Search results for: public health management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 19934

Search results for: public health management

14594 Full Disclosure Policy: Transparency in Fiscal Administration

Authors: Joyly Jill Apud

Abstract:

Corruption is an all-encompassing issue worldwide. Many attempts have been done to address such cases especially by the government through increasing transparency. The Philippine government increased the mechanism of transparency by opening to public its financial transactions through Full Disclosure Policy – mandating all local governments to post in their websites all financial transactions (Philippine Public Transparency Reporting Project, 2011). For transparency to be fully realized, the challenge lies in creating a mechanism where the constituents are encouraged to engage as social auditors. In line of the said challenge, the study focused in Davao City, Philippines measuring the respondent’s awareness, access and utilization of Full Disclosure Policy (FDP). Particularly, this study determined the significant difference on the awareness, access and utilization of respondents when grouped according to sector and the significant relationship between respondents’ awareness and in the access and utilization of FDP reports. The study used descriptive-correlation, Mean, Anova and Pearson R as statistical treatment. The 120 respondents are from the different sectors of Davao City. These are the Academe, Youth, LGUs, NGOs, Business, and Church groups. The awareness of the respondents was measured in three main categories: Existence of the Policy, Content of the Policy and the Manner of Publication. Access and Utilization of the FDP reports is divided into three: Budget Reports, Procurement Reports and Special Purpose Fund Reports. Results showed that the respondents are moderately aware of the Policy. Though it manifested that the respondents are aware of the disclosure, they are unaware of the Full Disclosure Policy and Full Disclosure Policy Portal. Moreover, the respondents seldom access and utilize all the FDP reports. Further results revealed that there is a significant difference in the awareness and the access and utilization of FDP when grouped according to sector. Moreover, significant relationship in the awareness and the access and utilization of the FDP is evident. It showed that the higher the awareness on FDP, the higher the level of access and utilization on the FDP reports.

Keywords: corruption, e-governance, budget transparency, participation

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14593 Spatial Temporal Change of COVID-19 Vaccination Condition in the US: An Exploration Based on Space Time Cube

Authors: Yue Hao

Abstract:

COVID-19 vaccines not only protect individuals but society as a whole. In this case, having an understanding of the change and trend of vaccination conditions may shed some light on revising and making up-to-date policies regarding large-scale public health promotions and calls in order to lead and encourage the adoption of COVID-19 vaccines. However, vaccination status change over time and vary from place to place hidden patterns that were not fully explored in previous research. In our research, we took advantage of the spatial-temporal analytical methods in the domain of geographic information science and captured the spatial-temporal changes regarding COVID-19 vaccination status in the United States during 2020 and 2021. After conducting the emerging hot spots analysis on both the state level data of the US and county level data of California we found that: (1) at the macroscopic level, there is a continuously increasing trend of the vaccination rate in the US, but there is a variance on the spatial clusters at county level; (2) spatial hotspots and clusters with high vaccination amount over time were clustered around the west and east coast in regions like California and New York City where are densely populated with considerable economy conditions; (3) in terms of the growing trend of the daily vaccination among, Los Angeles County alone has very high statistics and dramatic increases over time. We hope that our findings can be valuable guidance for supporting future decision-making regarding vaccination policies as well as directing new research on relevant topics.

Keywords: COVID-19 vaccine, GIS, space time cube, spatial-temporal analysis

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14592 Barriers of the Development and Implementation of Health Information Systems in Iran

Authors: Abbas Sheikhtaheri, Nasim Hashemi

Abstract:

Health information systems have great benefits for clinical and managerial processes of health care organizations. However, identifying and removing constraints and barriers of implementing and using health information systems before any implementation is essential. Physicians are one of the main users of health information systems, therefore, identifying the causes of their resistance and concerns about the barriers of the implementation of these systems is very important. So the purpose of this study was to determine the barriers of the development and implementation of health information systems in terms of the Iranian physicians’ perspectives. In this study conducted in 8 selected hospitals affiliated to Tehran and Iran Universities of Medical Sciences, Tehran, Iran in 2014, physicians (GPs, residents, interns, specialists) in these hospitals were surveyed. In order to collect data, a research made questionnaire was used (Cronbach’s α = 0.95). The instrument included 25 about organizational (9), personal (4), moral and legal (3) and technical barriers (9). Participants were asked to answer the questions using 5 point scale Likert (completely disagree=1 to completely agree=5). By using a simple random sampling method, 200 physicians (from 600) were invited to study that eventually 163 questionnaires were returned. We used mean score and t-test and ANOVA to analyze the data using SPSS software version 17. 52.1% of respondents were female. The mean age was 30.18 ± 7.29. The work experience years for most of them were between 1 to 5 years (80.4 percent). The most important barriers were organizational ones (3.4 ± 0.89), followed by ethical (3.18 ± 0.98), technical (3.06 ± 0.8) and personal (3.04 ± 1.2). Lack of easy access to a fast Internet (3.67±1.91) and the lack of exchanging information (3.61±1.2) were the most important technical barriers. Among organizational barriers, the lack of efficient planning for the development and implementation systems (3.56±1.32) and was the most important ones. Lack of awareness and knowledge of health care providers about the health information systems features (3.33±1.28) and the lack of physician participation in planning phase (3.27±1.2) as well as concerns regarding the security and confidentiality of health information (3.15 ± 1.31) were the most important personal and ethical barriers, respectively. Women (P = 0.02) and those with less experience (P = 0.002) were more concerned about personal barriers. GPs also were more concerned about technical barriers (P = 0.02). According to the study, technical and ethics barriers were considered as the most important barriers however, lack of awareness in target population is also considered as one of the main barriers. Ignoring issues such as personal and ethical barriers, even if the necessary infrastructure and technical requirements were provided, may result in failure. Therefore, along with the creating infrastructure and resolving organizational barriers, special attention to education and awareness of physicians and providing solution for ethics concerns are necessary.

