Search results for: public health risks
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13944

Search results for: public health risks

9084 Needs and Expectations of Digital Support among Parents of Children in Child Healthcare

Authors: Lotha Valan, Åsa Hörnsten, Ulf Isaksson

Abstract:

Introduction: Sweden has a national child health care program (CHCP) where all parents are offered support to raise their children and support them for lifelong health. A systematic review concludes that there is a request for guidance in using the internet effectively for the health purposes of their children. However, a study about internet use among young mothers means that the internet is not always easy to navigate for parents, and they may need support. To fill this gap and develop a digital channel to complement the child health care (CHC) for the support of parents of children within CHC, there is a demand to investigate parents' needs in relation to this purpose. Methods: The study had a qualitative approach using focus group interviews with parents. The interview data were analyzed using qualitative content analysis. Results: The main theme highlights that parents expected that a digital support channel would be something that might strengthen them toward independence concerning the care of their children in a positive way. However, they also felt that they needed personal support and that relationships with other parents and the child health care nurse were significant and meaningful. Another parental desire that emerged was that a future digital channel would facilitate and simplify access to care, and they suggested having both planned and urgent times available for parents to book. The digital channel was expected to make this possible and be a good complement to the physical contacts the traditional child healthcare currently offers. Discussion/conclusions: The parents in this study believed that digital solutions could increase their parental power in relation to the care of their children. Examples were given as nurse-led parent groups where parents with similar problems and experiences around their children could support each other and were expected to strengthen them over time. The parents stressed that a planned digital support channel also needs satisfactory solutions for both contact and response. It was suggested that there should be bookable times for both planned and urgent needs and also the possibility of rescheduling visits.

Keywords: child healthcare, parents, digital support, nursing

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9083 Canopy Temperature Acquired from Daytime and Nighttime Aerial Data as an Indicator of Trees’ Health Status

Authors: Agata Zakrzewska, Dominik Kopeć, Adrian Ochtyra

Abstract:

The growing number of new cameras, sensors, and research methods allow for a broader application of thermal data in remote sensing vegetation studies. The aim of this research was to check whether it is possible to use thermal infrared data with a spectral range (3.6-4.9 μm) obtained during the day and the night to assess the health condition of selected species of deciduous trees in an urban environment. For this purpose, research was carried out in the city center of Warsaw (Poland) in 2020. During the airborne data acquisition, thermal data, laser scanning, and orthophoto map images were collected. Synchronously with airborne data, ground reference data were obtained for 617 studied species (Acer platanoides, Acer pseudoplatanus, Aesculus hippocastanum, Tilia cordata, and Tilia × euchlora) in different health condition states. The results were as follows: (i) healthy trees are cooler than trees in poor condition and dying both in the daytime and nighttime data; (ii) the difference in the canopy temperatures between healthy and dying trees was 1.06oC of mean value on the nighttime data and 3.28oC of mean value on the daytime data; (iii) condition classes significantly differentiate on both daytime and nighttime thermal data, but only on daytime data all condition classes differed statistically significantly from each other. In conclusion, the aerial thermal data can be considered as an alternative to hyperspectral data, a method of assessing the health condition of trees in an urban environment. Especially data obtained during the day, which can differentiate condition classes better than data obtained at night. The method based on thermal infrared and laser scanning data fusion could be a quick and efficient solution for identifying trees in poor health that should be visually checked in the field.

Keywords: middle wave infrared, thermal imagery, tree discoloration, urban trees

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9082 The Portuguese Legal Instruments to Combat the Improper Use of the Contract Service

Authors: Ana Lambelho

Abstract:

Nowadays is very common that an activity may be performed independently or dependently. In Portugal, the Labour Law exclusively protects the dependent labour relations. The independent work is regulated by civil law, where the autonomy of the will is the main principle. For companies is more advantageous to hire people under a service agreement since, in that case, the relation is not submitted to the limits established in Labour law and collective bargaining. This practice has nothing wrong, if the performance of work is, in fact, made autonomously. The problem is the increased frequency of the celebration of service agreements to hide a legal relation of subordination. Aware of this and regarding the huge difficulty to demonstrate the existence of subordinated work (that often runs against the employee), the Portuguese legislator devoted some legislative rules in order to facilitate the evidence of legal subordination and, on the other hand, to avoid the misuse of the provision of service agreements. This study focuses precisely on the analysis of this solution, namely the so-called presumption of ‘laboralidade’ and on the lawsuit to recognize the existence of a labour contract. The presumption of the existence of a labour contract is present in the Portuguese legal system since 2003, and received, with the 2009 Labour Code, a new redaction that, according to the doctrine and the jurisprudence, finally approached it to a legal presumption, with the consequent reversal of the burden of proof and, in consequence, made easier to proof the legal subordination, because the employee will just have to plead and prove the existence of two of the elements described in the law to use this presumption. Another change in the Portuguese legal framework is related with the competencies of the Authority for Working Conditions (AWC): now, if during an inspection, the Authority finds a situation that seems to be an undeclared employment situation, it may access the company and, if it does not regularize voluntarily the situation, AWC has a duty to communicate to the public prosecutor, who will begin the lawsuit for the recognition of the existence of an employment contract. To defend the public interest, the action to recognize the existence of an employment contract will follow its terms, even against the employee will. Although the existence of these mechanisms does not solve by itself the problem of evasion of labour law and false ‘green receipts’, it is undeniable that it is an important step in combating fraud in this field.

