Search results for: sustainable health planning
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15026

Search results for: sustainable health planning

9926 Collaborative Early Warning System: An Integrated Framework for Mitigating Impacts of Natural Hazards in the UAE

Authors: Abdulla Al Hmoudi

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The impacts and costs of natural disasters on people, properties and the environment is often severe when they occur on a large scale or when not prepared for. Factors such as impacts of climate change, urban growth, poor planning to mention a few, have continued to significantly increase the frequencies and aggravate the impacts of natural hazards across the world; the United Arab Emirates (UAE) inclusive. The lack of deployment of an early warning system, low risk and hazard knowledge and impact of natural hazard experienced in some communities in the UAE have emphasised the need for more effective early warning systems. This paper focuses on the collaborative approach taken to instituting and implementing an early warning system. Using mixed methods 888 people completed the questionnaire and eight people were interviewed in Abu Dhabi. The results indicate that the collaborative approach to early warning system is UAE is needed, but lacks essential principles of the early warning system and currently underutilised. It is recommended that the collaborative early warning system is applied at every stage of the early warning system with the specific responsibility of each stakeholder and actor.

Keywords: community, early warning system, emergency management, UAE

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9925 Ophthalmic Services Covered by Albasar International Foundation in Sudan

Authors: Mohammad Ibrahim

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The study was conducted at Albasar international foundation ophthalmic hospitals in Sudan to study the burden and patterns of ophthalmic disorder in the sector. Review of the hospitals records revealed that the total number of patient examined in the hospitals and outreached camps conducted by the hospitals is 10,513,874, the total number of surgeries is 694,015 and the total number of pupils at school program is 230,382. The organization working with the highest management system and standards and quality result based planning. The study yielded that the ophthalmic problem in Sudan are of great percentage and the temporal blindness disorder are high since major cases and surgeries were Cataract (57.8%). Retinal problem (2.9%), Glaucoma (2.4%), Orbit and Occulo-plastic disorders (2.2%) other disorders are refractive errors, squint and strabismus, Corneal, Pediatrics and minor ophthalmic disorders.

Keywords: hospitals and outreach ophthalmic services, largest coverage of ophthalmic services, nonprofitable ophthalmic services, strong management system and standards

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9924 Introduction of Electronic Health Records to Improve Data Quality in Emergency Department Operations

Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe

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In its simplest form, data quality can be defined as 'fitness for use' and it is a concept with multi-dimensions. Emergency Departments(ED) require information to treat patients and on the other hand it is the primary source of information regarding accidents, injuries, emergencies etc. Also, it is the starting point of various patient registries, databases and surveillance systems. This interventional study was carried out to improve data quality at the ED of the National Hospital of Sri Lanka (NHSL) by introducing an e health solution to improve data quality. The NHSL is the premier trauma care centre in Sri Lanka. The study consisted of three components. A research study was conducted to assess the quality of data in relation to selected five dimensions of data quality namely accuracy, completeness, timeliness, legibility and reliability. The intervention was to develop and deploy an electronic emergency department information system (eEDIS). Post assessment of the intervention confirmed that all five dimensions of data quality had improved. The most significant improvements are noticed in accuracy and timeliness dimensions.

Keywords: electronic health records, electronic emergency department information system, emergency department, data quality

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9923 An Eco-Friendly Preparations of Izonicotinamide Quaternary Salts in Deep Eutectic Solvents

Authors: Dajana Gašo-Sokač, Valentina Bušić

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Deep eutectic solvents (DES) are liquids composed of two or three safe, inexpensive components, often interconnected by noncovalent hydrogen bonds which produce eutectic mixture whose melting point is lower than that of each component. No data in literature have been found on the quaternization reaction in DES. The use of DES have several advantages: they are environmentally benign and biodegradable, easy for purification and simple for preparation. An environmentally sustainable method for preparing quaternary salts of izonicotinamide and substituted 2-bromoacetophenones was demonstrated here using choline chloride-based DES. The quaternization reaction was carried out by three synthetic approaches: conventional method, microwave and ultrasonic irradiation. We showed that the highest yields were obtained by the microwave method.

Keywords: deep eutectic solvents, izonicotinamide salts, microwave synthesis, ultrasonic irradiation

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9922 The Impact of E-Learning on Medication Administration of Nursing Students

Authors: Z. Karakus, Z. Ozer

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Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

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9921 Prevalence of Physical Activity Levels and Perceived Benefits of and Barriers to Physical Activity among Jordanian Patients with Coronary Heart Disease: A Cross-Sectional Study

Authors: Eman Ahmed Alsaleh

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Background: Many studies published in other countries identified certain perceived benefits and barriers to physical activity among patients with coronary heart disease. Nevertheless, there is no data about the issue relating to Jordanian patients with coronary heart disease. Objective: This study aimed to describe the prevalence of level of physical activity, benefits of and barriers to physical activity as perceived by Jordanian patients with coronary heart disease, and the relationship between physical activity and perceived benefits of and barriers to physical activity. In addition, it focused on examining the influence of selected sociodemographic and health characteristics on physical activity and the perceived benefits of and barriers to physical activity. Methods: A cross-sectional design was performed on a sample of 400 patients with coronary heart disease. They were given a list of perceived benefits and barriers to physical activity and asked to what extent they disagreed or agreed with each. Results: Jordanian patients with coronary heart disease perceived various benefits and barriers to physical activity. Most of these benefits were physiologically related (average mean = 5.7, SD = .7). The most substantial barriers to physical activity as perceived by the patients were: feeling anxiety, not having enough time, lack of interest, bad weather, and feeling of being uncomfortable. Sociodemographic and health characteristics that significantly influenced perceived barriers to physical activity were age, gender, health perception, chest pain frequency, education, job, caring responsibilities, ability to travel alone, smoking, and previous and current physical activity behaviour. Conclusion: This research demonstrates that patients with coronary heart disease have perceived physiological benefits of physical activity, and they have perceived motivational, physical health, and environmental barriers to physical activity, which is significant in developing intervention strategies that aim to maximize patients' participation in physical activity and overcome barriers to physical activity.

