Search results for: prevention focus
492 Concussion: Clinical and Vocational Outcomes from Sport Related Mild Traumatic Brain Injury
Authors: Jack Nash, Chris Simpson, Holly Hurn, Ronel Terblanche, Alan Mistlin
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There is an increasing incidence of mild traumatic brain injury (mTBI) cases throughout sport and with this, a growing interest from governing bodies to ensure these are managed appropriately and player welfare is prioritised. The Berlin consensus statement on concussion in sport recommends a multidisciplinary approach when managing those patients who do not have full resolution of mTBI symptoms. There are as of yet no standardised guideline to follow in the treatment of complex cases mTBI in athletes. The aim of this project was to analyse the outcomes, both clinical and vocational, of all patients admitted to the mild Traumatic Brain Injury (mTBI) service at the UK’s Defence Military Rehabilitation Centre Headley Court between 1st June 2008 and 1st February 2017, as a result of a sport induced injury, and evaluate potential predictive indicators of outcome. Patients were identified from a database maintained by the mTBI service. Clinical and occupational outcomes were ascertained from medical and occupational employment records, recorded prospectively, at time of discharge from the mTBI service. Outcomes were graded based on the vocational independence scale (VIS) and clinical documentation at discharge. Predictive indicators including referral time, age at time of injury, previous mental health diagnosis and a financial claim in place at time of entry to service were assessed using logistic regression. 45 Patients were treated for sport-related mTBI during this time frame. Clinically 96% of patients had full resolution of their mTBI symptoms after input from the mTBI service. 51% of patients returned to work at their previous vocational level, 4% had ongoing mTBI symptoms, 22% had ongoing physical rehabilitation needs, 11% required mental health input and 11% required further vestibular rehabilitation. Neither age, time to referral, pre-existing mental health condition nor compensation seeking had a significant impact on either vocational or clinical outcome in this population. The vast majority of patients reviewed in the mTBI clinic had persistent symptoms which could not be managed in primary care. A consultant-led, multidisciplinary approach to the diagnosis and management of mTBI has resulted in excellent clinical outcomes in these complex cases. High levels of symptom resolution suggest that this referral and treatment pathway is successful and is a model which could be replicated in other organisations with consultant led input. Further understanding of both predictive and individual factors would allow clinicians to focus treatments on those who are most likely to develop long-term complications following mTBI. A consultant-led, multidisciplinary service ensures a large number of patients will have complete resolution of mTBI symptoms after sport-related mTBI. Further research is now required to ascertain the key predictive indicators of outcome following sport-related mTBI.Keywords: brain injury, concussion, neurology, rehabilitation, sports injury
Procedia PDF Downloads 156491 Explaining Motivation in Language Learning: A Framework for Evaluation and Research
Authors: Kim Bower
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Evaluating and researching motivation in language learning is a complex and multi-faceted activity. Various models for investigating learner motivation have been proposed in the literature, but no one model supplies a complex and coherent model for investigating a range of motivational characteristics. Here, such a methodological framework, which includes exemplification of sources of evidence and potential methods of investigation, is proposed. The process model for the investigation of motivation within language learning settings proposed is based on a complex dynamic systems perspective that takes account of cognition and affects. It focuses on three overarching aspects of motivation: the learning environment, learner engagement and learner identities. Within these categories subsets are defined: the learning environment incorporates teacher, course and group specific aspects of motivation; learner engagement addresses the principal characteristics of learners' perceived value of activities, their attitudes towards language learning, their perceptions of their learning and engagement in learning tasks; and within learner identities, principal characteristics of self-concept and mastery of the language are explored. Exemplifications of potential sources of evidence in the model reflect the multiple influences within and between learner and environmental factors and the possible changes in both that may emerge over time. The model was initially developed as a framework for investigating different models of Content and Language Integrated Learning (CLIL) in contrasting contexts in secondary schools in England. The study, from which examples are drawn to exemplify the model, aimed to address the following three research questions: (1) in what ways does CLIL impact on learner motivation? (2) what are the main elements of CLIL that enhance motivation? and (3) to what extent might these be transferable to other contexts? This new model has been tried and tested in three locations in England and reported as case studies. Following an initial visit to each institution to discuss the qualitative research, instruments were developed according to the proposed model. A questionnaire was drawn up and completed by one group prior to a 3-day data collection visit to each institution, during which interviews were held with academic leaders, the head of the department, the CLIL teacher(s), and two learner focus groups of six-eight learners. Interviews were recorded and transcribed verbatim. 