Search results for: international employee health

Authors: Woosik Jang, Seung H. Han, Seung Won Baek, Chan Young Park

Abstract:

Natural gas (NG) is a local energy resource that exists in certain countries, and most NG producers operate within unstable governments. Moreover, about 90% of the liquefied natural gas (LNG) market is governed by a small number of international oil companies (IOCs) and national oil companies (NOCs), market entry of second movers is extremely limited. To overcome these barriers, project viability should be assessed based on limited information at the project screening perspective. However, there have been difficulties at the early stages of projects as follows: (1) What factors should be considered? (2) How many experts are needed to make a decision? and (3) How to make an optimal decision with limited information? To answer these questions, this research suggests a LNG project viability assessment model based on the Dempster-Shafer theory (DST). Total of 11 indices for the gas field analysis and 23 indices for the market environment analysis are identified that reflect unique characteristics of LNG industry. Moreover, the proposed model evaluates LNG projects based on questionnaire survey and it provides not only quantified results but also uncertainty level of results based on DST. Consequently, the proposed model as a systematic framework can support the decision-making process from the gas field projects using quantitative results, and it is developed to a stand-alone system to enhance the practical usability. It is expected to improve the decision-making quality and opportunity in LNG projects for enterprise through informed decision.

Keywords: project viability, LNG project, enterprise information system, Dempster-Shafer Theory, strategic decision-making

Procedia PDF Downloads 251

Authors: Yuki Hara

Abstract:

Healthy assets are recognized as important for all people in the world through experiencing COVID-19. Each part of life and work is important to be changed against the preceding wide-spreading of COVID-19. Furthermore, it is necessary to innovate the whole structure of a city upon the sum of the parts. This study aims at creating a comprehensive strategy from a small practice of making healthier lives with collaborating local actors for a city. This paper employs action research as the research framework. The core practice is the 'Ken’iku Festival' at Ken’iku Festival Committee. The field locates the urban-rural fringe in the northwest part of Fujisawa city, Kanagawa prefecture, Japan. The data is collected through the author's practices for three years from the observations and interviews at meetings and discussions among stakeholders, texts in municipal reports, books, and movies, 3 questionnaires for customers and stakeholders at the Ken’iku Festival. These data are analysed by qualitative methods. The results show that couples in their 40s with children and couples or friends over the 70s are at the heart of promoting healthy lifestyles. In contrast, 40% of the visitors at the festival are the people who have no idea or no interest in healthier actions, which the committee has to suggest healthy activities through more pleasing services. The committee could organize staff and local actors as the core parties involved through gradually expanding its tasks relating to the local practices. This private sectoral activity from health promotion is covering a part of the whole-city planning of Fujisawa municipality by including many people over organisations into one community. This paper concludes from local practice networking through the festival that a comprehensive strategy for a healthy city is both a practical approach easily applied to each partner and one of the holistic services.

Keywords: communal practice network, healthy cities, health & development, health promotion, with and after COVID-19

Procedia PDF Downloads 120

Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

Abstract:

This paper adopted a retrospective review of China’s assistance to Latin America from the1950s to 2020. Findings suggested that China’s assistance to Latin America can be roughly divided into five stages: The 1950s to 1960s was the initial stage of China’s assistance to Latin America, mainly focusing on the establishment of diplomatic relations with Cuba and other Latin American countries. The strategy has a strong ideological basis. The 1980s was the stage of development of China's aid to Latin America, which was characterized by consolidating and expanding diplomatic space, emphasizing the spirit of cooperation of equality, mutual benefit, and common development. 90-20 marked the further development of diplomatic relations with Latin American countries, plus domestic market-oriented reforms, emphasizing the importance of economic considerations and less ideological orientation, and this period also witnessed more Chinese state-owned enterprises going out to invest in Latin America. 2010-2019 marked the further development of Latin American relations. This paper contributes to the literature of diplomacy and health assistance to Latin America and highlights the importance of foreign aid and health assistance in sealing bilateral diplomatic relations.

