Search results for: behavioral healthcare

Authors: Khadiza Akter, Tammy Greer, Raegan Bishop

Abstract:

An in-depth study of the psycho-social effects of gynecological health disparities among immigrant women in the USA is the goal of this integrative review paper. Immigrant women frequently encounter unique obstacles that have severe psycho-social repercussions when it comes to receiving high-quality gynecological treatment. The review investigates the interaction of psychological, sociological, and health factors that affect the psycho-social effects that immigrant women experience in recognition of the significance of addressing these imbalances. The difficulties that immigrant women face in providing high-quality gynecological treatment in the USA are examined in this study. These difficulties are caused by a variety of psychological issues, including acculturation stress and stigma, as well as by social problems like prejudice, language hurdles, and cultural norms. Additionally, variations in healthcare access and affordability have a role. This study highlights the particular challenges that immigrant women have in receiving high-quality gynecological treatment in the United States. These difficulties are caused by both social problems like language obstacles, cultural norms, and biases, as well as psychological ones like acculturation stress and stigma. Additionally, variations in gynecological care for immigrant women are greatly influenced by variances in healthcare availability and price. To find pertinent research looking at the psychological effects of gynecological health disparities among immigrant women in the USA, a thorough search of numerous databases was done. Numerous approaches, including mixed, quantitative, and qualitative ones, were used in the studies. The important findings from various investigations were extracted and synthesized after they underwent a careful evaluation. In order to lessen these discrepancies and enhance the overall well-being of immigrant women, healthcare professionals, legislators, and researchers must collaborate to create specialized treatments, regulations, and health system reforms.

Keywords: cultural barriers, gynecological health disparities, health care access, immigrant women, mental health, psycho-social consequences, social stigma

Procedia PDF Downloads 67

Authors: R. Pussinen, V. Jankovic, U. Herzberg, M. Cerrada-Gimenez, T. Huhtala, A. Nurmi, T. Ahtoniemi

Abstract:

Targeted over-expression of human α-synuclein using viral-vector mediated gene delivery into the substantia nigra of rats and non-human primates has been reported to lead to dopaminergic cell loss and the formation of α-synuclein aggregates reminiscent of Lewy bodies. We have previously shown how AAV-mediated expression of α-synuclein is seen in the chronic phenotype of the rats over 16 week follow-up period. In the context of these findings, we attempted to further characterize this long term PD related functional and motor deficits as well as neurochemical and neuropathological changes in AAV-mediated α-synuclein transfection model in rats during chronic follow-up period. Different titers of recombinant AAV expressing human α-synuclein (A53T) were stereotaxically injected unilaterally into substantia nigra of Wistar rats. Rats were allowed to recover for 3 weeks prior to initial baseline behavioral testing with rotational asymmetry test, stepping test and cylinder test. A similar behavioral test battery was applied again at weeks 5, 9,12 and 15. In addition to traditionally used rat PD model tests, MotoRater test system, a high speed kinematic gait performance monitoring was applied during the follow-up period. Evaluation focused on animal gait between groups. Tremor analysis was performed on weeks 9, 12 and 15. In addition to behavioral end-points, neurochemical evaluation of dopamine and its metabolites were evaluated in striatum. Furthermore, integrity of the dopamine active transport (DAT) system was evaluated by using 123I- β-CIT and SPECT/CT imaging on weeks 3, 8 and 12 after AAV- α-synuclein transfection. Histopathology was examined from end-point samples at 3 or 12 weeks after AAV- α-synuclein transfection to evaluate dopaminergic cell viability and microglial (Iba-1) activation status in substantia nigra by using stereological analysis techniques. This study focused on the characterization and validation of previously published AAV- α-synuclein transfection model in rats but with the addition of novel end-points. We present the long term phenotype of AAV- α-synuclein transfected rats with traditionally used behavioral tests but also by using novel fine motor analysis techniques and tremor analysis which provide new insight to unilateral effects of AAV α-synuclein transfection. We also present data about neurochemical and neuropathological end-points for the dopaminergic system in the model and how well they correlate with behavioral phenotype.

