Search results for: reduced private care use
8595 Human Rights, Ethics, Medical Care and HIV/AIDS in Bangladesh: A Philosophical Investigation
Authors: Asm Habibullah Choudhury
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Background: This study is an investigation into medical care, ethics, and human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in the context of Bangladesh. The low prevalence of HIV and high prevalence of STDs in Bangladesh, in common with the global experience of HIV epidemics, has been characterized by tremendous stigmatization of those affected. Stigmatization has resulted in an extraordinary degree of unjust discrimination and in numerous human rights violations of PLWHA. Methodology: This will be a cross-sectional descriptive study and will be conducted at different points of Bangladesh. Result: PLWHA will be identified as many as possible and will be interviewed. Medical care providers will be interviewed to assess their attitude and will be observed for stigma while providing medical services. Some of the religious leaders, local influential people will be interviewed to assess their attitude towards PLWHA. Conclusion: If effective responses to HIV/AIDS-related stigma and discrimination are to be promoted in the region, work has to occur simultaneously on several fronts: Legal challenge, where necessary, to bring to account governments, employers, institutions and individuals. To create enabling environment in which PLWHA and their families, women, boys, and girls are able to access prevention and care services. Access to quality and comprehensive care. The fundamental objective, however, is to strive for action based on this understanding—action that will promote egalitarian and gender-progressive role models, and that will help guide the manner in which we interact with one another.Keywords: HIV, AIDS, Bangladesh, human rights
Procedia PDF Downloads 3228594 Production of Pre-Reduction of Iron Ore Nuggets with Lesser Sulphur Intake by Devolatisation of Boiler Grade Coal
Authors: Chanchal Biswas, Anrin Bhattacharyya, Gopes Chandra Das, Mahua Ghosh Chaudhuri, Rajib Dey
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Boiler coals with low fixed carbon and higher ash content have always challenged the metallurgists to develop a suitable method for their utilization. In the present study, an attempt is made to establish an energy effective method for the reduction of iron ore fines in the form of nuggets by using ‘Syngas’. By devolatisation (expulsion of volatile matter by applying heat) of boiler coal, gaseous product (enriched with reducing agents like CO, CO2, H2, and CH4 gases) is generated. Iron ore nuggets are reduced by this syngas. For that reason, there is no direct contact between iron ore nuggets and coal ash. It helps to control the minimization of the sulphur intake of the reduced nuggets. A laboratory scale devolatisation furnace designed with reduction facility is evaluated after in-depth studies and exhaustive experimentations including thermo-gravimetric (TG-DTA) analysis to find out the volatile fraction present in boiler grade coal, gas chromatography (GC) to find out syngas composition in different temperature and furnace temperature gradient measurements to minimize the furnace cost by applying one heating coil. The nuggets are reduced in the devolatisation furnace at three different temperatures and three different times. The pre-reduced nuggets are subjected to analytical weight loss calculations to evaluate the extent of reduction. The phase and surface morphology analysis of pre-reduced samples are characterized using X-ray diffractometry (XRD), energy dispersive x-ray spectrometry (EDX), scanning electron microscopy (SEM), carbon sulphur analyzer and chemical analysis method. Degree of metallization of the reduced nuggets is 78.9% by using boiler grade coal. The pre-reduced nuggets with lesser sulphur content could be used in the blast furnace as raw materials or coolant which would reduce the high quality of coke rate of the furnace due to its pre-reduced character. These can be used in Basic Oxygen Furnace (BOF) as coolant also.Keywords: alternative ironmaking, coal gasification, extent of reduction, nugget making, syngas based DRI, solid state reduction
Procedia PDF Downloads 2598593 Health Literacy Levels of South African Primary Health Care Patients
Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,
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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.Keywords: health literacy, primary health care, South Africa, patients
Procedia PDF Downloads 788592 Adaptability in Older People: A Mixed Methods Approach
Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger
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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.Keywords: adaptability, intervention study, mixed methods, nursing home residents
Procedia PDF Downloads 1488591 Association between Occupational Characteristics and Well-Being: An Exploratory Study of Married Working Women in New Delhi, India
Authors: Kanchan Negi
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Background: Modern and urban occupational culture have driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and wellbeing in a sample of women living in the metropolitan hub of Delhi. Method: This study is based on the data collected from 360 currently married women between age 29 and 49 years, working in the urban capital hub of India, i.e., Delhi. The women interviewed were professionals from the education, health, banking and information and technology (IT) sector. Bivariate analysis was done to study the characteristics of the sample. Logistic regression analysis was used to estimate the physical and psychological wellbeing across occupational characteristics. Results: Most of the working women were below age 35 years; around 30% of women worked in the education sector, 23% in health, 21% in banking and 26% in the IT sector. Over 55% of women were employed in the private sector and only 36% were permanent employees. Nearly 30% of women worked for more than the standard 8 hours a day. The findings from logistic regression showed that compared to women working in the education sector, those who worked in the banking and IT sector more likely to have physical and psychological health issues (OR 2.07-4.37, CI 1.17-4.37); women who bear dual burden of responsibilities had higher odds of physical and psychological health issues than women who did not (OR 1.19-1.85 CI 0.96-2.92). Women who worked for more than 8 hours a day (OR 1.15, CI 1.01-1.30) and those who worked for more than five days a week (OR 1.25, CI 1.05-1.35) were more likely to have physical health issues than women who worked for 6-8 hours a day and five days e week, respectively. Also, not having flexible work timings and compensatory holidays increased the odds of having physical and psychological health issues among working women (OR 1.17-1.29, CI 1.01-1.47). Women who worked in the private sector, those employed temporarily