Search results for: health care workers' knowledge
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16823

Search results for: health care workers' knowledge

11303 Using Short Narrative Film to Drive Healthcare Policy: A Case Study

Authors: T. L. Granzyk, S. Scarborough, J. DeCosmo

Abstract:

The use of health-related or medical narratives has gained increasing anecdotal and research-based support as a successful device for changing health behavior and outcomes. These narratives, in the form of oral storytelling, short films, and educational documentaries, for example, are most effective when including empathetic characters that transport viewers into the story and command both their attention and emotional response. This case study outlines how and why one large health system created a short narrative film for their internal Sepsis Awareness campaign, which told the dramatic story of a patient recovering from a missed sepsis diagnosis, leaving her a quad-amputee. Results include positive global anecdotal response to the film from healthcare professionals and patients, as well as use of the film to support legislation, ultimately passed in favor of the formation of Sepsis Awareness Workgroups in Maryland. Authors conclude that narrative films can be used successfully to initiate healthcare legislation and to increase internal and external awareness of health-related areas in need of greater improvement and support. As such, healthcare leaders and stakeholders would benefit from learning how to intentionally create, cultivate, and curate narratives from within their own health systems that elicit an empathetic response.

Keywords: healthcare policy, healthcare narratives, sepsis awareness, short films

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11302 Effective Public Health Communication: Vaccine Health Messaging with Aboriginal and Torres Strait Islander Peoples

Authors: Maria Karidakis, Barbara Kelly

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The challenges precipitated by the advent of COVID-19 have brought to the fore the task governments and key stakeholders are faced with; ensuring public health communication is readily accessible to vulnerable populations. COVID-19 has presented challenges for the provision and reception of timely, accessible, and accurate health information pertaining to vaccine health messaging to Aboriginal and Torres Strait Islander peoples. The aim of this qualitative study was to explore strategies used by Aboriginal-led organisations to improve communication about COVID-19 and vaccination for their communities and to explore how these mediation and outreach strategies were received by community members. We interviewed 6 Aboriginal-led organisations and 15 community members from several states across Australian, and these interviews were analysed thematically. The findings suggest that effective public health communication is enhanced when aFirst nations-led response defines the governance that happens in First Nations communities. Pro-active and self-determining Aboriginal leadership and decision-making helps drive the response to counter a growing trend towards vaccine hesitancy. Other strategies include establishing partnerships with government departments and relevant non-governmental organisations to ensure services are implemented and culturally appropriate. The outcomes of this research will afford policymakers, stakeholders in healthcare, and cultural mediators the capacity to identify strengths and potential problems associated with pandemic health information and to subsequently implement creative and culturally specific solutions that go beyond the provision of written documentation via translation or interpreting. It will also enable governing bodies to adjust multilingual polices and to adopt mediation strategies that will improve information delivery and intercultural services on a national and international level.

Keywords: intercultural communication, qualitative, public health communication, COVID-19, pandemic, mediated communication, first nations people

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11301 Wearable Heart Rate Sensor Based on Wireless System for Heart Health Monitoring

Authors: Murtadha Kareem, Oliver Faust

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Wearable biosensor systems can be designed and developed for health monitoring. There is much interest in both scientific and industrial communities established since 2007. Fundamentally, the cost of healthcare has increased dramatically and the world population is aging. That creates the need to harvest technological improvements with small bio-sensing devices, wireless-communication, microelectronics and smart textiles, that leads to non-stop developments of wearable sensor based systems. There has been a significant demand to monitor patient's health status while the patient leaves the hospital in his/her personal environment. To address this need, there are numerous system prototypes which has been launched in the medical market recently, the aim of that is to provide real time information feedback about patient's health status, either to the patient himself/herself or direct to the supervising medical centre station, while being capable to give a notification for the patient in case of possible imminent health threatening conditions. Furthermore, wearable health monitoring systems comprise new techniques to address the problem of managing and monitoring chronic heart diseases for elderly people. Wearable sensor systems for health monitoring include various types of miniature sensors, either wearable or implantable. To be specific, our proposed system able to measure essential physiological parameter, such as heart rate signal which could be transmitted through Bluetooth to the cloud server in order to store, process, analysis and visualise the data acquisition. The acquired measurements are connected through internet of things to a central node, for instance an android smart phone or tablet used for visualising the collected information on application or transmit it to a medical centre.

Keywords: Wearable sensor, Heart rate, Internet of things, Chronic heart disease

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11300 Electronic Patient Record (EPR) System in South Africa: Results of a Pilot Study

Authors: Temitope O. Tokosi, Visvanathan Naicker

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Patient health records contain sensitive information for which an electronic patient record (EPR) system can safely secure and transmit amongst clinicians for use in improving health delivery. Clinician’s use of the behaviour of these systems is under scrutiny to assess their attributes towards health technology. South Africa (SA) clinicians responded to a pilot study survey to assess their understanding of EPR, what attributes are important towards technology use and more importantly streamlining the survey for a larger study. Descriptive statistics using mean scores was used because of the small sample size of 11 clinicians who completed the survey. Nine (9) constructs comprising 62 items were used and a Cronbach alpha score of 0.883 was obtained. Limitations and discussions conclude the study.