Keywords: adeno-associated virus, alphasynuclein, animal model, Parkinson’s disease

Procedia PDF Downloads 282

Authors: Roberta Martino, Viviana Ventre

Abstract:

Empirical evidence has, over time, confirmed that the behavior of individuals is inconsistent with the descriptions provided by the Discounted Utility Model, an essential reference for calculating the utility of intertemporal prospects. The model assumes that individuals calculate the utility of intertemporal prospectuses by adding up the values of all outcomes obtained by multiplying the cardinal utility of the outcome by the discount function estimated at the time the outcome is received. The trend of the discount function is crucial for the preferences of the decision maker because it represents the perception of the future, and its trend causes temporally consistent or temporally inconsistent preferences. In particular, because different formulations of the discount function lead to various conclusions in predicting choice, the descriptive ability of models with a hyperbolic trend is greater than linear or exponential models. Suboptimal choices from any time point of view are the consequence of this mechanism, the psychological factors of which are encapsulated in the discount rate trend. In addition, analyzing the decision-making process from a psychological perspective, there is an equivalence between the selection of dominated prospects and a degree of impatience that decreases over time. The first part of the paper describes and investigates the anomalies of the discounted utility model by relating the cognitive distortions of the decision-maker to the emotional factors that are generated during the evaluation and selection of alternatives. Specifically, by studying the degree to which impatience decreases, it’s possible to quantify how the psychological and emotional mechanisms of the decision-maker result in a lack of decision persistence. In addition, this description presents inconsistency as the consequence of an inconsistent attitude towards time-delayed choices. The second part of the paper presents an experimental phase in which we show the relationship between inconsistency and impatience in different contexts. Analysis of the degree to which impatience decreases confirms the influence of the decision maker's emotional impulses for each anomaly in the utility model discussed in the first part of the paper. This work provides an application in the field of personalized behavioral finance. Indeed, the numerous behavioral diversities, evident even in the degrees of decrease in impatience in the experimental phase, support the idea that optimal strategies may not satisfy individuals in the same way. With the aim of homogenizing the categories of investors and to provide a personalized approach to advice, the results proven in the experimental phase are used in a complementary way with the information in the field of behavioral finance to implement the Analytical Hierarchy Process model in intertemporal choices, useful for strategic personalization. In the construction of the Analytic Hierarchy Process, the degree of decrease in impatience is understood as reflecting irrationality in decision-making and is therefore used for the construction of weights between anomalies and behavioral traits.

Keywords: analytic hierarchy process, behavioral finance, financial anomalies, impatience, time inconsistency

Procedia PDF Downloads 53

Authors: Osuagwu Justine Ugochukwu

Abstract:

Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

Procedia PDF Downloads 69

Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

Abstract:

Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

Procedia PDF Downloads 109

Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

Abstract:

Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

Procedia PDF Downloads 34

Authors: Siti Noor Baiti Binti Mustafa

Abstract:

Energy management studies regarding energy efficiency investments in Malaysia has yet to address the lack of empirical research that examines pro- sustainability behavior of managers in the industrial sector and how it influences energy efficiency investment decision-making. This study adopts the Theory of Planned Behavior (TPB) to examine the relationship between personal attitude, subjective norms, and perceived behavioral control (PBC), the intention of energy efficiency investments, and how perceptions of Non-Energy Benefits (NEB) influence these intentions among managers in the industrial sector in Malaysia. Managers from various sub-sectors in the industrial sector were selected from a sample of companies that are participants of the Government-led program named the Energy Audit Conditional Grant (EACG) that aimed to promote energy efficiency. Data collection was conducted through an online semi-structured, open-ended questionnaire and then later interviewed. The results of this explorative sequential qualitative study showed that perceived behavioral control was a significant predictor of energy efficiency investment intentions as compared to factors such as attitude and subjective norms. The level of awareness and perceptions towards NEB further played a significant factor in influencing energy efficiency investment decision-making as well. Various measures and policy recommendations are provided together with insights on factors that influence decision-makers intention to invest in energy efficiency, whilst new knowledge on NEB perceptions will be useful to enhance the attractiveness of energy-efficient investments.

Keywords: energy efficiency investments, non-energy benefits, theory of planned behavior, personal attitude, subjective norms, perceived behavioral control, Malaysia industrial sector

Procedia PDF Downloads 96

Authors: Sakkaphat T. Ngamake, Arunya Tuicomepee, Panrapee Suttiwan, Rewadee Watakakosol, Sompoch Iamsupasit

Abstract:

