Search results for: health care market

Authors: Mohammad Tahir Yousafzai, Rubina Qasim

Abstract:

We assessed Hepatitis B vaccination and its determinants among health care workers (HCW) in Northwest Pakistan. HCWs from both public and private clinics were interviewed about hepatitis B vaccination, socio-demographic, hepatitis B virus transmission modes, disease threat and benefits of vaccination. Logistic regression was performed. Hepatitis B vaccination was 40% (Qualified Physicians: 86% and non-qualified Dispensers:16%). Being Qualified Physician (Adj. OR 26.6; 95%CI 9.3-73.2), Non-qualified Physician (Adj.OR 1.9; 95%CI 0.8-4.6), qualified Dispensers (Adj. OR 3.6; 95%CI 1.3-9.5) compared to non-qualified Dispensers, working in public clinics (Adj. OR 2.5; 95%CI 1.1-5.7) compared to private, perceived disease threat after exposure to blood and body fluids (Adj. OR 1.1; 95%CI 1.1-1.2) and perceived benefits of vaccination (Adj. OR 1.1; 95%CI 1.1-1.2) were significant predictors of hepatitis B vaccination. Improved perception of disease threat and benefits of vaccination and qualification of HCWs are associated with hepatitis B vaccination.

Keywords: Hepatitis B vaccine, immunization, healthcare workers, primary health

Procedia PDF Downloads 318

Authors: Lily Farris, Chantel E. Canessa, Rena Heathcote, Susan Shumay, Suzanna V. McRae, Alissa Collingridge, Minna K. Miller

Abstract:

Objective: To describe how the Lean approach can be applied to improve access, quality and safety of care in an ambulatory pediatric primary care setting. Background: Lean was originally developed by Toyota manufacturing in Japan, and subsequently adapted for use in the healthcare sector. Lean is a systematic approach, focused on identifying and reducing waste within organizational processes, improving patient-centered care and efficiency. Limited literature is available on the implementation of the Lean methodologies in a pediatric ambulatory care setting. Methods: A strategic continuous improvement event or Rapid Process Improvement Workshop (RPIW) was launched with the aim evaluating and structurally supporting clinic workflow, capacity building, sustainability, and ultimately improving access to care and enhancing the patient experience. The Lean process consists of five specific activities: Current state/process assessment (value stream map); development of a future state map (value stream map after waste reduction); identification, quantification and prioritization of the process improvement opportunities; implementation and evaluation of process changes; and audits to sustain the gains. Staff engagement is a critical component of the Lean process. Results: Through the implementation of the RPIW and shifting workload among the administrative team, four hours of wasted time moving between desks and doing work was eliminated from the Administrative Clerks role. To streamline clinic flow, the Nursing Assistants completed patient measurements and vitals for Nurse Practitioners, reducing patient wait times and adding value to the patients visit with the Nurse Practitioners. Additionally, through the Nurse Practitioners engagement in the Lean processes a need was recognized to articulate clinic vision, mission and the alignment of NP role and scope of practice with the agency and Ministry of Health strategic plan. Conclusions: Continuous improvement work in the Pediatric Primary Care NP Clinic has provided a unique opportunity to improve the quality of care delivered and has facilitated further alignment of the daily continuous improvement work with the strategic priorities of the Ministry of Health.

Keywords: ambulatory care, lean, pediatric primary care, system efficiency

Procedia PDF Downloads 301

Authors: Oliver Takawira, Thembi Hope

Abstract:

This study will analyse the relationship between Bitcoin price movements and the Johannesburg stock exchange (JSE). The aim is to determine whether Bitcoin price movements affect the stock market performance. As crypto currencies continue to gain prominence as a safe asset during periods of economic distress, this raises the question of whether Bitcoin’s prosperity could affect investment in the stock market. To identify the existence of a short run and long run linear relationship, the study will apply the Autoregressive Distributed Lag Model (ARDL) bounds test and a Vector Error Correction Model (VECM) after testing the data for unit roots and cointegration using the Augmented Dicker Fuller (ADF) and Phillips-Perron (PP). The Non-Linear Auto Regressive Distributed Lag (NARDL) will then be used to check if there is a non-linear relationship between bitcoin prices and stock market prices.

