Search results for: planning intervention

Authors: Avadh Bihari

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Corporate social responsibility (CSR) has become a global parameter to define corporates' ethical and responsible behaviour. It was a voluntary practice in India till 2013, driven by various guidelines, which has become a mandate since 2014 under the Companies Act, 2013. This has compelled the corporates to redesign their CSR strategies by bringing in structures, planning, accountability, and transparency in their processes with a mandate to 'comply or explain'. Based on the author's M.Phil. dissertation, this paper presents the changes in organisational practices and institutional mechanisms of third-sector organisations (TSOs) with the theoretical frameworks of institutionalism and co-optation. It became an interesting case as India is the only country to have a law on CSR, which is not only mandating the reporting but the spending too. The space of CSR in India is changing rapidly and affecting multiple institutions, in the context of the changing roles of the state, market, and TSOs. Several factors such as stringent regulation on foreign funding, mandatory CSR pushing corporates to look out for NGOs, and dependency of Indian NGOs on CSR funds have come to the fore almost simultaneously, which made it an important area of study. Further, the paper aims at addressing the gap in the literature on the effects of mandated CSR on the functioning of TSOs through the empirical and theoretical findings of this study. The author had adopted an interpretivist position in this study to explore changes in organisational practices from the participants' experiences. Data were collected through in-depth interviews with five corporate officials, eleven officials from six TSOs, and two academicians, located at Mumbai and Delhi, India. The findings of this study show the legislation has institutionalised CSR, and TSOs get co-opted in the process of implementing mandated CSR. Seventy percent of the corporates implement their CSR projects through TSOs in India; this has affected the organisational practices of TSOs to a large extent. They are compelled to recruit expert workforce, create new departments for monitoring & evaluation, communications, and adopt management practices of project implementation from corporates. These are attempts to institutionalise the TSOs so that they can produce calculated results as demanded by corporates. In this process, TSOs get co-opted in a struggle to secure funds and lose their autonomy. The normative, coercive, and mimetic isomorphisms of institutionalism come into play as corporates are mandated to take up CSR, thereby influencing the organisational practices of TSOs. These results suggest that corporates and TSOs require an understanding of each other's work culture to develop mutual respect and work towards the goal of sustainable development of the communities. Further, TSOs need to retain their autonomy and understanding of ground realities without which they become an extension of the corporate-funder. For a successful CSR project, engagement beyond funding is required from corporate, through their involvement and not interference. CSR-led community development can be structured by management practices to an extent, but cannot overshadow the knowledge and experience of TSOs.

Keywords: corporate social responsibility, institutionalism, organisational practices, third-sector organisations

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Authors: Narjes Abbasabadi

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As the world continues to urbanize and suburbanize, where suburbanization associated with mass sprawl has been the dominant form of this expansion, sustainable development challenges will be more concerned. Sprawling, characterized by low density and automobile dependency, presents significant environmental issues regarding energy consumption and Co2 emissions. This paper examines the vertical expansion of suburbs integrated into mass transit nodes as a planning strategy for boosting density, intensification of land use, conversion of single family homes to multifamily dwellings or mixed use buildings and development of viable alternative transportation choices. It analyzes the spatial patterns of tall building transit-oriented development (TB-TOD) of suburban regions in Sydney (Australia), Toronto (Canada), and Washington D.C. (United States). The main objectives of this research seek to understand the effect of the new morphology of suburban tall, the physical dimensions of individual buildings and their arrangement at a larger scale with energy efficiency. This study aims to answer these questions: 1) why and how can the potential phenomenon of vertical expansion or high-rise development be integrated into suburb settings? 2) How can this phenomenon contribute to an overall denser development of suburbs? 3) Which spatial pattern or typologies/ sub-typologies of the TB-TOD model do have the greatest energy efficiency? It addresses these questions by focusing on 1) energy, heat energy demand (excluding cooling and lighting) related to design issues at two levels: macro, urban scale and micro, individual buildings—physical dimension, height, morphology, spatial pattern of tall buildings and their relationship with each other and transport infrastructure; 2) Examining TB-TOD to provide more evidence of how the model works regarding ridership. The findings of the research show that the TB-TOD model can be identified as the most appropriate spatial patterns of tall buildings in suburban settings. And among the TB-TOD typologies/ sub-typologies, compact tall building blocks can be the most energy efficient one. This model is associated with much lower energy demands in buildings at the neighborhood level as well as lower transport needs in an urban scale while detached suburban high rise or low rise suburban housing will have the lowest energy efficiency. The research methodology is based on quantitative study through applying the available literature and static data as well as mapping and visual documentations of urban regions such as Google Earth, Microsoft Bing Bird View and Streetview. It will examine each suburb within each city through the satellite imagery and explore the typologies/ sub-typologies which are morphologically distinct. The study quantifies heat energy efficiency of different spatial patterns through simulation via GIS software.

Keywords: energy efficiency, spatial pattern, suburb, tall building transit-oriented development (TB-TOD)

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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Contraceptive methods play a fundamental role in preventing unwanted pregnancies and protecting users from sexually transmitted infections (STIs). Despite being known to almost the entire population of reproductive age living in Colombia, there are barriers, practices and complex notions about contraceptives that affect their desired mass use and effectiveness. This work aims to analyse some of the perceptions and practices discussed with young people (13-28 years old) living in Colombia regarding the use of contraceptives in their daily lives, preferences, needs and perceived side effects. This research also examines the perceived paradox in autonomy that young people experience regarding contraceptive use: in one hand, its use (or lack of it) is interpreted as an act of self-determination and primary example of reproductive agency, on the other hand, it was frequently associated with coercion and limited autonomy derived from the gaps in reliable information available for young people, the difficulty of accessing certain preferred methods, and sometimes the experienced coercion exercise by doctors, partners and/or family members. The data and analysis discussed in this work stems from a research project whose objective was to provide information about needs and preferences in sexual and reproductive health of young people living in Colombia in relation to a possible telehealth service that could close the gap in access to quality care and safe information. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 inperson interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings on contraception use in young people living in Colombia reveal that 85,8% of participants had used a contraceptive method in the last two years, and that the most commonly used methods were condoms, contraceptive pills, the morning-after pill and the method of interruption. The remaining 14,2% of respondents who declared to not have used contraceptives in the last two years expressed that the main four barriers to access were: "Lack of knowledge about contraceptive methods and where to obtain information and/or access them (13.9%)", "Have had sex with people who have vaginas (10.2%)", "Cost of contraceptive method (8.4%)" and "Difficulties in obtaining medical authorisations (7.6%)". These barriers coincided with the ones used to explain the non-use of contraceptives in young people, which reveals that limitations in information, cost, and quality care represent structural issues that need to be address in programmes, services, and public policy. Finally, interviews showed that young people perceive contraceptive use and non-use as an example of reaffirming reproductive agency and limitations to this can be explained through the widespread incomplete knowledge about how methods work and the prevalence of other social representations of contraception associated with trust, fidelity, and partner preferences, that in the end create limitations to young people’s autonomy.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: M. Doudi, M. H. Pazandeh, L. Rahimzadeh Torabi

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Bedsores are pressure ulcers that occur on the skin or tissue due to being immobile and lying in bed for extended periods. Bedsores have the potential to progress into open ulcers, increasing the possibility of a variety of bacterial infections. Acinetobacter baumannii, a pathogen of considerable clinical importance, exhibited a significant correlation with Bedsores (pressure ulcers) infections, thereby manifesting a wide spectrum of antibiotic resistance. The emergence of drug resistance has led researchers to focus on alternative methods, particularly phage therapy, for tackling bacterial infections. Phage therapy has emerged as a novel therapeutic approach to regulate the activity of these agents. The management of bacterial infections greatly benefits from the clinical utilization of bacteriophages as a valuable antimicrobial intervention. The primary objective of this investigation consisted of isolating and discerning potent bacteriophage capable of targeting multi-drug-resistant (MDR) and extensively drug-resistant (XDR) bacteria obtained from pressure ulcers. The present study analyzed and isolated A. baumannii strains obtained from a cohort of patients suffering from pressure ulcers at Taleghani Hospital in Ahvaz, Iran. An approach that included biochemical and molecular identification techniques was used to determine the taxonomic classification of bacterial isolates at the genus and species levels. The molecular identification process was facilitated by using the 16S rRNA gene in combination with universal primers 27 F and 1492 R. Bacteriophage was obtained through the isolation process conducted on treatment plant sewage located in Isfahan, Iran. The main goal of this study was to evaluate different characteristics of phage, such as their appearance, the range of hosts they can infect, how quickly they can enter a host, their stability at varying temperatures and pH levels, their effectiveness in killing bacteria, the growth pattern of a single phage stage, mapping of enzymatic digestion, and identification of proteomics patterns. The findings demonstrated that an examination was conducted on a sample of 50 specimens, wherein 15 instances of A. baumannii were identified. These microorganisms are the predominant Gram-negative agents known to cause wound infections in individuals suffering from bedsores. The study's findings indicated a high prevalence of antibiotic resistance in the strains isolated from pressure ulcers, excluding the clinical strains that exhibited responsiveness to colistin. According to the findings obtained from assessments of host range and morphological characteristics of bacteriophage VbɸAB-1, it can be concluded that this phage possesses specificity towards A. Baumannii BAH_Glau1001 was classified as a member of the Podoviridae family. The bacteriophage mentioned earlier showed the strongest antibacterial effect at a temperature of 18 °C and a pH of 6.5. Through the utilization of sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on protein fragments, it was established that the bacteriophage VbɸAB-1 exhibited a size range between 50 and 75 kilodaltons (KDa). The numerous research findings on the effectiveness of phages and the safety studies conducted suggest that the phages studied in this research can be considered as a practical solution and recommended approach for controlling and treating stubborn pathogens in burn wounds among hospitalized patients. The findings of our research indicated that isolated phages could be an effective antimicrobial and an appreciate candidate for prophylaxis against pressure ulcers.

