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706 Assessment of Incomplete Childhood Immunization Determinants in Ethiopia: A Nationwide Multilevel Study
Authors: Mastewal Endeshaw Getnet
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Imunization is one of the most cost-effective and extensively adopted public health strategies for preventing child disability and mortality. Expanded Program on Immunization (EPI) was launched in 1974 with the goal of providing life-saving vaccines to all children in all and building on the success of the global smallpox eradication program. According to World Health Organization report, by 2020, all countries should have achieved 90% vaccination coverage. Many developing countries still have not achieved the goal. Ethiopia is one of Africa's developing countries. The Ethiopian Ministry of health (MoH) launched the EPI program in 1980, with the goal of achieving 90% coverage among children under the age of 1 year by 1990. Among children aged 12-23 months, complete immunization coverage was 47% based on the Ethiopian Demographic and Health Survey (EDAS) 2019 report. The coverage varies depending on the administrative region, ranging from 21% in Afar region to 89% in Amhara region, Ethiopia. Therefore, identifying risk factors for incomplete immunization among children is a key challenge, particularly in Ethiopia, which has a large geographical diversity and a predicted with 119.96 million projected population size in the year 2022. Despite its critical and challenging issue, this issue is still open and has not yet been fully investigated. Recently, a few previous studies have been conducted on the assessment of incomplete children immunization determinants. However, the majority of the studies were cross-sectional surveys that assessed only EPI coverage. Motivated by the above investigation, this study focuses on investigating determinants associated with incomplete immunization among Ethiopian children to facilitate the rate of full immunization coverage. Moreover, we consider both individual immunization and service performance-related factors to investigate incomplete children's determinants. Consequently, we adopted an ecological model in this study. Individual and environmental factors are combined in the Ecological model, which provides multilevel framework for exploring different determinants related with health behaviors. The Ethiopian Demographic and Health Survey will be used as a source of data from 2021 to achieve the objective of this study. The findings of this study will be useful to the Ethiopian government and other public health institutes to improve the coverage score of childhood immunization based on the identified risk determinants.Keywords: incomplete immunization, children, ethiopia, ecological model
Procedia PDF Downloads 46705 Use of WhatsApp Messenger for Optimal Healthcare Operational Communication during the COVID-19 Pandemic
Authors: Josiah O. Carter, Charlotte Hayden, Elizabeth Arthurs
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Background: During the COVID-19 pandemic, hospital management policies have changed frequently and rapidly. This has created novel challenges in keeping the workforce abreast of these changes to enable them to deliver safe and effective care. Traditional communication methods, e.g. email, do not keep pace with the rapidly changing environment in the hospital, resulting in inaccurate, irrelevant, or outdated information being communicated, resulting in inefficiencies in patient care. Methods: The creation of a WhatsApp messaging group within the medical division at the Bristol Royal Infirmary has enabled senior clinicians and the hospital management team to update the medical workforce in real-time. It has two primary functions: (1) To enable dissemination of a concise, important operational summary. This comprises information on bed status and infection control procedural changes. It is fed directly from a daily critical incident briefing (2) To facilitate a monthly scheduled question and answer (Q&A) session for junior doctors to clarify issues with clinical directors, rota, and management staff. Additional ad-hoc updates are sent out for time-critical information; otherwise, it mainly functions as a broadcast-only group to prevent important information from being lost amongst other communication. All junior doctors within the medical division were invited to join the group. At present, the group comprises 131 participants, of which 10 are administrative staff (rota coordinators, management staff & clinical directors); the remaining 121 are junior clinicians working within the medical division. An electronic survey via Microsoft forms was sent out to junior doctors via the WhatsApp group and via email to assess its utilisation and effectiveness with the aim of quality improvements. Results: Of the 121 group participants, 19 completed the questionnaire (response rate 15.7%). Of these, 16/19 (84.2%) used it regularly, and 12/19 (63.2%) rated it as the most useful source for reliable updates relating to the hospital response to the COVID-19 pandemic, whereas only 2/19 (10.5%) found the trust intranet and the trust COVID-19 operational email update most useful. Respondents rated the WhatsApp group more useful as an information source (mean score 7.7/10) than as a means of providing feedback to management staff (mean score 6.3/10). Qualitative feedback suggested information around ward closures and changes to COVID cohorting, along with updates on staffing issues, were most useful. Respondents also noted the Q&A sessions were an efficient way of relaying feedback about management decisions but that it would be preferable if these sessions could be delivered more frequently. Discussion: During the current global COVID-19 pandemic, there is an increased need for rapid dissemination of critical information within NHS trusts; this includes communication between junior doctors, managers, and senior clinicians. The versatility of WhatsApp permits a variety of functions allowing for regular updates, the dissemination of time-critical information, and enables conversing and feedback. The project has demonstrated that reserved and well-managed use of a WhatsApp group is a welcome, efficient and practical means of communication between the senior management team and the junior medical workforce.Keywords: communication, COVID-19, hospital management, WhatsApp
Procedia PDF Downloads 116704 Periodicity of Solutions to Impulsive Equations
Authors: Jin Liang, James H. Liu, Ti-Jun Xiao
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It is known that there exist many physical phenomena where abrupt or impulsive changes occur either in the system dynamics, for example, ad-hoc network, or in the input forces containing impacts, for example, the bombardment of space antenna by micrometeorites. There are many other examples such as ultra high-speed optical signals over communication networks, the collision of particles, inventory control, government decisions, interest changes, changes in stock price, etc. These are impulsive phenomena. Hence, as a combination of the traditional initial value problems and the short-term perturbations whose duration can be negligible in comparison with the duration of the process, the systems with impulsive conditions (i.e., impulsive systems) are more realistic models for describing the impulsive phenomenon. Such a situation is also suitable for the delay systems, which include some of the past states of the system. So far, there have been a lot of research results in the study of impulsive systems with delay both in finite and infinite dimensional spaces. In this paper, we investigate the periodicity of solutions to the nonautonomous impulsive evolution equations with infinite delay in Banach spaces, where the coefficient operators (possibly unbounded) in the linear part depend on the time, which are impulsive systems in infinite dimensional spaces and come from the optimal control theory. It was indicated that the study of periodic solutions for these impulsive evolution equations with infinite delay was challenging because the fixed point theorems requiring some compactness conditions are not applicable to them due to the impulsive condition and the infinite delay. We are happy to report that after detailed analysis, we are able to combine the techniques developed in our previous papers, and some new ideas in this paper, to attack these impulsive evolution equations and derive periodic solutions. More specifically, by virtue of the related transition operator family (evolution family), we present a Poincaré operator given by the nonautonomous impulsive evolution system with infinite delay, and then show that the operator is a condensing operator with respect to Kuratowski's measure of non-compactness in a phase space by using an Amann's lemma. Finally, we derive periodic solutions from bounded solutions in view of the Sadovskii fixed point theorem. We also present a relationship between the boundedness and the periodicity of the solutions of the nonautonomous impulsive evolution system. The new results obtained here extend some earlier results in this area for evolution equations without impulsive conditions or without infinite delay.Keywords: impulsive, nonautonomous evolution equation, optimal control, periodic solution
Procedia PDF Downloads 257703 Challenges and Prospects of Preservation of Tangible Cultural Heritage Management: A Case Study in Lake Tana Islands, Ethiopia