Generally, 'positive' emotion regulation strategies such as cognitive reappraisal have linked to desirable outcomes while 'negative' strategies such as behavioral suppression have linked to undesirable outcomes. These trends have been found in both the elderly and professional practitioners. Hence, this study sought to investigate these trends further by examining the relationship between two dominant emotion regulation strategies in the literature (i.e., cognitive reappraisal and behavioral suppression) and well-being outcomes among the elderly (i.e., successful aging) and their caregivers (i.e., satisfaction with life), using the actor-partner interdependence model. A total of 150 elderly-caregiver dyads participated in the study. The elderly responded to two measures assessing the two emotion regulation strategies and successful aging while their caregivers responded to the same emotion regulation measure and a measure of satisfaction with life. Two criterion variables (i.e., successful aging and satisfaction with life) were specified as latent variables whereas four predictors (i.e., two strategies for the elderly and two strategies for their caregivers) were specified as observed variables in the model. Results have shown that, for the actor effect, the cognitive reappraisal strategy yielded positive relationships with the well-being outcomes for both the elderly and their caregivers. For the partner effect, a positive relationship between caregivers’ cognitive reappraisal strategy and the elderly’s successful aging was observed. The behavioral suppression strategy has not related to any well-being outcomes, within and across individual agents. This study has contributed to the literature by empirically showing that the mental activity of the elderly’s immediate environment such as their family members or close friends could affect their quality of life.

Keywords: emotion regulation, caregiver, older adult, well-being

Procedia PDF Downloads 406

Authors: Tiantian Gu, Dezhi Li, Mian Zhang, Ying Jiang

Abstract:

Considering the characteristics of residents’ participation in the governance of old community renewal (OCR), a theoretical model of the determinant of residents’ intention to participate in the governance of OCR has been built based on the theory of planned behavior. Seven old communities in Nanjing have been chosen as cases to conduct empirical analysis. The result indicates that participation attitude, subjective norm and perceived behavioral control have significant positive effects on residents’ intention to participate in the governance of the OCR. Recognition of the community, cognition of the OCR and perceived behavioral control have indirect positive effects on residents’ intention to participate in the OCR. In addition, the education level and the length of residence have positive effects on their participation intention, while the gender, age, and monthly income have little effect on it. The research result provides suggestions for the improvement of residents’ participation in the OCR.

Keywords: old community renewal, residents’ participation in governance, intention, theory of planned behavior

Procedia PDF Downloads 165

Authors: R. Stoyanova, R. Dimova, M. Tarnovska, T. Boeva, R. Dimov, I. Doykov

Abstract:

Patient safety culture (PSC) is an essential component of quality of healthcare. Improving PSC is considered a priority in many developed countries. Specialized software platform for registration and evaluation of hospital patient safety culture has been developed with the support of the Medical University Plovdiv Project №11/2017. The aim of the study is to assess the status of PSC in Bulgarian hospitals and to compare it to that in USA and Croatian hospitals. Methods: The study was conducted from June 01 to July 31, 2018 using the web-based Bulgarian Version of the Hospital Survey on Patient Safety Culture Questionnaire (B-HSOPSC). Two hundred and forty-eight medical professionals from different hospitals in Bulgaria participated in the study. To quantify the differences of positive scores distributions for each of the 42 HSOPSC items between Bulgarian, Croatian and USA samples, the x²-test was applied. The research hypothesis assumed that there are no significant differences between the Bulgarian, Croatian and US PSCs. Results: The results revealed 14 significant differences in the positive scores between the Bulgarian and Croatian PSCs and 15 between the Bulgarian and the USA PSC, respectively. Bulgarian medical professionals provided less positive responses to 12 items compared with Croatian and USA respondents. The Bulgarian respondents were more positive compared to Croatians on the feedback and communication of medical errors (Items - C1, C4, C5) as well as on the employment of locum staff (A7) and the frequency of reported mistakes (D1). Bulgarian medical professionals were more positive compared with their USA colleagues on the communication of information at shift handover and across hospital units (F5, F7). The distribution of positive scores on items: ‘Staff worries that their mistakes are kept in their personnel file’ (RA16), ‘Things ‘fall between the cracks’ when transferring patients from one unit to another’ (RF3) and ‘Shift handovers are problematic for patients in this hospital’ (RF11) were significantly higher among Bulgarian respondents compared with Croatian and US respondents. Conclusions: Significant differences of positive scores distribution were found between Bulgarian and USA PSC on one hand and between Bulgarian and Croatian on the other. The study reveals that distribution of positive responses could be explained by the cultural, organizational and healthcare system differences.