Keywords: EPR, clinicians, pilot study, South Africa

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11299 Antioxidant and Acute Toxicity of Stem Extracts of the Ficus Iteophylla

Authors: Muhammad Mukhtar

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The aim of this study is to evaluate the antioxidant activity and acute toxicity of the extracts of Ficus iteophylla by reactions with 1, 1-diphenyl-2-picryhydrazyl radical (DPPH) and method developed by Lork 1983, respectively. Stem bark of Ficus iteophylla was collected, air dried, pulverized to fine powdered and sequentially extracted using acetone, methanol and water in order of increasing polarity. The result shows strong radical scavenging activity against DPPH for all the extracts when compared with ascorbic acid. The LD50 of 316 mg/kg was calculated for all the three extras, and the values were found to be within the practically toxic range, and therefore, care should be taken when using the plants in traditional medicine.

Keywords: antioxidant, acute toxicity, Ficus iteophylla

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11298 Data Protection, Data Privacy, Research Ethics in Policy Process Towards Effective Urban Planning Practice for Smart Cities

Authors: Eugenio Ferrer Santiago

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The growing complexities of the modern world on high-end gadgets, software applications, scams, identity theft, and Artificial Intelligence (AI) make the “uninformed” the weak and vulnerable to be victims of cybercrimes. Artificial Intelligence is not a new thing in our daily lives; the principles of database management, logical programming, and garbage in and garbage out are all connected to AI. The Philippines had in place legal safeguards against the abuse of cyberspace, but self-regulation of key industry players and self-protection by individuals are primordial to attain the success of these initiatives. Data protection, Data Privacy, and Research Ethics must work hand in hand during the policy process in the course of urban planning practice in different environments. This paper focuses on the interconnection of data protection, data privacy, and research ethics in coming up with clear-cut policies against perpetrators in the urban planning professional practice relevant in sustainable communities and smart cities. This paper shall use expository methodology under qualitative research using secondary data from related literature, interviews/blogs, and the World Wide Web resources. The claims and recommendations of this paper will help policymakers and implementers in the policy cycle. This paper shall contribute to the body of knowledge as a simple treatise and communication channel to the reading community and future researchers to validate the claims and start an intellectual discourse for better knowledge generation for the good of all in the near future.

Keywords: data privacy, data protection, urban planning, research ethics

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11297 Promoting Environmental Sustainability in Rural Areas with CMUH Green Experiential Education Center

Authors: Yi-Chu Liu, Hsiu-Huei Hung, Li-Hui Yang, Ming-Jyh Chen

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introduction: To promote environmental sustainability, the hospital formed a corporate volunteer team in 2016 to build the Green Experiential Education Center. Our green creation center utilizes attic space to achieve sustainability objectives such as energy efficiency and carbon reduction. Other than executing sustainable plans, the center emphasizes experiential education. We invite our community to actively participate in building a sustainable, economically viable environment. Since 2020, the China Medical University Hospital has provided medical care to the Tgbin community in Taichung City's Heping District. The tribe, primarily composed of Atayal people, the elderly comprise 18% of the total population, and these families' per capita income is relatively low compared to Taiwanese citizens elsewhere. Purpose / Methods: With the experiences at the Green Experiential Education Center, CMUH team identifies the following objectives: Create an aquaponic system to supply vulnerable local households with food. Create a solar renewable energy system to meet the electricity needs of vulnerable local households. Promote the purchase of green electricity certificates to reduce the hospital's carbon emissions and generate additional revenue for the local community. Materials and Methods: In March 2020, we visited the community and installed The aquaponic system in January 2021. CMUH spent 150,000NT (approximately 5000US dollars) in March 2021 to build a 100-square-meter aquaponic system. The production of vegetables and fish caught determines the number of vulnerable families that can be supported. The aquaponics system is a kind of Low energy consumption and environmentally friendly production method, and can simultaneously achieve energy saving, water saving, and fertilizer saving .In September 2023, CMUH will complete a solar renewable energy system. The system will cover an area of 308 square meters and costs approximately NT$240,000 (approximately US$8,000). The installation of electricity meters will enable statistical analysis of power generation. And complete the Taiwan National Renewable Energy Certificate application process. The green electricity certificate will be obtained based on the monthly power generation from the solar renewable energy system. Results: I Food availability and access are crucial considering the remote location and aging population. By creating a fish and vegetable symbiosis system, the vegetables and catches produced will enable economically disadvantaged families to lower food costs. In 2021 and 2022, the aquaponic system produced 52 kilograms of vegetables and 75 kilograms of catch. The production ensures the daily needs of 8 disadvantaged families. Conclusions: The hospital serves as a fortress for public health and the ideal setting for corporate social responsibility. China Medical University Hospital and the Green Experiential Education Center work to strengthen ties with rural communities and offer top-notch specialty medical care. We are committed to assisting people in escaping poverty and hunger as part of the 2030 Sustainable Development Goals.

Keywords: environmental education, sustainability, energy conservation, carbon emissions, rural area development

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11296 Hazardous Waste Management at Chemistry Section in Dubai Police Forensic Lab

Authors: Adnan Lanjawi

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This paper is carried out to investigate the management of hazardous waste in the chemistry section which belongs to Dubai Police forensic laboratory. The chemicals are the main contributor toward the accumulation of hazardous waste in the section. This is due to the requirement to use it in analysis, such as of explosives, drugs, inorganic and fire debris cases. This leads to negative effects on the environment and to the employees’ health and safety. The research investigates the quantity of chemicals there, the labels, the storage room and equipment used. The target is to reduce the need for disposal by looking at alternative options, such as elimination, substitution and recycling. The data was collected by interviewing the top managers there who have been working in the lab more than 20 years. Also, data was collected by observing employees and how they carry out experiments. Therefore, a survey was made to assess their knowledge about the hazardous waste. The management of hazardous chemicals in the chemistry section needs to be improved. The main findings illustrate that about 110 bottles of reference substances were going to be disposed of in 2014. These bottles were bought for about 100,000 UAE Dirhams (£17,600). This means that the management of substances purchase is not organised. There is no categorisation programme in place, which makes the waste control very difficult. In addition, the findings show that chemical are segregated according to alphabetical order, whereas the efficient way is to separate them according to their nature and property. In addition, the research suggested technology and experiments to follow to reduce the need for using solvents and chemicals in the sample preparation.