Authors: Ayele Tamene
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Cultural heritage is the legacy of physical artifacts and intangible attributes of a group or society that are inherited from past generations, maintained in the present and bestowed for the benefit of future generations. Tangible heritage e includes buildings and historic places, monuments, artifacts, etc., which are considered worthy of preservation for the future. These include objects significant to the archaeology, architecture, science or technology of a specific culture. The research addressed the challenges and prospects of preservation of tangible cultural heritage management in Lake Tana islands; Amahara Regional State. Specifically, the research inquired the major factors which affected tangible cultural heritage management, investigated how communities successfully involved in tangible cultural heritage management, and described the contribution of cultural management to tourism development. It employed qualitative research approaches to grasp the existing condition in the study area. Major techniques of data gathering such as in-depth interview, observation/photographing and Focus Group Discussion (FGDs) were used. Related documents collected through secondary sources were examined and analyzed. In Lake Tana Islands precious heritages such as ancient religious manuscripts (written since 9th century), sacral wall paintings, gold and silver Crosses, crowns and prestigious clothes of the various kings of the medieval and the 19th century are found. The study indicated that heritages in Tana islands were affected by both natural and manmade problems. In Lake Tana Islands, movable heritages were looted several times by foreign aggressors, tourists, and local people who serve there. Some heritages were affected by visitors by their camera flash light and hand touch. Most heritages in the Tana islands lacked community ownership and preserved non- professionally which highly affected their originality and authenticity. Therefore, the local community and the regional government should work together in the preservation of these heritage sites and enhance their role for socio-economic development as a center of research and tourist destinations.Keywords: cultural heritages, heritage preservation, lake Tana heritages, non professional preservation tangible heritages
Procedia PDF Downloads 334702 Coastal Water Quality Assessment in Hormozgan Province: Implications for Sustainable Marine Ecosystems and Aquaculture in the Persian Gulf
Authors: Sharareh Khodami, Mohammad Seddiq Mortazavi, Seyedeh Laili Mohebbi-Nozar, Fereshteh Saraji, S. Behzadi, Gholam Ali Akbarzadeh, Mitra Naemi, Pararin Bahreini
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Water quality is a critical driver of healthy marine ecosystems and a cornerstone of the blue economy, particularly fisheries. The coastal waters of Hormozgan Province, located in the northern Persian Gulf and Gulf of Oman, are increasingly threatened by wastewater discharges from industrial, urban, and agricultural activities. This study evaluates the spatial and temporal patterns of coastal water quality over two decades (2001–2021), drawing on a comprehensive dataset from 200 sampling stations along the province’s shoreline. Key environmental parameters temperature, dissolved oxygen, pH, turbidity, nitrate, ammonium, phosphate, chlorophyll-a, and total bacteria count were analyzed. Using Geographic Information Systems (GIS), spatial distributions were mapped, and a Water Quality Index (WQI) was derived to classify overall water quality conditions. The weight and normalization factors were determined using the Analytic Hierarchy Process (AHP) and expert judgment, supported by questionnaires and a range of literature sources. Four distinct groups of experts contributed to this process: academics, researchers, government officials, and consultants. The WQI values ranged from weak to excellent, reflecting notable spatial variability. The interquartile range (IQR) method was applied to determine acceptable parameter ranges and establish early-warning thresholds for management. Zones were categorized into “caution” and “action” areas, guiding targeted interventions. Results highlight the significant impacts of sustained nutrient loading, particularly from nitrate and phosphate linked to anthropogenic sources, on coastal ecosystem health. These findings underscore the urgent need for stringent nutrient management policies to protect marine ecosystems, ensuring the long-term sustainability of fisheries and other marine resources in this region.Keywords: coastal area, Hormozgan, Persian Gulf, water quality
Procedia PDF Downloads 13701 Climate Changes Impact on Artificial Wetlands
Authors: Carla Idely Palencia-Aguilar
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Artificial wetlands play an important role at Guasca Municipality in Colombia, not only because they are used for the agroindustry, but also because more than 45 species were found, some of which are endemic and migratory birds. Remote sensing was used to determine the changes in the area occupied by water of artificial wetlands by means of Aster and Modis images for different time periods. Evapotranspiration was also determined by three methods: Surface Energy Balance System-Su (SEBS) algorithm, Surface Energy Balance- Bastiaanssen (SEBAL) algorithm, and Potential Evapotranspiration- FAO. Empirical equations were also developed to determine the relationship between Normalized Difference Vegetation Index (NDVI) versus net radiation, ambient temperature and rain with an obtained R2 of 0.83. Groundwater level fluctuations on a daily basis were studied as well. Data from a piezometer placed next to the wetland were fitted with rain changes (with two weather stations located at the proximities of the wetlands) by means of multiple regression and time series analysis, the R2 from the calculated and measured values resulted was higher than 0.98. Information from nearby weather stations provided information for ordinary kriging as well as the results for the Digital Elevation Model (DEM) developed by using PCI software. Standard models (exponential, spherical, circular, gaussian, linear) to describe spatial variation were tested. Ordinary Cokriging between height and rain variables were also tested, to determine if the accuracy of the interpolation would increase. The results showed no significant differences giving the fact that the mean result of the spherical function for the rain samples after ordinary kriging was 58.06 and a standard deviation of 18.06. The cokriging using for the variable rain, a spherical function; for height variable, the power function and for the cross variable (rain and height), the spherical function had a mean of 57.58 and a standard deviation of 18.36. Threatens of eutrophication were also studied, given the unconsciousness of neighbours and government deficiency. Water quality was determined over the years; different parameters were studied to determine the chemical characteristics of water. In addition, 600 pesticides were studied by gas and liquid chromatography. Results showed that coliforms, nitrogen, phosphorous and prochloraz were the most significant contaminants.Keywords: DEM, evapotranspiration, geostatistics, NDVI
Procedia PDF Downloads 125700 Challenges and Recommendations for Medical Device Tracking and Traceability in Singapore: A Focus on Nursing Practices
Authors: Zhuang Yiwen
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The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms
Procedia PDF Downloads 80699 Investigating the Role of Social Media in Supporting Parents and Teachers of Students with Down Syndrome: Focus on Early Intervention Services in the Kingdom of Saudi Arabia
Authors: Awatif Habeeb Al-Shamare
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The number of social media users amongst special education teachers and parents of children with Down Syndrome (DS) is increasing annually. This is also the case in the Kingdom of Saudi Arabia (KSA). However, according to the best of the author’s knowledge, there are no qualitative studies which testify to the true nature of the interaction between teachers and parents when using social media, nor the role of social media in supporting and assisting parents and teachers with regards to the children’s educational needs in KSA. Therefore, this ongoing study aims to identify the role of social media in supporting parents and teachers of DS students, with a special emphasis on early intervention services in KSA. By bridging the knowledge gap on social media and special education in KSA and presenting socially relevant and applied information on the topic, this research provides a theoretical and practical base for the establishment of appropriate and effective programmes between the ministries of Information and Special Education in particular. A qualitative approach was selected because it was the most suitable approach for exploring the participants’ experiences, which could not be determined through scientific tests. Interviewing, chosen as the research instrument, allowed the researcher to obtain a detailed understanding of the topic linked to the study objectives. Initially, a pilot study was conducted at the Daycare Center in May 2016. Its aim was to examine and refine the methodology and assess whether the questions were understood with the potential for re-drafting them, if necessary. The main study consists of five teachers and five mothers with experience of using social media and with links to the Daycare Center. Thematic Analysis has been chosen for analysing the findings because it is a flexible method that allows themes to emerge from the data. Results of the current study are still in the initial stages, but the preliminary findings are as follows: (1) social media is an important tool in encouraging parents and teachers to access the necessary information and knowledge about, and experience in, early intervention services; (2) it acts as a support network for the parents; (3) it helps raise awareness about DS and the need for early intervention; (4) it can be used to put pressure on the government for an expansion in early intervention services, and finally (5) its use can be problematic in that parents and teachers face some difficulties and challenges when using the different platforms. It can be concluded that social media plays a significant role in the lives of teachers and parents with special needs children in KSA.Keywords: down syndrome, early intervention services, social media, support parents and teachers