Keywords: aid, china, latin america, bilateral relations

Procedia PDF Downloads 221

Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

Abstract:

Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

Procedia PDF Downloads 136

Authors: Mohammad S. Razai, Jan Williams, Rachel Nestel, Dermot Dalton

Abstract:

Purpose: This descriptive qualitative study aimed to obtain parents recommendations for improving the notification process and communication of positive newborn screening result for cystic fibrosis (CF). Methods: Thematic analysis of semi-structured open-ended interviews with 11 parents of 7 children with confirmed diagnosis of CF between 2 months — 2 years of age. Results: Parents preferred face to face disclosure of positive NBS results by a pediatrician with CF professional qualification. They trusted a pediatrician more than any other professional in providing accurate, credible and comprehensive information about the diagnosis and its implications. Parents recommended that health professionals be knowledgeable and provide clear, succinct and understandable information. Providers should also explore parents concerns and acknowledge feelings and emotions. Most parents reported that they preferred to be notified immediately as soon as the results were available. Several parents preferred to be told once the diagnosis was certain. Most parents regarded open access to CF team as the most significant part of care coordination. In addition to health professionals, most parents used internet as an important source of information, interaction and exchange of experiences. Most parents also used social networking sites such as Facebook groups and smart phone apps. Conclusion: This study provides significant new evidence from parental perspective in emphasizing the pivotal role of good communication skills deployed by a knowledgeable CF specialist in person. Parents use of social media and internet has replaced some traditional methods of information exchange and may reduce the need for professional input for newly diagnosed CF patients.

Keywords: care coordination, cystic fibrosis, newborn screening, notification process, parental preferences, professional-paren communication

Procedia PDF Downloads 394

Authors: Sonja Goegele, Petra Kletzenbauer

Abstract:

The FH JOANNEUM- a university of applied sciences based in Austria - cooperates in teaching and research with well-known international universities and thus aims to foster so-called strategic partnerships. The exchange of university lecturers and other faculty members is a way to achieve and secure strategic company goals, in which excellent research and teaching play a central role in order to improve both the development of academics and administration. Thanks to mobility not only the university but also the involved people truly benefit in their professional development which can be seen on several levels: increased foreign language proficiency, excellent networking possibilities within the scientific community as well as reinforced didactic competencies in the form of different teaching and learning methodologies. The paper discusses mobility in the light of the university’s strategic paper entitled ‘Hands on 2022’ by presenting results from an empirical research study among faculty members who participate in exchange programmes on a regular basis. In the form of an online questionnaire, mobility was discussed from different angles such as networking, collaborative research, professional training for academics and the overall impact of the exchange within and outside the organization. From the findings, it can be concluded that mobility is an asset for any university. However, keeping in constant dialogue with partner universities requires more than the purpose of the exchange itself. Building rapport and keeping a relationship of trust are challenges that need to be addressed more closely in order to run successful mobility programmes. Best Practice examples should highlight the importance of mobility as a vital initiative to transfer disciplines.

Keywords: higher education, internationalization, mobility, strategic partnerships

Procedia PDF Downloads 131

Authors: Syed Toqueer Akhter, Muhammad Awais

Abstract:

Pakistan is a country which is gifted by naturally abundant resources these resources are a pioneer towards a prospect and developed country. Pakistan is the fourth largest exporter of the textile in the world and with the passage of time the competitiveness of these exports is subject to a decline. With a lot of International players in the textile world like China, Bangladesh, India, and Sri Lanka, Pakistan needs to put up a lot of effort to compete with these countries. This research paper would determine the impact of Foreign Direct Investment upon technological diffusion and that how significantly it may be affecting on export performance of the country. It would also demonstrate that with the increase in Foreign Direct Investment, technological diffusion, strong property rights, and using different policy tools, export competitiveness of the country could be improved. The research has been carried out using time series data from 1995 to 2013 and the results have been estimated by using competing Econometrics modes such as Robust regression and Generalized least squares so that to consolidate the impact of the Foreign Investments and Technological diffusion upon export competitiveness comprehensively. Distributed Lag model has also been used to encompass the lagged effect of policy tools variables used by the government. Model estimates entail that 'FDI' and 'Technological Diffusion' do have a significant impact on the competitiveness of the exports of Pakistan. It may also be inferred that competitiveness of Textile Sector requires integrated policy framework, primarily including the reduction in interest rates, providing subsides, and manufacturing of value added products.

