in promoting, practicing, exercising SRHR at home. Recommended therefore to duplicate this innovative practice and experience on SRHR as implemented by the SWr in any work setting.Keywords: women development, promoting gender equality, equity, empowerment of women
Procedia PDF Downloads 47711766 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers
Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie
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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.Keywords: abortion, contraception, quality improvement, service provision
Procedia PDF Downloads 22411765 The Effect of Employees' Positive Attitude and Smile and Its Impact on the Quality of Service in the Hospitality Service
Authors: Mariam Kutateladze
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In the twenty-first century, in the customer service settings for hospitality institution’s employee management and their well-being have become a core issue since it is linked to the customers' increased demand for high-quality service. Employees' positive attitude to customers plays an essential role in the serving process; for this reason, in the hospitality institutions service with a smile is a job requirement. This research is devoted to the issues of employee management systems improvement and its effect of the genuine smile as a positive attitude expressed by the employees to the customer. Different researchers work about the effect of the genuine smile, which is analyzed in the present paper. Based on it, the link between satisfied employees from service climate and their genuine smile is determined. An investigation in local resort hotels which are located in the regions of Georgia is conducted. In the methodology of the paper, we have used linkage research, which stated that employee satisfaction in a working place depends on the existing service climate in an organization. We have prepared questioners according to eight dimensions of good service climate by linkage research, and extra questions about the effect of the smile on customers were added. Questionnaires were distributed among employees, and the results have shown that dissatisfaction from organizations’ service climate led to employees' false smile toward customers. Demanding positive emotions from frustrated employees was the mistake of the hotel management. The false smile was easily recognized by the customers, and the frustrated employee with a false smile could not provide high-quality service. The findings of the paper will help managers to realize the importance of forming the positive service climate within the institutions since it is linked to employees' well-being who are the creators of high-quality service. The conclusion drawn from this study indicates there are core issues those managers need to take into account when planning their organizations’ profit. Managers should know their employees very well, their feelings and attitudes toward work before asking them expressing a smile since forced smile does not have a good result and quite often has bad outcomes; therefore, first of all, managers should investigate service climate in the organization. Managers should take into consideration employees’ opinions about the service climate in the organization, motivate their employees, and respect their ideas. Also, they should satisfy employees' basic needs and stress more value on extrinsic goals such as competence, relatedness, and autonomy. Managers should create a positive working environment, positive service climate, which will lead to employee satisfaction and genuine feelings, as well as improve the working environment since negative working climate will cause customers disappointment because of low-quality service provided by the unsatisfied employees.Keywords: employee management, hotel, quality of service, service climate
Procedia PDF Downloads 11411764 Microglia Activation in Animal Model of Schizophrenia
Authors: Esshili Awatef, Manitz Marie-Pierre, Eßlinger Manuela, Gerhardt Alexandra, Plümper Jennifer, Wachholz Simone, Friebe Astrid, Juckel Georg
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Maternal immune activation (MIA) resulting from maternal viral infection during pregnancy is a known risk factor for schizophrenia. The neural mechanisms by which maternal infections increase the risk for schizophrenia remain unknown, although the prevailing hypothesis argues that an activation of the maternal immune system induces changes in the maternal-fetal environment that might interact with fetal brain development. It may lead to an activation of fetal microglia inducing long-lasting functional changes of these cells. Based on post-mortem analysis showing an increased number of activated microglial cells in patients with schizophrenia, it can be hypothesized that these cells contribute to disease pathogenesis and may actively be involved in gray matter loss observed in such patients. In the present study, we hypothesize that prenatal treatment with the inflammatory agent Poly(I:C) during embryogenesis at contributes to microglial activation in the offspring, which may, therefore, represent a contributing factor to the pathogenesis of schizophrenia and underlines the need for new pharmacological treatment options. Pregnant rats were treated with intraperitoneal injections a single dose of Poly(I:C) or saline on gestation day 17. Brains of control and Poly(I:C) offspring, were removed and into 20-μm-thick coronal sections were cut by using a Cryostat. Brain slices were fixed and immunostained with ba1 antibody. Subsequently, Iba1-immunoreactivity was detected using a secondary antibody, goat anti-rabbit. The sections were viewed and photographed under microscope. The immunohistochemical analysis revealed increases in microglia cell number in the prefrontal cortex, in offspring of poly(I:C) treated-rats as compared to the controls injected with NaCl. However, no significant differences were observed in microglia activation in the cerebellum among the groups. Prenatal immune challenge with Poly(I:C) was able to induce long-lasting changes in the offspring brains. This lead to a higher activation of microglia cells in the prefrontal cortex, a brain region critical for many higher brain functions, including working memory and cognitive flexibility. which might be implicated in possible changes in cortical neuropil architecture in schizophrenia. Further studies will be needed to clarify the association between microglial cells activation and schizophrenia-related behavioral alterations.Keywords: Microglia, neuroinflammation, PolyI:C, schizophrenia
Procedia PDF Downloads 41711763 Investigation of Long-Term Thermal Insulation Performance of Vacuum Insulation Panels with Various Enveloping Methods
Authors: Inseok Yeo, Tae-Ho Song
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To practically apply vacuum insulation panels (VIPs) to buildings or home appliances, VIPs have demanded long-term lifespan with outstanding insulation performance. Service lives of VIPs enveloped with Al-foil and three-layer Al-metallized envelope are calculated. For Al-foil envelope, the service life is longer but edge conduction is too large compared with the Al metallized envelope. To increase service life even more, the proposed double enveloping method and metal-barrier-added enveloping method are further analyzed. The service lives of the VIP to employ two enveloping methods are calculated. Also, pressure increase and thermal insulation performance characteristics are investigated. For the metal- barrier-added enveloping method, effective thermal conductivity increase with time is close to that of Al-foil envelope, especially, for getter-inserted VIPs. For the double enveloping method, if water vapor is perfectly adsorbed, the effect of service life enhancement becomes much greater. From these methods, the VIP can be guaranteed for the service life of more than 20 years.Keywords: vacuum insulation panels, service life, double enveloping, metal-barrier-added enveloping, edge conduction
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