and who worked in the non-conducive environments were more likely to have psychological health issues as compared to women in the public sector, permanent employees and those who worked in a conducive environment, respectively (OR 1.33-1.67, CI 1.09-2.91). Women who did not have poor work-life balance had reduced the odds of psychological health issues than women with poor work-life balance (OR 0.46, CI 0.25-0.84). Conclusion: Poor wellbeing significantly linked to strenuous and rigid work patterns, suggesting that modern and urban work culture may contribute to the poor wellbeing of working women. Noticing the recent decline in female workforce participation in Delhi, schemes like Flexi-timings, compensatory holidays, work-from-home and daycare facilities for young ones must be welcomed; these policies already exist in some private sector firms, and the public sectors companies should also adopt such changes to ease the dual burden as homemaker and career maker. This could encourage women in the urban areas to readily take up the jobs with less juggle to manage home and work.Keywords: occupational characteristics, urban India, well-being, working women
Procedia PDF Downloads 2058590 Study on Environmental Capacity System of the Aged Care Villages Influenced by Tourists
Authors: Yuan Fang, Wang-Ming Li, Yi-Chen Ruan
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Rural healthy old-age care for urban elderly who go to surrounding villages on vacation is a new mode of old-age care in developed coastal areas of China. Such villages that receive urban elderly can be called old-caring villages. Due to the popularity of healthy old-age care in rural areas, more and more urban elderly people participate in the ranks of rural old-age care, resulting in excessive number of tourists in some old-caring villages, exceeding the carrying capacity of the village. Excessive passenger flow may damage the ecological environment, social environment, and facilities environment of the village, and even affect the development potential of the village pension industry. On the basis of on-site investigation and questionnaire survey, this paper summarizes the willingness and behavioral characteristics of the urban elderly population and finds that it will have a certain impact on the old-caring villages in the process of pension vacation in the aspects of ecology, construction, society, and economy. According to the influence of tourists, the paper constructs a system of capacity restriction factors of the old-caring villages, which includes four types: ecological environment capacity, policy environment capacity, perceived congestion capacity, and village service capacity, and fourteen specific indicators. It will provide a theoretical basis for reasonable control of the development scale of the old-caring villages.Keywords: old-caring villages, restriction factors system, tourists' influence, environmental capacity
Procedia PDF Downloads 1478589 Gendering Science, Technology and Innovation: The Case of R&D in Turkey
Authors: Setenay Nil Doğan, Ece Oztan
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Research and development (R&D) as a term denotes the innovative studies conducted systematically to increase knowledge and its practices. As R&D intensity of Turkey (0,84%) is quite below the EU average intensity score, it has displayed a continuous increase since the 2000s. Also, the development of human capital in R&D has been one of the basic aims of National Strategy of Science, Technology, and Innovation, and National Innovation System 2023 of Turkey. R&D is considered to one of the fields in which the gender gap is wide. The reflections of the analogy of leaky pipeline, a term used for vertical differentiation in academy can also be observed in those scientific activities related with the private sector. In the private sector, the gender gap becomes wider: the percentage of female researchers in the universities (41%) decreases to 24% in the private sector. Though half of the undergraduates and gradutes are female in Turkey, a widening gender gap is observed in terms of employment in R&D. Given this background, this paper will focus on gendered dynamics of careers in R&D through the interviews conducted with 25 female and 25 male employees, working in a university technopark and some of the large RD centers in Turkey working in several sectors such as electronics, automotive etc. Focusing on some aspects of gender differences in terms of career experiences in R&D and innovation, mobility, participation to the projects, patents and inclusion to other innovatory activities, home-work balance, it aims to explore the relationships between science, technology, innovation and gender.Keywords: gender, innovation, R&D, science, technology
Procedia PDF Downloads 4418588 The Potential of On-Demand Shuttle Services to Reduce Private Car Use
Authors: B. Mack, K. Tampe-Mai, E. Diesch
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Findings of an ongoing discrete choice study of future transport mode choice will be presented. Many urban centers face the triple challenge of having to cope with ever increasing traffic congestion, environmental pollution, and greenhouse gas emission brought about by private car use. In principle, private car use may be diminished by extending public transport systems like bus lines, trams, tubes, and trains. However, there are limits to increasing the (perceived) spatial and temporal flexibility and reducing peak-time crowding of classical public transport systems. An emerging new type of system, publicly or privately operated on-demand shuttle bus services, seem suitable to ameliorate the situation. A fleet of on-demand shuttle busses operates without fixed stops and schedules. It may be deployed efficiently in that each bus picks up passengers whose itineraries may be combined into an optimized route. Crowding may be minimized by limiting the number of seats and the inter-seat distance for each bus. The study is conducted as a discrete choice experiment. The choice between private car, public transport, and shuttle service is registered as a function of several push and pull factors (financial costs, travel time, walking distances, mobility tax/congestion charge, and waiting time/parking space search time). After the completion of the discrete choice items, the study participant is asked to rate the three modes of transport with regard to the pull factors of comfort, safety, privacy, and opportunity to engage in activities like reading or surfing the internet. These ratings are entered as additional predictors into the discrete choice experiment regression model. The study is conducted in the region of Stuttgart in southern Germany. N=1000 participants are being recruited. Participants are between 18 and 69 years of age, hold a driver’s license, and live in the city or the surrounding region of Stuttgart. In the discrete choice experiment, participants are asked to assume they lived within the Stuttgart region, but outside of the city, and were planning the journey from their apartment to their place of work, training, or education during the peak traffic time in the morning. Then, for each item of the discrete choice experiment, they are asked to choose between the transport modes of private car, public transport, and on-demand shuttle in the light of particular values of the push and pull factors studied. The study will provide valuable information on the potential of switching from private car use to the use of on-demand shuttles, but also on the less desirable potential of switching from public transport to on-demand shuttle services. Furthermore, information will be provided on the modulation of these switching potentials by pull and push factors.Keywords: determinants of travel mode choice, on-demand shuttle services, private car use, public transport