Keywords: bitcoin, stock market, interest rates, ARDL

Procedia PDF Downloads 107

Authors: Hannah Yael Ephraim

Abstract:

During reproductive age (between 15 and 44), women are particularly susceptible to psychiatric illness. Depression and anxiety disorders are especially common for women during reproductive age. Women of reproductive age are also at greater risk for multiple physical conditions during this time. Existing literature focuses on the impact of mental health on physical health, showing that people with anxiety and depression repeatedly show greater physical health risk among those with developing chronic medical illness. However, there is limited research on the impact physical health has on mental health in women of reproductive age, a large and vulnerable population. For this reason, the current study seeks to ask the following questions: are women of reproductive age with a diagnosis of a chronic physical condition more likely to experience symptoms of mental illness than women without a diagnosis of a chronic physical condition? Does the type of physical illness relate to signs and symptoms of depression and anxiety? A quasi-experimental research design was implemented to compare the mental health outcomes of women with the diagnosis of chronic medical conditions and women without the diagnosis of a chronic medical condition. Quantitative data was collected through an anonymous ten-minute Qualtrics survey. The survey was sent out through multiple online platforms. The sample includes two groups of women: one group with the diagnosis of a chronic medical illness, and one group without a diagnosis and/or symptoms (N = 541). Participants identify as a woman and are between the ages of 15 and 44. A comparison of women with a diagnosis of a chronic physical condition and those without a diagnosis will be conducted to explore differences in depression and anxiety symptoms between women with and without a chronic medical diagnosis. The impact race, SES, and occupation will also be addressed in relation to anxiety and/or depression in women of reproductive age. This study will further the understanding of the relationship between mental illness in women of reproductive age with chronic medical conditions. The results of this study will have implications for the integration of mental health care in women’s health centers and perhaps training of clinicians and physicians providing psychological and medical care to women of reproductive age.

Keywords: mental health, physical health, reproductive age, women

Procedia PDF Downloads 315

Authors: Katarina Živković, Ivana Joksimović

Abstract:

Many different chemicals may occur in drinking water and cause significant human health risks after prolonged periods of exposure. In particular concern are contaminants that have cumulative toxic properties, such as heavy metals. This investigation was done to clarify concerns about chemical quality and safety of drinking tap water in Podgorica. For comparison, all available natural bottled water on Montenegrin market were bought. All samples (bottled water and tap water from Podgorica) were analyzed using ICP –OES on contents of Al, Cd, Pb, Cu, Zn,Cr, Fe, As and Mn. All results compared with the maximum concentration levels allowed by international standards and World Health Organization (WHO) guidelines. The results of analysis showed that all trace of heavy metals were very low and in same time below MCL according to WHO and International standard.

Keywords: inductively coupled plasma - optical emission spectrometry (ICP-OES), Montenegro (Podgorica), natural bottled water, tap water , trace of heavy metal

Procedia PDF Downloads 455

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

Abstract:

AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

Procedia PDF Downloads 162

Authors: Mannan Mridha, Mohammad S. Islam

Abstract:

Innovative medical technologies offer more effective medical care, with less risk to patient and healthcare personnel. Medical technology and devices when properly used provide better data, precise monitoring and less invasive treatments and can be more targeted and often less costly. The Intensive Care Unit (ICU) equipped with patient monitoring, respiratory and cardiac support, pain management, emergency resuscitation and life support devices is particularly prone to medical errors for various reasons. Many people in the developing countries now wonder whether their visit to hospital might harm rather than help them. This is because; clinicians in the developing countries are required to maintain an increasing workload with limited resources and absence of well-functioning safety system. A team of experts from the medical, biomedical and clinical engineering in Sweden and Bangladesh have worked together to study the incidents, adverse events at the ICU in Bangladesh. The study included both public and private hospitals to provide a better understanding for physical structure, organization and practice in operating processes of care, and the occurrence of adverse outcomes the errors, risks and accidents related to medical devices at the ICU, and to develop a ICT based support system in order to reduce hazards and errors and thus improve the quality of performance, care and cost effectiveness at the ICU. Concrete recommendations and guidelines have been made for preparing appropriate ICT related tools and methods for improving the routine for use of medical devices, reporting and analyzing of the incidents at the ICU in order to reduce the number of undetected and unsolved incidents and thus improve the patient safety.