Keywords: high technology export, robust regression, patents, technological diffusion, export competitiveness

Procedia PDF Downloads 489

Authors: Ryota Kuzuki, Mitsuhiro Kohara, Noboru Kizuki, Satoshi Yoshida, Hidetaka Hirai, Yuta Nezasa

Abstract:

About fifty years have passed since Japan's gas supply industry became the first in the world to switch from coal and oil to LNG as a city gas feedstock. Since the Japanese government target of net-zero carbon emission in 2050 was announced in October 2020, it has now entered a new era of challenges to commit to the requirement for decarbonization. This paper describes the situation that synthetic methane, produced from renewable energy-derived hydrogen and recycled carbon, is a promising national policy of transition toward net-zero society. In November 2020, the Japan Gas Association announced the 'Carbon Neutral Challenge 2050' as a vision to contribute to the decarbonization of society by converting the city gas supply to carbon neutral. The key technologies is methanation. This paper shows that methanation is a realistic solution to contribute to the decarbonization of the whole country at a lower social cost, utilizing the supply chain that already exists, from LNG plants to burner chips. The challenges during the transition period (2030-2050), as CO2 captured from exhaust of thermal power plants and industrial factories are expected to be used, it is proposed that a system of guarantee of origin (GO) for H2 and CO2 should be established and harmonize international rules for calculating and allocating greenhouse gas emissions in the supply chain, a platform is also needed to manage tracking information on certified environmental values.

Keywords: synthetic methane, recycled carbon fuels, methanation, transition period, environmental value transfer platform

Procedia PDF Downloads 99

Authors: Danika Tynes

Abstract:

Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

Procedia PDF Downloads 119

Authors: Randolf Von N. Salindo

Abstract:

The study was conducted to measure the logistics integration capabilities of selected companies in the Bahrain construction industry using the Supply Chain 2000 framework; and, determine the extent and direction of influence of these logistics capabilities and integration competencies on the supply chain performance of the firm. A total of 50 executive respondents (from supervisor to managing director level) from 22 construction and construction supplier firms participated in the study from September to November 2014. The results reveal that respondent Bahraini construction firms have significantly lower levels of logistics capabilities, but higher levels of logistics integration competencies compared to international benchmarks. Using stepwise multiple regression analysis, eight logistics capabilities of Bahraini constructions firms were identified to be positively associated with firm performance; with comprehensive metrics as the most positively dominant influential logistics capability. Activity based and total cost methodology is found to be the most negatively dominant influential logistics capability. In terms of logistics integration competencies, the study revealed that that customer integration, internal integration, and, measurement integration are negatively associated with firm performance. There was no logistics integration competency found to be positively associated with the supply chain performance among the companies who participated in the study. The research reveals that there are areas for improvement in supply chain capabilities and logistics integration competencies of the construction firms in the Kingdom of Bahrain to improve their supply chain performance to a global level.

Keywords: comprehensive metrics, customer integration, logistics integration capabilities, logistics integration competencies

Procedia PDF Downloads 632

Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

Abstract:

BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

Procedia PDF Downloads 354

Authors: Amina Aquil, Abdeljalil El Got

Abstract:

Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

Procedia PDF Downloads 108

Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

Abstract:

Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

Procedia PDF Downloads 238

Authors: Akbarova Gulnozakhon

Abstract:

Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.

Keywords: girls health, anthropometric, physical development, reproductive health

Procedia PDF Downloads 97

Authors: Ashimolowo Olubunmi

Abstract:

Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

Procedia PDF Downloads 60

Authors: H. Ju, M. Jones, G. D. Mishra

Abstract:

Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

Procedia PDF Downloads 313

Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

Abstract:

Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

Procedia PDF Downloads 147

Authors: Tuji Jemal Ahmed

Abstract:

This paper is to provides a comprehensive review of current research works on foodborne illness and food safety, including the risks associated with foodborne illnesses, the latest research on food safety, and the mitigation strategies used to prevent and control foodborne illnesses. Foodborne illness is a major public health concern that affects millions of people every year. As foodborne illnesses have grown more common and dangerous in recent years, it is vital that we research and build upon methods to ensure food remains safe throughout consumption. Additionally, this paper will discuss future directions for food safety research, including emerging technologies, changes in regulations and standards, and collaborative efforts to improve food safety. The first section of the paper provides an overview of the risks of foodborne illness, including a definition of foodborne illness, the causes of foodborne illness, the types of foodborne illnesses, and high-risk foods for foodborne illness, Health Consequences of Foodborne Illness. The second section of the paper focuses on current research on food safety, including the role of regulatory agencies in food safety, food safety standards and guidelines, emerging food safety concerns, and advances in food safety technology. The third section of the paper explores mitigation strategies for foodborne illness, including preventative measures, hazard analysis and critical control points (HACCP), good manufacturing practices (GMPs), and training and education. Finally, this paper examines future directions for food safety research, including hurdle technologies and their impact on food safety, changes in food safety regulations and standards, collaborative efforts to improve food safety, and research gaps and areas for further exploration. In general, this work provides a comprehensive review of current research and future directions in food safety and understanding the risks associated with foodborne illness. The implications of the assessment for food safety and public health are discussed, as well as recommended for research scholars.