Procedia PDF Downloads 152698 Assessing the Impact of Adopting Climate Smart Agriculture on Food Security and Multidimensional Poverty: Case of Rural Farm Households in the Central Rift Valley of Ethiopia
Authors: Hussien Ali, Mesfin Menza, Fitsum Hagos, Amare Haileslassie
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Climate change has perverse effects on agricultural productivity and natural resource base, negatively affecting the well-being of the households and communities. The government and NGOs promote climate smart agricultural (CSA) practices to help farmers adapt to and mitigate the negative effects of climate change. This study aims to identify widely available CSA practices and examine their impacts on food security and multi-dimensional poverty of rural farm households in the Central Rift Valley, Ethiopia. Using three-stage proportional to size sampling procedure, the study randomly selected 278 households from two kebeles from four districts each. A cross-sectional data of 2020/21 cropping season was collected using structured and pretested survey questionnaire. Food consumption score, dietary diversity score, food insecurity experience scale, and multidimensional poverty index were calculated to measure households’ welfare indicators. Multinomial endogenous switching regression model was used to assess average treatment effects of CSA on these outcome indicators on adopter and non-adopter households. The results indicate that the widely adopted CSA practices in the area are conservation agriculture, soil fertility management, crop diversification, and small-scale irrigation. Adopter households have, on average, statistically higher food consumption score, dietary diversity score and lower food insecurity access scale than non-adopters. Moreover, adopter households, on average, have lower deprivation score in multidimensional poverty compared to non-adopter households. Up scaling the adoption of CSA practices through the improvement of households’ implementation capacity and better information, technical advice, and innovative financing mechanisms is advised. Up scaling CSA practices can further promote achieving global goals such as SDG 1, SDG 2, and SDG 13 targets, aimed to end poverty and hunger and mitigate the adverse impacts of climate change, respectively.Keywords: climate-smart agriculture, food security, multidimensional poverty, upscaling CSA, Ethiopia
Procedia PDF Downloads 98697 Water Quality Management Based on Hydrodynamic Approach, Landuse, and Human Intervention in Wulan Delta Central Java Indonesia: Problems Identification and Review
Authors: Lintang Nur Fadlillah, Muh Aris Marfai, M. Widyastuti
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Delta is dynamics area which is influenced by marine and river. Increasing human population in coastal area and the need of life exert pressure in delta that provides various resources. Wulan Delta is one of active Delta in Central Java, Indonesia. It has been experienced multiple pressures because of natural factors and human factors. In order to provide scientific solution and to analyze the main driving force in river delta, we collected several evidences based on news, papers, and publications related to Wulan Delta. This paper presents a review and problems identification in Wulan Delta, based on hydrodynamic approach, land use, and human activities which influenced water quality in the delta. A comprehensive overview is needed to address best policies under local communities and government. The analysis based on driving forces which affect delta estuary and river mouth. Natural factor in particular hydrodynamic influenced by tides, waves, runoff, and sediment transport. However, hydrodynamic affecting mixing process in river estuaries. The main problem is human intervention in land which is land use exchange leads to several problems such us decreasing water quality. Almost 90% of delta has been transformed into fish pond by local communities. Yet, they have not apply any water management to treat waste water before flush it to the sea and estuary. To understand the environmental condition, we need to assess water quality of river delta. The assessment based on land use as non-point source pollution. In Wulan Delta there are no industries. The land use in Wulan Delta consist of fish pond, settlement, and agriculture. The samples must represent the land use, to estimate which land use are most influence in river delta pollution. The hydrodynamic condition such as high tides and runoff must be considered, because it will affect the mixing process and water quality as well. To determine the samples site, we need to involve local community, in order to give insight into them. Furthermore, based on this review and problem identification, recommendations and strategies for water management are formulated.Keywords: delta, land use, water quality, management, hydrodynamics
Procedia PDF Downloads 251696 Comparison of Hydrogen and Electrification Perspectives in Decarbonizing the Transport Sector
Authors: Matteo Nicoli, Gianvito Colucci, Valeria Di Cosmo, Daniele Lerede, Laura Savoldi
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The transport sector is currently responsible for approximately 1/3 of greenhouse gas emissions in Europe. In the wider context of achieving carbon neutrality of the global energy system, different alternatives are available to decarbonizethe transport sector. In particular, while electricity is already the most consumed energy commodity in rail transport, battery electric vehicles are one of the zero-emissions options on the market for road transportation. On the other hand, hydrogen-based fuel cell vehicles are available for road and non-road vehicles. The European Commission is strongly pushing toward the integration of hydrogen in the energy systems of European countries and its widespread adoption as an energy vector to achieve the Green Deal targets. Furthermore, the Italian government is defining hydrogen-related objectives with the publication of a dedicated Hydrogen Strategy. The adoption of energy system optimization models to study the possible penetration of alternative zero-emitting transport technologies gives the opportunity to perform an overall analysis of the effects that the development of innovative technologies has on the entire energy system and on the supply-side, devoted to the production of energy carriers such as hydrogen and electricity. Using an open-source modeling framework such as TEMOA, this work aims to compare the role of hydrogen and electric vehicles in the decarbonization of the transport sector. The analysis investigates the advantages and disadvantages of adopting the two options, from the economic point of view (costs associated with the two options) and the environmental one (looking at the emissions reduction perspectives). Moreover, an analysis on the profitability of the investments in hydrogen and electric vehicles will be performed. The study investigates the evolution of energy consumption and greenhouse gas emissions in different transportation modes (road, rail, navigation, and aviation) by detailed analysis of the full range of vehicles included in the techno-economic database used in the TEMOA model instance adopted for this work. The transparency of the analysis is guaranteed by the accessibility of the TEMOA models, based on an open-access source code and databases.Keywords: battery electric vehicles, decarbonization, energy system optimization models, fuel cell vehicles, hydrogen, open-source modeling, TEMOA, transport
Procedia PDF Downloads 117695 A Comparative Analysis of Legal Novelties on Telework in Portugal and Spain: A Gender Perspective
Authors: Ekaterina Reznikova