Keywords: acinetobacter baumannii, extremely drug-resistant, phage therapy, surgery wound

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Authors: Kim Bower

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Evaluating and researching motivation in language learning is a complex and multi-faceted activity. Various models for investigating learner motivation have been proposed in the literature, but no one model supplies a complex and coherent model for investigating a range of motivational characteristics. Here, such a methodological framework, which includes exemplification of sources of evidence and potential methods of investigation, is proposed. The process model for the investigation of motivation within language learning settings proposed is based on a complex dynamic systems perspective that takes account of cognition and affects. It focuses on three overarching aspects of motivation: the learning environment, learner engagement and learner identities. Within these categories subsets are defined: the learning environment incorporates teacher, course and group specific aspects of motivation; learner engagement addresses the principal characteristics of learners' perceived value of activities, their attitudes towards language learning, their perceptions of their learning and engagement in learning tasks; and within learner identities, principal characteristics of self-concept and mastery of the language are explored. Exemplifications of potential sources of evidence in the model reflect the multiple influences within and between learner and environmental factors and the possible changes in both that may emerge over time. The model was initially developed as a framework for investigating different models of Content and Language Integrated Learning (CLIL) in contrasting contexts in secondary schools in England. The study, from which examples are drawn to exemplify the model, aimed to address the following three research questions: (1) in what ways does CLIL impact on learner motivation? (2) what are the main elements of CLIL that enhance motivation? and (3) to what extent might these be transferable to other contexts? This new model has been tried and tested in three locations in England and reported as case studies. Following an initial visit to each institution to discuss the qualitative research, instruments were developed according to the proposed model. A questionnaire was drawn up and completed by one group prior to a 3-day data collection visit to each institution, during which interviews were held with academic leaders, the head of the department, the CLIL teacher(s), and two learner focus groups of six-eight learners. Interviews were recorded and transcribed verbatim. 2-4 naturalistic observations of lessons were undertaken in each setting, as appropriate to the context, to provide colour and thereby a richer picture. Findings were subjected to an interpretive analysis by the themes derived from the process model and are reported elsewhere. The model proved to be an effective and coherent framework for planning the research, instrument design, data collection and interpretive analysis of data in these three contrasting settings, in which different models of language learning were in place. It is hoped that the proposed model, reported here together with exemplification and commentary, will enable teachers and researchers in a wide range of language learning contexts to investigate learner motivation in a systematic and in-depth manner.

Keywords: investigate, language-learning, learner motivation model, dynamic systems perspective

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Authors: Alua Masalimova, Dameli Sulubecova, Talgat Isaev, Raushan Magzumova

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The usual relation to nurses of heads of medical organizations in Kazakhstan is to use them only for per performing medical manipulations, but new economic conditions require the introduction of nursing innovations. There is an increasing need for managers of hospital departments and regions of ambulatory clinics to ensure comfortable conditions for doctors, nurses, aides, as well as monitoring marketing technology (the needs and satisfaction of staff work, the patient satisfaction of the department). It is going to the past the nursing activities as physician assistant performing his prescriptions passively. We are suggesting a model for the developing the head nurse as the manager on the example of Blood Service. We have studied in the scientific-production center of blood transfusion head nurses by the standard method of interviewing for involvement in coordinating the flow of information, promoting the competitiveness of the department. Results: the average age of the respondents 43,1 ± 9,8, female - 100%; manager in the Organization – 9,3 ± 10,3 years. Received positive responses to the knowledge of the nearest offices in providing similar medical service - 14,2%. The cost of similar medical services in other competitive organizations did not know 100%, did a study of employee satisfaction Division labour-85,7% answered negatively, the satisfaction donors work staff studied in 50.0% of cases involved in attracting paid Services Division showed a 28.5% of the respondent. Participation in management decisions medical organization: strategic planning - 14,2%, forming analysis report for the year – 14,2%, recruitment-30.0%, equipment-14.2%. Participation in the social and technical designing workplaces Division staff showed 85,0% of senior nurses. Participate in the cohesion of the staff of the Division method of the team used the 10.0% of respondents. Further, we have studied the behavioral competencies for senior sisters: customer focus – 20,0% of respondents have attended, the ability to work in a team – 40,0%. Personal qualities senior nurses were apparent: sociability – 80,0%, the ability to manage information – 40,0%, to make their own decisions - 14,2%, 28,5% creativity, the desire to improve their professionalism – 50,0%. Thus, the modern market conditions dictate this organization, which works for the rights of economic management; include the competence of the post of the senior nurse knowledge and skills of Marketing Management Department. Skills to analyses the information collected and use of management offers superior medical leadership organization. The medical organization in the recruitment of the senior nurse offices take into account personal qualities: flexibility, fluency of thinking, communication skills and ability to work in a team. As well as leadership qualities, ambition, high emotional and social intelligence, that will bring out the medical unit on competitiveness within the country and abroad.

Keywords: blood service, head nurse, manager, skills

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Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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Authors: Ayla Hoeta

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In a post-colonial Aotearoa New Zealand, solutions by rangatahi (youth) for rangatahi are essential as is civic participation and building economic agency in an increasingly tough economic climate. Upsouth was an online community crowdsourcing platform developed by The Southern Initiative, in collaboration with Itsnoon that provides rangatahi and whānau (family) a safe space to share lived experience, thoughts and ideas about local kaupapa (issues/topics) of importance to them. The target participants were Māori indigenous peoples and Pacifica groups, aged 14 - 21 years. In the Aotearoa New Zealand context, this participant group is not likely to engage in traditional consultation processes despite being an essential constituent in helping shape better local communities, whānau and futures. The Upsouth platform was active for two years from 2018-2019 where it completed 42 callups with 4300+ participants. The web platform collates the ideas, voices, feedback, and content of users around a callup that has been commissioned by a sponsor, such as Auckland Council, Z Energy or Auckland Transport. A callup may be about a pressing challenge in a community such as climate change, a new housing development, homelessness etc. Each callup was funded by the sponsor with Upsouths main point of difference being that participants are given koha (money donation) through digital wallets for their ideas. Depending on the quality of what participants upload, the koha varies between small micropayments and larger payments. This encouraged participants to develop creative and critical thinking - upskilling for future focussed jobs, enterprise and democratic skills while earning pocket money at the same time. Upsouth enables youth-led action and voice, and empowers them to be a part of a reciprocal and creative economy. Rangatahi are encouraged to express themselves culturally, creatively, freely and in a way they are free to choose - for example, spoken word, song, dance, video, drawings, and/or poems. This challenges and changes what is considered acceptable as community engagement feedback by the local government. Many traditional engagement platforms are not as consultative, do not accept diverse types of feedback, nor incentivise this valuable expression of feedback. Upsouth is also empowering for rangatahi, since it allows them the opportunity to express their opinions directly to the government. Upsouth gained national and international recognition for the way it engages with youth: winning the Supreme Award and the Accessibility and Transparency Award at Auckland Council’s 2018 Engagement Awards, becoming a finalist in the 2018 Digital Equity and Accessibility category of International Data Corporation’s Smart City Asia and Pacific Awards. This paper will fully contextualize the challenges of rangatahi and whānau civic engagement in Aotearoa New Zealand and then present a reflective case study of the Upsouth project, with examples from some of the callups. This is intended to form part of the Divided Cities 22 conference New Ground sub-theme as a critical reflection on a design intervention, which was conceived and implemented by the lead author to overcome the post-colonial divisions of Māori, Pacifica and minority ethnic rangatahi in Aotearoa New Zealand.