Keywords: barriers, development health information systems, implementation, physicians

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14591 Biogas Production from Lake Bottom Biomass from Forest Management Areas

Authors: Dessie Tegegne Tibebu, Kirsi Mononen, Ari Pappinen

Abstract:

In areas with forest management, agricultural, and industrial activity, sediments and biomass are accumulated in lakes through drainage system, which might be a cause for biodiversity loss and health problems. One possible solution can be utilization of lake bottom biomass and sediments for biogas production. The main objective of this study was to investigate the potentials of lake bottom materials for production of biogas by anaerobic digestion and to study the effect of pretreatment methods for feed materials on biogas yield. In order to study the potentials of biogas production lake bottom materials were collected from two sites, Likokanta and Kutunjärvi lake. Lake bottom materials were mixed with straw-horse manure to produce biogas in a laboratory scale reactor. The results indicated that highest yields of biogas values were observed when feeds were composed of 50% lake bottom materials with 50% straw horse manure mixture-while with above 50% lake bottom materials in the feed biogas production decreased. CH4 content from Likokanta lake materials with straw-horse manure and Kutunjärvi lake materials with straw-horse manure were similar values when feed consisted of 50% lake bottom materials with 50% straw horse manure mixtures. However, feeds with lake bottom materials above 50%, the CH4 concentration started to decrease, impairing gas process. Pretreatment applied on Kutunjärvi lake materials showed a slight negative effect on the biogas production and lowest CH4 concentration throughout the experiment. The average CH4 production (ml g-1 VS) from pretreated Kutunjärvi lake materials with straw horse manure (208.9 ml g-1 VS) and untreated Kutunjärvi lake materials with straw horse manure (182.2 ml g-1 VS) were markedly higher than from Likokanta lake materials with straw horse manure (157.8 ml g-1 VS). According to the experimental results, utilization of 100% lake bottom materials for biogas production is likely to be impaired negatively. In the future, further analyses to improve the biogas yields, assessment of costs and benefits is needed before utilizing lake bottom materials for the production of biogas.

Keywords: anaerobic digestion, biogas, lake bottom materials, sediments, pretreatment

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14590 The Relationship between Job Stress and Handover Effectiveness of Nurses

Authors: Rujnan Tuna, Ayse Cil Akinci

Abstract:

Work life takes up an important place in human life, and an employed person faces many stimuli from internal and external environments and is affected by them in a positive or negative way. Also, the handover process, which is the process of sharing information about the patient with other health professionals, is an important criterion to maintain patient care and enhance the quality of care provided. Handover is a key component for sustaining daily basic clinical practices and is also essential to maintain the safe patient care. This investigation followed a descriptive and correlation design in order to establish job stress and the handover efficiency of nurses and the relationship in between. The study was conducted with 192 nurses working in a public hospital in Istanbul between January and March 2017. Descriptive information form, Job Stressors Scale, and Handover Evaluation Scale were used to collect the data of the study. The data were analyzed by using IBM SPSS Statistics 22.0 statistical software. Approvals from participants, managers of institution, and ethics committee were taken for the study. As a result of the research, it was found that job stress was above the median value, and the highest score in the ‘work role conflict’ subdimension. Also, it was found that the effectiveness of the nurses' handover effectiviness was above the median value and the highest score in the ‘quality of information’ subdimension. In the study, there was a negatively weak correlation between ‘work role overload’ subdimension of Job Stressors Scale and ‘interaction and support’ subdimension of Handover Evaluation Scale. There is a need for further study in order to maintain patient safety.

Keywords: handover, job stress, nurse, patient

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14589 Collective Bargaining Agreement with Its Related Factors and Employees’ Perceived Productivity: The Case of an Academic Institution in Davao City, Philippines

Authors: Amylyn F. Labasano, M. S. Econ

Abstract:

The study predicts the impact of collective bargaining agreement and its related factors on employees’ perceived productivity in terms of union-management relation’s climate, income, fringe benefits, and job satisfaction of the employees. It also determines whether there are significant differences in the employees’ perceived productivity based on the demographic characteristics of the respondents. The results revealed that the relationship climate which exists between the union and the management is found to have significant adverse effect on the average unpaid hours spent by employees working within the college. On the other hand, the total monthly wage earnings of employees have negative effect on the average hours an employee spent in bringing his work home while job satisfaction positively influences the overall productivity level of employees. The result further shows significant differences in the productivity level of employees across civil status and current designation.

Keywords: perceived productivity, collective bargaining agreement, union, union-management relations climate, income, fringe benefits, job satisfaction

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14588 Facility Layout Improvement: Based on Safety and Health at Work and Standards of Food Production Facility

Authors: Asifa Fitriani, Galih Prakoso

Abstract:

This study aims to improve the design layout of a Micro, Small and Medium Enterprises (SMEs) to minimize material handling and redesigning the layout of production facilities based on the safety and health and standards of food production facilities. Problems layout in the one of chip making industry mushrooms in Indonesia is cross movement between work stations, work accidents, and the standard of facilities that do not conform with the standards of the food industry. Improvement layout design using CORELAP and 5S method to give recommendation and implementation of occupational health and safety standards of food production facilities. From the analysis, improved layout using CORELAP provide a smaller displacement distance is 155.84 meters from the initial displacement distance of 335.9 meters, and providing a shorter processing time than the original 112.726 seconds to 102.831 seconds. 5S method also has recommended the completion of occupational health and safety issues as well as the standard means of food production by changing the working environment better.