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The paper provides an overview of the comparative analysis of legal novelties on telework in Portugal and Spain from a gender perspective. Telework, defined as the practice of working remotely using information and communication technologies, has gained increased attention in recent years, particularly in the context of the COVID-19 pandemic. As countries implement legal frameworks to regulate telework, it is essential to assess their gender implications and their impact on promoting gender equality in the workplace. In Portugal, legal novelties on telework have been introduced through various legislative measures, including the Telework Regulation Act (Lei do Teletrabalho) enacted in 2018. This legislation aims to provide a framework for telework arrangements, outlining rights and obligations for both employers and employees. However, the gender perspective in Portugal's telework regulations remains somewhat limited, with few explicit provisions addressing gender disparities in telework participation or the unequal distribution of caregiving responsibilities. In contrast, Spain has taken a more proactive approach to addressing gender equality in telework through its legal novelties. The Spanish government passed the Royal Decree-Law 28/2020, which introduced significant reforms to telework regulations in response to the COVID-19 pandemic. This legislation includes provisions aimed at promoting gender equality in telework, such as measures to ensure work-life balance and prevent discrimination based on gender in telework arrangements. Additionally, Spain has implemented initiatives to encourage "joint responsibility" at home, emphasizing the importance of shared caregiving duties between men and women. By comparing the legal novelties on telework in Portugal and Spain from a gender perspective, this study aims to identify best practices and areas for improvement in promoting gender equality in telework arrangements. Through a comprehensive analysis of the legal frameworks, this study will assess the extent to which Portugal and Spain's telework regulations address gender disparities and support the advancement of women in the workforce. The findings of this comparative analysis will have significant implications for policymakers, employers, and other stakeholders involved in shaping telework policies. By identifying effective strategies for promoting gender equality in telework, this study seeks to contribute to the development of inclusive and sustainable work environments that benefit all employees, regardless of gender.Keywords: telework, labour law, digitalization, gender
Procedia PDF Downloads 66694 Oral Hygiene Behaviors among Pregnant Women with Diabetes Who Attend Primary Health Care Centers at Baghdad City
Authors: Zena F. Mushtaq, Iqbal M. Abbas
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Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.Keywords: diabetes, health behavior, pregnant women, oral hygiene
Procedia PDF Downloads 290693 Designing Financing Schemes to Make Forest Management Units Work in Aceh Province, Indonesia
Authors: Riko Wahyudi, Rezky Lasekti Wicaksono, Ayu Satya Damayanti, Ridhasepta Multi Kenrosa
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Implementing Forest Management Unit (FMU) is considered as the best solution for forest management in developing countries. However, when FMU has been formed, many parties then blame the FMU and assume it is not working on. Currently, there are two main issues that make FMU not be functional i.e. institutional and financial issues. This paper is addressing financial issues to make FMUs in Aceh Province can be functional. A mixed financing scheme is proposed here, both direct and indirect financing. The direct financing scheme derived from two components i.e. public funds and businesses. Non-tax instruments of intergovernmental fiscal transfer (IFT) system and FMU’s businesses are assessed. Meanwhile, indirect financing scheme is conducted by assessing public funds within villages around forest estate as about 50% of total villages in Aceh Province are located surrounding forest estate. Potential instruments under IFT system are forest and mining utilization royalties. In order to make these instruments become direct financing for FMU, interventions on allocation and distribution aspects of them are conducted. In the allocation aspect, alteration in proportion of allocation is required as the authority to manage forest has shifted from district to province. In the distribution aspect, Government of Aceh can earmark usage of the funds for FMUs. International funds for climate change also encouraged to be domesticated and then channeled through these instruments or new instrument under public finance system in Indonesia. Based on FMU’s businesses both from forest products and forest services, FMU can impose non-tax fees for each forest product and service utilization. However, for doing business, the FMU need to be a Public Service Agency (PSA). With this status, FMU can directly utilize the non-tax fees without transferring them to the state treasury. FMU only need to report the fees to Ministry of Finance. Meanwhile, indirect financing scheme is conducted by empowering villages around forest estate as villages in Aceh Province is receiving average village fund of IDR 800 million per village in 2017 and the funds will continue to increase in subsequent years. These schemes should be encouraged in parallel to establish a mixed financing scheme in order to ensure sustainable financing for FMU in Aceh Province, Indonesia.Keywords: forest management, public funds, mixed financing, village
Procedia PDF Downloads 196692 The Effects of Cultural Distance and Institutions on Foreign Direct Investment Choices: Evidence from Turkey and China
Authors: Nihal Kartaltepe Behram, Göksel Ataman, Dila Okçu
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With the development of foreign direct investments, the social, cultural, political and economic interactions between countries and institutions have become visible and they have become determining factors for the strategic structuring and market goals. In this context the purpose of this study is to investigate the effects of cultural distance and institutions on foreign direct investment choices in terms of location and investment model. For international establishments, the concept of culture, as well as the concept of cultural distance, is taken specifically into consideration, especially in the selection of methods for entering the market. In the researches and empirical studies conducted, a direct relationship between cultural distance and foreign direct investments is set and institutions and effective variable factors are examined at the level of defining the investment types. When the detailed calculation strategies and empirical researches and studies are taken into consideration, the most common methods for determining the direct investment model, considering the cultural distances, are full-ownership enterprises and joint ventures. Also, when all of the factors affecting the investments are taken into consideration, it was seen that the effect of institutions such as Government Intervention, Intellectual Property Rights, Corruption and Contract Enforcements is very important. Furthermore agglomeration is more intense and effective on the investment, compared to other factors. China has been selected as the target country, due to its effectiveness in world economy and its contributions to developing countries, which has commercial relationships with. Qualitative research methods are used for this study conducted, to measure the effects of determinative variable factors in the hypotheses of study, on the direct foreign investors and to evaluate the findings. In this study in-depth interview is used as a data collection method and the data analysis is made through descriptive analysis. Foreign Direct Investments are so reactive to institutions and cultural distance is identified by all interviews and analysis. On the other hand, agglomeration is the most strong determiner factor on foreign direct investors in Chinese Market. The reason of this factors, which comprise the sectorial aggregate, are not the strongest factors as agglomeration that the most important finding. We expect that this study became a beneficial guideline for developed and developing countries and local and national institutions’ strategic plans.Keywords: China, cultural distance, Foreign Direct Investments, institutions
Procedia PDF Downloads 421691 Attitude to the Types of Organizational Change
Authors: O. Y. Yurieva, O. V. Yurieva, O. V. Kiselkina, A. V. Kamaseva