Keywords: rangatahi, youth empowerment, civic engagement, enabling, relating, digital platform, participation

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Authors: Chuanqiao Zheng, Wei Zeng, Haozhen Lin

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As of March 2020, the number of Chinese netizens has reached 904 million. The proportion of Internet users accessing the Internet through mobile phones is as high as 99.3%. Under the background of 'Internet +', tourists have a stronger sense of independence in the choice of tourism destinations and tourism products. Tourists are more inclined to learn about the relevant information on tourism destinations and other tourists' evaluations of tourist products through the Internet. The search engine, as an integrated platform that contains a wealth of information, is highly valuable to the analysis of the characteristics of the Internet attention given to various tourism destinations, through big data mining and analysis. This article uses the Baidu Index as the data source, which is one of the products of Baidu Search. The Baidu Index is based on big data, which collects and shares the search results of a large number of Internet users on the Baidu search engine. The big data used in this article includes search index, demand map, population profile, etc. The main research methods used are: (1) based on the search index, analyzing the Internet attention given to the tourism in five cities in Northeast Sichuan at different times, so as to obtain the overall trend and individual characteristics of tourism development in the region; (2) based on the demand map and the population profile, analyzing the demographic characteristics and market positioning of the tourist groups in these cities to understand the characteristics and needs of the target groups; (3) correlating the Internet attention data with the permanent population of each province in China in the corresponding to construct the Boston matrix of the Internet attention rate of the Northeast Sichuan tourism, obtain the tourism target markets, and then propose development strategies for different markets. The study has found that: a) the Internet attention given to the tourism in the region can be categorized into tourist off-season and peak season; the Internet attention given to tourism in different cities is quite different. b) tourists look for information including tour guide information, ticket information, traffic information, weather information, and information on the competing tourism cities; with regard to the population profile, the main group of potential tourists searching for the keywords of tourism in the five prefecture-level cities in Northeast Sichuan are youth. The male to female ratio is about 6 to 4, with males being predominant. c) through the construction of the Boston matrix, it is concluded that the star market for tourism in the Northeast Sichuan Economic Zone includes Sichuan and Shaanxi; the cash cows market includes Hainan and Ningxia; the question market includes Jiangsu and Shanghai; the dog market includes Hubei and Jiangxi. The study concludes with the following planning strategies and recommendations: i) creating a diversified business format that integrates cultural and tourism; ii) creating a brand image of niche tourism; iii) focusing on the development of tourism products; iv) innovating composite three-dimensional marketing channels.

Keywords: Baidu Index, big data, internet attention, tourism

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Authors: Praniil Nagaraj

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This paper proposes a method to collect homeless data using crowdsourcing and presents an approach to analyze the data, demonstrating its potential to strengthen existing and future policies aimed at promoting socio-economic equilibrium. The 2022 Annual Homeless Assessment Report (AHAR) to Congress highlighted alarming statistics, emphasizing the need for effective decision-making and budget allocation within local planning bodies known as Continuums of Care (CoC). This paper's contributions can be categorized into three main areas. Firstly, a unique method for collecting homeless data is introduced, utilizing a user-friendly smartphone app (currently available for Android). The app enables the general public to quickly record information about homeless individuals, including the number of people and details about their living conditions. The collected data, including date, time, and location, is anonymized and securely transmitted to the cloud. It is anticipated that an increasing number of users motivated to contribute to society will adopt the app, thus expanding the data collection efforts. Duplicate data is addressed through simple classification methods, and historical data is utilized to fill in missing information. The second contribution of this paper is the description of data analysis techniques applied to the collected data. By combining this new data with existing information, statistical regression analysis is employed to gain insights into various aspects, such as distinguishing between unsheltered and sheltered homeless populations, as well as examining their correlation with factors like unemployment rates, housing affordability, and labor demand. Initial data is collected in San Francisco, while pre-existing information is drawn from three cities: San Francisco, New York City, and Washington D.C., facilitating the conduction of simulations. The third contribution focuses on demonstrating the practical implications of the data processing results. The challenges faced by key stakeholders, including charitable organizations and local city governments, are taken into consideration. Two case studies are presented as examples. The first case study explores improving the efficiency of food and necessities distribution, as well as medical assistance, driven by charitable organizations. The second case study examines the correlation between micro-geographic budget expenditure by local city governments and homeless information to justify budget allocation and expenditures. The ultimate objective of this endeavor is to enable the continuous enhancement of the quality of life for the underprivileged. It is hoped that through increased crowdsourcing of data from the public, the Generosity Curve and the Need Curve will intersect, leading to a better world for all.

Keywords: crowdsourcing, homelessness, socio-economic policies, statistical regression

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Authors: Etienne Gatera

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Many studies have been conducted on SDT. Most of them focus on developed countries because of influencing factors such as; education, health, labor force, female labor force participation, industrialization, urbanization and migration. However, this thesis project paper aims to assess the impact of the total fertility rate (TFR) on the trends of the SDR in Rwanda. We will mainly be based in Rwanda after the 1994 genocide. Rwanda is located in East Africa, with approximately 13 million inhabitants. Thus, after the 1994 Tutsi genocide. The population growth rate exploded out of control with 6.17 children per woman in 1995. However, it's declined to 4.2 in 2014-2015 and declining to 4.1% in 2019-2020. Respectively with 3.4 children per woman in urban areas and 4.3 in rural areas. According to the National Institute of Statistics of Rwanda. Rwanda's population is expected to continue to grow for the rest of the century and reach 33.35 million people in 2099, with 2.1 children per woman in 2050. However, this project document aims to demonstrate the impact of the TFR on SDT trends in Rwanda. Thus, the decline in the TFR in Rwanda began with the introduction of family planning practices, which now account for 47.5% in 2019. Childbearing with three children for rural women compared to two children in the city, the increase in Divorce and separation caused by the behavior called "Kuza n'ijoro" or "coming at night" similar to cohabitation in developed countries. The decline in remarriage is caused by single mothers behavior who prefer to raise their children rather than remarry. Therefore, the study used probability sampling with (Stratified random sampling) method with a survey questionnaire of 1067 respondents in the 5 Districts (3 in rural areas and two in urban areas), with the target group of women Age between 15-49. The study demonstrated that the age of marriage in rural areas is two years higher than in urban areas. Divorce is more common in urban is with 6.2% with 5.2% in rural areas. However, separation is more common in rural areas than in urban areas, with a lower rate of 3%, due to the higher system called "Kuza n'ijoro" or "come at night", similar to cohabitation in developed countries. The study revealed that more than 85% of divorced people prefer to remain single, which confirms the low remarriage rate. Childbearing has started to decrease, especially for young singles in urban areas, due to the economic situation, with national statistics showing that unemployment in the youth community is still 16% higher. Therefore, the study concluded by confirming the hypothesis based on the results of the TFR indicators such as marriage, remarriage, divorce, separation, divorce, Kuza n'ijoro, childbearing] and abortion. The study consists of four sections, an introduction and background, a review of the literature, a description of the data and methodology, an analysis of the data, discussion results and a conclusion.

Keywords: Kuza n'ijoro, Rwanda, second demographic transition (SDT), total fertility rate (TFR)

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Authors: Moh'd Anwer Al-Shboul

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Jordan Customs (JC) has been established to achieve objectives that must be consistent with the guidance of the wise leadership and its aspirations toward tomorrow. Therefore, it has developed several needed tools to provide a distinguished service to simplify work procedures and used modern technologies. A supply chain (SC) consists of all parties that are involved directly or indirectly in order to fulfill a customer request, which includes manufacturers, suppliers, shippers, retailers and even customer brokers. Within each firm, the SC includes all functions involved in receiving a filling a customers’ requests; one of the main functions include customer service. JC and global SCs are evolving into dynamic environment, which requires flexibility, effective communication, and team management. Thus, human resources (HRs) insight in these areas are critical for the effective development of global process network. The importance of HRs has increased significantly due to the role of employees depends on their knowledge, competencies, abilities, skills, and motivations. Strategic planning in JC began at the end of the 1990’s including operational strategy for Human Resource Management and Development (HRM&D). However, a huge transformation in human resources happened at the end of 2006; new employees’ regulation for customs were prepared, approved and applied at the end of 2007. Therefore, many employees lost their positions, while others were selected based on professorial recruitment and selection process (enter new blood). One of several policies that were applied by human resources in JC department is job rotation. From the researcher’s point of view, it was not based on scientific basis to achieve its goals and objectives, which at the end leads to having a significant negative impact on the Organizational Performance (OP) and weak job rotation approach. The purpose of this study is to call attention to re-review the applying process and procedure of job rotation that HRM directorate is currently applied at JC. Furthermore, it presents an overview of managing the HRs in the SC network that affects their success. The research methodology employed in this study was described as qualitative by conducting few interviews with managers, internal employee, external clients and reviewing the related literature to collect some qualitative data from secondary sources. Thus, conducting frequently and unstructured job rotation policy (i.e. monthly) will have a significant negative impact on JC performance as a whole. The results of this study show that the main impacts will affect on three main elements in JC: (1) internal employees' performance; (2) external clients, who are dealing with customs services; and finally, JC performance as a whole. In order to implement a successful and perfect job rotation technique at JC in a scientific way and to achieve its goals and objectives; JCs should be taken into consideration the proposed solutions and recommendations that will be presented in this study.