Keywords: Layout Design, Corelap, 5S

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14587 Prevalence of Over-Schooling Preschoolers as Perceived by Teachers in Kwara Central, Nigeria

Authors: Rachael Ojima Agarry, Raheemat Opeyemi Omosidi

Abstract:

Over-schooling children is an abuse of the fundamental provisions of the National Policy on Education in Nigeria. The practice overburdens or places unwarranted academic demands on children, particularly preschoolers. This study was carried out to ascertain the prevalence of over-schooling preschoolers as perceived by teachers in the Kwara Central Senatorial District. One research question and two null hypotheses were formulated to guide the study. A descriptive survey design was employed. The population of the study consists of all preschool teachers in both private and public schools in Kwara Central. A validated instrument tagged “Questionnaire on Prevalence of Over-schooling of Preschoolers (QPOP)” with a reliability index of 0.76 was used for data collection. The questionnaire consists of sections A and B. Section A solicited the respondents’ demographic information, and Section B sought the prevalence of over-schooling as perceived by teachers. Data collected were analyzed using descriptive statistics of frequency and percentage. Mean and standard deviation were used to analyze the demographic information and the research question. The two research hypotheses were analyzed using a t-test and Analysis of Variance (ANCOVA) at a 0.05 level of significance. The results revealed that there is a high level of prevalence of over-schooling of preschoolers in Kwara Central. Also, there is a significant difference in teachers' perception of the prevalence of over-schooling preschoolers based on school type and school location. It was concluded that both private and public schools in Kwara Central practice over-schooling of preschoolers at a high level. Hence, it was recommended that the government, through the State and/or Federal Ministry of Education, should enact and enforce a law that would ensure children in this category spend only the stipulated time in school as well as strict adherence to the recommended curriculum contents by proprietors and teachers.

Keywords: over-schooling, preschoolers, school type, school location

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14586 An Integrated Approach to Cultural Heritage Management in the Indian Context

Authors: T. Lakshmi Priya

Abstract:

With the widening definition of heritage, the challenges of heritage management has become more complex . Today heritage not only includes significant monuments but comprises historic areas / sites, historic cities, cultural landscapes, and living heritage sites. There is a need for a comprehensive understanding of the values associated with these heritage resources, which will enable their protection and management. These diverse cultural resources are managed by multiple agencies having their own way of operating in the heritage sites. An Integrated approach to management of these cultural resources ensures its sustainability for the future generation. This paper outlines the importance of an integrated approach for the management and protection of complex heritage sites in India by examining four case studies. The methodology for this study is based on secondary research and primary surveys conducted during the preparation of the conservation management plansfor the various sites. The primary survey included basic documentation, inventorying, and community surveys. Red Fort located in the city of Delhi is one of the most significant forts built in 1639 by the Mughal Emperor Shahjahan. This fort is a national icon and stands testimony to the various historical events . It is on the ramparts of Red Fort that the national flag was unfurled on 15th August 1947, when India became independent, which continues even today. Management of this complex fort necessitated the need for an integrated approach, where in the needs of the official and non official stakeholders were addressed. The understanding of the inherent values and significance of this site was arrived through a systematic methodology of inventorying and mapping of information. Hampi, located in southern part of India, is a living heritage site inscribed in the World Heritage list in 1986. The site comprises of settlements, built heritage structures, traditional water systems, forest, agricultural fields and the remains of the metropolis of the 16th century Vijayanagar empire. As Hampi is a living heritage site having traditional systems of management and practices, the aim has been to include these practices in the current management so that there is continuity in belief, thought and practice. The existing national, regional and local planning instruments have been examined and the local concerns have been addressed.A comprehensive understanding of the site, achieved through an integrated model, is being translated to an action plan which safeguards the inherent values of the site. This paper also examines the case of the 20th century heritage building of National Archives of India, Delhi and protection of a 12th century Tomb of Sultan Ghari located in south Delhi. A comprehensive understanding of the site, lead to the delineation of the Archaeological Park of Sultan Ghari, in the current Master Plan for Delhi, for the protection of the tomb and the settlement around it. Through this study it is concluded that the approach of Integrated Conservation has enabled decision making that sustains the values of these complex heritage sites in Indian context.

Keywords: conservation, integrated, management, approach

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14585 A Cost Effective Approach to Develop Mid-Size Enterprise Software Adopted the Waterfall Model

Authors: Mohammad Nehal Hasnine, Md Kamrul Hasan Chayon, Md Mobasswer Rahman

Abstract:

Organizational tendencies towards computer-based information processing have been observed noticeably in the third-world countries. Many enterprises are taking major initiatives towards computerized working environment because of massive benefits of computer-based information processing. However, designing and developing information resource management software for small and mid-size enterprises under budget costs and strict deadline is always challenging for software engineers. Therefore, we introduced an approach to design mid-size enterprise software by using the Waterfall model, which is one of the SDLC (Software Development Life Cycles), in a cost effective way. To fulfill research objectives, in this study, we developed mid-sized enterprise software named “BSK Management System” that assists enterprise software clients with information resource management and perform complex organizational tasks. Waterfall model phases have been applied to ensure that all functions, user requirements, strategic goals, and objectives are met. In addition, Rich Picture, Structured English, and Data Dictionary have been implemented and investigated properly in engineering manner. Furthermore, an assessment survey with 20 participants has been conducted to investigate the usability and performance of the proposed software. The survey results indicated that our system featured simple interfaces, easy operation and maintenance, quick processing, and reliable and accurate transactions.