Keywords: prevalence, coronary heart disease, physical activity, perceived barriers

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9920 Improved Anatomy Teaching by the 3D Slicer Platform

Authors: Ahmedou Moulaye Idriss, Yahya Tfeil

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Medical imaging technology has become an indispensable tool in many branches of the biomedical, health area, and research and is vitally important for the training of professionals in these fields. It is not only about the tools, technologies, and knowledge provided but also about the community that this training project proposes. In order to be able to raise the level of anatomy teaching in the medical school of Nouakchott in Mauritania, it is necessary and even urgent to facilitate access to modern technology for African countries. The role of technology as a key driver of justifiable development has long been recognized. Anatomy is an essential discipline for the training of medical students; it is a key element for the training of medical specialists. The quality and results of the work of a young surgeon depend on his better knowledge of anatomical structures. The teaching of anatomy is difficult as the discipline is being neglected by medical students in many academic institutions. However, anatomy remains a vital part of any medical education program. When anatomy is presented in various planes medical students approve of difficulties in understanding. They do not increase their ability to visualize and mentally manipulate 3D structures. They are sometimes not able to correctly identify neighbouring or associated structures. This is the case when they have to make the identification of structures related to the caudate lobe when the liver is moved to different positions. In recent decades, some modern educational tools using digital sources tend to replace old methods. One of the main reasons for this change is the lack of cadavers in laboratories with poorly qualified staff. The emergence of increasingly sophisticated mathematical models, image processing, and visualization tools in biomedical imaging research have enabled sophisticated three-dimensional (3D) representations of anatomical structures. In this paper, we report our current experience in the Faculty of Medicine in Nouakchott Mauritania. One of our main aims is to create a local learning community in the fields of anatomy. The main technological platform used in this project is called 3D Slicer. 3D Slicer platform is an open-source application available for free for viewing, analysis, and interaction with biomedical imaging data. Using the 3D Slicer platform, we created from real medical images anatomical atlases of parts of the human body, including head, thorax, abdomen, liver, and pelvis, upper and lower limbs. Data were collected from several local hospitals and also from the website. We used MRI and CT-Scan imaging data from children and adults. Many different anatomy atlases exist, both in print and digital forms. Anatomy Atlas displays three-dimensional anatomical models, image cross-sections of labelled structures and source radiological imaging, and a text-based hierarchy of structures. Open and free online anatomical atlases developed by our anatomy laboratory team will be available to our students. This will allow pedagogical autonomy and remedy the shortcomings by responding more fully to the objectives of sustainable local development of quality education and good health at the national level. To make this work a reality, our team produced several atlases available in our faculty in the form of research projects.

Keywords: anatomy, education, medical imaging, three dimensional

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9919 Yoga for Holistic Health Wellbeing

Authors: Pothula Madhusudhan Reddy

Abstract:

Introduction: Yoga is a way of life. of uniting the mind, body and soul. It is also an art of living the right way. The techniques of Yoga are very practical, so they can always be applied. This is the reason why Yoga has been practiced for thousands of years and is still valid today. Importance of Yoga: Yoga that helps to inculcate healthy habits and adopt a healthy lifestyle to achieve good health Research Aim: The aim of this study is to explore the potential benefits of yoga for holistic health and wellbeing, both at an individual and societal level The ultimate goal of human being is to attain the state of perfect freedom from the shackles of ignorance, which is the generator of all the pangs and miseries of life. Methodology: This research follows a thematic and practical experience approach. Yoga includes body postures and movements (stretching), breathing practices, imagery, meditation, and progressive relaxation techniques. Data Collection: The data for this research is collected through a combination of literature review, expert interviews, and practical yoga sessions. The literature review provides a comprehensive understanding of the principles and practices of yoga, while expert interviews offer insights from experienced practitioners. Practical yoga sessions allow for first hand experiences and observations, facilitating a deeper understanding of the subject matter. Analysis Procedures: The collected data is analyzed thematically, where key themes and patterns related to the benefits and effects of yoga on holistic health and wellbeing are identified. The findings are then interpreted and synthesized to draw meaningful conclusions. Questions Addressed: This research addresses the following questions: What are the potential benefits of yoga for holistic health and wellbeing? How does yoga promote rejuvenate the body, mind, and senses? What are the implications of a society embracing yoga for overall societal wellbeing and happiness? Findings: The research highlights that practicing yoga can lead to increased awareness of the body, mind, and senses. It promotes overall physical and mental health, helping individuals achieve a state of happiness and contentment. Moreover, the study emphasizes that a society embracing yoga can contribute to the development of a healthy and happy community. Theoretical Importance: The study of yoga for holistic health and wellbeing holds theoretical importance as it provides insights into the science of yoga and its impact on individuals and society. It contributes to the existing body of knowledge on the subject and further establishes yoga as a potential tool for enhancing overall wellness. Conclusion: The study concludes that yoga is a powerful practice for achieving holistic health and wellbeing. This research provides valuable insights into the science of yoga and its potential as a tool for promoting overall wellness.