Keywords: efficiency, supply chain, human resources, job rotation, organizational performance, Jordan customs

Procedia PDF Downloads 196

Authors: Oscar Nieto-Garzón, Angélica Lozano

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In urban areas, on-road freight transportation creates several social and environmental externalities. Then, it is crucial that freight transport considers not only economic aspects, like retailer distribution cost reduction and service improvement, but also environmental effects such as global CO2 and local emissions (e.g. Particulate Matter, NOX, CO) and noise. Inadequate infrastructure development, high rate of urbanization, the increase of motorization, and the lack of transportation planning are characteristics that urban areas from developing countries share. The Metropolitan Area of Mexico City (MAMC), the Metropolitan Area of São Paulo (MASP), and Bogota are three of the largest urban areas in Latin America where air pollution is often a problem associated with emissions from mobile sources. The effect of the lockdown due to COVID-19 was analyzedfor these urban areas, comparing the same period (January to August) of years 2016 – 2019 with 2020. A strong reduction in the concentration of primary criteria pollutants emitted by road traffic were observed at the beginning of 2020 and after the lockdown measures.Daily mean concentration of NOx decreased 40% in the MAMC, 34% in the MASP, and 62% in Bogota. Daily mean ozone levels increased after the lockdown measures in the three urban areas, 25% in MAMC, 30% in the MASP and 60% in Bogota. These changes in emission patterns from mobile sources drastically changed the ambient atmospheric concentrations of CO and NOX. The CO/NOX ratioat the morning hours is often used as an indicator of mobile sources emissions. In 2020, traffic from cars and light vehicles was significantly reduced due to the first lockdown, but buses and trucks had not restrictions. In theory, it implies a decrease in CO and NOX from cars or light vehicles, maintaining the levels of NOX by trucks(or lower levels due to the congestion reduction). At rush hours, traffic was reduced between 50% and 75%, so trucks could get higher speeds, which would reduce their emissions. By means an emission model, it was found that an increase in the average speed (75%) would reduce the emissions (CO, NOX, and PM) from diesel trucks by up to 30%. It was expected that the value of CO/NOXratio could change due to thelockdownrestrictions. However, although there was asignificant reduction of traffic, CO/NOX kept its trend, decreasing to 8-9 in 2020. Hence, traffic restrictions had no impact on the CO/NOX ratio, although they did reduce vehicle emissions of CO and NOX. Therefore, these emissions may not adequately represent the change in the vehicle emission patterns, or this ratio may not be a good indicator of emissions generated by vehicles. From the comparison of the theoretical data and those observed during the lockdown, results that the real NOX reduction was lower than the theoretical reduction. The reasons could be that there are other sources of NOX emissions, so there would be an over-representation of NOX emissions generated by diesel vehicles, or there is an underestimation of CO emissions. Further analysis needs to consider this ratioto evaluate the emission inventories and then to extend these results forthe determination of emission control policies to non-mobile sources.

Keywords: COVID-19, emissions, freight transport, latin American metropolis

Procedia PDF Downloads 115

Authors: Arzu Firlarer, Duygu Gocmen, Gokhan Uysal

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There is currently a growing trend among universities towards blended learning. Blended learning is becoming increasingly important in higher education, with the aims of better accomplishing course learning objectives, meeting students’ changing needs and promoting effective learning both in a theoretical and practical dimension like interior architecture discipline. However, the practical dimension of the discipline cannot be supported in the university environment. During the undergraduate program, the practical training which is tried to be supported by two different internship programs cannot fully meet the requirements of the blended learning. The lack of education program frequently expressed by our graduates and employers is revealed in the practical knowledge and skills dimension of the profession. After a series of meetings for curriculum studies, interviews with the chambers of profession, meetings with interior architects, a gap between the theoretical and practical training modules is seen as a problem in all interior architecture departments. It is thought that this gap can be solved by a new education model which is formed by the cooperation of University-Industry in the concept of blended learning. In this context, it is considered that theoretical and applied knowledge accumulation can be provided by the creation of industry-supported educational environments at the university. In the application process of the Interior Architecture discipline, the use of materials and technical competence will only be possible with the cooperation of industry and participation of students in the production/manufacture processes as observers and practitioners. Wood manufacturing is an important part of interior architecture applications. Wood productions is a sustainable structural process where production details, material knowledge, and process details can be observed in the most effective way. From this point of view, after theoretical training about wooden materials, wood applications and production processes are given to the students, practical training for production/manufacture planning is supported by active participation and observation in the processes. With this blended model, we aimed to develop a training model in which theoretical and practical knowledge related to the production of wood works will be conveyed in a meaningful, lasting way by means of university-industry cooperation. The project is carried out in Ankara with Arcora Architecture and Furniture Company and Başkent University Department of Interior Design where university-industry cooperation is realized. Within the scope of the project, every week the video of that week’s lecture is recorded and prepared to be disseminated by digital medias such as Udemy. In this sense, the program is not only developed by the project participants, but also other institutions and people who are trained and practiced in the field of design. Both academicians from University and at least 15-year experienced craftsmen in the wood metal and dye sectors are preparing new training reference documents for interior architecture undergraduate programs. These reference documents will be a model for other Interior Architecture departments of the universities and will be used for creating an online education module.

Keywords: blended learning, interior design, sustainable training, effective learning.

Procedia PDF Downloads 118

Authors: Ashish Sinha, Pushpend Agrawal

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Background: Patients with undiagnosed pulmonary TB predominantly act as reservoirs for its transmission through 10-15 secondary infections in the next 1-5 Yrs. Delays in the diagnosis and treatment may worsen the disease with increase the risk of death. Factors responsible for such delays by tracking patient pathways to treatment may help in planning better interventions. The provision of ‘free diagnosis and treatment’ forms the cornerstone of the National Tuberculosis Elimination Programme (NTEP). OOPE is defined as the money spent by the patient during TB care other than public health facilities. Free TB care at all health facilities could reduce out-of-pocket expenses to the minimum possible levels. Material and Methods: This cross-sectional study was conducted among randomly selected 252 TB patients from Nov – Oct 2022 by taking in-depth interviews following informed verbal consent. We documented their journey from initial symptoms until they reached the public health facility, along with their ‘out-of-pocket expenditure’ (OOPE) pertaining to TB care. Results: Total treatment delay was 91±72 days on average (median: 77days, IQR: 45-104 days), while the isolated patient delay was 31±45 days (median: 15 days, IQR: 0 days to 43 days); diagnostic delay; 57±60 days (median: 42days, IQR 14-78 days), treatment delay 19 ± 18 days (median: 15days, IQR: 11-19 days). A patient delay (> 30 days) was significantly associated with ignorance about classic symptoms of pulmonary TB, adoption of self-medication, illiteracy, and middle and lower social class. Diagnostic delay was significantly higher among those who contacted private health facilities, were unaware of signs and symptoms, had >2 consultations, and not getting an appropriate referral for TB care. Most (97%) of the study participants interviewed claimed to have incurred some expenditure.Median total expenses were 6155(IQR: 2625-15175) rupees. More than half 141 (56%) of the study participants had expenses >5000 rupees. Median transport expenses were 525(IQR: 200-1012) rupees; Median consultation expenses were 700(IQR: 200-1600) rupees; Median investigation expenses were 1000(IQR: 0-3025) rupees and the Median medicine expenses were 3350(IQR: 1300-7525).OOPE for consultation, investigation, and medicine was observed to be significantly higher among patients who ignored classical signs& symptoms of TB, repeated visits to private health facilities, and due to self-medication practices. Transport expenses and delays in seeking care at facilities were observed to have an upward trend with OOP Expenses (r =1). Conclusion: Delay in TB care due to low awareness about signs and symptoms of TB and poor seeking care, lack of proper consultation, and appropriate referrals reported by the study subjects indicate the areas which need proper attention by the program managers. Despite a centrally sponsored programme, the financial burden on TB patients is still in the unacceptable range. OOPE could be reduced as low as possible by addressing the responsible factors linked to it.