Keywords: independent work, labour contract, Portugal, service agreement

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9081 Differential Diagnosis of Malaria and Dengue Fever on the Basis of Clinical Findings and Laboratory Investigations

Authors: Aman Ullah Khan, Muhammad Younus, Aqil Ijaz, Muti-Ur-Rehman Khan, Sayyed Aun Muhammad, Asif Idrees, Sanan Raza, Amar Nasir

Abstract:

Dengue fever and malaria are important vector-borne diseases of public health significance affecting millions of people around the globe. Dengue fever is caused by Dengue virus while malaria is caused by plasmodium protozoan. Generally, the consequences of Malaria are less severe compared to dengue fever. This study was designed to differentiate dengue fever and malaria on the basis of clinical and laboratory findings and to compare the changes in both diseases having different causative agents transmitted by the common vector. A total of 200 patients of dengue viral infection (120 males, 80 females) were included in this prospective descriptive study. The blood samples of the individuals were first screened for malaria by blood smear examination and then the negative samples were tested by anti-dengue IgM strip. The strip positive cases were further screened by IgM capture ELISA and their complete blood count including hemoglobin estimation (Hb), total and differential leukocyte counts (TLC and DLC), erythrocyte sedimentation rate (ESR) and platelet counts were performed. On the basis of the severity of signs and symptoms, dengue virus infected patients were subdivided into dengue fever (DF) and dengue hemorrhagic fever (DHF) comprising 70 and 100 confirmed patients, respectively. On the other hand, 30 patients were found infected with Malaria while overall 120 patients showed thrombocytopenia. The patients of DHF were found to have more leucopenia, raised hemoglobin level and thrombocytopenia < 50,000/µl compared to the patients belonging to DF and malaria. On the basis of the outcomes of the study, it was concluded that patients affected by DF were at a lower risk of undergoing haematological disturbance than suffering from DHF. While, the patients infected by Malaria were found to have no significant change in their blood components.

Keywords: dengue fever, blood, serum, malaria, ELISA

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9080 Study on Renewal Strategy of Old District with an Example of SQ in Shenzhen

Authors: Yun Zuo, Wenju Li

Abstract:

Shenzhen is one of China’s gates to the world. What was once a fishing village is now a metropolis of more than 10 million people. Because of its unprecedented pace of development, it also brings a serious of issues, such as the self-renewal of the city. In the paper, we use Sungang-Quingshuihe(SQ) as an example. SQ is one of the oldest districts in the east of Shenzhen. Nowadays, SQ faces many challenges. This is because once the logistics area has been slowly disappear, the new identity will be replaced. As a result, we are to minimize damages to the city in transforming process by seeking for a new design strategy. In the meantime, we think that each district in a city has its own role forming the whole city together. Therefore, a district transformation is functionally-oriented and for improving city quality in focus.

Keywords: old district, renewal strategy, public space, sustainable development

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9079 Prevalence of Caesarean-Section Delivery and Its Determinants in India: Evidence for Fifth National Family Health Surveys

Authors: Daisy Saikia

Abstract:

Long-term maternal health issues with Caesarean section deliveries are significant. Thus, this study aims to investigate the prevalence of caesarean section deliveries in India and to comprehend its associated predictors in light of the high caesarean section delivery rate. The study uses data from the fifth National Family Health Surveys (NFHS-5) round. Specifically, live births to women aged 15-49 in the 5 years preceding the survey. Binary logistic regression was used to check the adjusted effects of the predictor variables on caesarean section delivery. STATA/SE v16.0 was used for the data analysis with a 5% significance level. Twenty-two per cent of the live births to women were delivered by caesarean section. There was socio-economic, demographic and geographical variation in the prevalence of caesarean section delivery in India. Increasing age, body mass index, marital status, mother’s occupation and education, birth order, place of delivery, full ANC, non-tribal status, wealth quintile and region are significantly associated with caesarean section deliveries in India. Caesarean section deliveries should only be performed when essential from a medical perspective, and regions, where the rate is too high, should follow the guidelines. Additionally, it needs to be investigated whether private hospitals compel patients to have caesarean section deliveries to increase their revenue. Thus, these unnecessary deliveries must be examined immediately for safe childbirth and the wellness of both mother and child.

Keywords: caesarean section, delivery, maternal health, India

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9078 Religion, Health and Ageing: A Geroanthropological Study on Spiritual Dimensions of Well-Being among the Elderly Residing in Old Age Homes in Jallandher Punjab, India

Authors: A. Rohit Kumar, B. R. K. Pathak

Abstract:

Background: Geroanthropology or the anthropology of ageing is a term which can be understood in terms of the anthropology of old age, old age within anthropology, and the anthropology of age. India is known as the land of spirituality and philosophy and is the birthplace of four major religions of the world namely Hinduasim, Buddhisim, Jainisim, and Sikhism. The most dominant religion in India today is Hinduism. About 80% of Indians are Hindus. Hinduism is a religion with a large number of Gods and Goddesses. Religion in India plays an important role at all life stages i.e. at birth, adulthood and particularly during old age. India is the second largest country in the world with 72 million elder persons above 60 years of age in 2001 as compared to china 127 million. The very concept of old age homes in India is new. The elderly people staying away from their homes, from their children or left to them is not considered to be a very happy situation. This paper deals with anthropology of ageing, religion and spirituality among the elderly residing in old age homes and tries to explain that how religion plays a vital role in the health of the elderly during old age. Methods: The data for the present paper was collected through both Qualitative and Quantitative methods. Old age homes located in Jallandher (Punjab) were selected for the present study. Age sixty was considered as a cut off age. Narratives, case studies were collected from 100 respondents residing in old age homes. The dominant religion in Punjab was found to be Sikhism and Hinduism while Jainism and Buddhism were found to be in minority. It was found that as one grows older the religiosity increases. Religiosity and sprituality was found to be directly proportional to ageing. Therefore religiosity and health were found to be connected. Results and Conclusion: Religion was found out to be a coping mechanism during ill health. The elderly living in old age homes were purposely selected for the study as the elderly in old age homes gets medical attention provided only by the old age home authorities. Moreover, the inmates in old age homes were of low socio-economic status couldn’t afford medical attention on their own. It was found that elderly who firmly believed in religion were found to be more satisfied with their health as compare to elderly who does not believe in religion at all. Belief in particular religion, God and godess had an impact on the health of the elderly.

Keywords: ageing, geroanthropology, religion, spirituality

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9077 The Effect of Evil Eye in the Individuals' Journey for Personhood within a Christian Orthodox Society

Authors: Nikolaos Souvlakis

Abstract:

The present paper negotiates the effect of 'the evil eye' on individuals' mental health while at the same time poses the problem of how the evil eye fits into the anthropological arena as a key question that forges a fundamental link between religion, anthropology and mental health professions. It is the argument of the paper that the evil eye is an essential and fundamental human phenomenon and therefore any scholarly field involved in its study must consider the insight it provides into the development of personhood. The study was an anthropological study in the geographical area of Corfu, a Greek Orthodox society uninfluenced by the Ottoman Islamic Culture. The paper aims to deepen our understanding of the evil eye as it analyses the interaction between the evil eye and gaze and how they affect the development of personhood; based on the empirical data collected from the fieldwork. Therefore, the paper adopts a psychoanalytic anthropology approach to facilitate a better understanding of the evil eye through the accounts of individuals’ journeys in the process of their development of personhood. Finally, the paper aims to offer a detailed analysis of the particular element of eye (‘I’) and, more specifically, of ‘the others’, as they relate to the phenomenon of the evil eye.