Procedia PDF Downloads 1838587 Traumatic Experiences as the Predictor of Maladaptive Outcomes among Children in Foster Care
Authors: Aleksandra Bogdanovic, Milicat Tošić Radev, Tatjana Stefanovic Stanojevic
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The aim behind this study was to first analyze the nature and the extent of childhood trauma and existing maladaptive outcomes (internalized and externalized problems and dissociation) among adolescents in the foster system and then analyze the possibility of using traumatic experiences to predict the aforementioned outcomes of childhood trauma. The sample consists of 121 respondents, children, and youths in the care of child protective services, without adequate parental care, residing in temporary foster care families on the territory of Serbia, aged between 11 and 18. The respondents filled out the Childhood Trauma Questionnaire – CTQ, Relationship Questionaire – Clinical version RQ-CV, the Dissociative experience scale for adolescents, A-DES and the Child behavior checklist – youth self-report. The results of the analyses have indicated that physical and emotional neglect are the most frequent forms of maltreatment in early childhood, with a relatively high prevalence of the other individual forms of trauma. Early childhood trauma statistically significantly predicted all the analyzed maladaptive outcomes, explaining approximately 20% of the variance of internalized and externalized problems and dissociation. Recommendations are given for future studies.Keywords: trauma, maladaptive outcomes, disorganization, dissociation
Procedia PDF Downloads 988586 The Strategic Formulation of Competitive Advantage on Private Higher Education Institution Using Participatory Prospective Analysis
Authors: Muhammad Yusuf Sulfarano Barusman
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Research for the strategic formulation of competitive advantage development on Indonesian Private Higher Education Institutions (IPHEI) is mostly done using positivistic paradigm by means of analytical thinking. This study emphasized of the participatory paradigm by using synthesis as a way of thinking in order to achieve its goal. The purposes of this study are to: 1) build future scenario of the external environmental dynamics that will be encountered by IPHEI, 2) formulate a strategy that can be implemented by IPHEI through developing the organization's competitive advantage in the future. The used research methodology is Participatory Prospective Analysis (PPA). The results showed that the future scenario of external environmental conditions that will be encountered by IPHEI in the future can be described in three conditions, namely: optimistic, moderate, and pessimistic scenarios. The strategic formulation from the research results is based on four internal factors as its foundation (the effectiveness of leadership, the availability of funds and financing, the effectiveness of human resource management strategy, and the relevance of curriculum). A set of resulted strategic formulation is knowledge of the experts that needed to be followed up wisely so that their use can be optimized for the development of IPHE organizational competitive advantage in the future.Keywords: competitive advantage, participatory prospective analysis, PPA, private higher education institutions, PHEI, strategic formulation
Procedia PDF Downloads 2878585 Telephonic Communication in Palliative Care for Better Management of Terminal Cancer Patients in Rural India: An NGO Based Approach
Authors: Aditya Manna, L. K. Khanra, S. K. Sarkar
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Aim: Due to financial incapability and the absence of manpower-poor families often fail to carry their advanced cancer patients to the nodal centers. This pilot study will explore whether communication by mobile phone can lessen this burden. Method: Initially a plan was generated regarding management of an advanced cancer patient in a nodal center at District Head Quarter. Subsequently every two week a trained social worker attached to the nodal center will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complain and urgency in between. Results: Since initiation in January 2013, 193 cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situation trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover, patient’s family was really overwhelmed by the emotional support offered by the team over the phone. Only 24% of cancer patients have to attend the nodal center for expert advice from Palliative Care specialists. Conclusion: This novel approach helped: (a) In providing regular physical and emotional support to the patients and their families. (b) In significantly reducing the financial and manpower problems of carrying patients to the nodal units. (c) In improving the quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.Keywords: palliative care, terminal care, home based palliative care, rural india
Procedia PDF Downloads 3048584 Telemedicine in Physician Assistant Education: A Partnership with Community Agency
Authors: Martina I. Reinhold, Theresa Bacon-Baguley
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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine
Procedia PDF Downloads 1978583 Euthanasia in Dementia Cases: An Interview Study of Dutch Physicians' Experiences
Authors: J. E. Appel, R. N. Bouwmeester, L. Crombach, K. Georgieva, N. O’Shea, T. I. van Rijssel, L. Wingens
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The Netherlands has a unique and progressive euthanasia law. Even people with advanced neurodegenerative diseases, like dementia, can request euthanasia when an Advanced Euthanasia Directive (AED) was written. Although the law sets some guidelines, in practice many complexities occur. Especially doctors experience difficult situations, as they have to decide whether euthanasia is justified. Research suggests that this leads to an emotional burden for them, due to feelings of isolation, fear of prosecution, as well as pressures from patient, family, or society. Existing literature, however, failed to address problems arising in dementia cases in particular, as well as possible sources of support. In order to investigate these issues, semi-structured in-depth interviews with 20 Dutch general practitioners and elderly care physicians will be conducted. Results are expected to be obtained by the end of December 2017.Keywords: dementia, euthanasia, general practitioners, elderly care physicians, palliative care