Keywords: yoga, asana, pranayama, meditation

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9918 COVID-19 Laws and Policy: The Use of Policy Surveillance For Better Legal Preparedness

Authors: Francesca Nardi, Kashish Aneja, Katherine Ginsbach

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The COVID-19 pandemic has demonstrated both a need for evidence-based and rights-based public health policy and how challenging it can be to make effective decisions with limited information, evidence, and data. The O’Neill Institute, in conjunction with several partners, has been working since the beginning of the pandemic to collect, analyze, and distribute critical data on public health policies enacted in response to COVID-19 around the world in the COVID-19 Law Lab. Well-designed laws and policies can help build strong health systems, implement necessary measures to combat viral transmission, enforce actions that promote public health and safety for everyone, and on the individual level have a direct impact on health outcomes. Poorly designed laws and policies, on the other hand, can fail to achieve the intended results and/or obstruct the realization of fundamental human rights, further disease spread, or cause unintended collateral harms. When done properly, laws can provide the foundation that brings clarity to complexity, embrace nuance, and identifies gaps of uncertainty. However, laws can also shape the societal factors that make disease possible. Law is inseparable from the rest of society, and COVID-19 has exposed just how much laws and policies intersects all facets of society. In the COVID-19 context, evidence-based and well-informed law and policy decisions—made at the right time and in the right place—can and have meant the difference between life or death for many. Having a solid evidentiary base of legal information can promote the understanding of what works well and where, and it can drive resources and action to where they are needed most. We know that legal mechanisms can enable nations to reduce inequities and prepare for emerging threats, like novel pathogens that result in deadly disease outbreaks or antibiotic resistance. The collection and analysis of data on these legal mechanisms is a critical step towards ensuring that legal interventions and legal landscapes are effectively incorporated into more traditional kinds of health science data analyses. The COVID-19 Law Labs see a unique opportunity to collect and analyze this kind of non-traditional data to inform policy using laws and policies from across the globe and across diseases. This global view is critical to assessing the efficacy of policies in a wide range of cultural, economic, and demographic circumstances. The COVID-19 Law Lab is not just a collection of legal texts relating to COVID-19; it is a dataset of concise and actionable legal information that can be used by health researchers, social scientists, academics, human rights advocates, law and policymakers, government decision-makers, and others for cross-disciplinary quantitative and qualitative analysis to identify best practices from this outbreak, and previous ones, to be better prepared for potential future public health events.

Keywords: public health law, surveillance, policy, legal, data

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9917 Developing of Ecological Internal Insulation Composite Boards for Innovative Retrofitting of Heritage Buildings

Authors: J. N. Nackler, K. Saleh Pascha, W. Winter

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WHISCERS™ (Whole House In-Situ Carbon and Energy Reduction Solution) is an innovative process for Internal Wall Insulation (IWI) for energy-efficient retrofitting of heritage building, which uses laser measuring to determine the dimensions of a room, off-site insulation board cutting and rapid installation to complete the process. As part of a multinational investigation consortium the Austrian part adapted the WHISCERS system to local conditions of Vienna where most historical buildings have valuable stucco facades, precluding the application of an external insulation. The Austrian project contribution addresses the replacement of commonly used extruded polystyrene foam (XPS) with renewable materials such as wood and wood products to develop a more sustainable IWI system. As the timber industry is a major industry in Austria, a new innovative and more sustainable IWI solution could also open up new markets. The first approach of investigation was the Life Cycle Assessment (LCA) to define the performance of wood fibre board as insulation material in comparison to normally used XPS-boards. As one of the results the global-warming potential (GWP) of wood-fibre-board is 15 times less the equivalent to carbon dioxide while in the case of XPS it´s 72 times more. The hygrothermal simulation program WUFI was used to evaluate and simulate heat and moisture transport in multi-layer building components of the developed IWI solution. The results of the simulations prove in examined boundary conditions of selected representative brickwork constructions to be functional and usable without risk regarding vapour diffusion and liquid transport in proposed IWI. In a further stage three different solutions were developed and tested (1 - glued/mortared, 2 - with soft board, connected to wall with gypsum board as top layer, 3 - with soft board and clay board as top layer). All three solutions presents a flexible insulation layer out of wood fibre towards the existing wall, thus compensating irregularities of the wall surface. From first considerations at the beginning of the development phase, three different systems had been developed and optimized according to assembly technology and tested as small specimen in real object conditions. The built prototypes are monitored to detect performance and building physics problems and to validate the results of the computer simulation model. This paper illustrates the development and application of the Internal Wall Insulation system.

Keywords: internal insulation, wood fibre, hygrothermal simulations, monitoring, clay, condensate

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9916 Industrial Hemp Agronomy and Fibre Value Chain in Pakistan: Current Progress, Challenges, and Prospects

Authors: Saddam Hussain, Ghadeer Mohsen Albadrani

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Pakistan is one of the most vulnerable countries to climate change. Being a country where 23% of the country’s GDP relies on agriculture, this is a serious cause of concern. Introducing industrial hemp in Pakistan can help build climate resilience in the agricultural sector of the country, as hemp has recently emerged as a sustainable, eco-friendly, resource-efficient, and climate-resilient crop globally. Hemp has the potential to absorb huge amounts of CO₂, nourish the soil, and be used to create various biodegradable and eco-friendly products. Hemp is twice as effective as trees at absorbing and locking up carbon, with 1 hectare (2.5 acres) of hemp reckoned to absorb 8 to 22 tonnes of CO₂ a year, more than any woodland. Along with its high carbon-sequestration ability, it produces higher biomass and can be successfully grown as a cover crop. Hemp can grow in almost all soil conditions and does not require pesticides. It has fast-growing qualities and needs only 120 days to be ready for harvest. Compared with cotton, hemp requires 50% less water to grow and can produce three times higher fiber yield with a lower ecological footprint. Recently, the Government of Pakistan has allowed the cultivation of industrial hemp for industrial and medicinal purposes, making it possible for hemp to be reinserted into the country’s economy. Pakistan’s agro-climatic and edaphic conditions are well-suitable to produce industrial hemp, and its cultivation can bring economic benefits to the country. Pakistan can enter global markets as a new exporter of hemp products. The production of hemp in Pakistan can be most exciting to the workforce, especially for farmers participating in hemp markets. The minimum production cost of hemp makes it affordable to small holding farmers, especially those who need their cropping system to be as highly sustainable as possible. Dr. Saddam Hussain is leading the first pilot project of Industrial Hemp in Pakistan. In the past three years, he has been able to recruit high-impact research grants on industrial hemp as Principal Investigator. He has already screened the non-toxic hemp genotypes, tested the adaptability of exotic material in various agroecological conditions, formulated the production agronomy, and successfully developed the complete value chain. He has developed prototypes (fabric, denim, knitwear) using hemp fibre in collaboration with industrial partners and has optimized the indigenous fibre processing techniques. In this lecture, Dr. Hussain will talk on hemp agronomy and its complete fibre value chain. He will discuss the current progress, and will highlight the major challenges and future research direction on hemp research.