Keywords: gaze, evil eye, mental health, personhood

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9076 Youth Health Promotion Project for Indigenous People in Canada: Together against Bullying and Cyber-Dependence

Authors: Mohamed El Fares Djellatou, Fracoise Filion

Abstract:

The Ashukin program that means bridge in Naskapi or Atikamekw language, has been designed to offer a partnership between nursing students and an indigenous community. The students design a health promotion project tailored to the needs of the community. The issues of intimidation in primary school and cyber-dependence in high school were some concerns in a rural Atikamekw community. The goal of the project was to have a conversation with indigenous youths, aged 10-16 years old, on the challenges presented by intimidation and cyber dependence as well as promoting healthy relationships online and within the community. Methods: Multiple progressive inquiry questions (PIQs) were used to assess the feasibility and importance of this project for the Atikamekw nation, and to determine a plan to follow. The theoretical foundations to guide the conception of the project were the Population Health Promotion Model (PHPM), the First Nations Holistic Lifelong Learning Model, and the Medicine Wheel. A broad array of social determinants of health were addressed, including healthy childhood development, personal health practices, and coping skills, and education. The youths were encouraged to participate in interactive educational sessions, using PowerPoint presentations and pamphlets as the main effective strategies. Additional tools such as cultural artworks and physical activities were introduced to strengthen the inter-relational and team spirit within the Indigenous population. A quality assurance tool (QAT) was developed specifically to determine the appropriateness of these health promotion tools. Improvements were guided by the feedback issued by the indigenous schools’ teachers and social workers who filled the QATs. Post educational sessions, quantitative results have shown that 93.48% of primary school students were able to identify the different types of intimidation, 72.65% recognized more than two strategies, and 52.1% were able to list at least four resources to diffuse intimidation. On the other hand, around 75% of the adolescents were able to name at least three negative effects, and 50% listed three strategies to reduce cyber-dependence. This project was meant to create a bridge with the First Nation through health promotion, a population that is known to be disadvantaged due to systemic health inequity and disparities. Culturally safe care was proposed to deal with the two identified priority issues, and an educational toolkit was given to both schools to ensure the sustainability of the project. The project was self-financed through fundraising activities, and it yielded better results than expected.

Keywords: indigenous, first nation, bullying, cyber-dependence, internet addiction, intimidation, youth, adolescents, school, community nursing, health promotion

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9075 Blue Whale Body Condition from Photographs Taken over a 14-Year Period in the North East Pacific: Annual Variations and Connection to Measures of Ocean Productivity

Authors: Rachel Wachtendonk, John Calambokidis, Kiirsten Flynn

Abstract:

Large marine mammals can serve as an indicator of the overall state of the environment due to their long lifespan and apex position in marine food webs. Reductions in prey, driven by changes in environmental conditions can have resounding impacts on the trophic system as a whole; this can manifest in reduced fat stores that are visible on large whales. Poor health can lead to reduced survivorship and fitness, both of which can be detrimental to a recovering population. A non-invasive technique was used for monitoring blue whale health and for seeing if it changes with ocean conditions. Digital photographs of blue whales taken in the NE Pacific by Cascadia Research and collaborators from 2005-2018 (n=3,545) were scored for overall body condition based on visible vertebrae and body shape on a scale of 0-3 where a score of 0 indicated best body condition and a score of 3 indicated poorest. The data was analyzed to determine if there were patterns in the health of whales across years and whether overall poor health was related to oceanographic conditions and predictors of prey abundance on the California coast. The year was a highly significant factor in body condition (Chi-Square, p<0.001). The proportion of whales showing poor body condition (scores 2 & 3) overall was 33% but by year varied widely from a low of 18% (2008) to a high of 55% (2015). The only two years where >50% of animals had poor body condition were 2015 and 2017 (no other year was above 45%). The 2015 maximum proportion of whales in poor body condition coincide with the marine heat wave that affected the NE Pacific 2014-16 and impacted other whale populations. This indicates that the scoring method was an effective way to evaluate blue whale health and how they respond to a changing ocean.

Keywords: blue whale, body condition, environmental variability, photo-identification

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9074 Shift Work and Its Consequences

Authors: Parastoo Vasli

Abstract:

In today's society, more and more people work during ‘non-standard’ working hours, including shift and night work, which are perceived danger factors for health, safety, and social prosperity. Appropriate preventive and protective measures are needed to reduce side effects and ensure that the worker can adapt sufficiently. Of the many health effects associated with shift work, sleep disorders are the most widely recognized. The most troubling acute symptoms are difficulty falling asleep, short sleep, and drowsiness during working hours that last for days on end. The outcomes checked on plainly exhibit that shift work is related to expanded mental, social, and physiological drowsiness. Apparently, the effects are due to circadian and hemostatic compounds (sleep loss). Drowsiness is especially evident during night shifts and may lead to drowsiness in real workplace accidents. In some occupations, this is clearly a risk that could endanger human lives and has enormous financial outcomes. These dangers clearly affect a large number of people and should be of great importance to society. In particular, safety on night shifts is consistently reduced.