Keywords: end-user application development, enterprise software design, information resource management, usability

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14584 Work Life Balance Strategies and Retention of Medical Professionals

Authors: Naseem M. Twaissi

Abstract:

Medical professionals play an important role in society, and in general, they care more about their patients than about their personal well-being. They need to take a professional approach to maintain a work-life balance. Through a collection of primary data from 1020 medical professionals and the application of relevant statistical tools, this paper explores the pressures on medical professionals with reference to their work-life balance. This study highlights how hospital management, in addition to economic reasons, needs to identify variables to enhance the work-life balance of medical professionals so that quality healthcare facilities may be provided to the citizens of Jordan. Results indicate that formulation and implementation of policies for enhancing work-life balance together with career and retention plans for medical professionals would enhance the performance of hospitals and the quality of health care in Jordan, leading to greater societal well-being.

Keywords: work life balance, job environment, job satisfaction, employee well-being, stress, hospital industry

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14583 Water Resources and Sanitation in Public Schools of Datu Odin Sinsuat, Maguindanao

Authors: Lahaina U. Dilangalen

Abstract:

Using descriptive-experimental research methods, this study aimed to identify the main resources of water, assessed the water quality, sanitation and hygiene practices, and extent of implementation. Complete enumeration was done in 28 elementary public schools of Datu Odin Sinsuat Municipality. Questionnaires were given to the school advisers. Water samples were obtained from the same schools and were submitted to the Department of Science and Technology (DOST) Region XII for microbial analysis, specifically the presence of fecal coliform bacteria. Four water resources such as hand pump, faucet, deep well and spring were found being used in the 28 schools. Of water resources, the only treated was from the faucet. Most of the schools used the water for drinking and washing. Two schools strongly agreed, nine schools agreed and seventeen schools disagreed that they implemented DepEd Order no.56 s. 2009. In addition, two schools strongly agreed and twenty six agreed that they implemented DepEd Order No. 65 s. 2009. Five schools had water supply that were safe to drink while sixteen schools had water supply that were not safe to drink due to high fecal coliform count and did not undergo chemical treatment. The only safe for drinking were water resources that came from faucet because they were chemically treated. Seven out of 28 schools did not have water supply due to their location in mountainous areas. More than half of the schools did not comply with the DepEd Order No. 56 s. 2009 due to the lack of funds and support from the PTA and LGU. It is recommended that the Department of Education must have an urgent assessment of implementing both DepEd Orders No.56 and 65, to assure that the schoolchildren be protected from water and sanitation related ailments. Also, all water resources that are not treated must be used for washing only. Ideally, all the water resources must be treated to assure the safety of all school constituents. Moreover, the school administrators and teachers in the municipality must be provided copies of the results of this study for reference in implementing the said programs.

Keywords: assessment, drinking water, fecal coliform, groundwater

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14582 Developing Urban Design and Planning Approach to Enhance the Efficiency of Infrastructure and Public Transportation in Order to Reduce GHG Emissions

Authors: A. Rostampouryasouri, A. Maghoul, S. Tahersima

Abstract:

The rapid growth of urbanization and the subsequent increase in population in cities have resulted in the destruction of the environment to cater to the needs of citizens. The industrialization of urban life has led to the production of pollutants, which has significantly contributed to the rise of air pollution. Infrastructure can have both positive and negative effects on air pollution. The effects of infrastructure on air pollution are complex and depend on various factors such as the type of infrastructure, location, and context. This study examines the effects of infrastructure on air pollution, drawing on a range of empirical evidence from Iran and China. Our paper focus for analyzing the data is on the following concepts: 1. Urban design and planning principles and practices 2. Infrastructure efficiency and optimization strategies 3. Public transportation systems and their environmental impact 4. GHG emissions reduction strategies in urban areas 5. Case studies and best practices in sustainable urban development This paper employs a mixed methodology approach with a focus on developmental and applicative purposes. The mixed methods approach combines both quantitative and qualitative research methods to provide a more comprehensive understanding of the research topic. A group of 20 architectural specialists and experts who are proficient in the field of research, design, and implementation of green architecture projects were interviewed in a systematic and purposeful manner. The research method was based on content analysis using MAXQDA2020 software. The findings suggest that policymakers and urban planners should consider the potential impacts of infrastructure on air pollution and take measures to mitigate negative effects while maximizing positive ones. This includes adopting a nature-based approach to urban planning and infrastructure development, investing in information infrastructure, and promoting modern logistic transport infrastructure.

Keywords: GHG emissions, infrastructure efficiency, urban development, urban design

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14581 Creating a Quasi-Folklore as a Tool for Knowledge Sharing in a Family-Based Business

Authors: Chico A. E. Hindarto

Abstract:

Knowledge management practices are more contextual when they combine with the corporate culture. Each entity has a specific cultural climate that enables knowledge sharing in both functional and individual levels. The interactions between people within organization can be influenced by the culture and how the knowledge is transmitted. On the other hand, these interactions have impacts in culture modification as well. Storytelling is one of the methods in delivering the knowledge throughout the organization. This paper aims to explore the possibility in using a quasi-folklore in the family-based business. Folklore is defined as informal tradition culture that spreading through a word-of-mouth, without knowing the source of the story. In this paper, the quasi-folklore term is used to differentiate it with the original term of folklore. The story is created by somebody in the organization, not like the folklore with unknown source. However, the source is not disclosed, in order to avoid the predicted interest from the story origin. The setting of family-based business is deliberately chosen, since the kinship is considerably strong in this type of entity. Through a thorough literature review that relates to knowledge management, storytelling, and folklore, this paper determines how folklore can be an option for knowledge sharing within the organization.