Keywords: food safety, foodborne illness, technologies, mitigation

Procedia PDF Downloads 88

Authors: Adam Jenkins

Abstract:

The Maritime RobotX Challenge provides a platform for postgraduate students conducting research in autonomous robotic systems to participate in an international competition. Although targeted to postgraduate students, the problem domain lends itself to a wide range of different levels of student expertise. In 2022, undergraduate Information Technology students from the University of South Australia undertook the challenge, utilizing a System of the Systems approach to the project's architecture. Each student group produced an independent solution to an identified task, which was then implemented on a Single Board Computer (SBC). A Central Control System then engaged each solution when appropriate, allowing the encapsulated SBC systems to manage each task as it was encountered. This approach facilitated collaboration among the multiple independent student teams over an 18-month period, and the fundamental system-agnostic architecture allowed for both the variance in student solutions and the limitations caused by the global electronics shortage. By adopting this approach, Information Technology teams were able to work independently yet produce an effective solution, leveraging their expertise to develop and construct an autonomous catamaran capable of meeting the competition's demanding requirements while producing a high level of engagement. The System of Systems approach is recommended to other universities interested in competing at this level and engaging students in a real-world problem.

Keywords: case study, robotics, education, programming, system of systems, multi-disciplinary collaboration

Procedia PDF Downloads 69

Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

Abstract:

Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

Procedia PDF Downloads 180

Authors: Tak Mau Simon Chan

Abstract:

While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

Procedia PDF Downloads 297

Authors: M. N. Khajavi, S. Nasiri, E. Farokhi, M. R. Bavir

Abstract:

Alcohol fuels are renewable, have low pollution and have high octane number; therefore, they are important as fuel in internal combustion engines. Percentage detection of these alcoholic fuels with gasoline is a complicated, time consuming, and expensive process. Nowadays, these processes are done in equipped laboratories, based on international standards. The aim of this research is to determine percentage detection of different fuels based on vibration analysis of engine block signals. By doing, so considerable saving in time and cost can be achieved. Five different fuels consisted of pure gasoline (G) as base fuel and combination of this fuel with different percent of ethanol and methanol are prepared. For example, volumetric combination of pure gasoline with 10 percent ethanol is called E10. By this convention, we made M10 (10% methanol plus 90% pure gasoline), E30 (30% ethanol plus 70% pure gasoline), and M30 (30% Methanol plus 70% pure gasoline) were prepared. To simulate real working condition for this experiment, the vehicle was mounted on a chassis dynamometer and run under 1900 rpm and 30 KW load. To measure the engine block vibration, a three axis accelerometer was mounted between cylinder 2 and 3. After acquisition of vibration signal, eight time feature of these signals were used as inputs to an Adaptive Neuro Fuzzy Inference System (ANFIS). The designed ANFIS was trained for classifying these five different fuels. The results show suitable classification ability of the designed ANFIS network with 96.3 percent of correct classification.

Keywords: internal combustion engine, vibration signal, fuel composition, classification, ANFIS

Procedia PDF Downloads 392

Authors: Bahram Khan, Anderson Rocha Ramos, Rui R. Paulo, Fernando J. Velez

Abstract:

With the growing demand for a new blend of applications, the users dependency on the internet is increasing day by day. Mobile internet users are giving more attention to their own experiences, especially in terms of communication reliability, high data rates and service stability on move. This increase in the demand is causing saturation of existing radio frequency bands. To address these challenges, researchers are investigating the best approaches, Carrier Aggregation (CA) is one of the newest innovations, which seems to fulfill the demands of the future spectrum, also CA is one the most important feature for Long Term Evolution - Advanced (LTE-Advanced). For this purpose to get the upcoming International Mobile Telecommunication Advanced (IMT-Advanced) mobile requirements (1 Gb/s peak data rate), the CA scheme is presented by 3GPP, which would sustain a high data rate using widespread frequency bandwidth up to 100 MHz. Technical issues such as aggregation structure, its implementations, deployment scenarios, control signal techniques, and challenges for CA technique in LTE-Advanced, with consideration of backward compatibility, are highlighted in this paper. Also, performance evaluation in macro-cellular scenarios through a simulation approach is presented, which shows the benefits of applying CA, low-complexity multi-band schedulers in service quality, system capacity enhancement and concluded that enhanced multi-band scheduler is less complex than the general multi-band scheduler, which performs better for a cell radius longer than 1800 m (and a PLR threshold of 2%).