Keywords: shift work, night work, safety, health, drowsiness

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9073 An Exploration of Cyberspace Security, Strategy for a New Era

Authors: Laxmi R. Kasaraneni

Abstract:

The Internet connects all the networks, including the nation’s critical infrastructure that are used extensively by not only a nation’s government and military to protect sensitive information and execute missions, but also the primary infrastructure that provides services that enable modern conveniences such as education, potable water, electricity, natural gas, and financial transactions. It has become the central nervous system for the government, the citizens, and the industries. When it is attacked, the effects can ripple far and wide impacts not only to citizens’ well-being but nation’s economy, civil infrastructure, and national security. As such, these critical services may be targeted by malicious hackers during cyber warfare, it is imperative to not only protect them and mitigate any immediate or potential threats, but to also understand the current or potential impacts beyond the IT networks or the organization. The Nation’s IT infrastructure which is now vital for communication, commerce, and control of our physical infrastructure, is highly vulnerable to attack. While existing technologies can address some vulnerabilities, fundamentally new architectures and technologies are needed to address the larger structural insecurities of an infrastructure developed in a more trusting time when mass cyber attacks were not foreseen. This research is intended to improve the core functions of the Internet and critical-sector information systems by providing a clear path to create a safe, secure, and resilient cyber environment that help stakeholders at all levels of government, and the private sector work together to develop the cybersecurity capabilities that are key to our economy, national security, and public health and safety. This research paper also emphasizes the present and future cyber security threats, the capabilities and goals of cyber attackers, a strategic concept and steps to implement cybersecurity for maximum effectiveness, enabling technologies, some strategic assumptions and critical challenges, and the future of cyberspace.

Keywords: critical challenges, critical infrastructure, cyber security, enabling technologies, national security

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9072 The Impacts of the COVID-19 Pandemic on Social Activities and Residential Areas

Authors: Asghar Motea Noparvar

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According to the World Health Organization (WHO), the coronavirus disease (COVID-19), which has been characterized as a pandemic since December 2019, is attacking societies in terms of different ways. It means that this is much more than a crisis that is related to human health. It is a human, economic and social crisis. Since December 2019, not only some significant transformations have happened in human life, but also there has been some mental health, daily life activities, and even urban space changes. The purpose of this study is to mention some tangible transformations in society by applying two main restrictions such as “lock down” and “social distancing,” and how people took refuge in their homes and fit every activity there. How this pandemic has been transforming human life and social activities is the main issue of this study. In order to gather the information, review the impacts of COVID-19 on social life by revising the literature and considering the “Risk Society” theory, which is gotten credited by a German sociologist, Ulrich Beck. Additionally, COVID-19 not only had a direct impact on health but also had significant impacts on the economy, education, tourism, the environment, and the construction industry. Therefore, the pandemic caused a disruption in the whole urban system. In this study, the main focused point is the transformation of activities and residential areas. In order to achieve this finding, the literature review is analyzed in the case of COVID-19 and its impacts on social life. To sum up, it can be concluded that a pandemic can change social life along with other transformations that it is able to do.

Keywords: infectious disease, COVID-19, social activities, residential areas, transformation

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9071 Delayed Contralateral Prophylactic Mastectomy (CPM): Reasons and Rationale for Patients with Unilateral Breast Cancer

Authors: C. Soh, S. Muktar, C. M. Malata, J. R. Benson

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Introduction Reasons for requesting CPM include prevention of recurrence, peace of mind and moving on after breast cancer. Some women seek CPM as a delayed procedure but factors influencing this are poorly understood. Methods A retrospective analysis examined patients undergoing CPM as either an immediate or delayed procedure with or without breast reconstruction (BR) between January 2009 and December 2019. A cross-sectional survey based on validated questionnaires (5 point Likert scale) explored patients’ decision-making process in terms of timing of CPM and any BR. Results A total of 123 patients with unilateral breast cancer underwent CPM with 39 (32.5%) delayed procedures with or without BR. The response rate amongst patients receiving questionnaires (n=33) was 22/33 (66%). Within this delayed CPM cohort were three reconstructive scenarios 1) unilateral immediate BR with CPM (n=12); 2) delayed CPM with concomitant bilateral BR (n=22); 3) delayed bilateral BR after delayed CPM (n=3). Two patients had delayed CPM without BR. The most common reason for delayed CPM was to complete all cancer treatments (including radiotherapy) before surgery on the unaffected breast (score 2.91). The second reason was unavailability of genetic test results at the time of therapeutic mastectomy (score 2.64) whilst the third most cited reason was a subsequent change in family cancer history. Conclusion Factors for delayed CPM are patient-driven with few women spontaneously changing their mind having initially decided against immediate CPM for reasons also including surgical duration. CPM should be offered as a potentially delayed option with informed discussion of risks and benefits.

Keywords: Breast Cancer, CPM, Prophylactic, Rationale

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9070 The Food and Nutrition Security in Brazilian Quilombo: The Account of Experiences in Two Titled Territories

Authors: Dyego Ramos Henrique, Viviane Pimentel, Katia Souto, Ana Valéria Mendonça, Andrea Gallassi

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Socioeconomic inequalities in Brazil have accentuated the aggravations of poverty among the most vulnerable populations, among which are the quilombola communities. The objective was to reflect on a situation of food and nutritional security in two Brazilian quilombola communities. The data were collected by means of reports of experience through the production of talk wheels in two quilombola communities (Itamatatiua and Mesquita), located in the cities of Alcântara and Cidade Ocidental. Access to health services and health promotion actions were still incipient in the quilombola communities visited. The perceptions of the participants of the quilombolas revealed that there are still repressed demands that have rendered the fulfillment of the principles of equity, universality and integrality, both for access to health and for access and availability of food. They recognize in governmental instances a socioeconomic-cultural valorization and nutritional qualities intrinsic to the foods produced by them. Although they have been used as communities of quilombolas live and their level of access to services and programs, dealing with quilombola communities does not mean dealing with 'isolated groups or a strictly homogeneous population.' It demands a great need of attention in relation to the access and availability of food, besides overcoming barriers that made it an unfeasible valuation of social, economic and cultural precepts, intrinsic to the thought about food and nutritional security in Brazilian quilombos.

Keywords: access to services, food and nutrition security, health promotion, quilombo population

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9069 Acupuncture Reduces Pain Disability, Stress, and Depression in United States Military Veterans with Chronic Pain

Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan

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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.

Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing

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9068 Living at Density: Resident Perceptions in Auckland, New Zealand

Authors: Errol J. Haarhoff

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Housing in New Zealand, particularly in Auckland, is dominated by low-density suburbs. Over the past 20 years, housing intensification policies aimed to curb outward low-density sprawl and to concentrate development within an urban boundary have been implemented. This requires the greater deployment of attached housing typologies such apartments, duplexes and terrace housing. There has been strong market response and uptake for higher density development, with the number of building approvals received by the Auckland Council for attached housing units increasing from around 15 percent in 2012/13, to 54 percent in 2017/18. A key question about intensification and strong market uptake in a city where lower density has been the norm, is whether higher density neighborhoods will deliver necessary housing satisfaction? This paper reports on the findings to a questionnaire survey and focus group discussions probing resident perceptions to living at higher density in relation to their dwellings, the neighborhood and their sense of community. The findings reveal strong overall housing satisfaction, including key aspects such as privacy, noise and living in close proximity to neighbors. However, when residents are differentiated in terms of length of tenure, age or whether they are bringing up children, greater variation in satisfaction is detected. For example, residents in the 65-plus age cohort express much higher levels of satisfaction, when compared to the 18-44 year cohorts who more likely to be binging up children. This suggests greater design sensitivity to better accommodate the range of household types. Those who have live in the area longer express greater satisfaction than those with shorter duration, indicating time for adaption to living at higher density. Findings strongly underpin the instrumental role that the public amenities play in overall housing satisfaction and the emergence of a strong sense of community. This underscores the necessity for appropriate investment in the public amenities often lacking in market-led higher density housing development. We conclude with an evaluation of the PPP model, and its part in delivering housing satisfaction. The findings should be of interest to cities, housing developers and built environment professional pursuing housing policies promoting intensification and higher density.

Keywords: medium density, housing satisfaction, neighborhoods, sense of community

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9067 Exclusive Breastfeeding Abandonment among Adolescent Mothers: A Cohort Study

Authors: Maria I. Nuñez-Hernández, Maria L. Riesco

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Background: Exclusive breastfeeding (EBF) up to 6 months old infant have been considered one of the most important factors in the overall development of children. Nevertheless, as resources are scarce, it is essential to identify the most vulnerable groups that have major risk of EBF abandonment, in order to deliver the best strategies. Children of adolescent mothers are within these groups. Aims: To determine the EBF abandonment rate among adolescent mothers and to analyze the associated factors. Methods: Prospective cohort study of adolescent mothers in the southern area of Santiago, Chile, conducted in primary care services of public health system. The cohort was established from 2014 to 2015, with a sample of 105 adolescent mothers and their children at 2 months of life. The inclusion criteria were: adolescent mother from 14 to 19 years old; not twin babies; mother and baby leaving the hospital together after birthchild; correct attachment of the baby to the breast; no difficulty understanding the Spanish language or communicating. Follow-up was performed at 4 and 6 months old infant. Data were collected by interviews, considering EBF as breastfeeding only, without adding other milk, tea, juice, water or other product that not breast milk, except drugs. Data were analyzed by descriptive and inferential statistics, by Kaplan-Meier estimator and Log-Rank test, admitting the probability of occurrence of type I error of 5% (p-value = 0.05). Results: The cumulative EBF abandonment rate at 2, 4 and 6 months was 33.3%, 52.2% and 63.8%, respectively. Factors associated with EBF abandonment were maternal perception of the quality of milk as poor (p < 0.001), maternal perception that the child was not satisfied after breastfeeding (p < 0.001), use of pacifier (p < 0.001), maternal consumption of illicit drugs after delivery (p < 0.001), mother return to school (p = 0.040) and presence of nipple trauma (p = 0.045). Conclusion: EBF abandonment rate was higher in the first 4 months of life and is superior to the population of women who breastfeed. Among the EBF abandonment factors, one of them is related to the adolescent condition, and two are related to the maternal subjective perception.

Keywords: adolescent, breastfeeding, midwifery, nursing

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9066 An Occupational Health Risk Assessment for Exposure to Benzene, Toluene, Ethylbenzene and Xylenes: A Case Study of Informal Traders in a Metro Centre (Taxi Rank) in South Africa

Authors: Makhosazana Dubazana

Abstract:

Many South Africans commuters use minibus taxis daily and are connected to the informal transport network through metro centres informally known as Taxi Ranks. Taxi ranks form part of an economic nexus for many informal traders, connecting them to commuters, their prime clientele. They work along designated areas along the periphery of the taxi rank and in between taxi lanes. Informal traders are therefore at risk of adverse health effects associated with the inhalation of exhaust fumes from minibus taxis. Of the exhaust emissions, benzene, toluene, ethylbenzene and xylenes (BTEX) have high toxicity. Purpose: The purpose of this study was to conduct a Human Health Risk Assessment for informal traders, looking at their exposure to BTEX compounds. Methods: The study was conducted in a subsection of a taxi rank which is representative of the entire taxi rank. This subsection has a daily average of 400 minibus taxi moving through it and an average of 60 informal traders working in it. In the health risk assessment, a questionnaire was conducted to understand the occupational behaviour of the informal traders. This was used to deduce the exposure scenarios and sampling locations. Three sampling campaigns were run for an average of 10 hours each covering the average working hours of traders. A gas chronographer was used for collecting continues ambient air samples at 15 min intervals. Results: Over the three sampling days, the average concentrations were, 8.46ppb, 0.63 ppb, 1.27ppb and 1.0ppb for benzene, toluene, ethylbenzene, and xylene respectively. The average cancer risk is 9.46E-03. In several cases, they were incidences of unacceptable risk for the cumulative exposure of all four BTEX compounds. Conclusion: This study adds to the body of knowledge on the Human Health Risk effects of urban BTEX pollution, furthermore focusing on the impact of urban BTEX on high risk personal such as informal traders, in Southern Africa.

Keywords: human health risk assessment, informal traders, occupational risk, urban BTEX

Procedia PDF Downloads 225
9065 Teaching Health in an Online 3D Virtual Learning Environment

Authors: Nik Siti Hanifah Nik Ahmad

Abstract:

This research discuss about teaching cupping therapy or hijama by using an online 3D Virtual Learning Environment. The experimental platform was using of flash and Second Life as 2D and 3D comparison. 81 samples have been used in three experiments with 21 in the first and 30 in each second and third. The design of the presentation was tested in five categories such as effectiveness, ease of use, efficacy, aesthetic and users’ satisfaction. The results from three experiments had shown promising outcome for usage of the technique to be implement in teaching Cupping Therapy as well as other alternative or conventional medicine knowledge especially for training.