Keywords: intensive care units, medical errors, medical devices, patient care and safety

Procedia PDF Downloads 149

Authors: Antoni Wibowo, Harry Pujianto, Dewi Retno Sari Saputro

Abstract:

The stock market can provide huge profits in a relatively short time in financial sector; however, it also has a high risk for investors and traders if they are not careful to look the factors that affect the stock market. Therefore, they should give attention to the dynamic fluctuations and movements of the stock market to optimize profits from their investment. In this paper, we present a nonlinear autoregressive exogenous model (NARX) to predict the movements of stock market; especially, the movements of the closing price index. As case study, we consider to predict the movement of the closing price in Indonesia composite index (IHSG) and choose the best structures of NARX for IHSG’s prediction.

Keywords: NARX (Nonlinear Autoregressive Exogenous Model), prediction, stock market, time series

Procedia PDF Downloads 244

Authors: Inna Vinokurova, N. Savvina

Abstract:

The goal of research: to study the organization of multi-field hospital’s work environment in the Republic of Sakha (Yakutia), Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine. Results: Autonomous public health care institution of Republic of Sakha (Yakutia) - Republican Hospital No. 1 - National Center of Medicine is a multidisciplinary, specialized hospital complex that provides specialized and high-tech medical care to children and adults in the Republic of Sakha (Yakutia) of the Russian Federation. There are 5 diagnostic and treatment centers (advisory and diagnostic, clinical, pediatric, perinatal, Republican cardiologic dispensary) with 45 clinical specialized departments with 727 cots, 5 resuscitation departments, 20 operating rooms and out-patient department with 905 visits in alternation in the National Center of Medicine. Annually more than 20,000 patients receive treatment in the hospital of the Republican Hospital of the Republic of Sakha (Yakutia), more than 70,000 patients visit out-patient sections, more than 2 million researches are done, more than 12,000 surgeries are performed, more than 2 thousand babies are delivered. National Center of Medicine has a great influence with such population’s health indicators as total mortality, birth rate, maternal, infant and perinatal mortality, circulatory system incidence. The work environment of the Republican Hospital of the Republic of Sakha (Yakutia) is represented by the following structural departments: pharmacy, blood transfusion department, sterilization department, laundry, dietetic department, infant-feeding centre, material and technical supply. More than 200 employees work in this service. The main function of these services is to provide on-time and fail-safe supply with all necessary: wear parts, medical supplies, donated blood and its components, foodstuffs, hospital linen , sterile instruments, etc. Thus, the activity of medical organization depends on the work environment, including quality health care, so it is a main part of multi-field hospital activity.

Keywords: organization of multi-field hospital’s, work environment, quality health care, pharmacy, blood transfusion department, sterilization department

Procedia PDF Downloads 243

Authors: Kulveer Sandhu

Abstract:

Background: In 1999, the Government of Canada legalized the use of cannabis for the therapeutic purpose (CTP); however, its users remain highly vulnerable to stigma and are judged by care providers and nonusers of cannabis. Findings from a literature review suggest health care providers (HCPs), including nurses in palliative care settings, lack knowledge about medical cannabis. For this reason, it is important to enhance HCPs’awarenessand knowledge of medical cannabis. Significance of the Project: Nurses are the first point of contact and spend more time with patients than other care providers; it is, therefore, important for them to be informed about CTPto provide quality and equitable care for medical cannabis users. Although nurses and other HCPs want information on CTP, the topic is rarely included in their educational curriculum. The purpose of this project is to create an evidence informed Package designed to increase knowledge among palliative care nurses about CTP. The information package will empower palliative nurses to help palliative patients make informed decisions about their treatment plan. Method: The information package will include a basic overview of the endocannabinoid system, common cannabis plants and products, and methods of consumption, as well as information to help nurses better understand consumption and harm reduction. The package will also include a set of cannabis fact sheets for nurses. Each fact sheet will comprise a high-level overview with graphics followed by a description of medical cannabis with links and references. At the end of the learning package, there are five self-reflection questions that allow nurses to examine their personal values, attitudes, and practices regarding medical cannabis. These questions will help each nurse understand their personal approach towards CTP and its users.