Procedia PDF Downloads 2138582 An Investigation into the Effect of Broken Homes on Students Academic Performance
Authors: Hafsat Mustapha Hanga
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The purpose of the this study was to investigate the effect of broken home on students' academic performance. Therefore, it focused on academic performance and Parental care of the student from and intact home from a cognitive motivational perceptive. The broken and intact home and also to find out if they differ in parental care this is done by using 376 subjects out of the population of 21,378. The sample was obtained using stratified random sampling techniques as the population contained sub-groups the study design was ex-post facto. The data was collected using 3 kind of instruments. To test the first and second hypotheses. Junior secondary school placement examination result was obtained to test the academic performance of the boys fron broken home and boys from and boys from intact home and then girl from broken home and girls from intact home.T-Test was used in the analysis of first and second hypotheses. For the third hypotheses two different kind of questionnaires were developed, the first was used to identify student that are from broken home while the second was for testing parental care between the subject. Chi-square was used to analyze the third hypotheses. Alkh the three 3 hypotheses were tested and rejected and were all in favor of student from intact home. The study found that there was a significant difference in the academic performance of the boys from brokeb and boys from intact home. When boys from intact home better then those boys from broken home. It also reveals that a student from a intact from intact home receives good parental care, love and concern than those from broken home.on the strength of these findings the need to establish an institution which will help those parent who have parenting problems was stressed and also the need to foster. Home school partnership was also stressed and advocate.Keywords: broken homes, academic performance, parental care, foster
Procedia PDF Downloads 4638581 Towards an Equitable Proprietary Regime: Property Rights Over Human Genes as a Case Study
Authors: Aileen Editha
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The legal recognition of property rights over human genes is a divisive topic to which there is no resolution. As a frequently discussed topic, scholars and practitioners often highlight the inadequacies of a proprietary regime. However, little has been said in regard to the nature of human genetic materials (HGMs). This paper proposes approaching the issue of property over HGMs from an alternative perspective that looks at the personal and social value and valuation of HGMs. This paper will highlight how the unique and unresolved status of HGMs is incompatible with the main tenets of property and, consequently, contributes to legal ambiguity and uncertainty in the regulation of property rights over human genes. HGMs are perceived as part of nature and a free-for-all while also being within an individual’s private sphere. Additionally, it is also considered to occupy a unique “not-private-nor-public” status. This limbo-like position clashes with property’s fundamental characteristic that relies heavily on a clear public/private dichotomy. Moreover, as property is intrinsically linked to the legal recognition of one’s personhood, this irresolution benefits some while disadvantages others. In particular, it demands the publicization of once-private genes for the “common good” but subsequently encourages privatization (through labor) of these now-public genes. This results in the gain of some (already privileged) individuals while enabling the disenfranchisement of members of minority groups, such as Indigenous communities. This paper will discuss real and intellectual property rights over human genes, such as the right to income or patent rights, in Canada and the US. This paper advocates for a sui generis approach to governing rights and interests over human genes that would not rely on having a strict public/private dichotomy. Not only would this improve legal certainty and clarity, but it would also alleviate—or, at the very least, minimize—the role that the current law plays in further entrenching existing systemic inequalities. Despite the specificity of this topic, this paper argues that there are broader lessons to be learned. This issue is an insightful case study on the interconnection of various principles in law, society, and property, and what must be done when discordance between one or more of those principles has detrimental societal outcomes. Ultimately, it must be remembered that property is an adaptable and malleable instrument that can be developed to ensure it contributes to equity and flourishing.Keywords: property rights, human genetic materials, critical legal scholarship, systemic inequalities
Procedia PDF Downloads 808580 Limits of the Dot Counting Test: A Culturally Responsive Approach to Neuropsychological Evaluations and Treatment
Authors: Erin Curtis, Avraham Schwiger
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Neuropsychological testing and evaluation is a crucial step in providing patients with effective diagnoses and treatment while in clinical care. The variety of batteries used in these evaluations can help clinicians better understand the nuanced declivities in a patient’s cognitive, behavioral, or emotional functioning, consequently equipping clinicians with the insights to make intentional choices about a patient’s care. Despite the knowledge these batteries can yield, some aspects of neuropsychological testing remain largely inaccessible to certain patient groups as a result of fundamental cultural, educational, or social differences. One such battery includes the Dot Counting Test (DCT), during which patients are required to count a series of dots on a page as rapidly and accurately as possible. As the battery progresses, the dots appear in clusters that are designed to be easily multiplied. This task evaluates a patient’s cognitive functioning, attention, and level of effort exerted on the evaluation as a whole. However, there is evidence to suggest that certain social groups, particularly Latinx groups, may perform worse on this task as a result of cultural or educational differences, not reduced cognitive functioning or effort. As such, this battery fails to account for baseline differences among patient groups, thus creating questions surrounding the accuracy, generalizability, and value of its results. Accessibility and cultural sensitivity are critical considerations in the testing and treatment of marginalized groups, yet have been largely ignored in the literature and in clinical settings to date. Implications and improvements to applications are discussed.Keywords: culture, latino, neuropsychological assessment, neuropsychology, accessibility