Keywords: medical and health, cupping therapy or hijama, second life, online 3D VLE, virtual worlds

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9064 Investigating the Flavin-Dependent Thymidylate Synthase (FDTS) Enzyme from Clostridioides Difficile (C. diff)

Authors: Sidra Shaw, Sarenna Shaw, Chae Joon Lee, Irimpan Mathews, Eric Koehn

Abstract:

One of the biggest public health concerns of our time is increasing antimicrobial resistance. As of 2019, the CDC has documented more than 2.8 million serious antibiotic resistant infections in the United States. Currently, antibiotic resistant infections are directly implicated in over 750,000 deaths per year globally. On our current trajectory, British economist Jim O’Neill predicts that by 2050, an additional 10 million people (about half the population of New York) will die annually due to drug resistant infections. As a result, new biochemical pathways must be targeted to generate next generation antibiotic drugs that will be effective against drug resistant bacteria. One enticing target is the biosynthesis of DNA within bacteria, as few drugs interrupt this essential life process. Thymidylate synthase enzymes are essential for life as they catalyze the synthesis of a DNA building block, 2′-deoxythymidine-5′-monophosphate (dTMP). In humans, the thymidylate synthase enzyme (TSase) has been shown to be distinct from the flavin-dependent thymidylate synthase (FDTS) produced by many pathogenic bacteria. TSase and FDTS have distinct structures and mechanisms of catalysis, which should allow selective inhibition of FDTS over human TSase. Currently, C. diff is one of the most antibiotic resistant bacteria, and no drugs that target thymine biosynthesis exist for C. diff. Here we present the initial biochemical characterization of FDTS from C. diff. Specifically, we examine enzyme kinetics and binding features of this enzyme to determine the nature of interaction with ligands/inhibitors and understand the molecular mechanism of catalysis. This research will provide more insight into the targetability of the C. diff FDTS enzyme for novel antibiotic drugs.

Keywords: flavin-dependent thymidylate synthase, FDTS, clostridioides difficile, C. diff, antibiotic resistance, DNA synthesis, enzyme kinetics, binding features

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9063 Prevalence of SARS-CoV-2 Infection and Associated Risk Factors in Selected Health Facilities of Tigray, Ethiopia: Cross-Sectional Study Design, 2023

Authors: Weldegerima Gebremedhin Hagos

Abstract:

Background: The Coronavirus disease of 2019 (COVID-19) is a catastrophic emerging global health threat caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 has a wide range of complications and sequels. It is devastating in developing countries, causing serious health and socioeconomic crises as a result of the increasingly overburdened healthcare system. Ethiopia reported the first case of SARS-CoV-2 on 13th March 2020, with community transmission ensuing by mid-May. The aim of this study was conducted to determine the prevalence of SARS-CoV-2 infection in Tigray, Ethiopia. Methods: Facility-based correctional study designs were used on a total of 380 study participants from March 2023 up to May 2023 in two general hospitals and one comprehensive specialized hospital in Tigray, Ethiopia. A pre-structured questionnaire was used to assess information regarding the socio-demographic, clinical data and other risk factors. A nasal swap was taken by trained health professionals, and the laboratory analysis was done by RT-PCR (quant studio 7-flex, applied biosystems) in Tigrai Health Research Institute and Mekelle University Medical Microbiology Research Laboratory. Result: The mean age of the study participants was 31 (SD+/-3.5) years, with 65% being male and 35% female. The overall seropositivity of sars-cov-2 among the study participants was 5.5%. The prevalence was higher in males (6.2%) than females which were (4.7%). Sars-cov-2 infection was significantly associated with a history of lack of vaccination (p-value 0.002). There was no significant association between seropositivity and demographic factors (P > 0.05). Conclusion: The seroprevalence of SARS-CoV-2 among the study participants is high. Those study participants with a previous history of vaccination have a low probability of developing COVID-19 infection. A low SARS-CoV-2 infection rate was recorded in those who frequently use masks.

Keywords: prevalence, SARS-CoV-2, infection, risk factors

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9062 A Voice Retrieved from the Holocaust in New Journalism in Kazuo Ishiguro's the Remains of the Day

Authors: Masami Usui

Abstract:

Kazuo Ishiguro’s The Remains of the Day (1989) underlines another holocaust, an imprisonment of human life, dignity, and self in the globalizing sphere of the twentieth century. The Remains of the Day delineates the invisible and cruel space of “lost and found” in the postcolonial and post-imperial discourse of this century, that is, the Holocaust. The context of the concentration camp or wartime imprisonment such as Auschwitz is transplanted into the public sphere of modern England, Darlington Hall. The voice is retrieved and expressed by the young journalist and heir of Darlington Hall, Mr. David Cardinal. The new media of journalism is an intruder at Darlington Hall and plays a role in revealing the wrongly-input ideology. “Lost and Found” consists of the private and public retrieved voices. Stevens’ journey in 1956 is a return to the past, especially the period between 1935 and 1936. Lost time is retrieved on his journey; yet lost life cannot be revived entirely in his remains of life. The supreme days of Darlington Hall are the terrifying days caused by the Nazis. Fascism, terrorism, and militarism destroyed the wholesomeness of the globe. Into blind Stevens, both Miss Kenton and Mr. Cardinal bring out the common issue, that is, the political conflicts caused by Nazis. Miss Kenton expresses her own ideas against anti-Semitism regarding the Jewish maids in the crucial time when Sir Oswald Mosley’s Blackshirts organization attacked the Anglo Jews between 1935 and 1936. Miss Kenton’s half-muted statement is reinforced and assured by Cardinal in his mention of the 1934 Olympic Rally threatened by Mosley’s Blackshirts. Cardinal’s invasion of Darlington Hall embodies the increasing tension of international politics related to World War II. Darlington Hall accommodates the crucial political issue that definitely influences the fate of the house, its residents, and the nation itself and that is retrieved in the newly progressive and established media.