Keywords: medical cannabis, improve knowledge, cannabis for therapeutic purpose (CTP), patient experience, palliative care

Procedia PDF Downloads 222

Authors: Aoife Prendergast

Abstract:

The synergy between theory and practice can be considered elusive, the touchstone for the development of successful undergraduate programmes particularly in allied health professions such as social care. A 'pracademic' is a person who spans both the somewhat ethereal world of academia as a scholar and the pragmatic world of practice. This paper examines the concept of 'pracademia' in relation to the role of the social care practitioner and continuing professional development. It also assists in the understanding of the synergy between social care professionals and higher education. A consideration of the identity and position in terms of approach to regulation is explored as well as an acknowledgement of the strengths and opportunities for sharing power in hierarchical positions. The world of practice serves as the centre point of the academic compass for most professional programs. Just as schools of engineering and law are disciplined by the marketplace, which seeks well-trained students, so our social care programmes must perennially find ways to address the fast changing needs of practitioners, whether they be government, not-for-profit organizations, consulting firms or contractors. We may not expect such traditional academic disciplines as history, sociology, or political science to cater to the needs of external audiences or practitioners— indeed, these disciplines' insulation from public concerns and issues is considered a strength by some. This paper aims to explore the integration of academic teaching and research with the communities of practice in social care. This appears to be a fundamental aspiration of the social care profession. While building and integrating an important body of academic theory and concepts from a variety of disciplines, social care as a field has embraced a professional orientation by seeking to be relevant to practitioners at various levels. While teaching theory, social care programmes, and faculty are often acutely aware that their academic content and credibility, in part, rest on a deep connection with practitioners. While theory can be self-contained, the impact of our research and teaching arguably finds its most compelling and highest audience when it addresses the agenda items and concerns of practitioners.

Keywords: social care, pracademia, supervision, practice education

Procedia PDF Downloads 164

Authors: Mualla McManus, Jenna Luche Thaye

Abstract:

World Health Organisation International Classification of Disease codes were created to define disease including infections in order to guide and educate diagnosticians. Most infectious diseases such as syphilis are clearly defined by their ICD 10 codes and aid/help to educate the clinicians in syphilis diagnosis and treatment globally. However, current ICD 10 codes for relapsing fever Borreliosis and Lyme disease are less clearly defined and can impede appropriate diagnosis especially if the clinician is not familiar with the symptoms of these infectious diseases. This is despite substantial number of scientific articles published in peer-reviewed journals about relapsing fever and Lyme disease. In the USA there are estimated 380,000 people annually contacting Lyme disease, more cases than breast cancer and 6x HIV/AIDS cases. This represents estimated 0.09% of the USA population. If extrapolated to the global population (7billion), 0.09% equates to 63 million people contracting relapsing fever or Lyme disease. In many regions, the rate of contracting some form of infection from tick bite may be even higher. Without accurate and appropriate diagnostic codes, physicians are impeded in their ability to properly care for their patients, leaving those patients invisible and marginalized within the medical system and to those guiding public policy. This results in great personal hardship, pain, disability, and expense. This unnecessarily burdens health care systems, governments, families, and society as a whole. With accurate diagnostic codes in place, robust data can guide medical and public health research, health policy, track mortality and save health care dollars. Better defined ICD codes are the way forward in educating the diagnosticians about relapsing fever and Lyme diseases.

Keywords: WHO ICD codes, relapsing fever, Lyme diseases, World Health Organisation

Procedia PDF Downloads 194

Authors: Yunice Karina Tumewang

Abstract:

As we have seen, the number of Muslim and their awareness toward financial products and services that conform to Islamic principles are growing rapidly today. Thus, it makes the market environment potentially beneficial for Shari-compliant funds with the expanding prospective client base. However, over the last decade, only small portion of this huge potential market has been covered by the established Islamic asset management firms. This study aims to examine the factors of this untapped market particularly in the demand side. This study will use the qualitative method with primary data through a questionnaire distributed to 500 samples of Muslim population. It will shed light on Muslim attitudes and expectations toward Sharia-compliant retirement planning and pensions. It will also help to raise the awareness of market players to see Islamic pension fund as a promising industry in the foreseeable future.

Keywords: Islamic marketing, Islamic finance, Islamic asset management, Islamic pension fund

Procedia PDF Downloads 338

Authors: Fayiz Saifurahman, Noori Fida Mohammad

Abstract:

Afghanistan produces the highest rate of wheat, it is the first source of food, and food security in Afghanistan is dependent on the availability of wheat. Although Afghanistan is the main producer of wheat, on the other hand, Afghanistan is the largest importers of flour. The objective of this study is to assess the structure and dynamics of the wheat market in Afghanistan, can compute with foreign markets, and increase the level of production. To complete this, a broad series of secondary data was complied with, group discussions and interviews with farmers, agricultural and market experts. The research findings propose that; the government should adopt different policies to support the local market. The government should distribute the seed, support financially and technically to increase wheat production.