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Since the early 2000s, there are some innovative changes in the civil service in Russia due to administrative reform. Perspectives of the reform of the civil service include a fundamental change in the personnel component, increasing the level of professionalism of officials, increasing their capacity for self-organization and self-regulation. In order to achieve this, the civil service must be able to continuously change. Organizational changes have long become the subject of scientific understanding; problems of research in the field of organizational change is presented by topics focused on the study of the methodological aspects of the implementation of the changes, the specifics of changes in different types of organizations (business, government, and so on), design changes in the organization, including based on the change in organizational culture. In this case, the organizational changes in the civil service are the least studied areas; research of problems of its transformation is carried out in fragments. According to the theory of resistance of Herbert Simon, the root of the opposition and rejection of change is in the person who will resist any change, if it threatens to undermine the degree of satisfaction as a member of the organization (regardless of the reasons for this change). Thus, the condition for successful adaptation to changes in the organization is the ability of its staff to perceive innovation. As part of the problem, the study sought to identify the innovation civil servants, to determine readiness for the development of proposals for the implementation of organizational change in the public service. To identify the relationship to organizational changes case study carried out by the method of "Attitudes to organizational change" of I. Motovilina, which allowed predicting the type of resistance to changes, to reveal the contradictions and hidden results. The advantage of the method of I. Motovilina is its brevity, simplicity, the analysis of the responses to each question, the use of "overlapping" issues potentially conflicting factors. Based on the study made by the authors, it was found that respondents have a positive attitude to change more local than those that take place in reality, such as "increase opportunities for professional growth", "increase the requirements for the level of professionalism of", "the emergence of possible manifestations initiatives from below". Implemented by the authors diagnostics related to organizational changes in the public service showed the presence of specific problem areas, with roots in the lack of understanding of the importance of innovation personnel in the process of bureaucratization of innovation in public service organizations.Keywords: innovative changes, self-organization, self-regulation, civil service
Procedia PDF Downloads 464690 Evaluating the Small-Strain Mechanical Properties of Cement-Treated Clayey Soils Based on the Confining Pressure
Authors: Muhammad Akmal Putera, Noriyuki Yasufuku, Adel Alowaisy, Ahmad Rifai
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Indonesia’s government has planned a project for a high-speed railway connecting the capital cities, Jakarta and Surabaya, about 700 km. Based on that location, it has been planning construction above the lowland soil region. The lowland soil region comprises cohesive soil with high water content and high compressibility index, which in fact, led to a settlement problem. Among the variety of railway track structures, the adoption of the ballastless track was used effectively to reduce the settlement; it provided a lightweight structure and minimized workspace. Contradictorily, deploying this thin layer structure above the lowland area was compensated with several problems, such as lack of bearing capacity and deflection behavior during traffic loading. It is necessary to combine with ground improvement to assure a settlement behavior on the clayey soil. Reflecting on the assurance of strength increment and working period, those were convinced by adopting methods such as cement-treated soil as the substructure of railway track. Particularly, evaluating mechanical properties in the field has been well known by using the plate load test and cone penetration test. However, observing an increment of mechanical properties has uncertainty, especially for evaluating cement-treated soil on the substructure. The current quality control of cement-treated soils was established by laboratory tests. Moreover, using small strain devices measurement in the laboratory can predict more reliable results that are identical to field measurement tests. Aims of this research are to show an intercorrelation of confining pressure with the initial condition of the Young modulus (E_o), Poisson ratio (υ_o) and Shear modulus (G_o) within small strain ranges. Furthermore, discrepancies between those parameters were also investigated. Based on the experimental result confirmed the intercorrelation between cement content and confining pressure with a power function. In addition, higher cement ratios have discrepancies, conversely with low mixing ratios.Keywords: amount of cement, elastic zone, high-speed railway, lightweight structure
Procedia PDF Downloads 146689 A Scoping Study and Stakeholder Consultation on Mental Health Determinants among Arab Immigrants and Refugees in North America
Authors: Sarah Elshahat, Tina Moffat
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Suboptimal mental health is a considerable global public health challenge that leads to considerable inequalities worldwide. Newcomers are at elevated risk for developing mental health issues as a result of social exclusion, stigmatization, racism, unequal employment opportunities, and discrimination. The problem can be especially serious amongst Arabic-speaking immigrants and refugees (ASIR) whose mental wellness may have already been affected by exposure to political violence, persecution, hunger or war in their countries of origin. A scoping review was conducted to investigate pre- and post-migration mental health determinants amongst ASIR in North America (the U.S. and Canada), who are a rapidly growing population in both regions. Pertinent peer-reviewed papers and grey literature were located through a systematic search of five electronic databases (Medline, Embase, PsycINFO, Anthropology Plus, and Sociology Database). A stakeholder consultation was implemented to validate the analyzed findings of the included 44 studies. About 80% of the studies were carried out in the US, underscoring a lack of Canadian ASIR-mental health research. A gap in qualitative, mixed-method, and longitudinal research was detected, where approximately two-thirds of the studies adopted a cross-sectional method. Pre-migration determinants of mental health were related to the political unrest, violence and armed conflict in the Arab world, increasing post-traumatic stress disorder and psychological distress levels among ASIR. English language illiteracy and generational variations in acculturation patterns were major post-migration mental health triggering factors. Exposure to domestic violence, stigmatization, poverty, racialization, and harassment were significant post-migration mental health determinants that stem from social inequalities, triggering depression, and distress amongst ASIR. Family conflicts linked to child-rearing and gendered norms were considered as both pre- and post-migration mental health triggering factors. Most post-migration mental health protective factors were socio-culturally related and included the maintenance of positive ethnic identity, faith, family support, and community cohesion. Individual resilience, articulated as self-esteem and hope, was a significant negative predictor of depression and psychological distress among ASIR. Community-engaged, mixed-methods, and longitudinal studies are required to address the current gap in mental health research among ASIR in North America. A more thorough determination of potential mental health triggers and protective factors would help inform the development of mental wellness and resilience-promoting programs that are culturally sensitive to ASIR. On the policy level, the Health in All Policies framework of the World Health Organization can be potentially useful for addressing social and health inequalities among ASIR, reducing mental health challenges.Keywords: depression, post-traumatic stress disorder, psychological distress, resilience
Procedia PDF Downloads 140688 Balance of Natural Resources to Manage Land Use Changes in Subosukawonosraten Area
Authors: Sri E. Wati, D. Roswidyatmoko, N. Maslahatun, Gunawan, Andhika B. Taji
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Natural resource is the main sources to fulfill human needs. Its utilization must consider not only human prosperity but also sustainability. Balance of natural resources is a tool to manage natural wealth and to control land use change. This tool is needed to organize land use planning as stated on spatial plan in a certain region. Balance of natural resources can be calculated by comparing two-series of natural resource data obtained at different year. In this case, four years data period of land and forest were used (2010 and 2014). Land use data were acquired through satellite image interpretation and field checking. By means of GIS analysis, its result was then assessed with land use plan. It is intended to evaluate whether existing land use is suitable with land use plan. If it is improper, what kind of efforts and policies must be done to overcome the situation. Subosukawonosraten is rapid developed areas in Central Java Province. This region consists of seven regencies/cities which are Sukoharjo Regency, Boyolali Regency, Surakarta City, Karanganyar Regency, Wonogiri Regency, Sragen Regency, and Klaten Regency. This region is regarding to several former areas under Karasidenan Surakarta and their location is adjacent to Surakarta. Balance of forest resources show that width of forest area is not significantly changed. Some land uses within the area are slightly changed. Some rice field areas are converted into settlement (0.03%) whereas water bodies become vacant areas (0.09%). On the other hand, balance of land resources state that there are many land use changes in this region. Width area of rice field decreases 428 hectares and more than 50% of them have been transformed into settlement area and 11.21% is converted into buildings such as factories, hotels, and other infrastructures. It occurs mostly in Sragen, Sukoharjo, and Karanganyar Regency. The results illustrate that land use change in this region is mostly influenced by increasing of population number. Some agricultural lands have been converted into built-up area since demand of settlement, industrial area, and other infrastructures also increases. Unfortunately, recent utilization of more than a half of total area is not appropriate with land use plan declared in spatial planning document. It means, local government shall develop a strict regulation and law enforcement related to any violation in land use management.Keywords: balance, forest, land, spatial plan