Keywords: control, hazard, laboratories, waste,

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11295 A Human Factors Approach to Workload Optimization for On-Screen Review Tasks

Authors: Christina Kirsch, Adam Hatzigiannis

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Rail operators and maintainers worldwide are increasingly replacing walking patrols in the rail corridor with mechanized track patrols -essentially data capture on trains- and on-screen reviews of track infrastructure in centralized review facilities. The benefit is that infrastructure workers are less exposed to the dangers of the rail corridor. The impact is a significant change in work design from walking track sections and direct observation in the real world to sedentary jobs in the review facility reviewing captured data on screens. Defects in rail infrastructure can have catastrophic consequences. Reviewer performance regarding accuracy and efficiency of reviews within the available time frame is essential to ensure safety and operational performance. Rail operators must optimize workload and resource loading to transition to on-screen reviews successfully. Therefore, they need to know what workload assessment methodologies will provide reliable and valid data to optimize resourcing for on-screen reviews. This paper compares objective workload measures, including track difficulty ratings and review distance covered per hour, and subjective workload assessments (NASA TLX) and analyses the link between workload and reviewer performance, including sensitivity, precision, and overall accuracy. An experimental study was completed with eight on-screen reviewers, including infrastructure workers and engineers, reviewing track sections with different levels of track difficulty over nine days. Each day the reviewers completed four 90-minute sessions of on-screen inspection of the track infrastructure. Data regarding the speed of review (km/ hour), detected defects, false negatives, and false positives were collected. Additionally, all reviewers completed a subjective workload assessment (NASA TLX) after each 90-minute session and a short employee engagement survey at the end of the study period that captured impacts on job satisfaction and motivation. The results showed that objective measures for tracking difficulty align with subjective mental demand, temporal demand, effort, and frustration in the NASA TLX. Interestingly, review speed correlated with subjective assessments of physical and temporal demand, but to mental demand. Subjective performance ratings correlated with all accuracy measures and review speed. The results showed that subjective NASA TLX workload assessments accurately reflect objective workload. The analysis of the impact of workload on performance showed that subjective mental demand correlated with high precision -accurately detected defects, not false positives. Conversely, high temporal demand was negatively correlated with sensitivity and the percentage of detected existing defects. Review speed was significantly correlated with false negatives. With an increase in review speed, accuracy declined. On the other hand, review speed correlated with subjective performance assessments. Reviewers thought their performance was higher when they reviewed the track sections faster, despite the decline in accuracy. The study results were used to optimize resourcing and ensure that reviewers had enough time to review the allocated track sections to improve defect detection rates in accordance with the efficiency-thoroughness trade-off. Overall, the study showed the importance of a multi-method approach to workload assessment and optimization, combining subjective workload assessments with objective workload and performance measures to ensure that recommendations for work system optimization are evidence-based and reliable.

Keywords: automation, efficiency-thoroughness trade-off, human factors, job design, NASA TLX, performance optimization, subjective workload assessment, workload analysis

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11294 The Relation between Cognitive Fluency and Utterance Fluency in Second Language Spoken Fluency: Studying Fluency through a Psycholinguistic Lens

Authors: Tannistha Dasgupta

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This study explores the aspects of second language (L2) spoken fluency that are related to L2 linguistic knowledge and processing skill. It draws on Levelt’s ‘blueprint’ of the L2 speaker which discusses the cognitive issues underlying the act of speaking. However, L2 speaking assessments have largely neglected the underlying mechanism involved in language production; emphasis is given on the relationship between subjective ratings of L2 speech sample and objectively measured aspects of fluency. Hence, in this study, the relation between L2 linguistic knowledge and processing skill i.e. Cognitive Fluency (CF), and objectively measurable aspects of L2 spoken fluency i.e. Utterance Fluency (UF) is examined. The participants of the study are L2 learners of English, studying at high school level in Hyderabad, India. 50 participants with intermediate level of proficiency in English performed several lexical retrieval tasks and attention-shifting tasks to measure CF, and 8 oral tasks to measure UF. Each aspect of UF (speed, pause, and repair) were measured against the scores of CF to find out those aspects of UF which are reliable indicators of CF. Quantitative analysis of the data shows that among the three aspects of UF; speed is the best predictor of CF, and pause is weakly related to CF. The study suggests that including the speed aspect of UF could make L2 fluency assessment more reliable, valid, and objective. Thus, incorporating the assessment of psycholinguistic mechanisms into L2 spoken fluency testing, could result in fairer evaluation.