Procedia PDF Downloads 1138579 RV Car Clinic as Cost-Effective Health Care
Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum
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Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.Keywords: health policy, health professional, remote areas, RV Car Clinic
Procedia PDF Downloads 2918578 Nurses Care Practices at End of Life in Intensive Care Units in the Kingdom of Bahrain
Authors: M. Yaqoob, C. S. O’Neill, S. Faraj, C. L. O’Neill
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This paper presents the preliminary findings from a study exploring nurse’s contributions to end of life decisions and to the care of dying patients in ICU units in the Kingdom of Bahrain. The process of dying is complex as medical clinicians are frequently unable to say with certainty when death will occur. It is generally accepted that end of life care begins when it is possible to know that death is imminent. Nurses do not make medical treatment decisions when caring for a dying patient. There are, however, many other types of decisions made when a patient is approaching the end of life and nurses are either formally or informally part of these decision making processes. This study explored nurses care practices at the end of life, in two ICU units in large hospitals in the Kingdom of Bahrain. The research design was a grounded theory approach. Ten nurses participated, six of whom were Bahraini nationals and four were Indian. A core category death avoidance talk was supported by three major subcategories, degrees of involvement in decision making; signalling and creating an awareness of death; care shifting from dying patients to family. Despite nurses asserting that they carried out the orders of doctors and had no role in decision making processes at end of life this study showed that there were degrees of nurse involvement. Doctors frequently discussed the patient’s clinical condition with nurses and also sought information regarding the family. Information about the family was of particular relevance if the doctor was considering a DNR order, which the nurses equated with dying. Families were not always informed when a DNR decision was made. When families were not informed the nurses engaged in sophisticated rituals signalling and creating awareness to family members that the death of their loved one was near. This process also involved a subtle shifting of care from the dying patient to the family. This seminar paper will focus particularly on how nurses signal and create an awareness of death in an ICU setting. The findings suggest that despite the avoidance of death talk in the ICU nurses indirectly convey and create an awareness that death is near to family members.Keywords: decision making, dying patients, end of life, intensive care unit
Procedia PDF Downloads 3908577 Preparation and Struggle of Two Generations for Future Care: A Study of Intergenerational Care Planning among Mainland Immigrant Ageing Families in Hong Kong
Authors: Xue Bai, Ranran He, Chang Liu
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Care planning before the onset of intensive care needs can benefit older adults’ psychological well-being and increases families’ ability to manage caregiving crises and cope with care transitions. Effective care planning requires collaborative ‘team-work’ in families. However, future care planning has not been substantially examined in intergenerational or family contexts, let alone among immigrant families who have to face particular challenges in parental caregiving. From a family systems perspective, this study intends to explore the extent, processes, and contents of intergenerational care planning of Mainland immigrant ageing families in Hong Kong and to examine the intergenerational congruence and discrepancies in the care planning process. Adopting a qualitative research design, semi-structured in-depth interviews were conducted with 17 adult child-older parent pairs and another 33 adult children. In total, 50 adult children who migrated to Hong Kong after the age of 18 with more than three years’ work experience in Hong Kong had at least one parent aged over 55 years old who was not a Hong Kong resident and considered his/herself as the primary caregiver of the parent were recruited. Seventeen ageing parents of the recruited adult children were invited for dyadic interviews. Scarcity of caregiving resources in the context of cross-border migration, intergenerational discrepancies in care planning stages, both generations’ struggle and ambivalence toward filial care, intergenerational transmission of care values, and facilitating role of accumulated family capital in care preparation were primary themes concluded from participants’ narratives. Compared with ageing parents, immigrant adult children generally displayed lower levels of care planning. Although with a strong awareness of parents’ future care needs, few adult children were found engaged in concrete planning activities. This is largely due to their uncertainties toward future life and career, huge work and living pressure, the relatively good health status of their parents, and restrictions of public welfare policies in the receiving society. By contrast, children’s cross-border migration encouraged ageing parents to have early and clear preparation for future care. Ageing parents mostly expressed low filial care expectations when realizing the scarcity of family caregiving resources in the cross-border context. Even though they prefer in-person support from children, most of them prepare themselves for independent ageing to prioritize the next generation’s needs or choose to utilize paid services, welfare systems, friend networks, or extended family networks in their sending society. Adult children were frequently found caught in the dilemma of desiring to provide high quality and in-person support for their parents but lacking sufficient resources. Notably, a salient pattern of intergenerational transmission in terms of family and care values and ideal care arrangement emerged from intergenerational care preparation. Moreover, the positive role of accumulated family capital generated by a reunion in care preparation and joint decision-making were also identified. The findings of the current study will enhance professionals’ and service providers’ awareness of intergenerational care planning in cross-border migration contexts, inform services to alleviate unpreparedness for elderly care and intergenerational discrepancies concerning care arrangements and broaden family services to encompass intergenerational care planning interventions. Acknowledgment: This study is supported by a General Research Grant from the Research Grants Council of the HKSAR, China (Project Number: 15603818).Keywords: intergenerational care planning, mainland immigrants in Hong Kong, migrant family, older adults