Procedia PDF Downloads 322687 Increasing Cervical Screening Uptake during the Covid-19 Pandemic at Lakeside Healthcare, Corby, UK
Authors: Devyani Shete, Sudeep Rai
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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.Keywords: gynaecology, cervical screening, public health, COVID-19
Procedia PDF Downloads 154686 The Implementation of Inclusive Education in Collaboration between Teachers of Special Education Classes and Regular Classes in a Preschool
Authors: Chiou-Shiue Ko
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As is explicitly stipulated in Article 7 of the Enforcement Rules of the Special Education Act as amended in 1998, "in principle, children with disabilities should be integrated with normal children for preschool education". Since then, all cities and counties have been committed to promoting preschool inclusive education. The Education Department, New Taipei City Government, has been actively recruiting advisory groups of professors to assist in the implementation of inclusive education in preschools since 2001. Since 2011, the author of this study has been guiding Preschool Rainbow to implement inclusive education. Through field observations, meetings, and teaching demonstration seminars, this study explored the process of how inclusive education has been successfully implemented in collaboration with teachers of special education classes and regular classes in Preschool Rainbow. The implementation phases for inclusive education in a single academic year include the following: 1) Preparatory stage. Prior to implementation, teachers in special education and regular classes discuss ways of conducting inclusive education and organize reading clubs to read books related to curriculum modifications that integrate the eight education strategies, early treatment and education, and early childhood education programs to enhance their capacity to implement and compose teaching plans for inclusive education. In addition to the general objectives of inclusive education, the objective of inclusive education for special children is also embedded into the Individualized Education Program (IEP). 2) Implementation stage. Initially, a promotional program for special education is implemented for the children to allow all the children in the preschool to understand their own special qualities and those of special children. After the implementation of three weeks of reverse inclusion, the children in the special education classes are put into groups and enter the regular classes twice a week to implement adjustments to their inclusion in the learning area and the curriculum. In 2013, further cooperation was carried out with adjacent hospitals to perform development screening activities for the early detection of children with developmental delays. 3) Review and reflection stage. After the implementation of inclusive education, all teachers in the preschool are divided into two groups to record their teaching plans and the lessons learned during implementation. The effectiveness of implementing the objective of inclusive education is also reviewed. With the collaboration of all teachers, in 2015, Preschool Rainbow won New Taipei City’s “Preschool Light” award as an exceptional model for inclusive education. Its model of implementing inclusive education can be used as a reference for other preschools.Keywords: collaboration, inclusive education, preschool, teachers, special education classes, regular classes
Procedia PDF Downloads 431685 High-Fidelity Materials Screening with a Multi-Fidelity Graph Neural Network and Semi-Supervised Learning
Authors: Akeel A. Shah, Tong Zhang
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Computational approaches to learning the properties of materials are commonplace, motivated by the need to screen or design materials for a given application, e.g., semiconductors and energy storage. Experimental approaches can be both time consuming and costly. Unfortunately, computational approaches such as ab-initio electronic structure calculations and classical or ab-initio molecular dynamics are themselves can be too slow for the rapid evaluation of materials, often involving thousands to hundreds of thousands of candidates. Machine learning assisted approaches have been developed to overcome the time limitations of purely physics-based approaches. These approaches, on the other hand, require large volumes of data for training (hundreds of thousands on many standard data sets such as QM7b). This means that they are limited by how quickly such a large data set of physics-based simulations can be established. At high fidelity, such as configuration interaction, composite methods such as G4, and coupled cluster theory, gathering such a large data set can become infeasible, which can compromise the accuracy of the predictions - many applications require high accuracy, for example band structures and energy levels in semiconductor materials and the energetics of charge transfer in energy storage materials. In order to circumvent this problem, multi-fidelity approaches can be adopted, for example the Δ-ML method, which learns a high-fidelity output from a low-fidelity result such as Hartree-Fock or density functional theory (DFT). The general strategy is to learn a map between the low and high fidelity outputs, so that the high-fidelity output is obtained a simple sum of the physics-based low-fidelity and correction, Although this requires a low-fidelity calculation, it typically requires far fewer high-fidelity results to learn the correction map, and furthermore, the low-fidelity result, such as Hartree-Fock or semi-empirical ZINDO, is typically quick to obtain, For high-fidelity outputs the result can be an order of magnitude or more in speed up. In this work, a new multi-fidelity approach is developed, based on a graph convolutional network (GCN) combined with semi-supervised learning. The GCN allows for the material or molecule to be represented as a graph, which is known to improve accuracy, for example SchNet and MEGNET. The graph incorporates information regarding the numbers of, types and properties of atoms; the types of bonds; and bond angles. They key to the accuracy in multi-fidelity methods, however, is the incorporation of low-fidelity output to learn the high-fidelity equivalent, in this case by learning their difference. Semi-supervised learning is employed to allow for different numbers of low and high-fidelity training points, by using an additional GCN-based low-fidelity map to predict high fidelity outputs. It is shown on 4 different data sets that a significant (at least one order of magnitude) increase in accuracy is obtained, using one to two orders of magnitude fewer low and high fidelity training points. One of the data sets is developed in this work, pertaining to 1000 simulations of quinone molecules (up to 24 atoms) at 5 different levels of fidelity, furnishing the energy, dipole moment and HOMO/LUMO.Keywords: .materials screening, computational materials, machine learning, multi-fidelity, graph convolutional network, semi-supervised learning
Procedia PDF Downloads 46684 The Influence of Perinatal Anxiety and Depression on Breastfeeding Behaviours: A Qualitative Systematic Review
Authors: Khulud Alhussain, Anna Gavine, Stephen Macgillivray, Sushila Chowdhry
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Background: Estimates show that by the year 2030, mental illness will account for more than half of the global economic burden, second to non-communicable diseases. Often, the perinatal period is characterised by psychological ambivalence and a mixed anxiety-depressive condition. Maternal mental disorder is associated with perinatal anxiety and depression and affects breastfeeding behaviors. Studies also indicate that maternal mental health can considerably influence a baby's health in numerous aspects and impact the newborn health due to lack of adequate breastfeeding. However, studies reporting factors associated with breastfeeding behaviors are predominantly quantitative. Therefore, it is not clear what literature is available to understand the factors affecting breastfeeding and perinatal women’s perspectives and experiences. Aim: This review aimed to explore the perceptions and experiences of women with perinatal anxiety and depression, as well as how these experiences influence their breastfeeding behaviours. Methods: A systematic literature review of qualitative studies in line with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). Four electronic databases (CINAHL, PsycINFO, Embase, and Google Scholar) were explored for relevant studies using a search strategy. The search was restricted to studies published in the English language between 2000 and 2022. Findings from the literature were screened using a pre-defined screening criterion and the quality of eligible studies was appraised using the Walsh and Downe (2006) checklist. Findings were extracted and synthesised based on Braun and Clark. The review protocol was registered on PROSPERO (Ref: CRD42022319609). Result: A total of 4947 studies were identified from the four