2-4 naturalistic observations of lessons were undertaken in each setting, as appropriate to the context, to provide colour and thereby a richer picture. Findings were subjected to an interpretive analysis by the themes derived from the process model and are reported elsewhere. The model proved to be an effective and coherent framework for planning the research, instrument design, data collection and interpretive analysis of data in these three contrasting settings, in which different models of language learning were in place. It is hoped that the proposed model, reported here together with exemplification and commentary, will enable teachers and researchers in a wide range of language learning contexts to investigate learner motivation in a systematic and in-depth manner.Keywords: investigate, language-learning, learner motivation model, dynamic systems perspective
Procedia PDF Downloads 267490 The Influence of Gender and Sexual Orientation on Police Decisions in Intimate Partner Violence Cases
Authors: Brenda Russell
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Police officers spend a great deal of time responding to domestic violence calls. Recent research has found that men and women in heterosexual and same-sex relationships are equally likely to initiate intimate partner violence IPV) and likewise susceptible to victimization, yet police training tends to focus primarily on male perpetration and female victimization. Criminal justice studies have found that male perpetrators of IPV are blamed more than female perpetrators who commit the same offense. While previous research has examined officer’s response in IPV cases with male and female heterosexual offenders, research has yet to investigate police response in same-sex relationships. This study examined officers’ decisions to arrest, perceptions of blame, perceived danger to others, disrespect, and beliefs in prosecution, guilt and sentencing. Officers in the U.S. (N = 248) were recruited using word of mouth and access to police association websites where a link to an online study was made available. Officers were provided with one of 4 experimentally manipulated scenarios depicting a male or female perpetrator (heterosexual or same-sex) in a clear domestic assault situation. Officer age, experience with IPV and IPV training were examined as possible covariates. Training in IPV was not correlated to any dependent variable of interest. Age was correlated with perpetrator arrest and blame (.14 and .16, respectively) and years of experience was correlated to arrest, offering informal advice, and mediating the incident (.14 to -.17). A 2(perpetrator gender) X 2 (victim gender) factorial design was conducted. Results revealed that officers were more likely to provide informal advice and mediate in gay male relationships, and were less likely to arrest perpetrators in same-sex relationships. When officer age and years of experience with domestic violence were statistically controlled, effects for perpetrator arrest and providing informal advice were no longer significant. Officers perceived heterosexual male perpetrators as more dangerous, blameworthy, disrespectful, and believed they would receive significantly longer sentences than all other conditions. When officer age and experience were included as covariates in the analyses perpetrator blame was no longer statistically significant. Age, experience and training in IPV were not related to perceptions of victims. Police perceived victims as more truthful and believable when the perpetrator was a male. Police also believed victims of female perpetrators were more responsible for their own victimization. Victims were more likely to be perceived as a danger to their family when the perpetrator was female. Female perpetrators in same-sex relationships and heterosexual males were considered to experience more mental illness than heterosexual female or gay male perpetrators. These results replicate previous research suggesting male perpetrators are more blameworthy and responsible for their own victimization, yet expands upon previous research by identifying potential biases in police response to IPV in same-sex relationships. This study brings to the forefront the importance of evidence-based officer training in IPV and provides insight into the need for a gender inclusive approach as well as addressing the necessity of the practical applications for police.Keywords: domestic violence, heterosexual, intimate partner violence, officer response, police officer, same-sex
Procedia PDF Downloads 346489 Integrative-Cyclical Approach to the Study of Quality Control of Resource Saving by the Use of Innovation Factors
Authors: Anatoliy A. Alabugin, Nikolay K. Topuzov, Sergei V. Aliukov
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It is well known, that while we do a quantitative evaluation of the quality control of some economic processes (in particular, resource saving) with help innovation factors, there are three groups of problems: high uncertainty of indicators of the quality management, their considerable ambiguity, and high costs to provide a large-scale research. These problems are defined by the use of contradictory objectives of enhancing of the quality control in accordance with innovation factors and preservation of economic stability of the enterprise. The most acutely, such factors are felt in the countries lagging behind developed economies of the world according to criteria of innovativeness and effectiveness of management of the resource saving. In our opinion, the following two methods for reconciling of the above-mentioned objectives and reducing of conflictness of the problems are to solve this task most effectively: 1) the use of paradigms and concepts of evolutionary improvement of quality of resource-saving management in the cycle "from the project of an innovative