Keywords: industrial hemp, agricultural sustainability, agronomic evaluation, hemp value chain

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9915 Site Selection and Construction Mechanism of the Island Settlements in China Based on CFD-GIS Technology

Authors: Weng Jiantao, Wu Yiqun

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The efficiency of natural ventilation, wind pressure distribution on building surface, wind comfort for pedestrians and buildings’ wind tolerance in traditional settlements are closely related to the pattern of terrain. On the basis of field research on the typical island terrain in China, the physical and mathematical models are established by using CFD software, and then the simulation results of the wind field are exported. We discuss the relationship between wind direction and wind field results. Furthermore simulation results are imported into ArcGIS platform. The evaluation model of island site selection is established with considering slope factor. We realize the visual model of site selection on complex island terrain. The multi-plans of certain residential are discussed based on wind simulation; at last the optimal project is selected. Results can provide the theory guidance for settlement planning and construction in China's traditional island.

Keywords: CFD, island terrain, site selection, construction mechanism

Procedia PDF Downloads 489
9914 Anxiety Treatment: Comparing Outcomes by Different Types of Providers

Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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9913 Development of People's Participation in Environmental Development in Pathumthani Province

Authors: Sakapas Saengchai

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Study on the development of people's participation in environmental development was a qualitative research method. Data were collected by participant observation, in-depth interview and discussion group in Pathumthani province. The study indicated that 1) People should be aware of environmental information from government agencies. 2) People in the community should be able to brainstorm information, exchange information about community environment development. 3) People should have a role with community leaders. 4) People in the community should have a role to play in the implementation of projects and activities in the development of the environment and 5) citizens, community leaders, village committee have directed the development of the area. Maintaining a community environment with a shared decision. By emphasizing the process of participation, self-reliance, mutual help, and responsibility for one's own community. Community empowerment strengthens the sustainable spatial development of the environment.

Keywords: people, participation, community, environment

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9912 Factors Influencing Telehealth Services for Diabetes Care in Nepal: A Mixed Method Study

Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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9911 Ultrasound Mechanical Index as a Parameter Affecting of the Ability of Proliferation of Cells

Authors: Z. Hormozi Moghaddam, M. Mokhtari-Dizaji, M. Movahedin, M. E. Ravari

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Mechanical index (MI) is used for quantifying acoustic cavitation and the relationship between acoustic pressure and the frequency. In this study, modeling of the MI was applied to provide treatment protocol and to understand the effective physical processes on reproducibility of stem cells. The acoustic pressure and MI equations are modeled and solved to estimate optimal MI for 28, 40, 150 kHz and 1 MHz frequencies. Radial and axial acoustic pressure distribution was extracted. To validate the results of the modeling, the acoustic pressure in the water and near field depth was measured by a piston hydrophone. Results of modeling and experiments show that the model is consistent well to experimental results with 0.91 and 0.90 correlation of coefficient (p<0.05) for 1 MHz and 40 kHz. Low intensity ultrasound with 0.40 MI is more effective on the proliferation rate of the spermatogonial stem cells during the seven days of culture, in contrast, high MI has a harmful effect on the spermatogonial stem cells. This model provides proper treatment planning in vitro and in vivo by estimating the cavitation phenomenon.

Keywords: ultrasound, mechanical index, modeling, stem cell

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9910 A Green Optically Active Hydrogen and Oxygen Generation System Employing Terrestrial and Extra-Terrestrial Ultraviolet Solar Irradiance