Keywords: component carrier, carrier aggregation, LTE-advanced, scheduling

Procedia PDF Downloads 185

Authors: Nuha Alamro

Abstract:

Besides achieving of weight loss, Bariatric surgery (BS) shown metabolic improvement including reduction of cardiovascular disease, insulin resistance and diabetes. This study aimed to measure BS effects on Framingham Risk Score (FRS) and metabolic syndrome (MetS) among patients who underwent BS. Additionally, to determine the effect of BS on TSH among euthyroid obese patients. A Retrospective follow-up study was conducted in King Abdullah Medical City. A total of 160 participants who underwent BS and completed one year of follow ups. Medical history, biochemical, anthropometric, and hormonal parameters were evaluated at baseline and 3-12 months after BS. International Diabetes Federation (IDF) criteria were used to diagnose MetS pre and postoperative. The mean age of participants was 41.9 ± 10.6 with Body Mass Index (BMI) of 48.8 ± 7.3. After 3 months, Systolic, Diastolic blood pressure (SBP, DBP), glycated haemoglobin (HBA1C), Low-density lipoprotein (LDL), cholesterol, triglycerides and Thyroid stimulating hormone (TSH) were significantly decrease (P < 0.001). Significant decrease was seen in Mets, BMI, FRS, SBP, DBP, HBA1C, LDL, triglycerides, cholesterol, liver enzyme, with significant increase in high-density lipoprotein (HDL) level 12 months post-op (P < 0.001). After 1 year, the prevalence of MetS, DM, HTN, FRS were significantly decrease from 72.5%, 43.1%, 78.1%, 11.4 to 16.3%, 9.4%, 22.5% and 5.4, respectively. Besides achieving substantial weight loss, MetS resolution was linked to improvement in cardiovascular risk profile.

Keywords: bariatric surgery, cardiovascular disease, metabolic syndrome, thyroid stimulating hormone

Procedia PDF Downloads 90

Authors: Ho-Dae Chong, Jong-Kil Kim

Abstract:

Collaborative research has become more prevalent and important across disciplines because it stimulates innovation and interaction between scholars. Seeing as existing studies relatively disregarded the institutional conditions triggering collaborative research, this work aims to analyze the changing trend in collaborative work patterns among Korean social scientists. The focus of this research is the performance of social scientists who received research grants through the government’s Social Science Korea (SSK) program. Using quantitative statistical methods, collaborative research patterns in a total of 2,354 papers published under the umbrella of the SSK program in peer-reviewed scholarly journals from 2013 to 2016 were examined to identify changing trends and triggering factors in collaborative research. A notable finding is that the share of collaborative research is overwhelmingly higher than that of individual research. In particular, levels of collaborative research surpassed 70%, increasing much quicker compared to other research done in the social sciences. Additionally, the most common composition of collaborative research was for two or three researchers to conduct joint research as coauthors, and this proportion has also increased steadily. Finally, a strong association between international journals and co-authorship patterns was found for the papers published by SSK program researchers from 2013 to 2016. The SSK program can be seen as the driving force behind collaboration between social scientists. Its emphasis on competition through a merit-based financial support system along with a rigorous evaluation process seems to have influenced researchers to cooperate with those who have similar research interests.