Keywords: Afghanistan, wheat, production , import

Procedia PDF Downloads 168

Authors: Serpil Türkyılmaz, Mesut Balıbey

Abstract:

In this study, long memory properties in volatility of Turkey Stock Market are being examined through the FIGARCH, FIEGARCH and FIAPARCH models under different distribution assumptions as normal and skewed student-t distributions. Furthermore, structural changes in volatility of Turkey Stock Market are investigated. The results display long memory property and the presence of asymmetric effects of shocks in volatility of Turkey Stock Market.

Keywords: FIAPARCH model, FIEGARCH model, FIGARCH model, structural break

Procedia PDF Downloads 291

Authors: Kamel Malik Bensafta, Gervasio Semedo

Abstract:

The purpose of this paper is to investigate the relationship between oil prices and socks markets. The empirical analysis in this paper is conducted within the context of Multivariate GARCH models, using a transform version of the so-called BEKK parameterization. We show that mean and uncertainty of US market are transmitted to oil market and European market. We also identify an important transmission from WTI prices to Brent Prices.

Keywords: oil volatility, stock markets, MGARCH, transmission, structural break

Procedia PDF Downloads 525

Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

Abstract:

The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

Procedia PDF Downloads 311

Authors: M. Deligianni, P. Voultsos, E. Tsamadou

Abstract:

Background/Introduction: Moral distress is a common occurrence for health professionals working in neonatal critical care. Despite a growing number of critically ill neonatal and pediatric patients, only a few articles related to moral distress as experienced by neonatal physicians have been published over the last years. Objectives/Aims: The aim of this study was to define and identify barriers to and facilitators of moral distress based on the perceptions and experiences of neonatal physicians working in neonatal intensive care units (NICUs). This pilot study is a part of a larger nationwide project. Methods: A multicenter qualitative descriptive study using focus group methodology was conducted. In-depth interviews lasting 45 to 60 minutes were audio-recorded. Once data were transcribed, conventional content analysis was used to develop the definition and categories, as well as to identify the barriers to and facilitators of moral distress. Results: Participants defined moral distress broadly in the context of neonatal critical care. A wide variation of definitions was displayed. The physicians' responses to moral distress included different feelings and other situations. The overarching categories that emerged from the data were patient-related, family-related, and physician-related factors. Moreover, organizational factors may constitute major facilitators of moral distress among neonatal physicians in NICUs. Note, however, that moral distress may be regarded as an essential component to caring for neonates in critical care. The present study provides further insight into the moral distress experienced by physicians working in Greek NICUs. Discussion/Conclusions: Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for mitigating the prevalence of moral distress among neonate physicians in the context of NICUs.

Keywords: critical care, moral distress, neonatal physician, neonatal intensive care unit, NICU

Procedia PDF Downloads 151

Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi

Abstract:

Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.

Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research

Procedia PDF Downloads 48

Authors: L. Maiza, A. Cantagrel, M. Forestier, G. Laucoin, T. Regali

Abstract:

Evaluation of High Frequency Trading (HFT) impact on financial markets is very important for traders who use market analysis to detect winning transaction opportunity. Analysis of HFT data on tobacco commodity market is discussed here and interesting linear relationship has been shown between trading frequency and difference between averaged trading prices above and below considered trading frequency. This may open new perspectives on markets data understanding and could provide possible interpretation of Adam Smith invisible hand.

Keywords: financial market, high frequency trading, analysis, impacts, Adam Smith invisible hand

Procedia PDF Downloads 360

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

Abstract:

It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

Procedia PDF Downloads 176

Authors: Mario Zgela

Abstract:

Application of Benford’s Law is very rarely covered in the field of stock market analysis, especially in percentage change of stock market indices. Deutscher Aktien IndeX (DAX) is very important stock market index of Frankfurt Deutsche Börse which serves as underlying basis for large number of financial instruments. It is calculated for selected 30 German blue chips stocks. In this paper, Benford's Law first digit test is applied on 10 year DAX daily percentage changes in order to check compliance. Deviations of 10 year DAX percentage changes set as well as distortions of certain subsets from Benford's Law distribution are detected. It is possible that deviations are the outcome of speculations; and psychological influence should not be eliminated.