Authors: H. Shahid

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Due to Ozone layer depletion on earth, the incoming ultraviolet (UV) radiation is recorded at its high index levels such as 25 in South Peru (13.5° S, 3360 m a.s.l.) Also, the planning of human inhabitation on Mars is under discussion where UV radiations are quite high. The exposure to UV is health hazardous and is avoided by UV filters. On the other hand, artificial UV sources are in use for water thermolysis to generate Hydrogen and Oxygen, which are later used as fuels. This paper presents the utility of employing UVA (315-400nm) and UVB (280-315nm) electromagnetic radiation from the solar spectrum to design and implement an optically active, Hydrogen and Oxygen generation system via thermolysis of desalinated seawater. The proposed system finds its utility on earth and can be deployed in the future on Mars (UVB). In this system, by using Fresnel lens arrays as an optical filter and via active tracking, the ultraviolet light from the sun is concentrated and then allowed to fall on two sub-systems of the proposed system. The first sub-system generates electrical energy by using UV based tandem photovoltaic cells such as GaAs/GaInP/GaInAs/GaInAsP and the second elevates temperature of water to lower the electric potential required to electrolyze the water. An empirical analysis is performed at 30 atm and an electrical potential is observed to be the main controlling factor for the rate of production of Hydrogen and Oxygen and hence the operating point (Q-Point) of the proposed system. The hydrogen production rate in the case of the commercial system in static mode (650ᵒC, 0.6V) is taken as a reference. The silicon oxide electrolyzer cell (SOEC) is used in the proposed (UV) system for the Hydrogen and Oxygen production. To achieve the same amount of Hydrogen as in the case of the reference system, with minimum chamber operating temperature of 850ᵒC in static mode, the corresponding required electrical potential is calculated as 0.3V. However, practically, the Hydrogen production rate is observed to be low in comparison to the reference system at 850ᵒC at 0.3V. However, it has been shown empirically that the Hydrogen production can be enhanced and by raising the electrical potential to 0.45V. It increases the production rate to the same level as is of the reference system. Therefore, 850ᵒC and 0.45V are assigned as the Q-point of the proposed system which is actively stabilized via proportional integral derivative controllers which adjust the axial position of the lens arrays for both subsystems. The functionality of the controllers is based on maintaining the chamber fixed at 850ᵒC (minimum operating temperature) and 0.45V; Q-Point to realize the same Hydrogen production rate as-is for the reference system.

Keywords: hydrogen, oxygen, thermolysis, ultraviolet

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9909 Mental Health Challenges, Internalizing and Externalizing Behavior Problems, and Academic Challenges among Adolescents from Broken Families

Authors: Fadzai Munyuki

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Parental divorce is one of youth's most stressful life events and is associated with long-lasting emotional and behavioral problems. Over the last few decades, research has consistently found strong associations between divorce and adverse health effects in adolescents. Parental divorce has been hypothesized to lead to psychosocial development problems, mental health challenges, internalizing and externalizing behavior problems, and low academic performance among adolescents. This is supported by the Positive youth development theory, which states that a family setup has a major role to play in adolescent development and well-being. So, the focus of this research will be to test this hypothesized process model among adolescents in five provinces in Zimbabwe. A cross-sectional study will be conducted to test this hypothesis, and 1840 (n = 1840) adolescents aged between 14 to 17 will be employed for this study. A Stress and Questionnaire scale, a Child behavior checklist scale, and an academic concept scale will be used for this study. Data analysis will be done using Structural Equations Modeling. This study has many limitations, including the lack of a 'real-time' study, a few cross-sectional studies, a lack of a thorough and validated population measure, and many studies that have been done that have focused on one variable in relation to parental divorce. Therefore, this study seeks to bridge this gap between past research and current literature by using a validated population measure, a real-time study, and combining three latent variables in this study.

Keywords: mental health, internalizing and externalizing behavior, divorce, academic achievements

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9908 Community Development and Preservation of Heritage in Igbo Area of Nigeria

Authors: Elochukwu A. Nwankwo, Matthias U. Agboeze

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Many heritage sites abound in the shores of Nigeria with enormous tourism potentials. Heritage sites do not only depict the cultural and historical transmutation of people but also functions in the image design and promotion of a locality. This reveals the unique role of heritage sites to structural development of an area. Heritage sites have of recent been a victim of degradation and social abuse arising from seasonal ignorance; hence minimizing its potentials to the socio-economic development of an area. This paper is emphasizing on the adoption of community development approaches in heritage preservation in Igbo area. Its modalities, applications, challenges and prospect were discussed. Such understanding will serve as a catalyst in aiding general restoration and preservation of heritage sites in Nigeria and other African states.

Keywords: heritage resources, community development, preservation, sustainable development, approaches

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9907 An Exploratory Research of Human Character Analysis Based on Smart Watch Data: Distinguish the Drinking State from Normal State

Authors: Lu Zhao, Yanrong Kang, Lili Guo, Yuan Long, Guidong Xing

Abstract:

Smart watches, as a handy device with rich functionality, has become one of the most popular wearable devices all over the world. Among the various function, the most basic is health monitoring. The monitoring data can be provided as an effective evidence or a clue for the detection of crime cases. For instance, the step counting data can help to determine whether the watch wearer was quiet or moving during the given time period. There is, however, still quite few research on the analysis of human character based on these data. The purpose of this research is to analyze the health monitoring data to distinguish the drinking state from normal state. The analysis result may play a role in cases involving drinking, such as drunk driving. The experiment mainly focused on finding the figures of smart watch health monitoring data that change with drinking and figuring up the change scope. The chosen subjects are mostly in their 20s, each of whom had been wearing the same smart watch for a week. Each subject drank for several times during the week, and noted down the begin and end time point of the drinking. The researcher, then, extracted and analyzed the health monitoring data from the watch. According to the descriptive statistics analysis, it can be found that the heart rate change when drinking. The average heart rate is about 10% higher than normal, the coefficient of variation is less than about 30% of the normal state. Though more research is needed to be carried out, this experiment and analysis provide a thought of the application of the data from smart watches.