Keywords: patient safety culture, healthcare, HSOPSC, medical error

Procedia PDF Downloads 122

Authors: Carmen Pena-Díaz

Abstract:

Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

Procedia PDF Downloads 60

Authors: Areej Al-Hamad, Cheryl Forchuk, Abe Oudshoorn, Gerald Patrick Mckinley

Abstract:

Syrian refugee women face many obstacles when accessing health services in host countries that are influenced by various cultural, structural, and practical factors. This paper is based on critical ethnographic research undertaken in Canada to explore Syrian refugee women's migration experiences. Also, we aim to critically examine how the intersection of gender, trauma, violence and the political and economic conditions of Syrian refugee women shapes their everyday lives and health. The study also investigates the strategies and practices by which Syrian refugee women are currently addressing their healthcare needs and the models of care that are suggested for meeting their physical and mental health needs. Findings show that these women experienced constant worries, hardship, vulnerability, and intrusion of dignity. These experiences and challenges were aggravated by the structure of the Canadian social and health care system. This study offers a better understanding of the impact of migration and trauma on Syrian refugee women's roles, responsibilities, gender dynamics, and interaction with Ontario's healthcare system to improve interaction and outcomes. Health care models should address these challenges among Syrian refugee families in Canada.

Keywords: Syrian refugee women, intersectionality, critical ethnography, migration

Procedia PDF Downloads 74

Authors: Karina Lõbus, Silver Muld, Kadri Kööp, Mare Tupits

Abstract:

Aim: The aim of the research is to describe the experiences and needs of fathers’ of children with cancer in coping with the child's disease. Background: Today, about 80% of children diagnosed with malignancy in developed countries survive. Despite the positive statistics, recovery is not always certain, treatment is often very intensive and long-term. Cancer is affecting an increasing number of the population, which is increasing the demand for quality care, but the nature of expected care is currently unclear. This topic is important for the development of professional practice, as nurses complain that their knowledge to deal with the relatives of a patient with a difficult diagnosis is limited and would therefore like additional information to deal with the situation. Design: Qualitative, empirical, descriptive research. Method: The data were collected through semi-structured interviews and analysed by inductive content analysis method. Interviews were conducted during Autumn 2020. 4 subjects participated in the research. Results and Conclusions: The thesis revealed that fathers had different experiences and needs in dealing with the child's illness. Fathers' experiences of coping with child's diseases encompassed experiences with information, social relationships, healthcare, changes in personal health and experiences regarding the child. Regarding information, the respondents pointed out bad experiences with the availability of information and the ability to convey the necessary information. Experiences regarding social relationships included experiences with relatives and strangers. Regarding healthcare, fathers mentioned experiences related to the child's health and healthcare professionals. In regards to personal health, fathers pointed out negative changes in their mental and physical health. In relation to the child, the subjects revealed experiences regarding changed values, way of life and raising the child. According to the research, fathers’ needs in relation to dealing with child's cancer included material, social, and spiritual needs. In regard to material needs, fathers pointed out the need for state assistance and the needs related to the surrounding environment. The needs concerning social belonging involved needs for a driving force and involvement in the treatment process. Regarding spiritual needs, fathers expressed mixed feelings towards the need for outside and professional help.

Keywords: father, coping, cancer, child, experience, need

Procedia PDF Downloads 115

Authors: Kayla Renteria

Abstract:

This study explored the role animal-assisted psychotherapy (AAP) can play in treating Post-Traumatic Stress Disorder (PTSD) when incorporated into Trauma-informed cognitive behavioral therapy (TF-CBT). A review of the literature was performed to show how incorporating AAP could benefit TF-CBT since this treatment model often presents difficulties, such as client motivation and avoidance of the exposure element of the intervention. In addition, the fluidity of treatment goals during complex trauma cases was explored, as this issue arose in the case study. This study follows the course of treatment of a 12-year-old female presenting with symptoms of PTSD. Treatment consisted of traditional components of the TF-CBT model, with the added elements of AAP to address typical treatment obstacles in TF-CBT. A registered therapy dog worked with the subject in all sessions throughout her treatment. The therapy dog was incorporated into components such as relaxation and coping techniques, narrative therapy techniques, and psychoeducation on the cognitive triangle. Throughout the study, the client’s situation and clinical needs required the therapist to switch goals to focus on current safety and stability. The therapy dog provided support and neurophysiological benefits to the client through AAP during this shift in treatment. The client was assessed quantitatively using the Child PTSD Symptom Scale Self Report for DSM-5 (CPSS-SR-5) before and after therapy and qualitatively through a feedback form given after treatment. The participant showed improvement in CPSS-SR-V scores, and she reported that the incorporation of the therapy animal improved her therapy. The results of this study show how the use of AAP provided the client a solid, consistent relationship with the therapy dog that supported her through processing various types of traumas. Implications of the results of treatment and for future research are discussed.