Procedia PDF Downloads 1268576 Development of an Integrated Framework for Life-Cycle Economic, Environmental and Human Health Impact Assessment for Reclaimed Water Use in Water Systems of Various Scales
Authors: Yu-Yao Wang, Xiao-Meng Hu, Joanne Yeung, Xiao-Yan Li
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The high private cost and unquantified external cost limit the development of reclaimed water. In this study, an integrated framework comprising life cycle assessment (LCA), quantitative microbial risk assessment (QMRA), and life cycle costing (LCC) was developed to evaluate both costs of reclaimed water supply in water systems of various scales. LCA assesses the environmental impacts, and QMRA estimates the associated pathogenic impacts. These impacts are monetized as external costs and analyzed with the private cost by LCC to count the total life cycle cost. The framework evaluated the Hong Kong urban water system in the baseline scenario (BS) and five wastewater reuse scenarios (RS). They are RSI: substituting freshwater for toilet flushing only, RSII: substituting both freshwater and seawater for toilet flushing, RSIII: using reclaimed water for all non-potable uses, RSIV: using reclaimed water for all non-potable uses and indirect potable uses, and RSV: non-potable use and indirect potable use by conveying 100% reclaimed water to recharge the reservoirs. The results show that substituting freshwater and seawater for toilet flushing has the least total life cycle cost, exhibiting that it is the most cost-effective option for Hong Kong. Meanwhile, the evaluation results show that the external cost of each scenario is comparable to the corresponding private cost, indicating the importance of the inclusion of comprehensive external cost evaluation in private cost assessment of water systems with reclaimed water supply.Keywords: life cycle assessment, life cycle costing, quantitative microbial risk assessment, water reclamation, reclaimed water, alternative water resources
Procedia PDF Downloads 1218575 Effect of “Evidence Based Diabetes Management” Educational Sessions on Primary Care Physicians
Authors: Surjeet Bakshi, Surabhi Sharma
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Objective: To assess the impact of educational sessions by reputed regional faculties on knowledge of primary care physicians on evidence based diabetes management methods and practice. Study Design: Retrospective pre-post intervention study. Methodology: Nine cities in Kerala from August to October, 2012 were selected for the study. 125 MBBS doctors participated in the study. 11 regional faculties provided six educational sessions throughout the period. Validated questionnaires were used to evaluate the knowledge of the participants on evidence based diabetes management methods before and after the intervention. Results: The mean score on pre-test was 8 and the mean score on post-test was 9. A paired t-test was conducted on participant’s pre- and post test score and the results were statistically significant (p<0.001). Conclusion: Even though the general attitude to and level of knowledge of diabetes management is good among the primary care physicians in India, there do exist some knowledge gaps which might influence their future practices when it comes to counselling and information on diabetes management methods. In the present study, the performance and awareness level of the participants have expressively improved among primary care physicians. There is a significant improvement in the test score and the training conducted. It seems that if such study programmes are included in the students study programme, it will give higher score in the knowledge and attitude towards diabetes management.Keywords: diabetes, management, primary care physicians, evidence base, improvement score, knowledge
Procedia PDF Downloads 3528574 Application of Bundle Care to Reduce Invasive Catheter-Associated Infection in High Risk Units at a Medical Center
Authors: Hsin-Hsin Chang, Jann-Tay Wang, Wang-Huei Sheng
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Background: Hospital-associated infections (HAIs) have significant medical and social resource consumption. In view of medical technology change rapidly and the prolonged average life expectancy, the patients' chances of receiving invasive medical devices have also increased. As well as the potential disease of the patients, the aging, and immune dysfunction makes the disease more serious, raising the risk of HAIs. In our adult intensive care units, catheter-associated urinary tract infections (CAUTIs) have an average of 4.6% in 2014, which is much higher than that of the National Healthcare Safety Network (NHSN). Therefore, we started the intervention of CAUTI bundle care. Methods: This 3-year intervention was conducted in adults’ intensive care units (ICUs) during January 2015 to December 2017. The implementation of CAUTI bundle care in order to reduce invasive catheter-associated infections were built on evidence-based infection control measures. Prospective surveillance was performed on all patients admitted to hospital. The four major directions are 'Leader Engagement', 'Educate Personnel', 'Executive Multidisciplinary Teamwork', 'Innovation and Improvement of Tools'. Results: During the intervention period, there were 167,024 patient-days with a total of 508 episodes of CAUTIs in the entire adult ICUs identified. The incidence of CAUTIs in adult ICU was significantly decreased in the intervention period (from 2015 to 2017), from 4.6 to 3.6 per 1000 catheter days (p=0.05). Conclusion: The necessity for the implementation of CAUTI bundle care in the health care system plays an important role in the quality and policy of infection control. Multidisciplinary teamwork, education, a comprehensive checklist and from time to time audit feedback to improve healthcare workers’ compliance are the keys to success.Keywords: bundle care, hospital-associated infections, leader engagement, multidisciplinary team work
Procedia PDF Downloads 1538573 A Conceptual Framework of Digital Twin for Homecare
Authors: Raja Omman Zafar, Yves Rybarczyk, Johan Borg
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This article proposes a conceptual framework for the application of digital twin technology in home care. The main goal is to bridge the gap between advanced digital twin concepts and their practical implementation in home care. This study uses a literature review and thematic analysis approach to synthesize existing knowledge and proposes a structured framework suitable for homecare applications. The proposed framework integrates key components such as IoT sensors, data-driven models, cloud computing, and user interface design, highlighting the importance of personalized and predictive homecare solutions. This framework can significantly improve the efficiency, accuracy, and reliability of homecare services. It paves the way for the implementation of digital twins in home care, promoting real-time monitoring, early intervention, and better outcomes.Keywords: digital twin, homecare, older adults, healthcare, IoT, artificial intelligence