Keywords: modern English literature, culture studies, communication, history

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9061 Tide Contribution in the Flood Event of Jeddah City: Mathematical Modelling and Different Field Measurements of the Groundwater Rise

Authors: Aïssa Rezzoug

Abstract:

This paper is aimed to bring new elements that demonstrate the tide caused the groundwater to rise in the shoreline band, on which the urban areas occurs, especially in the western coastal cities of the Kingdom of Saudi Arabia like Jeddah. The reason for the last events of Jeddah inundation was the groundwater rise in the city coupled at the same time to a strong precipitation event. This paper will illustrate the tide participation in increasing the groundwater level significantly. It shows that the reason for internal groundwater recharge within the urban area is not only the excess of the water supply coming from surrounding areas, due to the human activity, with lack of sufficient and efficient sewage system, but also due to tide effect. The research study follows a quantitative method to assess groundwater level rise risks through many in-situ measurements and mathematical modelling. The proposed approach highlights groundwater level, in the urban areas of the city on the shoreline band, reaching the high tide level without considering any input from precipitation. Despite the small tide in the Red Sea compared to other oceanic coasts, the groundwater level is considerably enhanced by the tide from the seaside and by the freshwater table from the landside of the city. In these conditions, the groundwater level becomes high in the city and prevents the soil to evacuate quickly enough the surface flow caused by the storm event, as it was observed in the last historical flood catastrophe of Jeddah in 2009.

Keywords: flood, groundwater rise, Jeddah, tide

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9060 The Role of Twitter Bots in Political Discussion on 2019 European Elections

Authors: Thomai Voulgari, Vasilis Vasilopoulos, Antonis Skamnakis

Abstract:

The aim of this study is to investigate the effect of the European election campaigns (May 23-26, 2019) on Twitter achieving with artificial intelligence tools such as troll factories and automated inauthentic accounts. Our research focuses on the last European Parliamentary elections that took place between 23 and 26 May 2019 specifically in Italy, Greece, Germany and France. It is difficult to estimate how many Twitter users are actually bots (Echeverría, 2017). Detection for fake accounts is becoming even more complicated as AI bots are made more advanced. A political bot can be programmed to post comments on a Twitter account for a political candidate, target journalists with manipulated content or engage with politicians and artificially increase their impact and popularity. We analyze variables related to 1) the scope of activity of automated bots accounts and 2) degree of coherence and 3) degree of interaction taking into account different factors, such as the type of content of Twitter messages and their intentions, as well as the spreading to the general public. For this purpose, we collected large volumes of Twitter accounts of party leaders and MEP candidates between 10th of May and 26th of July based on content analysis of tweets based on hashtags while using an innovative network analysis tool known as MediaWatch.io (https://mediawatch.io/). According to our findings, one of the highest percentage (64.6%) of automated “bot” accounts during 2019 European election campaigns was in Greece. In general terms, political bots aim to proliferation of misinformation on social media. Targeting voters is a way that it can be achieved contribute to social media manipulation. We found that political parties and individual politicians create and promote purposeful content on Twitter using algorithmic tools. Based on this analysis, online political advertising play an important role to the process of spreading misinformation during elections campaigns. Overall, inauthentic accounts and social media algorithms are being used to manipulate political behavior and public opinion.

Keywords: artificial intelligence tools, human-bot interactions, political manipulation, social networking, troll factories

Procedia PDF Downloads 135
9059 Research on Energy Field Intervening in Lost Space Renewal Strategy

Authors: Tianyue Wan

Abstract:

Lost space is the space that has not been used for a long time and is in decline, proposed by Roger Trancik. And in his book Finding Lost Space: Theories of Urban Design, the concept of lost space is defined as those anti-traditional spaces that are unpleasant, need to be redesigned, and have no benefit to the environment and users. They have no defined boundaries and do not connect the various landscape elements in a coherent way. With the rapid development of urbanization in China, the blind areas of urban renewal have become a chaotic lost space that is incompatible with the rapid development of urbanization. Therefore, lost space needs to be reconstructed urgently under the background of infill development and reduction planning in China. The formation of lost space is also an invisible division of social hierarchy. This paper tries to break down the social class division and the estrangement between people through the regeneration of lost space. Ultimately, it will enhance vitality, rebuild a sense of belonging, and create a continuous open public space for local people. Based on the concept of lost space and energy field, this paper clarifies the significance of the energy field in the lost space renovation. Then it introduces the energy field into lost space by using the magnetic field in physics as a prototype. The construction of the energy field is support by space theory, spatial morphology analysis theory, public communication theory, urban diversity theory and city image theory. Taking Wuhan’s Lingjiao Park of China as an example, this paper chooses the lost space on the west side of the park as the research object. According to the current situation of this site, the energy intervention strategies are proposed from four aspects: natural ecology, space rights, intangible cultural heritage and infrastructure configuration. And six specific lost space renewal methods are used in this work, including “riveting”, “breakthrough”, “radiation”, “inheritance”, “connection” and “intersection”. After the renovation, space will be re-introduced into the active crow. The integration of activities and space creates a sense of place, improve the walking experience, restores the vitality of the space, and provides a reference for the reconstruction of lost space in the city.

Keywords: dynamic vitality intervention, lost space, space vitality, sense of place

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9058 mHealth-based Diabetes Prevention Program among Mothers with Abdominal Obesity: A Randomized Controlled Trial

Authors: Jia Guo, Qinyuan Huang, Qinyi Zhong, Yanjing Zeng, Yimeng Li, James Wiley, Kin Cheung, Jyu-Lin Chen

Abstract:

Context: Mothers with abdominal obesity, particularly in China, face challenges in managing their health due to family responsibilities. Existing diabetes prevention programs do not cater specifically to this demographic. Research Aim: To assess the feasibility, acceptability, and efficacy of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in reducing weight-related variables and diabetes risk. Methodology: A randomized controlled trial was conducted in Changsha, China, where the mHealth group received personalized modules and health messages, while the control group received general health education. Data were collected at baseline, 3 months, and 6 months. Findings: The mHealth intervention significantly improved waist circumference, modifiable diabetes risk scores, daily steps, self-efficacy for physical activity, social support for physical activity, and physical health satisfaction compared to the control group. However, no differences were found in BMI and certain other variables. Theoretical Importance: The study demonstrates the feasibility and efficacy of a tailored mHealth intervention for Chinese mothers with abdominal obesity, emphasizing the potential for such programs to improve health outcomes in this population. Data Collection: Data on various variables including weight-related measures, diabetes risk scores, behavioral and psychological factors were collected at baseline, 3 months, and 6 months from participants in the mHealth and control groups. Analysis Procedures: Generalized estimating equations were used to analyze the data collected from the mHealth and control groups at different time points during the study period. Question Addressed: The study addressed the effectiveness of an mHealth-based diabetes prevention program tailored for Chinese mothers with abdominal obesity in improving various health outcomes compared to traditional general health education approaches. Conclusion: The tailored mHealth intervention proved to be feasible and effective in improving weight-related variables, physical activity, and physical health satisfaction among Chinese mothers with abdominal obesity, highlighting its potential for delivering diabetes prevention programs to this population.