databases. Following duplicate removal and screening 16 studies met the inclusion criteria. The studies included 87 pregnant and 302 post-partum women from 12 countries. The participants were from a variety of economic, regional, and religious backgrounds, mainly from the age of 18 to 45 years old. Three main themes were identified: Barriers to breastfeeding, breastfeeding facilitators, emotional disturbance, and breastfeeding. Seven subthemes emerged from the data: expectation versus reality, uncertainly about maternal competencies, body image and breastfeeding, lack of sufficient breastfeeding support for family and caregivers’ support, influences positive breastfeeding practices, breastfeeding education, and causes of mental strain among breastfeeding women. Breastfeeding duration is affected in women with mental health disorders, irrespective of their desire to breastfeed. Conclusion: There is significant empirical evidence that breastfeeding behaviour and perinatal mental disturbance are linked. However, there is a lack of evidence to apply the findings to Saudi women due to lack of empirical qualitative information. To improve the psychological well-being of mothers, it is crucial to explore and recognise any concerns with their mental, physical, and emotional well-being. Therefore, robust research is needed so that breastfeeding intervention researchers and policymakers can focus on specifically what needs to be done to help mentally distressed perinatal women and their new-born.Keywords: pregnancy, perinatal period, anxiety, depression, emotional disturbance, breastfeeding
Procedia PDF Downloads 102683 Organizing Diabetes Care in a Resource Constrained Country: Bangladesh as an Example
Authors: Liaquat Ali, Khurshid Natasha
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Low resource countries are not usually equipped with the organizational tools to implement health care for chronic diseases, and thus, providing effective diabetes care in such countries is a challenging task. Diabetic Association of Bangladesh (BADAS in Bengali acronym) has created a stimulating example to meet this challenge. Starting its journey in 1956 with 39 patients in a small tin shed clinic BADAS, and its affiliated associations now operate 90 hospitals and health centres all over the country. Together, these facilities provide integrated health care to about 1.5 million registered diabetic patients which constitute about 20% of the estimated diabetic population in the country. BADAS has also become a pioneer in health manpower generation in Bangladesh. Along with its affiliates, it now runs 3 Medical Colleges (to generate graduate physicians), 2 Nursing Institutes, and 2 Postgraduate Institutes which conduct 25 postgraduate courses (under the University of Dhaka) in various basic, clinical and public health disciplines. BADAS gives great emphasis on research, which encompasses basic, clinical as well as public health areas. BADAS is an ideal example of public-private partnership in health as most of its infrastructure has been created through government support but it is almost self-reliant in managing its revenue budget which approached approximately 40 million US dollar during 2010. BADAS raises resources by providing high-quality services to the people, both diabetic and non-diabetic. At the same time, BADAS has developed a cross financing model, to support diabetic patients in general and poor diabetic patients (identified through a social welfare network) in particular, through redistribution of the resources. Along with financial sustainability BADAS ensure organizational sustainability through a process of decentralization, community ownership, and democratic management. Presently a large scale pilot project (named as a Health Care Development Project or HCDP) is under implementation under BADAS umbrella with an objective to transform the diabetes care model to a health care model in general. It is expected to create further evidence on providing sustainable (with social safety net) health care delivery for diabetes, and other chronic illnesses as an integral part of general health care delivery in a resource constrained setting.Keywords: Bangladesh, self sustain, health care, constrain
Procedia PDF Downloads 182682 Barriers and Facilitators of Physical Activity among Adults and Older Adults from Black and Minority Ethnic Groups in the UK: A Meta-Ethnographic Study
Authors: Janet Ige, Paul Pilkington, Selena Gray, Jane Powell
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Older adults from socially disadvantaged groups and Black and Minority Ethnic (BME) groups experience a higher burden of physical inactivity. Physical inactivity among BME groups is associated with the disproportionately higher level of health inequalities. People from minority ethnic groups encounter more barriers to physical activity. However, this is not often reported. There is very limited review-level evidence on the barriers and facilitators of physical activity among older adults from BME groups in the UK. This study aims to answer the following research question: what are the barriers and facilitators of physical activity participation among adults and older adults from BME background in the UK? To address this, we conducted a review of qualitative studies investigating the barriers and opportunities for physical activity among of BME adults and older adults in the UK. Method: This study is nested in an interpretive paradigm of meta-ethnography. A structured search for published literature was conducted on 6 electronic databases (MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health Literature, Applied Social Sciences Index and Abstracts, Cochrane Database of Systematic Reviews, Allied and Complementary Medicine) from January 2007 to July 2017. Hand searching of the reference list of publications was performed in addition to a search conducted on Google Scholar to identify grey literature. Studies were eligible provided they employed any qualitative method and included participants identified as being BME, aged 50 and above, living in any community within the UK. In total, 1036 studies were identified from the structured search for literature, 718 studies were screened by titles after duplicates were removed. On applying the inclusion and exclusion criteria, a final selection of 10 studies was considered eligible for synthesis. Quality assessment was performed using the Critical Appraisal Skills Programme tool. Logic maps were used to show the relationship between factors that impact on physical activity participation among adults and older adults Result: Six key themes emerged from the data: awareness of the links between physical activity and health, interaction, and engagement with health professionals, cultural expectations and social responsibilities, appropriate environment, religious fatalism and practical challenges. Findings also showed that the barriers and facilitators of physical activity exist at the individual, community, and socio-economic, cultural and environmental level. There was a substantial gap in research among Black African groups. Findings from the review also informed the design of an ongoing survey investigating the experience and attitude of adults from Somali backgrounds towards physical activity in the UK. Conclusion: Identifying the barriers and facilitators of physical activity among BME groups is a crucial step in addressing the widening inequality gap. Findings from this study highlight the importance of engaging local BME residents in the design of exercise facilities within the community. This will ensure that cultural and social concerns are recognized and properly addressed.Keywords: BME, UK, meta-ethnographic, adults
Procedia PDF Downloads 122681 Dynamic Effects of Energy Consumption, Economic Growth, International Trade and Urbanization on Environmental Degradation in Nigeria
Authors: Abdulkarim Yusuf
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Motivation: A crucial but difficult goal for governments and policymakers in Nigeria in recent years has been the sustainability of economic growth. This goal must be accomplished by regulating or lowering greenhouse gas emissions, which calls for switching to a low- or zero-carbon production system. The lack of in-depth empirical studies on the environmental impact of socioeconomic variables on Nigeria and a number of unresolved issues from earlier research is what led to the current study. Objective: This study fills an important empirical gap by investigating the existence of an Environmental Kuznets Curve hypothesis and the long and short-run dynamic impact of socioeconomic variables on ecological sustainability in Nigeria. Data and method: Annual time series data covering the period 1980 to 2020 and the Autoregressive Distributed Lag technique in the presence of structural breaks were adopted for this study. Results: The empirical findings support the existence of the environmental Kuznets curve hypothesis for Nigeria in the long and short run. Energy consumption and total import exacerbate environmental deterioration in the long and short run, whereas total export improves environmental quality in the long and short run. Financial development, which contributed to a conspicuous decrease in the level of environmental destruction in the long run, escalated it in the short run. In contrast, urbanization caused a significant increase in environmental damage in the long run but motivated a decrease in biodiversity loss in the short run. Implications: The government, policymakers, and all energy stakeholders should take additional measures to ensure the implementation and diversification of energy sources to accommodate more renewable energy sources that emit less carbon in order to promote efficiency in Nigeria's production processes and lower carbon emissions. In order to promote the production and trade of environmentally friendly goods, they should also revise and strengthen environmental policies. With affordable, dependable, and sustainable energy use for higher productivity and inclusive growth, Nigeria will be able to achieve its long-term development goals of good health and wellbeing.Keywords: economic growth, energy consumption, environmental degradation, environmental Kuznets curve, urbanization, Nigeria