Keywords: animal-assisted therapy, trauma-focused cognitive behavioral therapy, PTSD in children, trauma treatment

Procedia PDF Downloads 198

Authors: V. Durmus, M. Uydaci

Abstract:

In order to prevent overburdened courts, rising costs of litigation, and lengthy trial resolutions, the Law on Mediation for Civil Disputes was enacted, which was aimed at defining the procedure and guiding principles for dispute resolutions under Civil Law, in 2012. This “Mediation Code” also applies for civil healthcare disputes in Turkey. Aside from mediation, reconciliation, governed by Articles 253-255 of Criminal Procedure Law, has emerged as an alternative way to resolve criminal medical disputes, but the difference between mediation and conciliation is mostly procedural. This article deals with mediation in Turkish health law and aspect of medical malpractice mediation in Turkey. In addition, this study examines the issue of mediation in health law from both a legal and normative point of view, including codes of mediation which regulate both the structural and professional practice of mediation providers. As a result, although there is not official record about success rate of medical malpractice litigations and malpractice mediation in Turkey, it is widely accepted that the success rate for medical malpractice cases is relatively low compared to other personal injury cases even if it is generally considered that medical malpractice case filings have gradually increased recently. According to the Justice Ministry’s Department of Mediation in Turkey, 719 civil disputes have referred to mediators since 2013 (when the first mediation law came into force) with a 98% success rate.

Keywords: malpractice mediation, medical disputes, reconciliation, health litigation, Turkish health law

Procedia PDF Downloads 297

Authors: Mariia Karizhenskaia, Tanvi Nandani, Ali Tafazoli Moghadam

Abstract:

Hospice palliative care (HPC) is one of the most complicated philosophies of care in which physical, social/cultural, and spiritual aspects of human life are intermingled with an undeniably significant role in every aspect. Among these dimensions of care, culture possesses an outstanding position in the process and goal determination of HPC. This study shows the importance of cultural elements in the establishment of effective and optimized structures of HPC in the Canadian healthcare environment. Our systematic search included Medline, Google Scholar, and St. Lawrence College Library, considering original, peer-reviewed research papers published from 1998 to 2023 to identify recent national literature connecting culture and palliative care delivery. The most frequently presented feature among the articles is the role of culture in the efficiency of the HPC. It has been shown frequently that including the culturespecific parameters of each nation in this system of care is vital for its success. On the other hand, ignorance about the exclusive cultural trends in a specific location has been accompanied by significant failure rates. Accordingly, implementing a culture-wise adaptable approach is mandatory for multicultural societies. The following outcome of research studies in this field underscores the importance of culture-oriented education for healthcare staff. Thus, all the practitioners involved in HPC will recognize the importance of traditions, religions, and social habits for processing the care requirements. Cultural competency training is a telling sample of the establishment of this strategy in health care that has come to the aid of HPC in recent years. Another complexity of the culturized HPC nowadays is the long-standing issue of racialization. Systematic and subconscious deprivation of minorities has always been an adversity of advanced levels of care. The last part of the constellation of our research outcomes is comprised of the ethical considerations of culturally driven HPC. This part is the most sophisticated aspect of our topic because almost all the analyses, arguments, and justifications are subjective. While there was no standard measure for ethical elements in clinical studies with palliative interventions, many research teams endorsed applying ethical principles for all the involved patients. Notably, interpretations and projections of ethics differ in varying cultural backgrounds. Therefore, healthcare providers should always be aware of the most respectable methodologies of HPC on a case-by-case basis. Cultural training programs have been utilized as one of the main tactics to improve the ability of healthcare providers to address the cultural needs and preferences of diverse patients and families. In this way, most of the involved health care practitioners will be equipped with cultural competence. Considerations for ethical and racial specifications of the clients of this service will boost the effectiveness and fruitfulness of the HPC. Canadian society is a colorful compilation of multiple nationalities; accordingly, healthcare clients are diverse, and this divergence is also translated into HPC patients. This fact justifies the importance of studying all the cultural aspects of HPC to provide optimal care on this enormous land.

Keywords: cultural competence, end-of-life care, hospice, palliative care

Procedia PDF Downloads 59

Authors: Nazim Habibov, Alena Auchynnikava, Lida Fan

Abstract:

The exploration of the relationship between social trust and the support of the welfare system in transitional countries has attracted growing interests in recent decades. This study estimates the effects of interpersonal and institutional trust on the support of the welfare system in 27 countries in Eastern Europe the former Soviet Union. We estimate the data sets from the Life-in-Transition Survey 2010 and 2016 with binomial regression models. The results indicate that both interpersonal and institutional trust have positive effects on the support for the welfare system in all the three areas under investigation: helping the needy, public healthcare and public education, both in the less developed countries of the former Soviet Union and in the more developed Eastern European countries. Furthermore, the positive effects of interpersonal and institutional trust on support for helping the needy, public healthcare and public education were found to grow over time. In conclusion, this study confirms that interpersonal and institutional trusts have positive effects for the public support of the welfare system in these transitional countries under investigation, regardless of their level of development.