Keywords: attention-shifting, cognitive fluency, lexical retrieval, utterance fluency

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11293 Towards a More Inclusive Society: A Study on the Assimilation and Integration of the Migrant Children in Kerala

Authors: Arun Perumbilavil Anand

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For the past few years, the state of Kerala has been witnessing a large inflow of migrant workers from other states of the country, which emerged as a result of demographic transition and Gulf emigration. The in-migration patterns in Kerala have changed over the time with the migrants having a higher residence history bringing their families to the state, thereby making the process more complicated and divergent in its approach. These developments have led to an increase in the young migrant population at least in some parts of the state, which has opened up doubts and questions related to their future in the host society. At this juncture, the study ponders into the factors that are associated with the assimilation and wellbeing of migrant children in the society of Kerala. As one of the objectives, the study also analyzed the influence and role played by the educational institutions (both public and private) in meeting the needs and aspirations of both the children and their parents. The study gains significance as it tries to identify various impediments that hinder the cognitive skill formation and behaviour patterns of the migrant children in the host society. Data and Methodology: The study is based on the primary data collected through a series of interviews and interactions held with parents, children, and teachers of different educational institutions, including both public and private. The primary survey also made use of research techniques like observation, in-depth interviews, and case study method. The study was conducted in schools in the Kanjikode area of the Palakkad district in Kerala. The findings of the study are on the basis of a survey conducted in four schools and 40 migrant children. Findings: The study found that majority of the children have wholly integrated and assimilated into the host society. The influence of the peer group was quite visible in giving stimulus to the assimilation process. Most of the children do not have any emotional or cultural sentiments attached to their state of origin, and they consider Kerala as their ‘home state’ and the local language (Malayalam) as their ‘mother tongue'. The study could also find that the existing education system in the host society fails to meet the needs and aspirations of migrants as well as that of their children. On a comparative scale, to some extent, private schools have succeeded in fulfiling the special requirements of the migrant children. An interesting point that the study could pinpoint at is that the children of the migrants show better health conditions and wellbeing than compared to the natives, which is usually addressed as an epidemiologic paradox. As a concluding remark, the study recommends the inclusion concept of inclusive education into the education system of the state with giving due emphasis on those who are at higher risk of being excluded or marginalized, along with fostering increased interaction between diverse groups.

Keywords: assimilation, Kerala, migrant children, well-being

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11292 Distributed Listening in Intensive Care: Nurses’ Collective Alarm Responses Unravelled through Auditory Spatiotemporal Trajectories

Authors: Michael Sonne Kristensen, Frank Loesche, James Foster, Elif Ozcan, Judy Edworthy

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Auditory alarms play an integral role in intensive care nurses’ daily work. Most medical devices in the intensive care unit (ICU) are designed to produce alarm sounds in order to make nurses aware of immediate or prospective safety risks. The utilisation of sound as a carrier of crucial patient information is highly dependent on nurses’ presence - both physically and mentally. For ICU nurses, especially the ones who work with stationary alarm devices at the patient bed space, it is a challenge to display ‘appropriate’ alarm responses at all times as they have to navigate with great flexibility in a complex work environment. While being primarily responsible for a small number of allocated patients they are often required to engage with other nurses’ patients, relatives, and colleagues at different locations inside and outside the unit. This work explores the social strategies used by a team of nurses to comprehend and react to the information conveyed by the alarms in the ICU. Two main research questions guide the study: To what extent do alarms from a patient bed space reach the relevant responsible nurse by direct auditory exposure? By which means do responsible nurses get informed about their patients’ alarms when not directly exposed to the alarms? A comprehensive video-ethnographic field study was carried out to capture and evaluate alarm-related events in an ICU. The study involved close collaboration with four nurses who wore eye-level cameras and ear-level binaural audio recorders during several work shifts. At all time the entire unit was monitored by multiple video and audio recorders. From a data set of hundreds of hours of recorded material information about the nurses’ location, social interaction, and alarm exposure at any point in time was coded in a multi-channel replay-interface. The data shows that responsible nurses’ direct exposure and awareness of the alarms of their allocated patients vary significantly depending on work load, social relationships, and the location of the patient’s bed space. Distributed listening is deliberately employed by the nursing team as a social strategy to respond adequately to alarms, but the patterns of information flow prompted by alarm-related events are not uniform. Auditory Spatiotemporal Trajectory (AST) is proposed as a methodological label to designate the integration of temporal, spatial and auditory load information. As a mixed-method metrics it provides tangible evidence of how nurses’ individual alarm-related experiences differ from one another and from stationary points in the ICU. Furthermore, it is used to demonstrate how alarm-related information reaches the individual nurse through principles of social and distributed cognition, and how that information relates to the actual alarm event. Thereby it bridges a long-standing gap in the literature on medical alarm utilisation between, on the one hand, initiatives to measure objective data of the medical sound environment without consideration for any human experience, and, on the other hand, initiatives to study subjective experiences of the medical sound environment without detailed evidence of the objective characteristics of the environment.

Keywords: auditory spatiotemporal trajectory, medical alarms, social cognition, video-ethography

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11291 Predictive Functional Control with Disturbance Observer for Tendon-Driven Balloon Actuator

Authors: Jun-ya Nagase, Toshiyuki Satoh, Norihiko Saga, Koichi Suzumori

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In recent years, Japanese society has been aging, engendering a labour shortage of young workers. Robots are therefore expected to perform tasks such as rehabilitation, nursing elderly people, and day-to-day work support for elderly people. The pneumatic balloon actuator is a rubber artificial muscle developed for use in a robot hand in such environments. This actuator has a long stroke, and a high power-to-weight ratio compared with the present pneumatic artificial muscle. Moreover, the dynamic characteristics of this actuator resemble those of human muscle. This study evaluated characteristics of force control of balloon actuator using a predictive functional control (PFC) system with disturbance observer. The predictive functional control is a model-based predictive control (MPC) scheme that predicts the future outputs of the actual plants over the prediction horizon and computes the control effort over the control horizon at every sampling instance. For this study, a 1-link finger system using a pneumatic balloon actuator is developed. Then experiments of PFC control with disturbance observer are performed. These experiments demonstrate the feasibility of its control of a pneumatic balloon actuator for a robot hand.