Keywords: patient pathway, delay, pulmonary tuberculosis, out of pocket expenses

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Authors: Mustafa Mutahari, Nao Sugiki, Kojiro Matsuo

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The four decades of war, lack of job opportunities, poverty, lack of services, and natural disasters in different provinces of Afghanistan have contributed to a rapid increase in the population of Kabul, the capital city of Afghanistan. Population census has not been conducted since 1979, the first and last population census in Afghanistan. However, according to population estimations by Afghan authorities, the population of Kabul has been estimated at more than 4 million people, whereas the city was designed for two million people. Although the major transport mode of Kabul residents is public transport, responsible authorities within the country failed to supply the required means of transportation systems for the city. Besides, informal resettlement, lack of intersection control devices, presence of illegal vendors on streets, presence of illegal and unstandardized on-street parking and bus stops, driver`s unprofessional behavior, weak traffic law enforcement, and blocked roads and sidewalks have contributed to the extreme traffic congestion of Kabul. In 2018, the government of Afghanistan approved the Kabul city Urban Design Framework (KUDF), a vision towards the future of Kabul, which provides strategies and design guidance at different scales to direct urban development. Considering traffic congestion of the city and its budget limitations, the KUDF proposes a BRT route network with seven lines to reduce the traffic congestion, and it is said to facilitate more than 50% of Kabul population to benefit from this service. Based on the KUDF, it is planned to increase the BRT mode share from 0% to 17% and later to 30% in medium and long-term planning scenarios, respectively. Therefore, a detailed research study is needed to evaluate the proposed system before the implementation stage starts. The integrated land-use transport model is an effective tool to evaluate the Kabul BRT because of its future assessment capabilities that take into account the interaction between land use and transportation. This research aims to analyze and evaluate the proposed BRT route network with the application of an integrated land-use and transportation model. The research estimates the population distribution and travel behavior of Kabul within small boundary scales. The actual road network and land-use detailed data of the city are used to perform the analysis. The BRT corridors are evaluated not only considering its impacts on the spatial interactions in the city`s transportation system but also on the spatial developments. Therefore, the BRT are evaluated with the scenarios of improving the Kabul transportation system based on the distribution of land-use or spatial developments, planned development typology and population distribution of the city. The impacts of the new improved transport system on the BRT network are analyzed and the BRT network is evaluated accordingly. In addition, the research also focuses on the spatial accessibility of BRT stops, corridors, and BRT line beneficiaries, and each BRT stop and corridor are evaluated in terms of both access and geographic coverage, as well.

Keywords: accessibility, BRT, integrated land-use and transport model, travel behavior, spatial development

Procedia PDF Downloads 182

Authors: Jean-Philippe Amat, Timothée Vergne, Aymeric Hans, Bénédicte Ferry, Pascal Hendrikx, Jackie Tapprest, Barbara Dufour, Agnès Leblond

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The surveillance of infectious diseases is necessary to describe their occurrence and help the planning, implementation and evaluation of risk mitigation activities. However, the exact number of detected cases may remain unknown whether surveillance is based on serological tests because identifying seroconversion may be difficult. Moreover, incomplete detection of cases or outbreaks is a recurrent issue in the field of disease surveillance. This study addresses these two issues. Using a viral animal disease as an example (equine viral arteritis), the goals were to establish suitable rules for identifying seroconversion in order to estimate the number of cases and outbreaks detected by a surveillance system in France between 2006 and 2013, and to assess the sensitivity of this system by estimating the total number of outbreaks that occurred during this period (including unreported outbreaks) using a capture-recapture model. Data from horses which exhibited at least one positive result in serology using viral neutralization test between 2006 and 2013 were used for analysis (n=1,645). Data consisted of the annual antibody titers and the location of the subjects (towns). A consensus among multidisciplinary experts (specialists in the disease and its laboratory diagnosis, epidemiologists) was reached to consider seroconversion as a change in antibody titer from negative to at least 32 or as a three-fold or greater increase. The number of seroconversions was counted for each town and modeled using a unilist zero-truncated binomial (ZTB) capture-recapture model with R software. The binomial denominator was the number of horses tested in each infected town. Using the defined rules, 239 cases located in 177 towns (outbreaks) were identified from 2006 to 2013. Subsequently, the sensitivity of the surveillance system was estimated as the ratio of the number of detected outbreaks to the total number of outbreaks that occurred (including unreported outbreaks) estimated using the ZTB model. The total number of outbreaks was estimated at 215 (95% credible interval CrI95%: 195-249) and the surveillance sensitivity at 82% (CrI95%: 71-91). The rules proposed for identifying seroconversion may serve future research. Such rules, adjusted to the local environment, could conceivably be applied in other countries with surveillance programs dedicated to this disease. More generally, defining ad hoc algorithms for interpreting the antibody titer could be useful regarding other human and animal diseases and zoonosis when there is a lack of accurate information in the literature about the serological response in naturally infected subjects. This study shows how capture-recapture methods may help to estimate the sensitivity of an imperfect surveillance system and to valorize surveillance data. The sensitivity of the surveillance system of equine viral arteritis is relatively high and supports its relevance to prevent the disease spreading.

Keywords: Bayesian inference, capture-recapture, epidemiology, equine viral arteritis, infectious disease, seroconversion, surveillance

Procedia PDF Downloads 276

Authors: Georges Ghazi, Magali Gelhaye, Ruxandra Botez

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Over the years, the Flight Management System (FMS) has experienced a continuous improvement of its many features, to the point of becoming the pilot’s primary interface for flight planning operation on the airplane. With the assistance of the FMS, the concept of distance and time has been completely revolutionized, providing the crew members with the determination of the optimized route (or flight plan) from the departure airport to the arrival airport. To accomplish this function, the FMS needs an accurate Aircraft Performance Model (APM) of the aircraft. In general, APMs that equipped most modern FMSs are established before the entry into service of an individual aircraft, and results from the combination of a set of ordinary differential equations and a set of performance databases. Unfortunately, an aircraft in service is constantly exposed to dynamic loads that degrade its flight characteristics. These degradations endow two main origins: airframe deterioration (control surfaces rigging, seals missing or damaged, etc.) and engine performance degradation (fuel consumption increase for a given thrust). Thus, after several years of service, the performance databases and the APM associated to a specific aircraft are no longer representative enough of the actual aircraft performance. It is important to monitor the trend of the performance deterioration and correct the uncertainties of the aircraft model in order to improve the accuracy the flight management system predictions. The basis of this research lies in the new ability to continuously update an Aircraft Performance Model (APM) during flight using an adaptive lookup table technique. This methodology was developed and applied to the well-known Cessna Citation X business aircraft. For the purpose of this study, a level D Research Aircraft Flight Simulator (RAFS) was used as a test aircraft. According to Federal Aviation Administration the level D is the highest certification level for the flight dynamics modeling. Basically, using data available in the Flight Crew Operating Manual (FCOM), a first APM describing the variation of the engine fan speed and aircraft fuel flow w.r.t flight conditions was derived. This model was next improved using the proposed methodology. To do that, several cruise flights were performed using the RAFS. An algorithm was developed to frequently sample the aircraft sensors measurements during the flight and compare the model prediction with the actual measurements. Based on these comparisons, a correction was performed on the actual APM in order to minimize the error between the predicted data and the measured data. In this way, as the aircraft flies, the APM will be continuously enhanced, making the FMS more and more precise and the prediction of trajectories more realistic and more reliable. The results obtained are very encouraging. Indeed, using the tables initialized with the FCOM data, only a few iterations were needed to reduce the fuel flow prediction error from an average relative error of 12% to 0.3%. Similarly, the FCOM prediction regarding the engine fan speed was reduced from a maximum error deviation of 5.0% to 0.2% after only ten flights.