Procedia PDF Downloads 718572 Functional Analysis of Barriers in Disability Care Research: An Integrated Developmental Approach
Authors: Asma Batool
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Immigrant families raising a child with developmental disabilities in Canada encounter many challenges during the process of disability care. Starting from the early screening of their child for diagnosis followed by challenges associated with treatment, access and service utilization. A substantial amount of research focuses on identifying barriers. However, the functional aspects of barriers in terms of their potential influences on parents and children with disabilities are unexplored yet. This paper presents functional analysis of barriers in disability care research by adopting a method of integrated approach. Juxtaposition of two developmental approaches, Bronfenbrenner’s ecological model and parents ‘transformational process model is generating multiple hypotheses to be considered while empirically investigating causal relationships and mediating or moderating factors among various variables related with disability care research. This functional analysis suggests that barriers have negative impacts on the physical and emotional development of children with disabilities as well as on the overall quality of family life (QOFL). While, barriers have facilitating impacts on parents, alternatively, the process of transformation in parents expedite after experiencing barriers. Consequently, parents reconstruct their philosophy of life and experience irreversible but continuous developmental change in terms of transformations simultaneously with their developing child and may buffer the expected negative impacts of barriers on disabled child and QOFL. Overall, this paper is suggesting implications for future research and parents’ transformations are suggesting potential pathways to minimize the negative influences of barriers that parents experience during disability care, hence improving satisfaction in QOFL in general.Keywords: barriers in disability care, developmental disabilities, parents’ transformations, quality of family life
Procedia PDF Downloads 4058571 Patriotic Education through Private/Everyday Narratives: What We Can Learn from Young People
Authors: Yijie Wang, Hanwei Cheng
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Under the Chinese educational context, the materials for patriotic education typically take the form of grand narratives. However, in post-modern times the younger members of society tend to welcome elements of more micro and personal nature. It is therefore important to explore how patriotism can be integrated into an ‘everyday’, private narrative that holds more attraction for the young. Based on semi-structured interviews of eight Chinese graduate students, this research examines how Chinese young people draw materials to establish national identity and develop love for the country from everyday-life details, as well as how they perceive, interpret and articulate their patriotism through private narratives. And implications for patriotic education are proposed accordingly. Several conclusions are drawn from the pre-interviews. Firstly, sensory experiences that remind people of their country—such as the taste of Chinese delicacies and the sound of a traditional instrument—are a major source of patriotic feelings. Secondly, the love for the country often stems from and is continued to be mediated by the emotional attachment with other people, typically significant others, and patriotism is articulated (or acknowledged) by the young as a kind of ‘sentiment’ rather than ‘faith’ or ‘belief’. Thirdly, for young people who are currently studying abroad, their birth country represents a kind of familiar, well-accustomed life or lifestyle, and any nostalgic realization of it leads to increased national belonging and sense of identity. Fourthly, the awareness of the country’s transformations—positive ones and neutral ones alike—triggers young people affections towards the country, and even negative transformations may result in promoted sense of self-involvement and therefore consolidate national identity. Implications for patriotic education can be drawn accordingly, and although the research is conducted under the Chinese context, it will hopefully contribute to the understanding of relevant fields.Keywords: national identity, patriotic education, private narrative, young people
Procedia PDF Downloads 1948570 Use of Corporate Social Responsibility in Environmental Protection: Modern Mechanisms of Environmental Self-Regulation
Authors: Jakub Stelina, Janina Ciechanowicz-McLean
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Fifty years of existence and development of international environmental law brought a deep disappointment with efficiency and effectiveness of traditional command and control mechanisms of environmental regulation. Agenda 21 agreed during the first Earth Summit in Rio de Janeiro 1992 was one of the first international documents, which explicitly underlined the importance of public participation in environmental protection. This participation includes also the initiatives undertaken by business corporations in the form of private environmental standards setting. Twenty years later during the Rio 20+ Earth Summit the private sector obligations undertaken during the negotiations have proven to be at least as important as the ones undertaken by the governments. The private sector has taken the leading role in environmental standard setting. Among the research methods used in the article two are crucial in the analysis. The comparative analysis of law is the instrument used in the article to analyse the practice of states and private business companies in the field of sustainable development. The article uses economic analysis of law to estimate the costs and benefits of Corporate Social Responsibility Projects in the field of environmental protection. The study is based on the four premises. First is the role of social dialogue, which is crucial for both Corporate Social Responsibility and modern environmental protection regulation. The Aarhus Convention creates a procedural environmental human right to participate in administrative procedures of law setting and environmental decisions making. The public participation in environmental impact assessment is nowadays a universal standard. Second argument is about the role of precaution as a principle of modern environmental regulation. This principle can be observed both in governmental regulatory undertakings and also private initiatives within the Corporate Social Responsibility environmental projects. Even in the jurisdictions which are relatively reluctant to use the principle of preventive action in environmental regulation, the companies often use this standard in their own private business standard setting initiatives. This is often due to the fact that soft law standards are used as the basis for private Corporate Social Responsibility regulatory initiatives. Third premise is