Keywords: folklore, family business, organizational culture, knowledge management, storytelling

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14580 The Impact of Electronic Marketing on the Quality Banking Services

Authors: Ahmed Ghalem

Abstract:

The research to be explained is a collection of information about several public and private economic institutions. This information is represented in highlighting the large and useful role in adopting the method of electronic marketing. Which is widespread and easy to use among community members at the local and international levels. Which generates large sums of money with little effort and little time, and also satisfies the customers. Do these things, despite what we have said, run the risk of losing large amounts of money in a moment or a short time.

Keywords: economic, finance, bank, development, marketing

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14579 Influence of Food Microbes on Horizontal Transfer of β-Lactam Resistance Genes between Salmonella Strains in the Mouse Gut

Authors: M. Ottenbrite, G. Yilmaz, J. Devenish, M. Kang, H. Dan, M. Lin, C. Lau, C. Carrillo, K. Bessonov, J. Nash, E. Topp, J. Guan

Abstract:

Consumption of food contaminated by antibiotic-resistant (AR) bacteria may lead to the transmission of AR genes in the gut microbiota and cause AR bacterial infection, a significant public health concern. However, information is limited on if and how background microbes from the food matrix (food microbes) may influence resistance transmission. Thus, we assessed the colonization of a β-lactam resistant Salmonella Heidelberg strain (donor) and a β-lactam susceptible S. Typhimurium strain (recipient) and the transfer of the resistance genes in the mouse gut in the presence or absence of food microbes that were derived from washing freshly-harvested carrots. Mice were pre-treated with streptomycin and then inoculated with both donor and recipient bacteria or recipient only. Fecal shedding of the donor, recipient, and transconjugant bacteria was enumerated using selective culture techniques. Transfer of AR genes was confirmed by whole genome sequencing. Gut microbial composition was determined by 16s rRNA amplicon sequencing. Significantly lower numbers of donors and recipients were shed from mice that were inoculated with food microbes compared to those without food microbe inoculation. S. Typhimurium transconjugants were only recovered from mice without inoculation of food microbes. A significantly higher survival rate was in mice with vs. without inoculation of food microbes. The results suggest that the food microbes may compete with both the donor and recipient Salmonella, limit their growth and reduce transmission of the β-lactam resistance gene in the mouse gut.

Keywords: antibiotic resistance, gene transfer, gut microbiota, Salmonella infection

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14578 Seroepidemiology of Q Fever among Companion Dogs in Fars Province, South of Iran

Authors: Atefeh Esmailnejad, Mohammad Abbaszadeh Hasiri

Abstract:

Coxiella burnetii is a gram-negative obligatory intracellular bacterium that causes Q fever, a significant zoonotic disease. Sheep, cattle, and goats are the most commonly reported reservoirs for the bacteria, but infected cats and dogs have also been implicated in the transmission of the disease to human. The aim of present study was to investigate the presence of antibodies against Coxiella burnetii among companion dogs in Fars province, South of Iran. A total of 181 blood samples were collected from asymptomatic dogs, mostly referred to Veterinary Hospital of Shiraz University for regular vaccination. The IgG antibody detection against Coxiella burnetii was made by indirect Enzyme-linked Immunosorbent Assay (ELISA), employing phase I and II Coxiella burnetii antigens. A logistic regression model was developed to analyze multiple risk factors associated with seropositivity. An overall seropositivity of 7.7% (n=14) was observed. Prevalence was significantly higher in adult dogs above five years (18.18 %) compared with dogs between 1 and five years (7.86 %) and less than one year (6.17%) (P=0.043). Prevalence was also higher in male dogs (11.21 %) than in female (2.7 %) (P=0.035). There were no significant differences in the prevalence of positive cases and breed, type of housing, type of food and exposure to other farm animals (P>0.05). The results of this study showed the presence of Coxiella burnetii infection among the companion dogs population in Fars province. To our knowledge, this is the first study regarding Q fever in dogs carried out in Iran. In areas like Iran, where human cases of Q fever are not common or remain unreported, the public health implications of Q fever seroprevalence in dogs are quite significant.

Keywords: Coxiella burnetii, dog, Iran, Q fever

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14577 Health Risks Evaluation of Heavy Metals in Sea Food from Persian ‎Gulf

Authors: Mohsen Ehsanpour, Maryam Ehsanpour, ‎Majid Afkhami, Fatemeh Afkhami ‎

Abstract:

Heavy metals are increasingly being released into natural waters from geological and anthropogenic sources. The distribution of several heavy metals (Cd, Pb) was investigated in muscle, liver in six different fish species seasonally collected in Persian Gulf (autumn 2009-summer 2010). The concentrations of all metals were lower in flesh than those recorded in liver due to their physiological roles. The THQ index for fish was calculated. Estimation of target hazard quotients calculations for the contaminated fish consumption was calculated to evaluate the effect of pollution on health. Total metal THQs values (Pb and Cd) for adults were 0.05 and 0.04 in Bushehr and Bandar-Genaveh, respectively, and for children they were 0.08 and 0.05 in Bandar-Abbas and Bandar-Lengeh, respectively.