Keywords: aircraft performance, cruise, trajectory optimization, adaptive lookup tables, Cessna Citation X

Procedia PDF Downloads 243

Authors: Alexander Suuk Laar, Emmanuel Bekyieriya, Sylvester Isang, Benjamin Baguune

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Introduction: In Ghana, despite the implementation of strategies and initiatives to ensure universal access to reproductive health and family planning (FP) services for the past two decades, interventions have not adequately addressed the access and utilization needs of women of reproductive age, especially in rural Ghana. To improve access and use of reproductive and maternal health services in Ghana, a free maternal care exemption policy under the universal health coverage of the National Health Insurance Scheme was implemented in 2005. Despite the importance of FP, this service was left out of the benefit package of the policy. Low or no use of FP services is often associated with poor health among women. However, to date, there has been limited research on perspectives of women for not making FP services as part of the benefit package of the free maternal health services. This qualitative study explored perceptions of women on the comprehensiveness of the free maternal health benefit package and the effects on utilisation of services in the rural Upper West region of Ghana to improve services. Methods: This exploratory qualitative study used focus group discussions with pregnant and lactating women in three rural districts in the Upper West region of Ghana. Six focus groups were held with both pregnant women and lactating mothers at the time of the interview. Three focus group discussions were organised with the same category of women in each district. We used a purposive sampling procedure to select the participants from the districts. The interviews with the written consent of the participants lasted between 60 minutes and 120 minutes. Interviews were audio-recorded and transcribed verbatim. Data were analysed using Braun and Clarke thematic framework guidelines. Results: This research presents an in-depth account of women's perceptions on the effects associated with the uptake of FP services and its exclusion from the benefit package of the free maternal health policy. Our study found that participants did not support the exclusion of FP services in the benefit package. Participants mentioned factors hampering their access to and use of FP and contraceptive services to include the cost of services, distance and cost of transport to health facilities, lack of knowledge about FP services, socio-cultural norms and negative attitude of healthcare professionals. Participants are of the view that making FP services part of the benefit package could have addressed the cost aspect of services which act as the main barrier to improve the use of services by poor rural women. Conclusion: Women of reproductive age face cost barriers that limit their access to and use of FP and contraception services in the rural Upper West region of Ghana and need health policymakers to revise the free maternal health package to include FP services. It is essential for policymakers to begin considering revising the free maternal health policy benefit package to include FP services to help address the cost barrier for rural poor women to use services.

Keywords: benefit package, free maternal policy, women, Ghana, rural Upper West Region, Universal Health Coverage.

Procedia PDF Downloads 200

Authors: Alexandre Beaupré-Lavallée, Pier-André Bouchard St-Amant, Nathalie Beaulac

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The question of internal governance of universities is a political and scientific debate in the province of Quebec (Canada). Governments have called or set up inquiries on the subject on three separate occasions since the complete overhaul of the educational system in the 1960s: the Parent Commission (1967), the Angers Commission (1979) and the Summit on Higher Education (2013). All three produced reports that highlight the constant tug-of-war for authority and legitimacy within universities. Past and current research that cover Quebec universities have studied several aspects regarding internal governance: the structure as a whole or only some parts of it, the importance of certain key aspects such as collegiality or strategic planning, or of stakeholders, such as students or administrators. External governance has also been studied, though, as with internal governance, research so far as only covered well delineated topics like financing policies or overall impacts from wider societal changes such as New Public Management. The latter, NPM, is often brought up as a factor that influenced overall State policies like “steering-at-a-distance” or internal shifts towards “managerialism”. Yet, to the authors’ knowledge, there is not study that specifically maps how the Quebec State formally influences internal governance. In addition, most studies about the Quebec university system are not comparative in nature. This paper presents a portion of the results produced by a 2022- 2023 study that aims at filling these last two gaps in knowledge. Building on existing governmental, institutional, and scientific papers, we documented the legal and regulatory framework of the Quebec university system and of twenty-one other university systems in North America and Europe (2 in Canada, 2 in the USA, 16 in Europe, with the addition of the European Union as a distinct case). This allowed us to map the presence (or absence) of mandatory structures of governance enforced by States, as well as their composition. Then, using Clark’s “triangle of coordination”, we analyzed each system to assess the relative influences of the market, the State and the collegium upon the governance model put in place. Finally, we compared all 21 non-Quebec systems to characterize the province’s policies in an internal perspective. Preliminary findings are twofold. First, when all systems are placed on a continuum ranging from “no State interference in internal governance” to “State-run universities”, Quebec comes in the middle of the pack, albeit with a slight lean towards institutional freedom. When it comes to overall governance (like Boards and Senates), the dual nature of the Quebec system, with its public university and its coopted yet historically private (or ecclesiastic) institutions, in fact mimics the duality of all university systems. Second, however, is the sheer abundance of legal and regulatory mandates from the State that, while not expressly addressing internal governance, seems to require de facto modification of internal governance structure and dynamics to ensure institutional conformity with said mandates. This study is only a fraction of the research that is needed to better understand State-universities interactions regarding governance. We hope it will set the stage for future studies.

Keywords: internal governance, legislation, Quebec, universities

Procedia PDF Downloads 61

Authors: Hannah Dean

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The growth ideology, and its association with progress, is an important construct in the narrative of modernity. This ideology is embedded in neoclassical economic growth theory which conceptualises growth as linear and predictable, and the entrepreneur as a rational economic manager. This conceptualisation has been critiqued for reinforcing the managerial discourse in entrepreneurship studies. Despite these critiques, both the neoclassical growth theory and its adjacent managerial discourse dominate entrepreneurship studies notably the literature on female entrepreneurs. The latter is the focus of this paper. Given this emphasis on growth, female entrepreneurs are portrayed as problematic because their growth lags behind their male counterparts. This image which ignores the complexity and diversity of female entrepreneurs’ experience persists in the literature due to the lack of studies that analyse the process and contextual factors surrounding female entrepreneurs’ experience. This study aims to address the subordination of female entrepreneurs by questioning the hegemonic logic of economic growth and the managerial discourse as a true representation for the entrepreneurial experience. This objective is achieved by drawing on Schumpeter’s theorising and narrative inquiry. This exploratory study undertakes in depth interviews to gain insights into female entrepreneurs’ experience and the impact of the economic growth model and the managerial discourse on their performance. The narratives challenge a number of assumptions about female entrepreneurs. The participants occupied senior positions in the corporate world before setting up their businesses. This is at odds with much writing which assumes that women underperform because they leave their career without gaining managerial experience to achieve work-life balance. In line with Schumpeter, who distinguishes the entrepreneur from the manager, the participants’ main function was innovation. They did not believe that the managerial paradigm governing their corporate careers was applicable to their entrepreneurial experience. Formal planning and managerial rationality can hinder their decision making process. The narratives point to the gap between the two worlds which makes stepping into entrepreneurship a scary move. Schumpeter argues that the entrepreneurial process is evolutionary and that failure is an integral part of it. The participants’ entrepreneurial process was in fact irregular. The performance of new combinations was not always predictable. They therefore relied on their initiative. The inhibition to deploy these traits had an adverse effect on business growth. The narratives also indicate that over-reliance on growth threaten the business survival as it faces competing pressures. The study offers theoretical and empirical contributions to (female) entrepreneurship studies by presenting Schumpeter’s theorising as an alternative theoretical framework to the neoclassical economic growth theory. The study also reduces entrepreneurs’ vulnerability by making them aware of the negative influence that the linear growth model and the managerial discourse hold upon their performance. The study has implications for policy makers as it generates new knowledge that incorporates the current social and economic changes in the context of entrepreneurs that can no longer be sustained by the linear growth models especially in the current economic climate.