Keywords: character analysis, descriptive statistics analysis, drink state, heart rate, smart watch

Procedia PDF Downloads 152
9906 Factors of Self-Sustainability in Social Entrepreneurship: Case Studies of ACT Group Čakovec and Friskis and Svettis Stockholm

Authors: Filip Majetić, Dražen Šimleša, Jelena Puđak, Anita Bušljeta Tonković, Svitlana Pinchuk

Abstract:

This paper focuses on the self-sustainability aspect of social entrepreneurship (SE). We define SE as a form of entrepreneurship that is social/ecological mission oriented. It means SE organizations start and run businesses and use them to accomplish their social/ecological missions i.e. to solve social/ecological problems or fulfill social/ecological needs. Self-sustainability is defined as the capability of an SE organization to operate by relying on the money earned through trading its products in the free market. For various reasons, the achievement of self-sustainability represents a fundamental (business) challenge for many SE organizations. Those that are not able to operate using the money made through commercial activities, in order to remain active, rely on alternative, non-commercial streams of income such as grants, donations, and public subsidies. Starting from this widespread (business) challenge, we are interested in exploring elements that (could) influence the self-sustainability in SE organizations. Therefore, the research goal is to empirically investigate some of the self-sustainability factors of two notable SE organizations from different socio-economic contexts. A qualitative research, using the multiple case study approach, was conducted. ACT Group Čakovec (ACT) from Croatia was selected for the first case because it represents one of the leading and most self-sustainable SE organization in the region (in 2015 55% of the organization’s budget came from commercial activities); Friskis&Svettis Stockholm (F&S) from Sweden was selected for the second case because it is a rare example of completely self-sustainable SE organization in Europe (100% of the organization’s budget comes from commercial activities). The data collection primarily consists of conducting in-depth interviews. Additionally, the content of some of the organizations' official materials are analyzed (e.g. business reports, marketing materials). The interviewees are selected purposively and include: six highly ranked F&S members who represent five different levels in the hierarchy of their organization; five highly ranked ACT members who represent three different levels in the hierarchy of the organization. All of the interviews contain five themes: a) social values of the organization, b) organization of work, c) non-commercial income sources, d) marketing/collaborations, and e) familiarity with the industry characteristics and trends. The gathered data is thematically analyzed through the coding process for which Atlas.ti software for qualitative data analysis is used. For the purpose of creating thematic categories (codes), the open coding is used. The research results intend to provide new theoretical insights on factors of SE self-sustainability and, preferably, encourage practical improvements in the field.

Keywords: Friskis&Svettis, self-sustainability factors, social entrepreneurship, Stockholm

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9905 The Effect of Applying the Electronic Supply System on the Performance of the Supply Chain in Health Organizations

Authors: Sameh S. Namnqani, Yaqoob Y. Abobakar, Ahmed M. Alsewehri, Khaled M. AlQethami

Abstract:

The main objective of this research is to know the impact of the application of the electronic supply system on the performance of the supply department of health organizations. To reach this goal, the study adopted independent variables to measure the dependent variable (performance of the supply department), namely: integration with suppliers, integration with intermediaries and distributors and knowledge of supply size, inventory, and demand. The study used the descriptive method and was aided by the questionnaire tool that was distributed to a sample of workers in the Supply Chain Management Department of King Abdullah Medical City. After the statistical analysis, the results showed that: The 70 sample members strongly agree with the (electronic integration with suppliers) axis with a p-value of 0.001, especially with regard to the following: Opening formal and informal communication channels between management and suppliers (Mean 4.59) and exchanging information with suppliers with transparency and clarity (Mean 4.50). It also clarified that the sample members agree on the axis of (electronic integration with brokers and distributors) with a p-value of 0.001 and this is represented in the following elements: Exchange of information between management, brokers and distributors with transparency, clarity (Mean 4.18) , and finding a close cooperation relationship between management, brokers and distributors (Mean 4.13). The results also indicated that the respondents agreed to some extent on the axis (knowledge of the size of supply, stock, and demand) with a p-value of 0.001. It also indicated that the respondents strongly agree with the existence of a relationship between electronic procurement and (the performance of the procurement department in health organizations) with a p-value of 0.001, which is represented in the following: transparency and clarity in dealing with suppliers and intermediaries to prevent fraud and manipulation (Mean 4.50) and reduce the costs of supplying the needs of the health organization (Mean 4.50). From the results, the study recommended several recommendations, the most important of which are: that health organizations work to increase the level of information sharing between them and suppliers in order to achieve the implementation of electronic procurement in the supply management of health organizations. Attention to using electronic data interchange methods and using modern programs that make supply management able to exchange information with brokers and distributors to find out the volume of supply, inventory, and demand. To know the volume of supply, inventory, and demand, it recommended the application of scientific methods of supply for storage. Take advantage of information technology, for example, electronic data exchange techniques and documents, where it can help in contact with suppliers, brokers, and distributors, and know the volume of supply, inventory, and demand, which contributes to improving the performance of the supply department in health organizations.

Keywords: healthcare supply chain, performance, electronic system, ERP

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9904 Geotechnical Evaluation and Sizing of the Reinforcement Layer on Soft Soil in the Construction of the North Triage Road Clover, in Brasilia Federal District, Brazil

Authors: Rideci Farias, Haroldo Paranhos, Joyce Silva, Elson Almeida, Hellen Silva, Lucas Silva

Abstract:

The constant growth of the fleet of vehicles in the big cities, makes that the Engineering is dynamic, with respect to the new solutions for traffic flow in general. In the Federal District (DF), Brazil, it is no different. The city of Brasilia, Capital of Brazil, and Cultural Heritage of Humanity by UNESCO, is projected to 500 thousand inhabitants, and today circulates more than 3 million people in the city, and with a fleet of more than one vehicle for every two inhabitants. The growth of the city to the North region, made that the urban planning presented solutions for the fleet in constant growth. In this context, a complex of viaducts, road accesses, creation of new rolling roads and duplication of the Bragueto bridge over Paranoa lake in the northern part of the city was designed, giving access to the BR-020 highway, denominated Clover of North Triage (TTN). In the geopedological context, the region is composed of hydromorphic soils, with the presence of the water level at some times of the year. From the geotechnical point of view, are soils with SPT < 4 and Resistance not drained, Su < 50 kPa. According to urban planning in Brasília, special art works can not rise in the urban landscape, contrasting with the urban characteristics of the architects Lúcio Costa and Oscar Niemeyer. Architects hired to design the new Capital of Brazil. The urban criterion then created the technical impasse, resulting in the technical need to ‘bury’ the works of art and in turn the access greenhouses at different levels, in regions of low support soil and water level Outcrossing, generally inducing the need for this study and design. For the adoption of the appropriate solution, Standard Penetration Test (SPT), Vane Test, Diagnostic peritoneal lavage (DPL) and auger boring campaigns were carried out. With the comparison of the results of these tests, the profiles of resistance of the soils and water levels were created in the studied sections. Geometric factors such as existing sidewalks and lack of elevation for the discharge of deep drainage water have inhibited traditional techniques for total removal of soft soils, thus avoiding the use of temporary drawdown and shoring of excavations. Thus, a structural layer was designed to reinforce the subgrade by means of the ‘needling’ of the soft soil, without the need for longitudinal drains. In this context, the article presents the geological and geotechnical studies carried out, but also the dimensioning of the reinforcement layer on the soft soil with a view to the main objective of this solution that is to allow the execution of the civil works without the interference in the roads in use, Execution of services in rainy periods, presentation of solution compatible with drainage characteristics and soft soil reinforcement.

Keywords: layer, reinforcement, soft soil, clover of north triage

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9903 The Effects of Covid-19 on Oral Health among 19 to 29 Years Old - A Cross-sectional Study in Albania

Authors: Mimoza Canga, Alketa Qafmolla, Vergjini Mulo, Irene Malagnino

Abstract:

Aim: Assessment of oral health in young people aged 18-29 years after the Covid-19 pandemic in Albania. Materials and methods: The present study was conducted at the University of Medicine in Tirana, Albania, from March 2023 to September 2023. This is s cross-sectional study. In our research, 104 students participated, of which 64 were females (61.5%) and 40 were males (38.5%). In the present survey, the participants were divided into four age groups: 18-20, 21-23, 24-26, and 27-29 years old. Majority of the sample (69%) were 18-20 years. Participants were instructed to complete the questionnaire. The study had no dropouts. The current study was conducted in accordance to Helsinki declaration. Statistical analysis was performed using IBM SPSS Statistics Version 23.0, Microsoft Windows Linux, Chicago, IL, USA. Data were analyzed using analysis of variance (ANOVA). P ≤ 0.05 was considered statistically significant. Results: This study reported that 80 (76.9%) of the participants had passed Covid-19, while 24 (23.1%) of them had not passed Covid-19. Based on our data analysis, 70 (67.3%) of the participants had symptoms such as of fever 38°C- 40.5°C and headache. They stated that were treated with Azithromycin 500 mg tablets, Augmentin 625 mg tablets, Vitamin C 1000 mg, Magnesium, and Vitamin D. 40(38.4%) of the participants noticed hypersensitivity in gums (p = 0.004) and sensitive teeth (p = 0.001) after having passed Covid-19 compared to pre-pandemic. Nearly 40 (38.4%) of the participants who passed Covid-19 were treated with painful relievers for the gums and teeth, such as ibuprofen (Advil), used Sensodyne Toothpaste for sensitive teeth and Clove oil. Conclusion: Within the limitations of this study conducted in Albania, can concluded that Covid-19 has a direct impact on oral health.

Keywords: albania, Covid19, cross-sectional study, oral health

Procedia PDF Downloads 66
9902 PV Module as a Design Element of Barriers for Protection against Noise

Authors: Budimir S. Sudimac, Andjela N. Dubljevic

Abstract:

The aim of thisresearch paper is to consider possibilities for improving the street lighting on the E75 highway, which passes through Serbia, using renewable sources of energy. In this paper, we analyzed the possibilities for installing sound barriers along the highway and integrating photovoltaic (PV) modules, which would generate electrical energy to power the lighting on the section of the highway running through Belgrade. The main aim of this paper is to analyze, show and promote innovative, hybrid, multi-functional solar technology using PV modules as an element of sound barriers in urban areas. The paper seeks to show the hybridity of using sustainable technologies in solving environmental issues. This structure solves the problem of noise in populated areas and provides the electricity from renewable source.

Keywords: noise, PV modules, solar energy, sound barriers

Procedia PDF Downloads 456
9901 Interrelationship of Socio-Demographic Factors, Health Belief Dimensions and Compliance to Measles Vaccination among Filipino Mothers

Authors: Beryl Rene R. Lopez, Lesley Anne M. Lipat, Rhogene Barbette C. Lirio, Laurice Joy H. Llanes, Karl Philippe M. Llapitan, Einstein James R. Lopez, Socorro S. GuanHing

Abstract:

Background: Measles remain as one of the most common childhood diseases despite the availability of the vaccine that is safe and cost-effective. Because of morbidity and mortality associated with the recent measles outbreak in the Philippines, there is an increasing concern from the health care professionals. Objective: The purpose of this study is to determine the relationship between the compliance of Filipino mothers to measles vaccination and their health beliefs when grouped according to the given socio-demographic factors using a researcher-made questionnaire. Research Methodology: This research utilized the descriptive-correlational research design. With the use of purposive sampling technique, the study involved 200 Filipino mothers aged 18 years old and above excluding those who are healthcare professionals with children aged 2-3 years old with either urban or rural as their settlements. Pre-testing was done prior to the actual data gathering. A questionnaire composed of 26 items involving socio-demographic, compliance, and health beliefs was distributed to the sample population. Statistical analysis was done with the use of Exploratory Factor Analysis (EFA) for the first research question and Structural Equation Model (SEM) for the second research question. Results: Four dimensions were generated with the use of EFA namely: Vulnerability-Oriented Beliefs (VOB), Knowledge-Oriented Beliefs (KOB), Accessibility-Oriented Beliefs (AOB), and Outcomes-Oriented Beliefs (OOB). These were then correlated with the mothers’ socio-demographic factors (age, educational attainment, the area of residence, the number of children, and family income) and their compliance to the measles vaccination schedule. Results showed significant and direct relationships between area of residence and compliance, family income and compliance, KOB and compliance, education and KOB, KOB and VOB, KOB and OOB, AOB and KOB, AOB and OOB, AOB and VOB, and lastly, OOB and VOB. Conclusion: The Knowledge – Oriented Belief dimension greatly influence compliance to measles vaccination. Other determinants of compliance like the area of residence, educational attainment, and family income significantly increase the Filipino mothers’ likelihood of compliance to measles vaccination, which have implications to health education.