Keywords: disturbance observer, pneumatic balloon, predictive functional control, rubber artificial muscle

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11290 Co-Creational Model for Blended Learning in a Flipped Classroom Environment Focusing on the Combination of Coding and Drone-Building

Authors: A. Schuchter, M. Promegger

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The outbreak of the COVID-19 pandemic has shown us that online education is so much more than just a cool feature for teachers – it is an essential part of modern teaching. In online math teaching, it is common to use tools to share screens, compute and calculate mathematical examples, while the students can watch the process. On the other hand, flipped classroom models are on the rise, with their focus on how students can gather knowledge by watching videos and on the teacher’s use of technological tools for information transfer. This paper proposes a co-educational teaching approach for coding and engineering subjects with the help of drone-building to spark interest in technology and create a platform for knowledge transfer. The project combines aspects from mathematics (matrices, vectors, shaders, trigonometry), physics (force, pressure and rotation) and coding (computational thinking, block-based programming, JavaScript and Python) and makes use of collaborative-shared 3D Modeling with clara.io, where students create mathematics knowhow. The instructor follows a problem-based learning approach and encourages their students to find solutions in their own time and in their own way, which will help them develop new skills intuitively and boost logically structured thinking. The collaborative aspect of working in groups will help the students develop communication skills as well as structural and computational thinking. Students are not just listeners as in traditional classroom settings, but play an active part in creating content together by compiling a Handbook of Knowledge (called “open book”) with examples and solutions. Before students start calculating, they have to write down all their ideas and working steps in full sentences so other students can easily follow their train of thought. Therefore, students will learn to formulate goals, solve problems, and create a ready-to use product with the help of “reverse engineering”, cross-referencing and creative thinking. The work on drones gives the students the opportunity to create a real-life application with a practical purpose, while going through all stages of product development.

Keywords: flipped classroom, co-creational education, coding, making, drones, co-education, ARCS-model, problem-based learning

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11289 Development of in vitro Fertilization and Emerging Legal Issues

Authors: Malik Imtiaz Ahmad

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The development of In Vitro Fertilization (IVF) has revolutionized the field of reproductive medicine, offering hope to myriad individuals and couples facing infertility issues. IVF, a process involving the fertilization of eggs with sperm outside the body, has evolved over decades from an experimental procedure to a mainstream medical practice. The study sought to understand the evolution of IVF from its early stages to its present status as a groundbreaking fertility treatment. It also aimed to analyze the legal complexities surrounding IVF, including issues like embryo ownership, surrogacy agreements, and custody disputes. This research focused on the multidisciplinary approach involving both medical and legal fields. It aimed to explore the historical evolution of IVF, its techniques, and legal challenges concerning family law, health law, and privacy policies it has given rise to in modern times. This research aimed to provide insights into the intersection of medical technology and the law, offering valuable knowledge for policymakers, legal experts, and individuals involved in IVF. The study utilized various methods, including a thorough literature review, a historical analysis of IVF’s evolution, an examination of legal cases, and a review of emerging regulations. These approaches aimed to provide a comprehensive understanding of IVF and its modern legal issues, facilitating a holistic exploration of the subject matter.

Keywords: in vitro fertilization development, IVF techniques evolution, legal issues in IVF, IVF legal frameworks, ethical dilemmas in IVF

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11288 A Measurement Instrument to Determine Curricula Competency of Licensure Track Graduate Psychotherapy Programs in the United States

Authors: Laith F. Gulli, Nicole M. Mallory

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We developed a novel measurement instrument to assess Knowledge of Educational Programs in Professional Psychotherapy Programs (KEP-PPP or KEP-Triple P) within the United States. The instrument was designed by a Panel of Experts (PoE) that consisted of Licensed Psychotherapists and Medical Care Providers. Licensure track psychotherapy programs are listed in the databases of the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE); American Psychological Association (APA); Council on Social Work Education (CSWE); and the Council for Accreditation of Counseling & Related Educational Programs (CACREP). A complete list of psychotherapy programs can be obtained from these professional databases, selecting search fields of (All Programs) in (All States). Each program has a Web link that electronically and directly connects to the institutional program, which can be researched using the KEP-Triple P. The 29-item KEP Triple P was designed to consist of six categorical fields; Institutional Type: Degree: Educational Delivery: Accreditation: Coursework Competency: and Special Program Considerations. The KEP-Triple P was designed to determine whether a specific course(s) is offered in licensure track psychotherapy programs. The KEP-Triple P is designed to be modified to assess any part or the entire curriculum of licensure graduate programs. We utilized the KEP-Triple P instrument to study whether a graduate course in Addictions was offered in Marriage and Family Therapy (MFT) programs. Marriage and Family Therapists are likely to commonly encounter patients with Addiction(s) due to the broad treatment scope providing psychotherapy services to individuals, couples and families of all age groups. Our study of 124 MFT programs which concluded at the end of 2016 found that we were able to assess 61 % of programs (N = 76) since 27 % (N = 34) of programs were inaccessible due to broken Web links. From the total of all MFT programs 11 % (N = 14) did not have a published curriculum on their Institutional Web site. From the sample study, we found that 66 % (N = 50) of curricula did not offer a course in Addiction Treatment and that 34 % (N =26) of curricula did require a mandatory course in Addiction Treatment. From our study sample, we determined that 15 % (N = 11) of MFT doctorate programs did not require an Addictions Treatment course and that 1 % (N = 1) did require such a course. We found that 99 % of our study sample offered a Campus based program and 1 % offered a hybrid program with both online and residential components. From the total sample studied, we determined that 84 % of programs would be able to obtain reaccreditation within a five-year period. We recommend that MFT programs initiate procedures to revise curricula to include a required course in Addiction Treatment prior to their next accreditation cycle, to improve the escalating addiction crisis in the United States. This disparity in MFT curricula raises serious ethical and legal consideration for national and Federal stakeholders as well as for patients seeking a competently trained psychotherapist.