Keywords: economic growth, female entrepreneurs, managerial discourse, Schumpeter

Procedia PDF Downloads 273

Authors: Nayer Mofidtabatabaei

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Advancements in artificial intelligence (AI) have transformed various fields, including psychology and behavioral sciences. This paper explores the diverse ways in which AI is applied to enhance research, diagnosis, therapy, and understanding of human behavior and mental health. We discuss the potential benefits and challenges associated with AI in these fields, emphasizing the ethical considerations and the need for collaboration between AI researchers and psychological and behavioral science experts. Artificial Intelligence (AI) has gained prominence in recent years, revolutionizing multiple industries, including healthcare, finance, and entertainment. One area where AI holds significant promise is the field of psychology and behavioral sciences. AI applications in this domain range from improving the accuracy of diagnosis and treatment to understanding complex human behavior patterns. This paper aims to provide an overview of the various AI applications in psychological and behavioral sciences, highlighting their potential impact, challenges, and ethical considerations. Mental Health Diagnosis AI-driven tools, such as natural language processing and sentiment analysis, can analyze large datasets of text and speech to detect signs of mental health issues. For example, chatbots and virtual therapists can provide initial assessments and support to individuals suffering from anxiety or depression. Autism Spectrum Disorder (ASD) Diagnosis AI algorithms can assist in early ASD diagnosis by analyzing video and audio recordings of children's behavior. These tools help identify subtle behavioral markers, enabling earlier intervention and treatment. Personalized Therapy AI-based therapy platforms use personalized algorithms to adapt therapeutic interventions based on an individual's progress and needs. These platforms can provide continuous support and resources for patients, making therapy more accessible and effective. Virtual Reality Therapy Virtual reality (VR) combined with AI can create immersive therapeutic environments for treating phobias, PTSD, and social anxiety. AI algorithms can adapt VR scenarios in real-time to suit the patient's progress and comfort level. Data Analysis AI aids researchers in processing vast amounts of data, including survey responses, brain imaging, and genetic information. Privacy Concerns Collecting and analyzing personal data for AI applications in psychology and behavioral sciences raise significant privacy concerns. Researchers must ensure the ethical use and protection of sensitive information. Bias and Fairness AI algorithms can inherit biases present in training data, potentially leading to biased assessments or recommendations. Efforts to mitigate bias and ensure fairness in AI applications are crucial. Transparency and Accountability AI-driven decisions in psychology and behavioral sciences should be transparent and subject to accountability. Patients and practitioners should understand how AI algorithms operate and make decisions. AI applications in psychological and behavioral sciences have the potential to transform the field by enhancing diagnosis, therapy, and research. However, these advancements come with ethical challenges that require careful consideration. Collaboration between AI researchers and psychological and behavioral science experts is essential to harness AI's full potential while upholding ethical standards and privacy protections. The future of AI in psychology and behavioral sciences holds great promise, but it must be navigated with caution and responsibility.

Keywords: artificial intelligence, psychological sciences, behavioral sciences, diagnosis and therapy, ethical considerations

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Authors: Shiva Mardani, Mehdi Nasr-Esfahani, Majid Olia, Hamid Molahosseini, Hamed Hassanzadeh Khankahdani

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Plant-parasitic nematodes cause serious diseases on plants and effectively reduce food production in quality and quantity worldwide, with at least 17 nematode species in the three important and major genera, including Meloidogyne, Heterodera, and Pratylenchus. Root-knot nematodes (RKN), Meloidogyne spp. with the dominant species, Meloidogynejavanica, are considered as the important plant pathogens of agricultural products globally. The hosts range can be vegetables, bedding plants, grasses, shrubs, numerous weeds, and trees, including forests. In this study, chemical management was carried out on RKN, M. javanica, to investigate the efficacy of Iranian Abamectin insecticide product [acaricide Abamectin (Vermectin® 2% EC, Gyah Corp., Iran)] verses imported normal Abamectin available in the Iran markets [acaricide Abamectin (Vermectin® 1.8% EC, Cropstar Chemical Industry Co., Ltd.)] each of which at the rate of 8 L./ha, on Tomatoes, Solanumlycopersicum L., (No. 29-41, Dutch company Siemens) as a test plant, and the controls (infested to RKN and without any chemical pesticides treatments); and (sterile soil without any RKN and chemical pesticides treatments) at the greenhouse in Isfahan, Iran. The trails were repeated thrice. The results indicated a highly significant reduction in RKN population and an increase in biomass parameters at 1% level of significance, respectively. Relatively similar results were obtained in all the three experiments conducted on tomato root-knot nematodes. The treatments of Gyah-Abamectin (51.6%) and external Abamectin (40.4%) had the highest to least effect on reducing the number of larvae in the soil compared to the infected controls, respectively. Gyah-Abamectin by 44.1% and then external one by 31.9% had the highest effect on reducing the number of larvae and eggs in the root and 31.4% and 24.1% reduction in the number of galls compared to the infected controls, respectively. Based on priority, Gyah-Abamectin (47.4 % ) and external Abamectin (31.1 %) treatments had the highest effect on reducing the number of egg- masses in the root compared to the infected controls, with no significant difference between Gyah-Abamectin and external Abamectin. The highest reproduction of larvae and egg in the root was observed in the infected controls (75.5%) and the lowest in the healthy controls (0.0%). The highest reduction in the larval and egg reproduction in the roots compared to the infected controls was observed in Gyah-Abamectin and the lowest in the external one. Based on preference, Gyah-Abamectin (37.6%) and external Abamectin (26.9%) had the highest effect on the reduction of the larvae and egg reproduction in the root compared to the infected controls, respectively. Regarding growth parameters factors, the lowest stem length was observed in external Abamectin (51.9 cm), with nosignificantly different from Gyah-Abamectin and healthy controls. The highest root fresh weight was recorded in the infected controls (19.81 gr.) and the lowest in the healthy ones (9.81 gr.); the highest root length in the healthy controls (22.4 cm), and the lowest in the infected controls and external Abamectin (12.6 and 11.9 cm), respectively. Conclusively, the results of these three tests on tomato plants revealed that Gyah-Abamectin 2% compared to external Abamectin 1.8% is competitive in the chemical management of the root nematodes of these types of products and is a suitable alternative in this regard.

Keywords: solanum lycopersicum, vermectin, biomass, tomato

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Authors: P.V. Lostelius, M.Mattebo, E. Thors Adolfsson, A. Söderlund, Å. Revenäs

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Adolescents are vulnerable in healthcare settings. Early detection of poor health in young people is important to support a good quality of life and adult social functioning. Youth Health Clinics (YHCs) in Sweden provide healthcare for young people ages 13-25 years old. Using an overall mixed methods approach, the project’s main objective was to develop and evaluate an electronic health system, including a health questionnaire, a case report form, and an evaluation questionnaire to assess young people’s health risks in early stages, increase health, and quality of life. In total, 72 young people, 16-23 years old, eleven healthcare professionals and eight researchers participated in the three project studies. Results from interviews with fifteen young people gave that an electronic health questionnaire should include questions about physical-, mental-, sexual health and social support. It should specifically include questions about self-harm and suicide risk. The young people said that the questionnaire should be appealing, based on young people’s needs and be user-friendly. It was important that young people felt safe when responding to the questions, both physically and electronically. Also, they found that it had the potential to support the face-to face-meeting between young people and healthcare professionals. The electronic health report system was developed by the researchers, performing a structured development of the electronic health questionnaire, construction of a case report form to present the results from the health questions, along with an electronic evaluation questionnaire. An Information Technology company finalized the development by digitalizing the electronic health system. Four young people, three healthcare professionals and seven researchers evaluated the usability using interviews and a usability questionnaire. The electronic health questionnaire was found usable for YHCs but needed some clarifications. Essentially, the system succeeded in capturing the overall health of young people; it should be able to keep the interest of young people and have the potential to contribute to health assessment planning and young people’s self-reflection, sharing vulnerable feelings with healthcare professionals. In advance of effect studies, a feasibility study was performed by collecting electronic questionnaire data from 54 young people and interview data from eight healthcare professionals to assess the feasibility of the use of the electronic evaluation questionnaire, the case report form, and the planned recruitment method. When merging the results, the research group found that the evaluation questionnaire and the health report were feasible for future research. However, the COVID-19 pandemic, commitment challenges and drop-outs affected the recruitment of young people. Also, some healthcare professionals felt insecure about using computers and electronic devices and worried that their workload would increase. This project contributes knowledge about the development and use of electronic health tools for young people. Before implementation, clinical routines need for using the health report system need to be considered.