Keywords: coauthorship, collaboration, competition, cooperation, Social Science Korea, policy

Procedia PDF Downloads 218

Authors: Funmilola Ajani, I. A. Ayodele, O.A. Filade

Abstract:

Tourism has direct, indirect and induced impacts on economic development and the industry is one of the most crucial tradable sectors in the world. The study was therefore carried out to assess the potentials of ecotourism to nature conservation and its contributions to the improvement of the livelihood of Oke- Ila Orangun community. One hundred and fifty residents were chosen by stratified random sampling as respondents. Respondents awareness of ecotourism was assessed using an 8-point scale while respondents acceptance of ecotourism was assessed using a 14-point scale. Contributions to improvement of livelihood of residents and perceived constraints identified by residents to the development of the water fall and socio-economic variables among others were also obtained. Also, in-depth interview was conducted with the king of Ayikunnugba. The data was analyzed using descriptive statistics such as frequency count, mean and percentages. Correlation analysis was used to determine whether or not a relationship exists between two variables at 0.05 level of significance. Perception of respondents based on the awareness of ecotourism and contributions to livelihood development was high (78.3%). A significant relationship exists between acceptance of ecotourism and its contributions to peoples’ livelihood. Also, relationship between constraints encountered by respondents and its contributions to peoples livelihood is highly significant(r =0.546; P =0.00). Majority (71.3%) of the respondents believed that the development of the area will not lead to environmental pollution. Public- Private- Partnership (PPP) is therefore recommended so as to enable the recreation site to meet international standard in terms of development and management.

Keywords: Ayikunnugba water fall, ecotourism constraints, nature conservation, awareness

Procedia PDF Downloads 146

Authors: Vandana T. Gawande, Kailash G. Bothara, Chandani O. Satija

Abstract:

The present research work was aimed to determine stability of cefprozil monohydrate (CEFZ) as per various stress degradation conditions recommended by International Conference on Harmonization (ICH) guideline Q1A (R2). Forced degradation studies were carried out for hydrolytic, oxidative, photolytic and thermal stress conditions. The drug was found susceptible for degradation under all stress conditions. Separation was carried out by using High Performance Thin Layer Chromatographic System (HPTLC). Aluminum plates pre-coated with silica gel 60F254 were used as the stationary phase. The mobile phase consisted of ethyl acetate: acetone: methanol: water: glacial acetic acid (7.5:2.5:2.5:1.5:0.5v/v). Densitometric analysis was carried out at 280 nm. The system was found to give compact spot for cefprozil monohydrate (0.45 Rf). The linear regression analysis data showed good linear relationship in the concentration range 200-5.000 ng/band for cefprozil monohydrate. Percent recovery for the drug was found to be in the range of 98.78-101.24. Method was found to be reproducible with % relative standard deviation (%RSD) for intra- and inter-day precision to be < 1.5% over the said concentration range. The method was validated for precision, accuracy, specificity and robustness. The method has been successfully applied in the analysis of drug in tablet dosage form. Three unknown degradation products formed under various stress conditions were isolated by preparative HPTLC and characterized by mass spectroscopic studies.

Keywords: cefprozil monohydrate, degradation products, HPTLC, stress study, stability indicating method

Procedia PDF Downloads 292

Authors: Sara Bilal, Abdi Omar Shuriye, Raihan Othman

Abstract:

Numerical Methods is a course that can be conducted using workshops and group discussion. This study has been implemented on undergraduate students of level two at the Faculty of Engineering, International Islamic University Malaysia. The Numerical Method course has been delivered to two Sections 1 and 2 with 44 and 22 students in each section, respectively. Systematic steps have been followed to apply the student centered learning approach in teaching Numerical Method course. Initially, the instructor has chosen the topic which was Euler’s Method to solve Ordinary Differential Equations (ODE) to be learned. The students were then divided into groups with five members in each group. Initial instructions have been given to the group members to prepare their subtopics before meeting members from other groups to discuss the subtopics in an expert group inside the classroom. For the time assigned for the classroom discussion, the setting of the classroom was rearranged to accommodate the student centered learning approach. Teacher strength was by monitoring the process of learning inside and outside the class. The students have been assessed during the migrating to the expert groups, recording of a video explanation outside the classroom and during the final examination. Euler’s Method to solve the ODE was set as part of Question 3(b) in the final exam. It is observed that none of the students from both sections obtained a zero grade in Q3(b), compared to Q3(a) and Q3(c). Also, for Section 1(44 students), 29 students obtained the full mark of 7/7, while only 10 obtained 7/7 for Q3(a) and no students obtained 6/6 for Q3(c). Finally, we can recommend that the Numerical Method course be moved toward more student-centered Learning classrooms where the students will be engaged in group discussion rather than having a teacher one man show.

Keywords: teacher centered learning, student centered learning, mathematic, numerical methods

Procedia PDF Downloads 352

Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

Abstract:

Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

Procedia PDF Downloads 285

Authors: Veenapani Rajeev Verma

Abstract:

Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

Procedia PDF Downloads 103