about the role of ecological education in environmental protection. Many soft law instruments underline the importance of environmental education. Governments use environmental education only to the limited extent due to the costs of such projects and problems with effects assessment. Corporate Social Responsibility uses various means of ecological education as the basis of their actions in the field of environmental protection. Last but not least Sustainable development is a goal of both legal protection of the environment, and economic instruments of companies development. Modern environmental protection law uses to the increasing extent the Corporate Social Responsibility. This may be the consequence of the limits of hard law regulation. Corporate Social Responsibility is nowadays not only adapting to soft law regulation of environmental protection but also creates such standards by itself, showing new direction for development of international environmental law. Corporate Social Responsibility in environmental protection can be good investment in future development of the company.Keywords: corporate social responsibility, environmental CSR, environmental justice, stakeholders dialogue
Procedia PDF Downloads 2998569 Nursing Documentation of Patients' Information at Selected Primary Health Care Facilities in Limpopo Province, South Africa: Implications for Professional Practice
Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese
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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.Keywords: documentation, knowledge, patient care, patient’s information, training
Procedia PDF Downloads 1898568 The Study of Self-Care Regarding to the Valuable Living in Thai Elderly
Authors: Pannathorn Chachvarat, Smarnjit Piromrun
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Aging is the reality for the future world. An urgent priority for the development of the elderlies’ quality living is needed. The promotion of quality the elderly to live longer in their dignity and being independence are essential. The objective of this descriptive research was to study the self-care regarding to the valuable living in Thai elderly. The randomized sample was 100 elderly who live in Muang district of Phayao province. The tools included 2 parts; 1) Personal data (gender, age, income, occupation, marital status, living condition and disease), and 2) the self-care regarding to the valuable living questionnaire consisted of 3 domains, physical (21items), spiritual (13 items) and social domain (12 items). The content validity tool was tested the IOC ranged between 0.60 – 1.00 and the reliability test, Cronbach Alpha was 0.82. The research found that; The most participants were female (60 %), Farmer (37%), and underlying disease (65 %). The range of age was 68 years. Overall of the self-care regarding to the valuable living of physical, spiritual and social were at the high level.The highest level of physical activities was self-taking bath twice a day (morning and evening), and slept at least 5-6 hours at night time.The highest level of spirit activities was a good member of the family, contributions to persons in family, good emotion. Additionally were enjoyable, accepting changes in the body such as the dry skin and the blurred vision, accepting the roles and duties in taking care of house and grandchildren, selecting the applicable activities and practice according to religious Buddhateachingfor the happiness and meditated life.The highest of the social activities were the good relationship between other elderlies and family members, happy to help social activities as of their capacity, and being happy to help other people who have problems.Keywords: self-care, valuable living, elderly, Thai
Procedia PDF Downloads 2858567 Trauma and Its High Influence on Special Education
Authors: Athena Johnson
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Special education is an important field but often under-researched, particularly for the cause of learning deficiencies. Often times special education looks at the symptoms rather than the cause, and this can lead to many misdiagnoses. Student trauma, as measured by the Adverse Childhood Experiences (ACE) test, is extremely common, often resulting in Post Traumatic Stress Disorder (PTSD). PTSD affects the brain's ability to learn properly, making students have a much more difficult time with auditory learning and memory due to always being in flight or fight mode, and due to this, students with PTSD are often misdiagnosed with Attention Deficit and Hyperactivity Disorder (ADHD). This can lead to them getting the wrong support, with PTSD students needing more counseling than anything else. Through these research papers' methodologies, a literature review on article research from the perspectives of students who were misdiagnosed, and imperial research, the major findings of this study were the importance of trauma-informed care in schools. Trauma-informed care in the school system is crucial for helping the many students who experience traumatic life events and struggle in school due to it. It is important to support students with PTSD so that they are able to integrate and learn better in society and school with trauma-informed school care.Keywords: ACE test, ADHD, misdiagnoses, special education, trauma, trauma-informed care, PTSD
Procedia PDF Downloads 1098566 Music of the Openings’ Japanese Animes as a Tool for People with Reduced Visibility: The Case of Shingeki No Kyojin (Attack on Titan)
Authors: María Del Carmen Baena Lupiáñez
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Music has been considered for decades as a tool to express emotions. In the case of people with some physical disabilities, they are able to develop what is known as echolocation. It means that the development of some of the senses to compensate the lack of one of them. For instance, it has been proved that people with reduced visibility have a more developed hearing capacity. In series or films, music is fundamental to contextualize the viewer in the story. Music becomes an indispensable element to make people with reduced visibility to understand the plot and to avoid ambiguities, in the absence of an audio description. Since the songs of Japanese animes have not been as studied as other soundtracks from this point of view to our knowledge, the three openings of the anime Shingeki no Kyojin have been chosen to carry out the experiment from which this study will start. It will test the perceptions of people with reduced visibility by reproducing the three opening songs of Shingeki no Kyojin and asking the users questions related to their thoughts about the anime, their feelings when listening to these songs and the possible story that this anime could be about. In fact, users could identify in general the plot of the story and their perceptions corresponded to what the songs should transmit, taking into account its chords and harmonies.Keywords: anime, argumental contextualization, echolocations, emotions
Procedia PDF Downloads 199