Keywords: Persian Gulf, heavy metals, health risks, THQ index

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14576 Globalization and Public Policy Analysis: A Case Study of Foreign Policy of ASEAN Member States

Authors: Nattapol Pourprasert

Abstract:

This study has an objective to analyze foreign policy of member states in globalization current, aiming to answer that the foreign policy of member states have been changed or remained the same and there are any factors affecting changing of foreign policy of the member states. From the study results, it is found that the foreign policy of Thailand is a friendly foreign policy with all states. The policy of Indonesia is more opened because of a change in leader, allowing more democratic development in the country; the government has proceeded with friendly foreign policy with the states in order to bring funds into the state. The foreign policy of Malaysia is not much changed as there is no changing in the leader; the policy of Malaysia has reconciled relations with main city of Indian and Chinese residing in the country in order to bring investments into the country and to relieve tensions in the country. The foreign policy of the Philippines has proceeded with policy under the ASEAN framework and emphasized on international Islam communities. The foreign policy of Singapore has the least changed as the Singapore's policy focuses on internal trade since the state was found. As for the foreign policy of Brunei Darussalam, Brunei has a little role in the international stage; the state having closest relationship as from the view of history is Singapore as the Singaporean has invested in retailing business in Brunei. The foreign policy of Vietnam has emphasized on an omnidirectional foreign policy in order to compete with several states in global stage. The foreign policy of Myanmar has proceeded with a friendly foreign policy with all ASEAN member states, the East-west Corridor transportation line from Myanmar through Thailand and Lao to Vietnam has been developed. As for the foreign policy of Lao, In 2001, the Thai government and Lao government held a discussion which Thailand reaffirmed the position not to support the anti-Lao group. The foreign policy of Cambodia has proceeded with more openness, having good relation with China, Russia and USA as these states has invested in the state, especially the US company.

Keywords: globalization, public policy analysis, foreign policy, ASEAN member states

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14575 Bridging Minds, Building Success Beyond Metrics: Uncovering Human Influence on Project Performance: Case Study of University of Salford

Authors: David Oyewumi Oyekunle, David Preston, Florence Ibeh

Abstract:

The paper provides an overview of the impacts of the human dimension in project management and team management on projects, which is increasingly affecting the performance of organizations. Recognizing its crucial significance, the research focuses on analyzing the psychological and interpersonal dynamics within project teams. This research is highly significant in the dynamic field of project management, as it addresses important gaps and offers vital insights that align with the constantly changing demands of the profession. A case study was conducted at the University of Salford to examine how human activity affects project management and performance. The study employed a mixed methodology to gain a deeper understanding of the real-world experiences of the subjects and project teams. Data analysis procedures to address the research objectives included the deductive approach, which involves testing a clear hypothesis or theory, as well as descriptive analysis and visualization. The survey comprised a sample size of 40 participants out of 110 project management professionals, including staff and final students in the Salford Business School, using a purposeful sampling method. To mitigate bias, the study ensured diversity in the sample by including both staff and final students. A smaller sample size allowed for more in-depth analysis and a focused exploration of the research objective. Conflicts, for example, are intricate occurrences shaped by a multitude of psychological stimuli and social interactions and may have either a deterrent perspective or a positive perspective on project performance and project management productivity. The study identified conflict elements, including culture, environment, personality, attitude, individual project knowledge, team relationships, leadership, and team dynamics among team members, as crucial human activities to minimize conflict. The findings are highly significant in the dynamic field of project management, as they address important gaps and offer vital insights that align with the constantly changing demands of the profession. It provided project professionals with valuable insights that can help them create a collaborative and high-performing project environment. Uncovering human influence on project performance, effective communication, optimal team synergy, and a keen understanding of project scope are necessary for the management of projects to attain exceptional performance and efficiency. For the research to achieve the aims of this study, it was acknowledged that the productive dynamics of teams and strong group cohesiveness are crucial for effectively managing conflicts in a beneficial and forward-thinking manner. Addressing the identified human influence will contribute to a more sustainable project management approach and offer opportunities for exploration and potential contributions to both academia and practical project management.

Keywords: human dimension, project management, team dynamics, conflict resolution

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14574 Corporate Governance Mechanisms, Whistle-Blowing Policy and Earnings Management Practices of Firms in Malaysia

Authors: Mujeeb Saif Mohsen Al-Absy, Ku Nor Izah Ku Ismail, Sitraselvi Chandren

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This study examines whether corporate governance (CG) mechanisms in firms that have a whistle-blowing policy (WHBLP) are more effective in constraining earnings management (EM), than those without. A sample of 288 Malaysian firms for the years 2013 to 2015, amounting to 864 firm-years were grouped into firms with and without WHBLP. Results show that for firms without WHBLP, the board chairman tenure would minimize EM activities. Meanwhile, for firms with WHBLP, board chairman independence, board chairman tenure, audit committee size, audit committee meeting and women in the audit committees are found to be associated with less EM activities. Further, it is found that ownership concentration and Big 4 auditing firms help to reduce EM activities in firms with WHBLP, while not in firms without WHBLP. Hence, functional and effective governance can be achieved by having a WHBLP, which is in line with agency and resource dependent theories. Therefore, this study suggests that firms should have a WHBLP in place, and policymakers should come up with enhanced criteria to strengthen the mechanisms of WHBLP.

Keywords: corporate governance, earnings management, whistle-blowing policy, audit committee, board of directors

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14573 The Development of Sports Medicine and Physical Fitness in China from Reviewing Their Studies from the Journal of China Sports Science

Authors: Dong Zhan

Abstract:

China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.