Keywords: central and eastern Europe, former Soviet union, international social welfare policy, comparative social welfare policy

Procedia PDF Downloads 116

Authors: Griaznova Svetlana, Umedov Mekhroz

Abstract:

The current healthcare facilities trend is the creation of multidisciplinary large-scale centers to provide the maximum possible services in one place, minimizing the number of possible instances in the path of patient treatment. The multifunctional medical centers are mainly designed in urban infrastructure for good accessibility. However, many functions and connections define the building shape, often make it inharmonious, that greatly destroys the city's appearance. The purpose of the research is to scientifically substantiate the factors influencing the shaping, the formation of architectural solutions principles, the formation of recommendations and principles for the multifunctional medical centers' design. The result of the research is the elaboration of architectural and planning solutions principles and the determination of factors affecting the multifunctional healthcare facilities shaping. Research method: Study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research. An integrated approach to the study of existing international experience of multidisciplinary medical centers. Elaboration of graphical analysis and diagrams based on the system analysis of the processed information. Identification of methods and principles of functional zoning of nuclear medicine centers.

Keywords: health care, multifunctionality, form, medical center, hospital, PET, CT scan

Procedia PDF Downloads 86

Authors: Ekhlas Al Gamal, Tony Long

Abstract:

The impact on the parents of caring for a child with cancer was intense and wide-ranging. A high level of distress and low level or resilience remains during treatment. Even completion of treatment can be a time of increased anxiety and stress for parents particularly with worries about recurrence or relapse. The purpose of this study to examine the associations between parental satisfactions with healthcare provided for their child and the impact of being a caregiver for a child with cancer. Methodology: A descriptive, correlational and cross-sectional design was employed using data from Arabic versions of self-report questionnaires which were administered to 113 parents with children with cancer in Jordan during 2015. Findings: the result indicated that Family relationship functioning was ranked as the highest (better functioning) domain while daily activities were ranked as the lowest (poorer functioning) domain. Parents were generally satisfied with the health care provided, but their emotional needs were not met adequately. Parents with better social functioning were more satisfied in all areas of healthcare satisfaction other than emotional needs and communication. Parents who had a child with more emotional and behavioural problems were more likely to experience a negative impact on the family and a poor level of family functioning. Conclusion and Significance: Nurses and other health care providers should emphasis on family centred approach rather than child centred approach.

Keywords: parents, children, cancer, Jordan

Procedia PDF Downloads 323

Authors: Roza Rahbari

Abstract:

After the Nigatta earthquake in Japan, in 1960, the liquefaction and its related hazards, moved to the thick of matter. Most of the research have been carried out on clean sands and silty sands so far, in order to study the effect of fine particles, confinement pressures, density and so on. However, because of this delusion that adhesiveness of clay prevents the liquefaction in sand, studies on clayey sands have not been taken seriously. However, several liquefactions happened in clayey sands in recent years, and lead to the necessity of more studies in this field. The studies which were carried out so far focused on high plastic clays. In this paper, the effect of low plasticity clays on the behavioral characteristics of sands is discussed. Thus, some triaxial tests were carried out on clean sands and clayey sands with different percentages of added clay. Specimens were compacted in various densities to study the effect of quantity of clay on various densities, too. Based on the findings, the amount of clay affects the behavior of sand greatly and leads to substantial changes in peak bearing capacity and steady state values.

Keywords: liquefaction, clay, sand, triaxial, monotonic, failure

Procedia PDF Downloads 229

Authors: Muhammad Badruzzaman, Alif Hasan, Md. Shahjahan

Abstract:

Propiconazole is a triazole fungicide extensively used in agriculture which can harm to non-target organisms in aquatic environment through runoff. Chronic exposure to environmental pesticides turn to behavioral impairment in vertebrates including teleosts. However, the potential effect of this fungicide on neurobehavioral impairment and release from it in vertebrates has not been fully explored. In this work, we examined the role of melatonin to rescue fungicide induced neurobehavioral and reproductive alternation and its connection with changes in dopaminergic activity in the brain of Mystus cavasius. After fish were exposed to water containing propiconazole at 0, 0.1, 5, and 250 µg/L for 3 days, significant increases of DA, 3,4-dihydroxyphenylacetic acid (DOPAC; a DA metabolite), and their ratio (DOPAC/DA) were observed in whole brain at 250 µg/L concentration. When fish were treated with propiconazole at 250 µg/L for 3 days, there was a significant elevation of DA, DOPAC and DOPAC/DA in diencephalon and pituitary, and only DA in the telencephalon, compared with control fish. Besides, it induced a reduction in extracellular serotonin and had an anxiolytic-like effect, supported by a decrease in cortisol production. Increased locomotor activity, anxiety and aggressiveness, decreased gonadosomatic index with few vitellogenic oocytes in ovaries after propiconazole treatment. When fish were treated with melatonin, D1 (SCH-23390) or D2 (Haloperidol) dopamine receptor antagonists and combined of melatonin and D1/D2 receptor antagonist and was observed melatonin + D2 receptor antagonist rescued fungicide induced all behavioral changes in fish. These results indicate that propiconazole increases locomotor activity, anxiety and aggressiveness and decreases reproductive activity, which was rescued by combined treatment of melatonin and dopamine receptor antagonist.

Keywords: behavior, catfish, dopamine, fungicide, melatonin

Procedia PDF Downloads 102

Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

Abstract:

Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

Procedia PDF Downloads 400

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

Abstract:

Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

Procedia PDF Downloads 111

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

The quality of life and well-being of patients, staff and visitors are central to the delivery of health care. Architecture and design are becoming an integral part of the healing and recovery approach. The most significant point that can be implemented in hospital buildings is the therapeutic value of the artificial environment, the design and integration of plants to bring the natural world into the healthcare environment. The hospital environment should feel like home comfort. The techniques that therapeutic architecture uses are very cheap, but provide real benefit to patients, staff and visitors, demonstrating that the difference is not in cost but in design quality. The best environment is not necessarily more expensive - it is about special use of light and color, rational use of materials and flexibility of premises. All this forms innovative concepts in modern hospital architecture, in new construction, renovation or expansion projects. The aim of the study is to identify the methods and principles of therapeutic architecture. The research methodology consists in studying and summarizing international experience in scientific research, literature, standards, methodological manuals and project materials on the research topic. The result of the research is the development of graphic-analytical tables based on the system analysis of the processed information; 3d visualization of hospital interiors based on processed information.

Keywords: therapeutic architecture, healthcare interiors, sustainable design, materials, color scheme, lighting, environment.

Procedia PDF Downloads 104

Authors: Vish Putcha, Chandrasekhar Putcha, Siva Hari

Abstract:

In the current digital era of free trading and pandemic-driven remote work culture, markets worldwide gained momentum for retail investors to trade from anywhere easily. The number of retail traders rose to 24% of the market from 15% at the pre-pandemic level. Most of them are young retail traders with high-risk tolerance compared to the previous generation of retail traders. This trend boosted the growth of subscription-based market predictors and market data vendors. Young traders are betting on these predictors, assuming one of them is correct. However, 90% of retail traders are on the losing end. This paper presents multiple indicators and attempts to derive behavioral patterns from the underlying stocks. The two major indicators that traders and investors follow are technical and fundamental. The famous investor, Warren Buffett, adheres to the “Value Investing” method that is based on a stock’s fundamental Analysis. In this paper, we present multiple indicators from various methods to understand the behavior patterns of stocks. For this research, we picked five stocks with a market capitalization of more than $200M, listed on the exchange for more than 20 years, and from different industry sectors. To study the behavioral pattern over time for these five stocks, a total of 8 indicators are chosen from fundamental, technical, and financial indicators, such as Price to Earning (P/E), Price to Book Value (P/B), Debt to Equity (D/E), Beta, Volatility, Relative Strength Index (RSI), Moving Averages and Dividend yields, followed by detailed mathematical Analysis. This is an interdisciplinary paper between various disciplines of Engineering, Accounting, and Finance. The research takes a new approach to identify clear indicators affecting stocks. Statistical Analysis of the data will be performed in terms of the probabilistic distribution, then follow and then determine the probability of the stock price going over a specific target value. The Chi-square test will be used to determine the validity of the assumed distribution. Preliminary results indicate that this approach is working well. When the complete results are presented in the final paper, they will be beneficial to the community.