Keywords: type 2 diabetes, mHealth, obesity, prevention, mothers

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9057 Rethinking Urban Informality through the Lens of Inclusive Planning and Governance in Contemporary Cities: A Case Study of Johannesburg, South Africa

Authors: Blessings Masuku

Abstract:

Background: Considering that Africa is urbanizing faster than any other region globally, managing cities in the global South has become the centerpiece for the New Urban Agenda (i.e., a shared vision of how we rethink, rebuild, and manage our cities for a better and more sustainable future). This study is centered on governance and planning of urban informality practices with particular reference to the relationship between the state, informal actors (e.g., informal traders and informal dwellers), and other city stakeholders who are public space users (commuters, businesses, and environmental activists), and how informal actors organize themselves to lobby the state and claim for their rights in the city, and how they navigate their everyday livelihood strategies. Aim: The purpose of this study is to examine and interrogate contemporary approaches, policy and regulatory frameworks to urban spatial planning and management of informality in one of South Africa’s busiest and major cities, Johannesburg. Setting: The study uses the metropolitan region of the city of Johannesburg, South Africa to understand how this contemporary industrial city manages urban informality practices, including the use of public space, land zoning and street life, and paying a closer look at what progress has been made and gaps in their inclusive urban policy frameworks. Methods: This study utilized a qualitative approach that includes surveys (open-ended questions), archival research (i., e policy and other key document reviews), and key interviews mainly with city officials, and informality actors. A thematic analysis was used to analyze the data collected. Contribution: This study contributes to large urban informality scholarship in the global South cities by exploring how major cities particularly in Africa regulate and manage informality patterns and practices in their quest to build “utopian” smart cities. This study also brings a different perspective on the hacking ways used by the informal actors to resist harsh regulations and remain invisible in the city, which is something that previous literature has barely delved in-depth.

Keywords: inclusive planning and governance, infrastructure systems, livelihood strategies urban informality, urban space

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9056 Comparing Community Health Agents, Physicians and Nurses in Brazil's Family Health Strategy

Authors: Rahbel Rahman, Rogério Meireles Pinto, Margareth Santos Zanchetta

Abstract:

Background: Existing shortcomings of current health-service delivery include poor teamwork, competencies that do not address consumer needs, and episodic rather than continuous care. Brazil’s Sistema Único de Saúde (Unified Health System, UHS) is acknowledged worldwide as a model for delivering community-based care through Estratégia Saúde da Família (FHS; Family Health Strategy) interdisciplinary teams, comprised of Community Health Agents (in Portuguese, Agentes Comunitário de Saude, ACS), nurses, and physicians. FHS teams are mandated to collectively offer clinical care, disease prevention services, vector control, health surveillance and social services. Our study compares medical providers (nurses and physicians) and community-based providers (ACS) on their perceptions of work environment, professional skills, cognitive capacities and job context. Global health administrators and policy makers can leverage on similarities and differences across care providers to develop interprofessional training for community-based primary care. Methods: Cross-sectional data were collected from 168 ACS, 62 nurses and 32 physicians in Brazil. We compared providers’ demographic characteristics (age, race, and gender) and job context variables (caseload, work experience, work proximity to community, the length of commute, and familiarity with the community). Providers perceptions were compared to their work environment (work conditions and work resources), professional skills (consumer-input, interdisciplinary collaboration, efficacy of FHS teams, work-methods and decision-making autonomy), and cognitive capacities (knowledge and skills, skill variety, confidence and perseverance). Descriptive and bi-variate analysis, such as Pearson Chi-square and Analysis of Variance (ANOVA) F-tests, were performed to draw comparisons across providers. Results: Majority of participants were ACS (64%); 24% nurses; and 12% physicians. Majority of nurses and ACS identified as mixed races (ACS, n=85; nurses, n=27); most physicians identified as males (n=16; 52%), and white (n=18; 58%). Physicians were less likely to incorporate consumer-input and demonstrated greater decision-making autonomy than nurses and ACS. ACS reported the highest levels of knowledge and skills but the least confidence compared to nurses and physicians. ACS, nurses, and physicians were efficacious that FHS teams improved the quality of health in their catchment areas, though nurses tend to disagree that interdisciplinary collaboration facilitated their work. Conclusion: To our knowledge, there has been no study comparing key demographic and cognitive variables across ACS, nurses and physicians in the context of their work environment and professional training. We suggest that global health systems can leverage upon the diverse perspectives of providers to implement a community-based primary care model grounded in interprofessional training. Our study underscores the need for in-service trainings to instill reflective skills of providers, improve communication skills of medical providers and curative skills of ACS. Greater autonomy needs to be extended to community based providers to offer care integral to addressing consumer and community needs.

Keywords: global health systems, interdisciplinary health teams, community health agents, community-based care

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9055 A Location-Allocation-Routing Model for a Home Health Care Supply Chain Problem

Authors: Amir Mohammad Fathollahi Fard, Mostafa Hajiaghaei-Keshteli, Mohammad Mahdi Paydar

Abstract:

With increasing life expectancy in developed countries, the role of home care services is highlighted by both academia and industrial contributors in Home Health Care Supply Chain (HHCSC) companies. The main decisions in such supply chain systems are the location of pharmacies, the allocation of patients to these pharmacies and also the routing and scheduling decisions of nurses to visit their patients. In this study, for the first time, an integrated model is proposed to consist of all preliminary and necessary decisions in these companies, namely, location-allocation-routing model. This model is a type of NP-hard one. Therefore, an Imperialist Competitive Algorithm (ICA) is utilized to solve the model, especially in large sizes. Results confirm the efficiency of the developed model for HHCSC companies as well as the performance of employed ICA.

Keywords: home health care supply chain, location-allocation-routing problem, imperialist competitive algorithm, optimization

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