Keywords: adolescent health, developmental studies, electronic health questionnaire, mixed methods research

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Authors: Georgina Cherry, Taranpreet Rai, Luke Boyden, Sitira Williams, Andrea Wright, Richard Brown, Viva Chu, Alasdair Cook, Kevin Wells

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Estimating population-level burden, abilities of pet-parents to identify disease and demand for veterinary services worldwide is challenging. The purpose of this study is to compare a feline pruritus survey with social media listening (SML) data discussing this condition. Surveys are expensive and labour intensive to analyse, but SML data is freeform and requires careful filtering for relevancy. This study considers data from a survey of owner-observed symptoms of 156 pruritic cats conducted using Pet Parade® and SML posts collected through web-scraping to gain insights into the characterisation and management of feline pruritus. SML posts meeting a feline body area, behaviour and symptom were captured and reviewed for relevance representing 1299 public posts collected from 2021 to 2023. The survey involved 1067 pet-parents who reported on pruritic symptoms in their cats. Among the observed cats, approximately 18.37% (n=196) exhibited at least one symptom. The most frequently reported symptoms were hair loss (9.2%), bald spots (7.3%) and infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin (8.2%). Notably, bald spots were the primary symptom reported for short-haired cats, while other symptoms were more prevalent in medium and long-haired cats. Affected body areas, according to pet-parents, were primarily the head, face, chin, neck (27%), and the top of the body, along the spine (22%). 35% of all cats displayed excessive behaviours consistent with pruritic skin disease. Interestingly, 27% of these cats were perceived as non-symptomatic by their owners, suggesting an under-identification of itch-related signs. Furthermore, a significant proportion of symptomatic cats did not receive any skin disease medication, whether prescribed or over the counter (n=41). These findings indicate a higher incidence of pruritic skin disease in cats than recognized by pet owners, potentially leading to a lack of medical intervention for clinically symptomatic cases. The comparison between the survey and social media listening data revealed bald spots were reported in similar proportions in both datasets (25% in the survey and 28% in SML). Infection, crusting, scaling, redness, scabbing, scaling, or bumpy skin accounted for 31% of symptoms in the survey, whereas it represented 53% of relevant SML posts (excluding bumpy skin). Abnormal licking or chewing behaviours were mentioned by pet-parents in 40% of SML posts compared to 38% in the survey. The consistency in the findings of these two disparate data sources, including a complete overlap in affected body areas for the top 80% of social media listening posts, indicates minimal biases in each method, as significant biases would likely yield divergent results. Therefore, the strong agreement across pruritic symptoms, affected body areas, and reported behaviours enhances our confidence in the reliability of the findings. Moreover, the small differences identified between the datasets underscore the valuable insights that arise from utilising multiple data sources. These variations provide additional depth in characterising and managing feline pruritus, allowing for more comprehensive understanding of the condition. By combining survey data and social media listening, researchers can obtain a nuanced perspective and capture a wider range of experiences and perspectives, supporting informed decision-making in veterinary practice.

Keywords: social media listening, feline pruritus, surveys, felines, cats, pet owners

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Authors: Andrea Bikfalvi, Josep Llach, Ferran Lazaro, Bojan Jovanovski

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Due to the continuous need to foster university-business cooperation in both developed and developing countries, some higher education institutions face the challenge of designing, piloting, operating, and consolidating knowledge and technology transfer units. University-business cooperation has different maturity stages worldwide, with some higher education institutions excelling in these practices, but with lots of others that could be qualified as intermediate, or even some situated at the very beginning of their knowledge transfer adventure. These latter face the imminent necessity to formally create the technology transfer unit and to draw its roadmap. The complexity of this operation is due to various aspects that need to align and coordinate, including a major change in mission, vision, structure, priorities, and operations. Qualitative in approach, this study presents 5 case studies, consisting of higher education institutions located in the Western Balkans – 2 in Albania, 2 in Bosnia and Herzegovina, 1 in Montenegro- fully immersed in the entrepreneurial journey of creating their knowledge and technology transfer unit. The empirical evidence is developed in a pan-European project, illustratively called KnowHub (reconnecting universities and enterprises to unleash regional innovation and entrepreneurial activity), which is being implemented in three countries and has resulted in at least 15 pilot cooperation agreements between academia and business. Based on a peer-mentoring approach including more experimented and more mature technology transfer models of European partners located in Spain, Finland, and Austria, a series of initial lessons learned are already available. The findings show that each unit developed its tailor-made approach to engage with internal and external stakeholders, offer value to the academic staff, students, as well as business partners. The latest technology underpinning KnowHub services and institutional commitment are found to be key success factors. Although specific strategies and plans differ, they are based on a general strategy jointly developed and based on common tools and methods of strategic planning and business modelling. The main output consists of providing good practice for designing, piloting, and initial operations of units aiming to fully valorise knowledge and expertise available in academia. Policymakers can also find valuable hints on key aspects considered vital for initial operations. The value of this contribution is its focus on the intersection of three perspectives (service orientation, organisational innovation, business model) since previous research has only relied on a single topic or dual approaches, most frequently in the business context and less frequently in higher education.

Keywords: business model, capacity building, entrepreneurial education, knowledge transfer

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Authors: Lata Shakya, Toshio Otsuki, Saori Imoto, Bijaya Krishna Shrestha, Umesh Bahadur Malla

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2015 Gorkha Nepal earthquake have damaged the human settlements in 14 districts of Nepal. Historic core areas of three principal cities namely Kathmandu, Lalitpur and Bhaktapur including numerous traditional ‘newari’ settlements in the peripheral areas have been either collapsed or severely damaged. Despite Government of Nepal and (international) non-government organisations’ attempt towards disaster risk management through the preparation of policies and guidelines and implementation of community-based activities, the recent ‘Gorkha’ earthquake has demonstrated the inadequate preparedness, poor implementation of a legal instrument, resource constraints, and managerial weakness. However, the social capital through community based institutions, self-help attitude, and community bond has helped a lot not only in rescue and relief operation but also in a post-disaster temporary shelter living thereby exhibiting the resilient power of the local community. Conducting a detailed case study of ‘Kaminani’ community with 42 houses at ward no. 16 of Bhaktapur municipality, this paper analyses the local community’s response and activities on the Gorkha earthquake in rescue and relief operation as well as in post disaster work. Leadership, the existence of internal/external aid, physical and human support are also analyzed. Social resource and networking are also explained through critical review of the existing community organisation and their activities. The research methodology includes literature review, field survey, and interview with community leaders and residents based on a semi-structured questionnaire. The study reveals that community carried their recovery process in four different phases: (i) management of emergency evacuation, (ii) constructing community owed temporary shelter for individuals, (iii) demolishing upper floors of the damaged houses, and (iv) planning for collaborative housing reconstruction. As territorial based organization, religion based agency and aim based institution exist in the survey area from pre-disaster time, it can be assumed that the community activists including leaders are well experienced to create aim-based group and manage teamwork to deal with various issues and problems collaboratively. Physical and human support including partial financial aid from external source as a result of community leader’s personal networking is extended to the community members. Thus, human/social resource and personal/social network play a crucial role in the recovery process. And to build such social capital, community should have potential from pre-disaster time.

Keywords: Gorkha Nepal earthquake, local community, recovery process, social resource, social network

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Authors: Debarpita Pande

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On 22nd May 2013 Chinese Premier Li Keqiang on his visit to Pakistan tabled a proposal for connecting Kashgar in China’s Xinjiang Uygur Autonomous Region with the south-western Pakistani seaport of Gwadar via the China Pakistan Economic Corridor (hereinafter referred to as CPEC). The project, popularly termed as 'One Belt One Road' will encompass within it a connectivity component including a 3000-kilometre road, railways and oil pipeline from Kashgar to Gwadar port along with an international airport and a deep sea port. Superficially, this may look like a 'game changer' for Pakistan and other countries of South Asia but this article by doctrinal method of research will unearth some serious flaws in it, which may change the entire economic system of this region heavily affecting the socio-economic conditions of South Asia, further complicating the complete geopolitical situation of the region disturbing the world economic stability. The paper besets with a logical analyzation of the socio-economic issues arising out of this project with an emphasis on its impact on the Pakistani and Indian economy due to Chinese dominance, serious tension in international relations, security issues, arms race, political and provincial concerns. The research paper further aims to study the impact of huge burden of loan given by China towards this project where Pakistan already suffers from persistent debts in the face of declining foreign currency reserves along with that the sovereignty of Pakistan will also be at stake as the entire economy of the country will be held hostage by China. The author compares this situation with the fallout from projects in Sri Lanka, Tajikistan, and several countries of Africa, all of which are now facing huge debt risks brought by Chinese investments. The entire economic balance will be muddled by the increment in Pakistan’s demand of raw materials resulting to the import of the same from China, which will lead to exorbitant price-hike and limited availability. CPEC will also create Chinese dominance over the international movement of goods that will take place between the Atlantic and the Pacific oceans and hence jeopardising the entire economic balance of South Asia along with Middle Eastern countries like Dubai. Moreover, the paper also analyses the impact of CPEC in the context of international unrest and arms race between Pakistan and India as well as India and China due to border disputes and Chinese surveillance. The paper also examines the global change in economic dynamics in international trade that CPEC will create in the light of U.S.-China relationship. The article thus reflects the grave consequences of CPEC on the international economy, security and bilateral relations, which surpasses the positive impacts of it. The author lastly suggests for more transparency and proper diplomatic planning in the execution of this mega project, which can be a cause of economic complexity in international trade in near future.

Keywords: China, CPEC, international trade, Pakistan

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Authors: Giuliana Murfet, Heidi Behrens

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Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

Procedia PDF Downloads 212