Keywords: addiction, competency, curriculum, psychotherapy

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11287 The Impact of Information and Communication Technology on the Re-Engineering Process of Small and Medium Enterprises

Authors: Hiba Mezaache

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The current study aimed to know the impact of using information and communication technology on the process of re-engineering small and medium enterprises, as the world witnessed the speed development of the latter in its field of work and the diversity of its objectives and programs, that also made its process important for the growth and development of the institution and also gaining the flexibility to face the changes that may occur in the environment of work, so in order to know the impact of information and communication technology on the success of this process, we prepared an electronic questionnaire that included (70) items, and we also used the SPSS statistical calendar to analyze the data obtained. In the end of our study, our conclusion was that there was a positive correlation between the four dimensions of information and communication technology, i.e., hardware and equipment, software, communication networks, databases, and the re-engineering process, in addition to the fact that the studied institutions attach great importance to formal communication, for its positive advantages that it achieves in reducing time and effort and costs in performing the business. We could also say that communication technology contributes to the process of formulating objectives related to the re-engineering strategy. Finally, we recommend the necessity of empowering workers to use information technology and communication more in enterprises, and to integrate them more into the activity of the enterprise by involving them in the decision-making process, and also to keep pace with the development in the field of software, hardware, and technological equipment.

Keywords: information and communication technology, re-engineering, small and medium enterprises, the impact

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11286 The Factors Constitute the Interaction between Teachers and Students: An Empirical Study at the Notion of Framing

Authors: Tien-Hui Chiang

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The code theory, proposed by Basil Bernstein, indicates that framing can be viewed as the core element in constituting the phenomenon of cultural reproduction because it is able to regulate the transmission of pedagogical information. Strong framing increases the social relation boundary between a teacher and pupils, which obstructs information transmission, so that in order to improve underachieving students’ academic performances, teachers need to reduce to strength of framing. Weak framing enables them to transform academic knowledge into commonsense knowledge in daily life language. This study posits that most teachers would deliver strong framing due to their belief mainly confined within the aspect of instrumental rationality that deprives their critical minds. This situation could make them view the normal distribution bell curve of students’ academic performances as a natural outcome. In order to examine the interplay between framing, instrumental rationality and pedagogical action, questionnaires were completed by over 5,000 primary school teachers in Henan province, China, who were stratified sample. The statistical results show that most teachers employed psychological concepts to measure students’ academic performances and, in turn, educational inequity was legitimatized as a natural outcome in the efficiency-led approach. Such efficiency-led minds made them perform as the agent practicing the mechanism of social control and in turn sustaining the phenomenon of cultural reproduction.

Keywords: code, cultural reproduction, framing, instrumental rationality, social relation and interaction

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11285 The ‘Fun, Move, Play’ Project: Qualitative and Quantitative Findings from Irish Primary School Children (6-8 Years), Parents and Teachers

Authors: Jemma McGourty, Brid Delahunt, Fiona Hackett, Sharon Courtney, Richard English, Graham Russell, Sinéad O’Connor

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Fundamental Movement Skills (FMS) mastery is considered essential for children’s ongoing, meaningful engagement in Physical Activity (PA). There has been a dearth of Irish research on baseline FMS and their development by means of intervention in young primary school children. In addition, as children’s participation in PA is heavily influenced by both parents and teachers, it is imperative to understand their attitudes and perceptions towards PA participation and its’ promotion in children. The ‘Fun, Move, Play’ Project investigated the effect of a 6-week play based PA intervention on primary school children’s (aged 6-8 years) FMS while also exploring the attitudes and perceptions of their parents and teachers towards PA participation. The FMS intervention utilised a pre-post quasi-experimental design to determine the effect of a 6-week play based PA intervention (devised from the iCoach Kids Programme) on 176 primary school children’s FMS (N = 176: 90 girls and 86 boys; M = 7.2 years; SD = 0.48). Objective measures of 7 FMS (run, skip, vertical jump, static balance, stationary dribble, catch, kick) were made using a combination of the TGMD2 and Get Skilled, Get Active resources. One hundred parents (87 mothers; 13 fathers; M=36 years; SD=5.45) and 90 teachers (67 females; 23 males) completed surveys investigating their attitudes and perceptions towards PA participation. In addition, 19 of these parents and 9 of these teachers participated in semi-structured qualitative interviews to explore, in more depth, their views and perceptions of PA participation. Both the FMS data set and survey responses were analysed using SPSS version 23, using appropriate statistical analysis. A thematic analysis framework was used to analyse the qualitative findings. A significant improvement was observed in the children’s overall FMS score pre-post intervention (t = 16.67; df = 175; p < 0.001), while there were also significant improvements in each of the seven individual FMS measured in the children, pre-post intervention. Findings from the parent surveys and interviews indicated that parents had positive attitudes towards PA, viewed it as important and supported their child’s PA participation. However, a lack of knowledge regarding the amount and intensity of PA that children should participate in emerged as a recurrent finding. Also, there was a significant positive correlation between the PA levels of parents’ and their children (r = .41; n = 100; p < .001). Arising from the teachers’ surveys and interviews was a positive attitude towards PA and the impact that it has on a child’s health and well-being. They also reported feeling more confident teaching certain aspects of the PE curriculum (games and sports) compared to others (gymnastics, dance), where they appreciate working with specialist practitioners. Conclusion: A short-term PA intervention has a positive effect on children’s FMS. While parents are supportive of their child’s PA participation, there is a knowledge gap regarding National PA guidelines for children. Teachers appreciate the importance of PA in children, but face a number of challenges in its implementation and promotion.