Keywords: Benford's Law, DAX, index percentage changes, stock market

Procedia PDF Downloads 294

Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

Abstract:

Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

Procedia PDF Downloads 223

Authors: Hiranmoyee Das

Abstract:

Aim. Due to late presentation and delayed diagnosis mortality rate of retinoblastoma is more than 50% in developing counties. So to facilitate the diagnosis, to decrease the disease and treatment burden and to increase the disease survival rate, an attempt was made for early diagnosis of Retinoblastoma by including fundus examination in routine immunization programs. Methods- A unique immunization card is followed in a tertiary health care center where examination of pupillary reflex is made mandatory in each visit of the child for routine immunization. In case of any abnormality, the child is referred to the ophthalmology department. Conclusion- Early detection is the key in the management of retinoblastoma. Every child is brought to the health care system at least five times before the age of 2 years for routine immunization. We should not miss this golden opportunity for early detection of retinoblastoma.

Keywords: retinoblastoma, immunization, unique, early

Procedia PDF Downloads 198

Authors: Weera Weerasophon

Abstract:

The purpose of this research was to study Tourists’s satisfaction strategies case of Tourists who attended and shopped in Chatuchak weekend market (Bangkok) in order to improve service operation of Chatuchak weekend market to serve tourists’ need to impress them. The researcher used the marketing mix as a main factor that affect to tourist satisfaction. This research was emphasized as quantitative research as 400 of questionnaires were used for collecting the data from international tourists around Chatuchak weekend market that questionnaires divided in to 3 parts as a personal information part, satisfaction of marketing/services and facilities and suggestion part. After collecting all the data that would be processed in statistic program of SPSS to use for analyze the data later on. The result is described that most of international tourists satisfied Chatuchak weekend market in the level of 4 as more satisfaction for example friendly staff, Chatuchak information, price of product, facilities and service by the way, the environment of Chatuchak weekend market is the most satisfaction level.

Keywords: Chatuchak, satisfaction, Thailand tourism, marketing mix, tourists

Procedia PDF Downloads 360

Authors: A. Novikova, L. Rocchi, G. Startiene

Abstract:

Market and non-market outputs are produced jointly in agriculture. Their supply depends on the intensity and type of production. The role of agriculture as an economic activity and its effects are important for the Lithuanian case study, as agricultural land covers more than a half of country. Positive and negative externalities, created in agriculture are not considered in the market. Therefore, specific techniques such as stated preferences methods, in particular choice experiments (CE) are used for evaluation of non-market outputs in agriculture. The main aim of this paper is to present construction of the research path for evaluation of non-market farming system outputs in Lithuania. The conventional and organic farming, covering crops (including both cereal and industrial crops) and livestock (including dairy and cattle) production has been selected. The CE method and nested logit (NL) model were selected as appropriate for evaluation of non-market outputs of different farming systems in Lithuania. A pilot survey was implemented between October–November 2018, in order to test and improve the CE questionnaire. The results of the survey showed that the questionnaire is accepted and well understood by the respondents. The econometric modelling showed that the selected NL model could be used for the main survey. The understanding of the differences between organic and conventional farming by residents was identified. It was revealed that they are more willing to choose organic farming in comparison to conventional farming.

Keywords: choice experiments, farming system, Lithuania market outputs, non-market outputs

Procedia PDF Downloads 130

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

Abstract:

Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

Procedia PDF Downloads 79

Authors: N. W. Paul, S. Michl

Abstract:

In our globalized world we need to appreciate the fact that questions of health and justice need to be addressed on a global scale, too. The way in which diverse governmental and non-governmental initiatives are trying to answer the need for humanitarian medical aid has long since been a visible result of globalized responsibility. While the intention of humanitarian medical aids seems to be evident, the allocation of resources has become more and more an ethical and societal challenge. With a rising number and growing dimension of humanitarian catastrophes around the globe the search for ethically justifiable ways to decide who might benefit from limited resources has become a pressing question. Rooted in theories of justice (Rawls) and concepts of social welfare (Sen) we developed and implemented a model for an ethically sound distribution of a limited annual budget for humanitarian care in one of the largest medical universities of Germany. Based on our long lasting experience with civil casualties of war (Afghanistan) and civil war (Libya) as well as with under- and uninsured and/or stateless patients we are now facing the on-going refugee crisis as our most recent challenge in terms of global health and justice. Against this background, the paper strives to a) explain key issues of humanitarian medical aid in the 21st century, b) explore the problem of rationing from an ethical point of view, c) suggest a tool for the rational allocation of scarce resources in humanitarian medical aid, d) present actual cases of humanitarian care that have been managed with our toolbox, and e) discuss the international applicability of our model beyond local contexts.

Keywords: humanitarian care, medical ethics, allocation, rationing

Procedia PDF Downloads 399

Authors: Scarlet Tabot Enanga Longsti

Abstract:

Community-Based Health Insurance (CBHI) schemes have been proposed as a possible means to achieve affordable health care in low-and lower-middle-income countries. The existing evidence provides mixed results on the impact of CBHI schemes on healthcare utilisation and out -of-pocket payments (OOPP) for healthcare. Over 900 CBHI schemes have been implemented in underdeveloped countries, and these schemes have undergone different modifications over the years. Prior reviews have suggested that different designs of CBHI schemes may result in different outcomes. Objectives: This review sought to determine the interventions that affect the impact of CBHI schemes on OOPP and health service utilisation. Interventions in this study referred to any action or modification in the design of a CBHI scheme that affected the impact of the scheme on OOPP and/or healthcare utilization. Methods: Any CBHI study that was done in a lower middle-income country, that used an experimental design, that included OOPP or health care utilisation as outcome variables, and that was published in either English or French was included in this study. Studies were searched for in MEDLINE, Embase, CINAHL, EconLit, IBSS, Web of Science, Cochrane Library, and Global Index Medicus from July to August 2023. Bias was assessed using Joanna Brigs Institute tools for quality assessment for randomized control trials and quasi experimental studies. A narrative synthesis was done. Results: 12 studies were included in the review, with a total of 69 villages, 13,653 households, and 62,786 participants. Average premium collection was 4.8 USD/year. Most CBHI schemes had flat rates. The study revealed that a range of interventions impact OOPP and health care utilisation. Five categories of interventions were identified. The intervention with the highest impact on OOPP and utilisation was “Audit visits”. Next in line came external funds, training scheme workers, and engaging community leaders and village heads to advertise the scheme. Free healthcare led to a significant increase in utilisation of health services, a significant reduction in Catastrophic health expenditure, but an insignificant effect on OOPP among insured compared with uninsured. Conclusions: Community-Based Health Insurance could pave the way for Universal Health Care in low and middle-income countries. However, this can only be possible if careful thought is given to how schemes are designed. Due to the heterogeneity of studies and results on CBHI schemes, there is need for further research for more effective designs to be developed.

Keywords: community based health insurance, developing countries, health service utilisation, out of pocket payment

Procedia PDF Downloads 67

Authors: Haoyi Sheng

Abstract:

China's aging tendency is becoming increasingly severe, which leads to the embarrassing situation of "getting old before getting wealthy". The traditional pension model does not comply with the need of today. Relying on "Internet Plus", it can efficiently integrate information and resources and meet the personalized needs of elderly care. It can reduce the operating cost of community elderly care facilities and lay a technical foundation for providing better services for the elderly. The key for providing help for the elderly in the future is to effectively integrate technology, make good use of technology, and improve the efficiency of elderly care services. The effective integration of traditional home care, community care, intelligent elderly care equipment and medical resources to create the "Internet Plus" community intelligent pension service mode has become the future development trend of aging care. The research method of this paper is to collect literature and conduct theoretical research on community pension firstly. Secondly, the combination of suitable aging design and "Internet Plus" is elaborated through research. Finally, this paper states the current level of intelligent technology in old-age care and looks into the future by understanding multiple levels of "Internet Plus". The development of community intelligent pension mode and content under "Internet Plus" has enormous development potential. In addition to the characteristics and functions of ordinary houses, residential design of endowment housing has higher requirements for comfort and personalization, and the people-oriented is the principle of design.

Keywords: ageing tendency, 'Internet Plus', community intelligent elderly care, elderly care service model, technology

Procedia PDF Downloads 138