Keywords: socio-demographic, health beliefs, compliance, measles vaccination

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9900 Heavy Metal Pollution of the Soils around the Mining Area near Shamlugh Town (Armenia) and Related Risks to the Environment

Authors: G. A. Gevorgyan, K. A. Ghazaryan, T. H. Derdzyan

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The heavy metal pollution of the soils around the mining area near Shamlugh town and related risks to human health were assessed. The investigations showed that the soils were polluted with heavy metals that can be ranked by anthropogenic pollution degree as follows: Cu>Pb>As>Co>Ni>Zn. The main sources of the anthropogenic metal pollution of the soils were the copper mining area near Shamlugh town, the Chochkan tailings storage facility and the trucks transferring are from the mining area. Copper pollution degree in some observation sites was unallowable for agricultural production. The total non-carcinogenic chronic hazard index (THI) values in some places, including observation sites in Shamlugh town, were above the safe level (THI<1) for children living in this territory. Although the highest heavy metal enrichment degree in the soils was registered in case of copper, the highest health risks to humans especially children were posed by cobalt which is explained by the fact that heavy metals have different toxicity levels and penetration characteristics.

Keywords: Armenia, copper mine, heavy metal pollution of soil, health risks

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9899 Inhibitions in Implementing Green Supply Chain Management at Hospitals

Authors: M. Aruna, Uma Gunasilan

Abstract:

Hospitals play an ample role in securing the health of a country. Nevertheless, they also have an unhealthy side. Ecological issues strengthen ill-health throughout the domain which subsequently puts pressure on hospital supply chains. Medical waste indeed is hazardous for environment and subsequently for human. The hospital waste management is of immense prominence due to its infectious and hazardous nature that can source many effects on human health and the environment. Government regulations and public cognizance regarding hospital waste issues have imposed hospital units to admit these strategies. The innovative technologies and instruments have been developed to handle hospital wastes. Green supply chain management practices are common in the United States. In India, Green Supply Chain management (GSCM) has just started to be recognized and practiced. GSCM are green, integrated and ecologically optimized. In Green supply chain management environmental sustainability is found to be an important driver. Eleven barriers are identified in this work. Interpretive Structural Modeling (ISM) technique is used for ranking the obstructions.

Keywords: green supply chain management (GSCM), hospital waste management (HWM), interpretive structural modeling (ISM), medical waste (MW)

Procedia PDF Downloads 303
9898 Predicting Growth of Eucalyptus Marginata in a Mediterranean Climate Using an Individual-Based Modelling Approach

Authors: S.K. Bhandari, E. Veneklaas, L. McCaw, R. Mazanec, K. Whitford, M. Renton

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Eucalyptus marginata, E. diversicolor and Corymbia calophylla form widespread forests in south-west Western Australia (SWWA). These forests have economic and ecological importance, and therefore, tree growth and sustainable management are of high priority. This paper aimed to analyse and model the growth of these species at both stand and individual levels, but this presentation will focus on predicting the growth of E. Marginata at the individual tree level. More specifically, the study wanted to investigate how well individual E. marginata tree growth could be predicted by considering the diameter and height of the tree at the start of the growth period, and whether this prediction could be improved by also accounting for the competition from neighbouring trees in different ways. The study also wanted to investigate how many neighbouring trees or what neighbourhood distance needed to be considered when accounting for competition. To achieve this aim, the Pearson correlation coefficient was examined among competition indices (CIs), between CIs and dbh growth, and selected the competition index that can best predict the diameter growth of individual trees of E. marginata forest managed under different thinning regimes at Inglehope in SWWA. Furthermore, individual tree growth models were developed using simple linear regression, multiple linear regression, and linear mixed effect modelling approaches. Individual tree growth models were developed for thinned and unthinned stand separately. The developed models were validated using two approaches. In the first approach, models were validated using a subset of data that was not used in model fitting. In the second approach, the model of the one growth period was validated with the data of another growth period. Tree size (diameter and height) was a significant predictor of growth. This prediction was improved when the competition was included in the model. The fit statistic (coefficient of determination) of the model ranged from 0.31 to 0.68. The model with spatial competition indices validated as being more accurate than with non-spatial indices. The model prediction can be optimized if 10 to 15 competitors (by number) or competitors within ~10 m (by distance) from the base of the subject tree are included in the model, which can reduce the time and cost of collecting the information about the competitors. As competition from neighbours was a significant predictor with a negative effect on growth, it is recommended including neighbourhood competition when predicting growth and considering thinning treatments to minimize the effect of competition on growth. These model approaches are likely to be useful tools for the conservations and sustainable management of forests of E. marginata in SWWA. As a next step in optimizing the number and distance of competitors, further studies in larger size plots and with a larger number of plots than those used in the present study are recommended.

Keywords: competition, growth, model, thinning

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9897 Ambulatory Care Utilization of Individuals with Cerebral Palsy in Taiwan- A Country with Universal Coverage and No Gatekeeper Regulation

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

Abstract:

Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

Procedia PDF Downloads 363