Keywords: fundamental movement skills, parents attitudes to physical activity, short-term intervention, teachers attitudes to physical activity

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11284 Nurturing Resilient Families: Strategies for Positive Parenting and Emotional Well-Being

Authors: Xu Qian

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This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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11283 Religion and Suicide: Exploration of the Relationship Between Religiosity and Suicidal Ideation among Young Adults

Authors: Sandra D. Prewitt

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Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

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11282 Determinants of Quality of Life and Mental Health in Medical Students During Two Years Observation

Authors: Szymon Szemik, Małgorzata Kowalska

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Objective: Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK (POLski LEKarz, eng. Polish Physician) study aims to identify and evaluate the quality of life, mental health status, and ever-recognized chronic diseases by simultaneously assessing their determinants in Polish medical students during long-term observation. Material and Methods: The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results: The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. Obtained results confirmed that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domains. Moreover, we observed a significant increase in self-declared scoring of somatic symptoms year by year (from M=4.75 at T1 to M=8.06 at T2, p<0.001) in the GHQ-28 questionnaire survey. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the first year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in meat consumption. Conclusions: The QoL in medical students and selected determinants of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

Keywords: quality of life, mental health, medical students, follow-up study

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11281 Transition towards a Market Society: Commodification of Public Health in India and Pakistan

Authors: Mayank Mishra

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Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

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11280 A Study on the Effect of Socioeconomic Status on Adolescents' Health Promoting Behaviors: Mediating Effect of Family-Based Activity

Authors: Sue Lynn Kim, Sang-Gyun Lee, Joan P. Yoo

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Although adolescents in low socioeconomic status (SES) have been reported to less engage in health promoting behaviors (HPB), the specific mechanism between their SES and HPB has not been extensively studied. Considering the Korean education system which focuses only on college entrance exams while lacking of interest in students’ health, and unique traits of adolescents, such as ego-centric thinking, family members can significantly contribute to develop and enhance adolescents’ HPB. Based on the review of related literature and previous researches, this study examined the mediating effect of family-based activities on the relationship between SES and adolescents' HPB. 636 adolescents (4th graders in elementary and 1st graders in middle school) and their parents from the 1st year survey of Seoul Education & Health Welfare Panel were analyzed by AMOS 19.0 utilizing structural equation modeling. Analytic results show that adolescents in low SES were less likely to engage in family-based activities as well as HPB. This association between SES and HPB was partially mediated by family-based activities. Based on the findings, we suggest that special education programs to enhance HPB should be required in schools and community organizations especially for adolescents in low SES who may have difficulties in doing family-based activities due to parents’ low income and insufficient leisure time. In addition, family-based activities should be encouraged to enhance HPB by raising parents' awareness about the importance of family-based activities on their children's HPB.

Keywords: family-based activity, health promoting behaviors, socioeconomic status, HPB

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11279 Improving Fingerprinting-Based Localization System Using Generative AI

Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. It also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 0.39 m, and more than 90% of the errors are less than 0.82 m. According to numerical results, SRCLoc improves positioning performance and reduces radio map construction costs significantly compared to traditional methods.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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11278 Process Safety Evaluation of a Nuclear Power Plant through Virtual Process Hazard Analysis (PHA) using the What-If Technique

Authors: Lormaine Anne Branzuela, Elysa Largo, Julie Marisol Pagalilauan, Neil Concibido, Monet Concepcion Detras

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Energy is a necessity both for the people and the country. The demand for energy is continually increasing, but the supply is not doing the same. The reopening of the Bataan Nuclear Power Plant (BNPP) in the Philippines has been circulating in the media for the current time. The general public has been hesitant in accepting the inclusion of nuclear energy in the Philippine energy mix due to perceived unsafe conditions of the plant. This study evaluated the possible operations of a nuclear power plant, which is of the same type as the BNPP, considering the safety of the workers, the public, and the environment using a Process Hazard Analysis (PHA) method. What-If Technique was utilized to identify the hazards and consequences on the operations of the plant, together with the level of risk it entails. Through the brainstorming sessions of the PHA team, it was found that the most critical system on the plant is the primary system. Possible leakages on pipes and equipment due to weakened seals and welds and blockages on coolant path due to fouling were the most common scenarios identified, which further caused the most critical scenario – radioactive leak through sump contamination, nuclear meltdown, and equipment damage and explosion which could result to multiple injuries and fatalities, and environmental impacts.