Keywords: sports medicine, people's health, the young, the old

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14572 Design of a Mhealth Therapy Management to Maintain Therapy Outcomes after Bariatric Surgery

Authors: A. Dudek, P. Tylec, G. Torbicz, P. Duda, K. Proniewska, P. Major, M. Pedziwiatr

Abstract:

Background: Conservative treatments of obesity, based only on a proper diet and physical activity, without the support of an interdisciplinary team of specialist does not bring satisfactory bariatric results. Long-term maintenance of a proper metabolic results after rapid weight loss due to bariatric surgery requires engagement from patients. Mobile health tool may offer alternative model that enhance participant engagement in keeping the therapy. Objective: We aimed to assess the influence of constant monitoring and subsequent motivational alerts in perioperative period and on post-operative effects in the bariatric patients. As well as the study was designed to identify factors conductive urge to change lifestyle after surgery. Methods: This prospective clinical control study was based on a usage of a designed prototype of bariatric mHealth system. The prepared application comprises central data management with a comprehensible interface dedicated for patients and data transfer module as a physician’s platform. Motivation system of a platform consist of motivational alerts, graphic outcome presentation, and patient communication center. Generated list of patients requiring urgent consultation and possibility of a constant contact with a specialist provide safety zone. 31 patients were enrolled in continuous monitoring program during a 6-month period along with typical follow-up visits. After one year follow-up, all patients were examined. Results: There were 20 active users of the proposed monitoring system during the entire duration of the study. After six months, 24 patients took a part in a control by telephone questionnaires. Among them, 75% confirmed that the application concept was an important element in the treatment. Active users of the application indicated as the most valuable features: motivation to continue treatment (11 users), graphical presentation of weight loss, and other parameters (7 users), the ability to contact a doctor (3 users). The three main drawbacks are technical errors (9 users), tedious questionnaires inside the application (5 users), and time-consuming tasks inside the system (2 users). Conclusions: Constant monitoring and successive motivational alerts to continue treatment is an appropriate tool in the treatment after bariatric surgery, mainly in the early post-operative period. Graphic presentation of data and continuous connection with a clinical staff seemed to be an element of motivation to continue treatment and a sense of security.

Keywords: bariatric surgery, mHealth, mobile health tool, obesity

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14571 Economic Important of Manta Ray Watching Tourism in Dampier Strait, Raja Ampat, West Papua, Indonesia

Authors: Maulita Sari Hani, Abraham B. Sianipar, Jamaluddin Jompa, Natsir Nessa, Alan T. White

Abstract:

Manta ray is an icon for tourism in Raja Ampat. The tourist volume has been increased for the past ten years which up to approximately 23,000 tourists in 2017. Since 2013, Conservation International Indonesia deployed satellite and acoustic tags on manta ray in Dampier strait to track the species and identify the aggregation areas. These findings encourage the government and the local community to boost conservation through the management of marine protected areas for tourism purposes. Community in Dampier strait including the village of Arborek, Kurkapa, Kapisawar, and Sawingray involved in variety of small scale tourism business including homestay, dive shop, tour operator, and crafts. Working groups of related local businesses were established to support the local community and to ensure the sustainability of the economic viability and environmental sustainability. In order to analyze the economic benefits of manta ray tourism, this study was conducted to identify the number of local business in Dampier Strait and the economic impacts in terms of local finance security, social, humanity, individual, and physical assets. The results of this study identify 30 homestays, 2 dive shops, 10 tour operators, 30 women involved in crafts, and about 50 villagers worked for dive resorts. In addition to community assets, we confirmed the welfare of community has been improved in terms of food security, households, education for children, savings, and health insurance.

Keywords: marine wildlife tourism, elasmobranch, conservation, ecotourism, co-management, economic viability, environmental sustainability

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14570 Home-Based Care with Follow-Up at Outpatient Unit or Community-Follow-Up Center with/without Food Supplementation and/or Psychosocial Stimulation of Children with Moderate Acute Malnutrition in Bangladesh

Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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14569 Implications of Measuring the Progress towards Financial Risk Protection Using Varied Survey Instruments: A Case Study of Ghana

Authors: Jemima C. A. Sumboh

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Given the urgency and consensus for countries to move towards Universal Health Coverage (UHC), health financing systems need to be accurately and consistently monitored to provide valuable data to inform policy and practice. Most of the indicators for monitoring UHC, particularly catastrophe and impoverishment, are established based on the impact of out-of-pocket health payments (OOPHP) on households’ living standards, collected through varied household surveys. These surveys, however, vary substantially in survey methods such as the length of the recall period or the number of items included in the survey questionnaire or the farming of questions, potentially influencing the level of OOPHP. Using different survey instruments can provide inaccurate, inconsistent, erroneous and misleading estimates of UHC, subsequently influencing wrong policy decisions. Using data from a household budget survey conducted by the Navrongo Health Research Center in Ghana from May 2017 to December 2018, this study intends to explore the potential implications of using surveys with varied levels of disaggregation of OOPHP data on estimates of financial risk protection. The household budget survey, structured around food and non-food expenditure, compared three OOPHP measuring instruments: Version I (existing questions used to measure OOPHP in household budget surveys), Version II (new questions developed through benchmarking the existing Classification of the Individual Consumption by Purpose (COICOP) OOPHP questions in household surveys) and Version III (existing questions used to measure OOPHP in health surveys integrated into household budget surveys- for this, the demographic and health surveillance (DHS) health survey was used). Version I, II and III contained 11, 44, and 56 health items, respectively. However, the choice of recall periods was held constant across versions. The sample size for Version I, II and III were 930, 1032 and 1068 households, respectively. Financial risk protection will be measured based on the catastrophic and impoverishment methodologies using STATA 15 and Adept Software for each version. It is expected that findings from this study will present valuable contributions to the repository of knowledge on standardizing survey instruments to obtain estimates of financial risk protection that are valid and consistent.