product (technology) - to its commercialization and update parameters of customer value"; 2) the application of the so-called integrative-cyclical approach which consistent with complexity and type of the concept, to studies allowing to get quantitative assessment of the stages of achieving of the consistency of these objectives (from baseline of imbalance, their compromise to achievement of positive synergies). For implementation, the following mathematical tools are included in the integrative-cyclical approach: index-factor analysis (to identify the most relevant factors); regression analysis of relationship between the quality control and the factors; the use of results of the analysis in the model of fuzzy sets (to adjust the feature space); method of non-parametric statistics (for a decision on the completion or repetition of the cycle in the approach in depending on the focus and the closeness of the connection of indicator ranks of disbalance of purposes). The repetition is performed after partial substitution of technical and technological factors ("hard") by management factors ("soft") in accordance with our proposed methodology. Testing of the proposed approach has shown that in comparison with the world practice there are opportunities to improve the quality of resource-saving management using innovation factors. We believe that the implementation of this promising research, to provide consistent management decisions for reducing the severity of the above-mentioned contradictions and increasing the validity of the choice of resource-development strategies in terms of parameters of quality management and sustainability of enterprise, is perspective. Our existing experience in the field of quality resource-saving management and the achieved level of scientific competence of the authors allow us to hope that the use of the integrative-cyclical approach to the study and evaluation of the resulting and factor indicators will help raise the level of resource-saving characteristics up to the value existing in the developed economies of post-industrial type.Keywords: integrative-cyclical approach, quality control, evaluation, innovation factors. economic sustainability, innovation cycle of management, disbalance of goals of development
Procedia PDF Downloads 245488 Teaching English as a Foreign Language: Insights from the Philippine Context
Authors: Arlene Villarama, Micol Grace Guanzon, Zenaida Ramos
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This paper provides insights into teaching English as a Foreign Language in the Philippines. The authors reviewed relevant theories and literature, and provide an analysis of the issues in teaching English in the Philippine setting in the light of these theories. The authors made an investigation in Bagong Barrio National High School (BBNHS) - a public school in Caloocan City. The institution has a population of nearly 3,000 students. The performances of randomly chosen 365 respondents were scrutinised. The study regarding the success of teaching English as a foreign language to Filipino children were highlighted. This includes the respondents’ family background, surroundings, way of living, and their behavior and understanding regarding education. The results show that there is a significant relationship between demonstrative, communal, and logical areas that touch the efficacy of introducing English as a foreign Dialectal. Filipino children, by nature, are adventurous and naturally joyful even for little things. They are born with natural skills and capabilities to discover new things. They highly consider activities and work that ignite their curiosity. They love to be recognised and are inspired the most when given the assurance of acceptance and belongingness. Fun is the appealing influence to ignite and motivate learning. The magic word is excitement. The study reveals the many facets of the accumulation and transmission of erudition, in introduction and administration of English as a foreign phonological; it runs and passes through different channels of diffusion. Along the way, there are particles that act as obstructions in protocols where knowledge are to be gathered. Data gained from the respondents conceals a reality that is beyond one’s imagination. One significant factor that touches the inefficacy of understanding and using English as a foreign language is an erroneous outset gained from an old belief handed down from generation to generation. This accepted perception about the power and influence of the use of language, gives the novices either a negative or a positive notion. The investigation shows that a higher number of dislikes in the use of English can be tracked down from the belief of the story on how the English language came into existence. The belief that only the great and the influential have the right to use English as a means of communication kills the joy of acceptance. A significant notation has to be examined so as to provide a solution or if not eradicate the misconceptions that lie behind the substance of the matter. The result of the authors’ research depicts a substantial correlation between the emotional (demonstrative), social (communal), and intellectual (logical). The focus of this paper is to bring out the right notation and disclose the misconceptions with regards to teaching English as a foreign language. This will concentrate on the emotional, social, and intellectual areas of the Filipino learners and how these areas affect the transmittance and accumulation of learning. The authors’ aim is to formulate logical ways and techniques that would open up new beginnings in understanding and acceptance of the subject matter.Keywords: accumulation, behaviour, facets, misconceptions, transmittance
Procedia PDF Downloads 203487 The Readaptation of the Subscale 3 of the NLit-IT (Nutrition Literacy Assessment Instrument for Italian Subjects)