Keywords: process safety management, process hazard analysis, what-If technique, nuclear power plant

Procedia PDF Downloads 198
11277 Preventable Stress and Trauma, and Menstrual Health Management: Experiences of Adolescent Girls from India

Authors: Daisy Dutta, Chhanda Chakraborti

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Background and significance of the study: Menstrual Hygiene Management (MHM) is poor in many Lower and Middle-Income Countries (LMIC) such as India. Poor and inadequate menstrual hygiene has an adverse effect on the health and social life of adolescent girls and women. There are many well-known barriers to adequate Menstrual Hygiene Management (MHM); e.g., lack of awareness, lack of WASH (Water, Sanitation and Hygiene) facilities, lack of affordable menstrual absorbents, etc. But, there is a unique barrier which is very much avoidable; i.e., lack of proper guidance and counseling about menstruation. Menstruation is associated with various social and cultural restrictions and taboos and being a taboo topic; often there is no discussion in the society on this topic. Thus, many adolescent girls encounter the menarche with a lot of unnecessary and avoidable trauma, stress and awkwardness. This trauma, stress, and anxiety are even more prevalent among adolescent girls residing in rural areas. This study argues that this unnecessary stress and anxiety of the adolescent girls can be alleviated by reinforcing social support and adequate information and guidance about MHM and eliminating the futile socio-cultural restrictions during menstruation. Methodology: A qualitative study was conducted in a North-eastern State of India where 45 adolescent girls were interviewed both from rural and urban areas. The adolescent girls were asked about their experiences of stress and anxiety on their first menstruation, their preparedness for menarche, their source of information and guidance, their hygiene-practices, and the various restrictions they follow. Findings: Maximum number of girls did not receive any information about menstruation before menarche. Most of them reported that they were terrified about their first menstruation as they were unprepared. Among those who were aware before menarche, reported that they did not receive proper guidance to manage their menstruation in a hygienic manner. Hygiene-related practices are also influenced by their knowledge about MHM. In maximum cases, girls are bound to follow certain cultural and religious restrictions even if they don’t want to follow which created additional stress in managing their menstruation with dignity. Conclusion: Lack of proper guidance and counseling about menstruation and MHM along with an array of socio-cultural restrictions can enhance a negative attitude in adolescent girls towards menstruation due to which they have to go through an extra and unnecessary burden of stress and trauma. This stress and trauma is preventable by improving the provisions of proper guidance and counseling about menstruation in a supportive environment.

Keywords: adolescent girls, menstrual hygiene management, socio-cultural restrictions, stress, trauma

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11276 A Controlled Natural Language Assisted Approach for the Design and Automated Processing of Service Level Agreements

Authors: Christopher Schwarz, Katrin Riegler, Erwin Zinser

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The management of outsourcing relationships between IT service providers and their customers proofs to be a critical issue that has to be stipulated by means of Service Level Agreements (SLAs). Since service requirements differ from customer to customer, SLA content and language structures vary largely, standardized SLA templates may not be used and an automated processing of SLA content is not possible. Hence, SLA management is usually a time-consuming and inefficient manual process. For overcoming these challenges, this paper presents an innovative and ITIL V3-conform approach for automated SLA design and management using controlled natural language in enterprise collaboration portals. The proposed novel concept is based on a self-developed controlled natural language that follows a subject-predicate-object approach to specify well-defined SLA content structures that act as templates for customized contracts and support automated SLA processing. The derived results eventually enable IT service providers to automate several SLA request, approval and negotiation processes by means of workflows and business rules within an enterprise collaboration portal. The illustrated prototypical realization gives evidence of the practical relevance in service-oriented scenarios as well as the high flexibility and adaptability of the presented model. Thus, the prototype enables the automated creation of well defined, customized SLA documents, providing a knowledge representation that is both human understandable and machine processable.

Keywords: automated processing, controlled natural language, knowledge representation, information technology outsourcing, service level management

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11275 Determinants of Contraceptive Demand among Young Nulliparous Women in India: Evidence from National Family Health Survey-4

Authors: Bhawna Verma

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Looking at the contraceptive use and unmet need specific to the different age groups would help to understand various determinants and characteristics of women from different age groups, which are often being neglected. The study explores contraceptive behavior, unmet need for family planning and its correlates among young nulliparous women aged 15-29, using data from NFHS-4 (2015-16), India. Method: The study utilized information from 26,924 currently married women, who has no child or who have had first terminated pregnancy and was aged 15-29 at the time of the survey. Chi-Square and logistic regression analysis have been used to assess the effects of socio-economic characteristics. Results: Of all the considered explanatory variables religion, caste, education, current age, age at marriage, media exposure and regional differences were found to be significantly affecting the behavior of contraceptive use. Women of the 25-29 age group are 0.6 percent less likely to have an unmet need than women of 12-19 age group. Unmet need is increasing with the increased level of education. Muslim women are 0.3 percent less likely to have an unmet need than women of Hindu category. Conclusion: Separate considerations must be given to the needs for family planning formation among nulliparous women along with the factors associated with the use and non-use of contraceptives among them. Separate considerations must be given for effective promotion of FP knowledge through print, electronic media, towards the unequal access to the contraceptives among nulliparous women. Marriages after legal minimum age and encouraging women for higher education may address existing socio-economic barriers.

Keywords: contraceptive use, unmet need, family planning, contraceptive behavior

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11274 Findings from an Access Improvement Project for Antiretroviral Therapy Uptake through Traditional Birth Attendants at Mother Theresa Hospital, Lagos, Nigeria

Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

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In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

Procedia PDF Downloads 438