Keywords: Ghana, household budget surveys, measuring financial risk protection, out-of-pocket health payments, survey instruments, universal health coverage

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14568 Professional Working Conditions, Mental Health And Mobility In The Hungarian Social Sector Preliminary Findings From A Multi-method Study

Authors: Ágnes Győri, Éva Perpék, Zsófia Bauer, Zsuzsanna Elek

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The aim of the research (funded by Hungarian national grant, NFKI- FK 138315) is to examine the professional mobility, mental health and work environment of social workers with a complex approach. Previous international and Hungarian research has pointed out that those working in the helping professions are strongly exposed to the risk of emotional-mental-physical exhaustion due to stress. Mental and physical strain, as well as lack of coping (can) cause health problems, but its role in career change and high labor turnover has also been proven. Even though satisfaction with working conditions of those employed in the human service sector in the context of the stress burden has been researched extensively, there is a lack of large-sample international and Hungarian domestic studies exploring the effects of profession-specific conditions. Nor has it been examined how the specific features of the social profession and mental health affect the career mobility of the professionals concerned. In our research, these factors and their correlations are analyzed by means of mixed methodology, utilizing the benefits of netnographic big data analysis and a sector-specific quantitative survey. The netnographic analysis of open web content generated inside and outside the social profession offers a holistic overview of the influencing factors related to mental health and the work environment of social workers. On the one hand, the topics and topoi emerging in the external discourse concerning the sector are examined, and on the other hand, focus on mentions and streams of comments regarding the profession, burnout, stress, coping, as well as labor turnover and career changes among social professionals. The analysis focuses on new trends and changes in discourse that have emerged during and after the pandemic. In addition to the online conversation analysis, a survey of social professionals with a specific focus has been conducted. The questionnaire is based on input from the first two research phases. The applied approach underlines that the mobility paths of social professionals can only be understood if, apart from the general working conditions, the specific features of social work and the effects of certain aspects of mental health (emotional-mental-physical strain, resilience) are taken into account as well. In this paper, the preliminary results from this innovative methodological mix are presented, with the aim of highlighting new opportunities and dimensions in the research on social work. A gap in existing research is aimed to be filled both on a methodological and empirical level, and the Hungarian domestic findings can create a feasible and relevant framework for a further international investigation and cross-cultural comparative analysis. Said results can contribute to the foundation of organizational and policy-level interventions, targeted programs whereby the risk of burnout and the rate of career abandonment can be reduced. Exploring different aspects of resilience and mapping personality strengths can be a starting point for stress-management, motivation-building, and personality-development training for social professionals.

Keywords: burnout, mixed methods, netnography, professional mobility, social work

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14567 Modified Fuzzy Delphi Method to Incorporate Healthcare Stakeholders’ Perspectives in Selecting Quality Improvement Projects’ Criteria

Authors: Alia Aldarmaki, Ahmad Elshennawy

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There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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14566 The Impact of Diabetes Mellitus on Skin and Soft Tissue Infections

Authors: Stephanie Cheng, Benjamin Poh, Vivyan Tay, Sachin Mathur

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Aim: Diabetes mellitus (DM) is a worldwide pandemic affecting 500 million people. It is known to be associated with increased susceptibility to soft tissue infections (STI). Despite being a major public health burden, the literature relating the effects of DM and the presentation, severity and healing of STIs in general surgical patients remain limited. Methods: We conducted a retrospective review of all patients admitted with STI in a tertiary teaching hospital over a 12-month period. Patient demographics and surgical outcomes were collected and analyzed. Results: During the study period, 1059 patients were admitted for STIs, of which 936 (88%) required surgical intervention. Diabetic patients were presented with a higher body-mass index (BMI) (28 vs 26), larger abscess size (24 vs 14 cm²) and a longer length of stay (LOS)(4.4 days vs 2.9 days). They also underwent a higher proportion of wide debridement as well as application of negative pressure wound therapy (NPWT) (42% vs 35%). More diabetic patients underwent subsequent re-operation within the same sitting (8 vs 4). There were no differences in re-admission rates within 30 days nor subsequent abscess formation in those followed for 6 months. Conclusion: The incidence of STIs among DM patients represents a significant disease burden; surgeons should consider intensive patient counseling and partnering with primary care providers in order to help reduce the incidence of future STI admissions based on lifestyle modification and glucose control.

Keywords: general surgery, emergency general surgery, acute care surgery, soft tissue infections, diabetes mellitus

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14565 The Importance of Psychiatric Nursing in the Care of Mental Health in Transex Patient in Brazil

Authors: Aline Giardin, Ana Fontoura, Thomas Anderson

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Transsexuality is a condition that requires the work of professionals from various fields for diagnosis and treatment. The correct diagnosis is very important because the surgery is irreversible. Diagnostic elements are essentially clinical and an observation period of two years prior to surgery is recommended. In this review article, we discuss the importance of psychiatric nursing for the care of transgender patients, as well as their mental health. Transsexuality is a phenomenon that contrasts our common understandings of sexuality, but it is not a sexual issue. Also called gender dysphoria is a mismatch between the anatomical sex of an individual and their gender identity. In relation to mental health, among transsexuals, we find variations ranging from psychoses to total normality. As the etiology is still controversial, there is no biological marker and only the clinical criteria can be used. Portaria nº 2803, of November 19, 2013, Brazil, regulates the surgical reassignment of sex by the SUS and the nurse started to work also in operational groups (transsexuals who wish to perform surgery and other procedures of reassignment of sex). Health and education, establishes links and guides the care that female and male transsexual patients will have to have before and after surgery. It is also important to say that the work of health education is not only concerned with aspects related to the sexual reassignment surgery, but also with the mental health of its patients and with the family. One of the main complaints of patients is the impression that professionals seem to find them strange and feel extremely uncomfortable when they talk about their desire to undergo sex-change surgery: Investigate the role of nursing in the process of change sexual. Our methodology was a review of articles produced between 1994 and 2015. It was concluded that nursing should specialize for this new demand, which is growing more and more in our health services. We believe that nursing is specializing to enter this context and the expectations are good for the professionals and for the reception of the transsexual patient.

Keywords: transex, nursing, importance, patient

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