Keywords: stock pattern, stock market analysis, stock predictions, trading, investing, fundamental analysis, technical analysis, quantitative trading, financial analysis, behavioral analysis

Procedia PDF Downloads 62

Authors: Ramzi Shawahna

Abstract:

Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

Procedia PDF Downloads 62

Authors: Vera Jancurova

Abstract:

The financial theory is dominated by the believe that weekday effect has disappeared from current markets. The purpose of this article is to study anomalies, especially weekday effect, at real markets that disrupt the efficiency of financial markets. The research is based on the analyses of historical daily exchange rates of significant world indices to determine the presence of weekday effects on financial markets. The methodology used for the study is based on the analyzes of daily averages of particular indexes for different time periods. Average daily gains were analyzed for their whole time interval and then for particular five and ten years periods with the aim to detect the presence on current financial markets. The results confirm the presence of weekday effect at the most significant indices - for example: Nasdaq, S & P 500, FTSE 100 and the Hang Seng. It was confirmed that in the last ten years, the weekend effect disappeared from financial markets. However in last year’s the indicators show that weekday effect is coming back. The study shows that weekday effect has to be taken into consideration on financial markets, especially in the past years.

Keywords: indices, anomalies, behavioral finance, weekday effect

Procedia PDF Downloads 322

Authors: Wieke Ellen Bouwes

Abstract:

This study aims to unravel which factors enhance accessibility of video consultations (VCs) for patients with low digital literacy. Thirteen in-depth interviews with patients, hospital employees, eHealth experts, and digital support organizations were held. Patients with low digital literacy received in-home support during real-time video consultations and are observed during the set-up of these consultations. Key findings highlight the importance of patient acceptance, emphasizing video consultations benefits and avoiding standardized courses. The lack of a uniform video consultation system across healthcare providers poses a barrier. Familiarity with support organizations – to support patients in usage of digital tools - among healthcare practitioners enhances accessibility. Moreover, considerations regarding the Dutch General Data Protection Regulation (GDPR) law influence support patients receive. Also, provider readiness to use video consultations influences patient access. Further, alignment between learning styles and support methods seems to determine abilities to learn how to use video consultations. Future research could delve into tailored learning styles and technological solutions for remote access to further explore effectiveness of learning methods.

Keywords: video consultations, digital literacy skills, effectiveness of support, intra- and inter-organizational relationships, patient acceptance of video consultations

Procedia PDF Downloads 58

Authors: Salam Hadid, Mohammad Khatib

Abstract:

The International Council of Nurses-ICN defined nursing as a sphere integrating autonomous and collaborative care intended for the individual, family and community within and outside of the care setting. Nursing as a care profession has developed broadly over recent decades in terms of its essentials, expertise and primarily academically. Despite the impressive growth of the profession, there is still extreme diversity in the public’s perceptions and opinions of the profession and its professionals and in the knowledge on the fundamentals of its true function and spheres of engagement. The current study examines the existing knowledge among the general population regarding the nursing profession. The population consisted of 498 respondents, 236 women and 262 men, age 18-81. The respondents noted that nursing focuses on the technical, and the emotional aspects and promotion of health for the patient are not the nurse’s responsibility. Most of the respondents saw nurses working mainly in hospital and community-based clinic settings. They considered nursing to be a high prestige profession in general, but less prestigious among respondents exposed to healthcare provision. Most of the respondents considered nursing to be a humane profession but without independence and with no need for academic studies. The findings are incompatible with the definition of nursing and its spheres of action as defined in the ICN Code of Ethics. Two suggestions are to work through nursing schools addressing the student nurses, as ambassadors for the profession. The second is using the healthcare encounter between the nursing staff and the public to improve the image of nurses.

Keywords: ethics, nurse image, public, nursing

Procedia PDF Downloads 279

Authors: Loong Qing Zhe, Foo Jing Heng

Abstract:

A variety of data files are now available on the internet due to the advancement of technology across the globe today. As more and more data are being uploaded on the internet, people are becoming more concerned that their private data, particularly medical health records, are being compromised and sold to others for money. Hence, the accessibility and confidentiality of patients' medical records have to be protected through electronic means. Blockchain technology is introduced to offer patients security against adversaries or unauthorised parties. In the blockchain network, only authorised personnel or organisations that have been validated as nodes may share information and data. For any change within the network, including adding a new block or modifying existing information about the block, a majority of two-thirds of the vote is required to confirm its legitimacy. Additionally, a consortium permission blockchain will connect all the entities within the same community. Consequently, all medical data in the network can be safely shared with all authorised entities. Also, synchronization can be performed within the cloud since the data is real-time. This paper discusses an efficient method for storing and sharing electronic health records (EHRs). It also examines the framework of roles within the blockchain and proposes a new approach to maintain EHRs with keyword indexes to search for patients' medical records while ensuring data privacy.

Keywords: healthcare sectors, distributed system, blockchain, electronic health records (EHR)

Procedia PDF Downloads 172