Authors: Virginia Vettori, Chiara Lorini, Vieri Lastrucci, Giulia Di Pisa, Alessia De Blasi, Sara Giuggioli, Guglielmo Bonaccorsi
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The design of the Nutrition Literacy Assessment Instrument (NLit) responds to the need to provide a tool to adequately assess the construct of nutrition literacy (NL), which is strictly connected to the quality of the diet and nutritional health status. The NLit was originally developed and validated in the US context, and it was recently validated for Italian people too (NLit-IT), involving a sample of N = 74 adults. The results of the cross-cultural adaptation of the tool confirmed its validity since it was established that the level of NL contributed to predicting the level of adherence to the Mediterranean Diet (convergent validity). Additionally, results obtained proved that Internal Consistency and reliability of the NLit-IT were good (Cronbach’s alpha (ρT) = 0.78; 95% CI, 0.69–0.84; Intraclass Correlation Coefficient (ICC) = 0.68, 95% CI, 0.46–0.85). However, the Subscale 3 of the NLit-IT “Household Food Measurement” showed lower values of ρT and ICC (ρT = 0.27; 95% CI, 0.1–0.55; ICC = 0.19, 95% CI, 0.01–0.63) than the entire instrument. Subscale 3 includes nine items which are constituted by written questions and the corresponding pictures of the meals. In particular, items 2, 3, and 8 of Subscale 3 had the lowest level of correct answers. The purpose of the present study was to identify the factors that influenced the Internal Consistency and reliability of Subscale 3 of NLit-IT using the methodology of a focus group. A panel of seven experts was formed, involving professionals in the field of public health nutrition, dietetics, and health promotion and all of them were trained on the concepts of nutrition literacy and food appearance. A member of the group drove the discussion, which was oriented in the identification of the reasons for the low levels of reliability and Internal Consistency. The members of the group discussed the level of comprehension of the items and how they could be readapted. From the discussion, it emerges that the written questions were clear and easy to understand, but it was observed that the representations of the meal needed to be improved. Firstly, it has been decided to introduce a fork or a spoon as a reference dimension to better understand the dimension of the food portion (items 1, 4 and 8). Additionally, the flat plate of items 3 and 5 should be substituted with a soup plate because, in the Italian national context, it is common to eat pasta or rice on this kind of plate. Secondly, specific measures should be considered for some kind of foods such as the brick of yogurt instead of a cup of yogurt (items 1 and 4). Lastly, it has been decided to redo the photos of the meals basing on professional photographic techniques. In conclusion, we noted that the graphical representation of the items strictly influenced the level of participants’ comprehension of the questions; moreover, the research group agreed that the level of knowledge about nutrition and food portion size is low in the general population.Keywords: nutritional literacy, cross cultural adaptation, misinformation, food design
Procedia PDF Downloads 169486 Indigenous Firms Out-leverage other New Zealand firms through Cultural Practices: A Mixed Methods Study
Authors: Jarrod Haar, David Brougham, Azka Ghafoor
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Māori are the indigenous people of Aotearoa (New Zealand) and have a unique perspective called Te Ao Māori (the Māori worldview) and important cultural values around utu (reciprocation), collectivism, long-term orientation, and whanaungatanga (networking, relationships). The present research conducts two studies to better understand how Māori businesses might have similarities and differences to New Zealand businesses. In study 1, we conducted 50 interviews with 25 Māori business owners and 25 New Zealand (non-Māori) owners. For the indigenous population, we used a kaupapa Māori research approach using Māori protocols. This ensured the research is culturally safe. Interviews were conducted around semi-structured questions tapping into the existing business challenges, the role of innovation, and business values and approaches. Transcripts were analyzed using interpretative phenomenological analytic techniques. We identified several themes shared across all business owners: (1) the critical challenge around staff attraction and retention; (2) cost pressures including inflation; (3) and a focus on human resource (HR) practices to address issues including retention. Amongst the Māori businesses, the analysis also identified (4) a unique cultural approach to business relationships. Specifically, amongst the indigenous businesses we find a strong Te Ao Māori perspective amongst Māori business towards innovation. Analysis within this group only identified, within the following sub-themes: (a) whanaungatanga, around the development of strong relationships as a way to aid recruitment and retention, and business fluctuations; (b) mātauranga (knowledge) whereby Māori businesses seek to access advanced knowledge via universities; (c) taking a long-term orientation to business relationships – including with universities. The findings suggest people practices might be a way that firms address workforce retention issues, and we also acknowledge that Māori businesses might also leverage cultural practices to achieve better gains. Thus, in study 2, we survey 606 New Zealand private sector firms including 85 who self-identify as Māori Firms. We test the benefits of high-performance work-systems (HPWS), which represent bundle of human-resource practices designed to bolster workforce productivity through enhancing knowledge, skills, abilities, and commitment of the workforce. We test these on workforce retention and include Māori firm status and cultural capital (reflecting workforce knowledge around Māori cultural values) as moderators. Overall, we find all firms achieve superior workforce retention when they have high levels of HPWS, but Māori firms with high cultural capital are better able to leverage these HR practices to achieve superior workforce retention. In summary, the present study highlights how indigenous businesses in New Zealand might achieve superior performance by leveraging their unique cultural values. The study provides unique insights into established literatures around retention and HR practices and highlights the lessons around indigenous cultural values that appear to aid businesses.Keywords: Māori business, cultural values, employee retention, human resource practices