Procedia PDF Downloads 55680 Consumer Preferences Concerning Food from Carob: A Survey in Crete, Greece
Authors: Georgios A. Fragkiadakis, Antonia Psaroudaki, Theodora Mouratidou, Eirini Sfakianaki
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Research: The nutritional benefits of eating carob are many and important for the human organism, as it is a food rich in carbohydrates and low in fat and contains multiple nutrients, making it a "superfood". Within the framework of the project "Actions for the optimal utilization of the potential of carob in the Region of Crete" which is financed-supervised by the Region of Crete, a second-grade local self-government authority, with the collaboration of the University of Crete and of the Hellenic Mediterranean University, an online survey was carried out with the aim of evaluating dietary habits and views related to the consumption of carob and its products in a sample of local residents. Results and Conclusions: Of the 351 participants, 259 (73.8%) stated that they consume carob products, and 26.2% stated that they do not. Difficult access and limited availability of carob-food products (33.7%), high price (20.7%), and difficulties of use and preparation (15.2%) were cited as the main reasons for non-consumption. Other reasons, to a lesser extent, concern the taste, especially the sweet aftertaste of some products. Concerning the behavior and eating habits related to the consumption of carob products (n=259), 57.9% of the sample report that they buy carob products "sometimes"; 21.2% report "often"; 19.7% report "rarely", and a very small percentage of 1.2% report "constantly". With reference to the reasons for choosing carob products, the participants mention the main reason for their high nutritional value (51.7%), followed by 32.4% of nutritional claims and health claims, and the organoleptic characteristics (10.8%). Other positive factors are the final price of the product, the ease of use, and the respect for the local environment and producers. Some bakery products show the highest percentage of consumption among carob-food consumers, mainly in the form of rusks (86.1%) and breadsticks (70.3%). They are followed, in descending order, by bread (63.3%), toast (52.1%), and flour (50.6%). More specifically: 40.5% consume carob rusks less than once a month; 22% consume less than once a week; up to twice a week 12.4%; 6.6%, consume rusks 3 to 4 times a week, and daily 3.9%. It is worth mentioning that a high percentage of consumers of carob products recommend the consumption to their family and friends. Only a small percentage, in the range of 5%, does not recommend the consumption of carob products in their close family/social circle. The main motivating factors for the consumption of carob products are the expected effects they may have on health (74.1%) and the organoleptic characteristics with a percentage of 21.6%.Keywords: food, consumer, preferences, carob, Crete, Greece
Procedia PDF Downloads 68679 Integrating One Health Approach with National Policies to Improve Health Security post-COVID-19 in Vietnam
Authors: Yasser Sanad, Thu Trang Dao
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Introduction: Implementing the One Health (OH) approach requires an integrated, interdisciplinary, and cross-sectoral methodology. OH is a key tool for developing and implementing programs and projects and includes developing ambitious policies that consider the common needs and benefits of human, animal, plant, and ecosystem health. OH helps humanity readjust its path to environmentally friendly and impartial sustainability. As co-leader of the Global Health Security Agenda’s Zoonotic Disease Action Package, Vietnam pioneered a strong OH approach to effectively address early waves of the COVID-19 outbreak in-country. Context and Aim: The repeated surges in COVID-19 in Vietnam challenged the capabilities of the national system and disclosed the gaps in multi-sectoral coordination and resilience. To address this, FHI 360 advocated for the standardization of the OH platform by government actors to increase the resiliency of the system during and post COVID-19. Methods: FHI 360 coordinated technical resources to develop and implement evidence-based OH policies, promoting high-level policy dialogue between the Ministries of Health, Agriculture, and the Environment, and policy research to inform developed policies and frameworks. Through discussions, an OH-building Partnership (OHP) was formed, linking climate change, the environment, and human and animal health. Findings: The OHP Framework created a favorable policy environment within and between sectors, as well as between governments and international health security partners. It also promoted strategic dialogue, resource mobilization, policy advocacy, and integration of international systems with National Steering Committees to ensure accountability and emphasize national ownership. Innovative contribution to policy, practice and/or research: OHP was an effective evidence-based research-to-policy platform linking to the National One Health Strategic Plan (2021-2025). Collectively they serve as a national framework for the implementation and monitoring of OH activities. Through the adoption of policies and plans, the risk of zoonotic pathogens, environmental agent spillover, and antimicrobial resistance can be minimized through strengthening multi-sectoral OH collaboration for health security.Keywords: one health, national policies, health security, COVID-19, Vietnam
Procedia PDF Downloads 111678 Students' Performance, Perception and Attitude towards Interactive Online Modules to Improve Undergraduate Quantitative Skills in Biological Science
Authors: C. Suphioglu , V. Simbag, J. Markham, C. Coady, S. Belward, G. Di Trapani, P. Chunduri, J. Chuck, Y. Hodgson, L. Lluka, L. Poladian, D. Watters
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Advances in science have made quantitative skills (QS) an essential graduate outcome for undergraduate science programs in Australia and other parts of the world. However, many students entering into degrees in Australian universities either lack these skills or have little confidence in their ability to apply them in their biological science units. It has been previously reported that integration of quantitative skills into life science programs appears to have a positive effect on student attitudes towards the importance of mathematics and statistics in biological sciences. It has also been noted that there is deficiency in QS resources available and applicable to undergraduate science students in Australia. MathBench (http://mathbench.umd.edu) is a series of online modules involving quantitative biology scenarios developed by the University of Maryland. Through collaboration with Australian universities, a project was funded by the Australian government through its Office for Learning and Teaching (OLT) to develop customized MathBench biology modules to promote the quantitative skills of undergraduate biology students in Australia. This presentation will focus on the assessment of changes in performance, perception and attitude of students in a third year Cellular Physiology unit after use of interactive online cellular diffusion modules modified for the Australian context. The modules have been designed to integrate QS into the biological science curriculum using familiar scenarios and informal language and providing students with the opportunity to review solutions to diffusion QS-related problems with interactive graphics. This paper will discuss results of pre and post MathBench quizzes composed of general and module specific questions that assessed change in student QS after MathBench; and pre and post surveys, administered before and after using MathBench modules to evaluate the students’ change in perception towards the influence of the modules, their attitude towards QS and on the development of their confidence in completing the inquiry-based activity as well as changes to their appreciation of the relevance of mathematics to cellular processes. Results will be compared to changes reported by Thompson et al., (2010) at the University of Maryland and implications for further integration of interactive online activities in the curriculum will be explored and discussed.Keywords: quantitative skills, MathBench, maths in biology
Procedia PDF Downloads 385677 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education
Authors: Lauren G. Coggins
Abstract:
Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.Keywords: education, healthcare-associated infections, infection, nursing, prevention
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