Procedia PDF Downloads 66485 Reworking of the Anomalies in the Discounted Utility Model as a Combination of Cognitive Bias and Decrease in Impatience: Decision Making in Relation to Bounded Rationality and Emotional Factors in Intertemporal Choices
Authors: Roberta Martino, Viviana Ventre
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Every day we face choices whose consequences are deferred in time. These types of choices are the intertemporal choices and play an important role in the social, economic, and financial world. The Discounted Utility Model is the mathematical model of reference to calculate the utility of intertemporal prospects. The discount rate is the main element of the model as it describes how the individual perceives the indeterminacy of subsequent periods. Empirical evidence has shown a discrepancy between the behavior expected from the predictions of the model and the effective choices made from the decision makers. In particular, the term temporal inconsistency indicates those choices that do not remain optimal with the passage of time. This phenomenon has been described with hyperbolic models of the discount rate which, unlike the linear or exponential nature assumed by the discounted utility model, is not constant over time. This paper explores the problem of inconsistency by tracing the decision-making process through the concept of impatience. The degree of impatience and the degree of decrease of impatience are two parameters that allow to quantify the weight of emotional factors and cognitive limitations during the evaluation and selection of alternatives. In fact, although the theory assumes perfectly rational decision makers, behavioral finance and cognitive psychology have made it possible to understand that distortions in the decision-making process and emotional influence have an inevitable impact on the decision-making process. The degree to which impatience is diminished is the focus of the first part of the study. By comparing consistent and inconsistent preferences over time, it was possible to verify that some anomalies in the discounted utility model are a result of the combination of cognitive bias and emotional factors. In particular: the delay effect and the interval effect are compared through the concept of misperception of time; starting from psychological considerations, a criterion is proposed to identify the causes of the magnitude effect that considers the differences in outcomes rather than their ratio; the sign effect is analyzed by integrating in the evaluation of prospects with negative outcomes the psychological aspects of loss aversion provided by Prospect Theory. An experiment implemented confirms three findings: the greatest variation in the degree of decrease in impatience corresponds to shorter intervals close to the present; the greatest variation in the degree of impatience occurs for outcomes of lower magnitude; the variation in the degree of impatience is greatest for negative outcomes. The experimental phase was implemented with the construction of the hyperbolic factor through the administration of questionnaires constructed for each anomaly. This work formalizes the underlying causes of the discrepancy between the discounted utility model and the empirical evidence of preference reversal.Keywords: decreasing impatience, discount utility model, hyperbolic discount, hyperbolic factor, impatience
Procedia PDF Downloads 102484 Motivations, Communication Dimensions, and Perceived Outcomes in the Multi-Sectoral Collaboration of the Visitor Management Program of Mount Makiling Forest Reserve in Los Banos, Laguna, Philippines
Authors: Charmaine B. Distor
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Collaboration has long been recognized in different fields, but there’s been little research on operationalizing it especially on a multi-sectoral setting as per the author’s best knowledge. Also, communication is one of the factors that is usually overlooked when studying it. Specifically, this study aimed to describe the organizational profile and tasks of collaborators in the visitor management program of Make It Makiling (MIM). It also identified the factors that motivated collaborators to collaborate in MIM while determining the communication dimensions in the collaborative process. It also determined the communication channels used by collaborators in MIM while identifying the outcomes of collaboration in MIM. This study also found out if a relationship exists between collaborators’ motivations for collaboration and their perceived outcomes of collaboration, and collaborators' communication dimensions and their perceived outcomes of collaboration. Lastly, it also provided recommendations to improve the communication in MIM. Data were gathered using a self-administered survey that was patterned after Mattessich and Monsey’s (1992) collaboration experience questionnaire. Interviews and secondary sources mainly provided by the Makiling Center for Mountain Ecosystems (MCME) were also used. From the seven MIM collaborating organizations that were selected through purposive sampling, 86 respondents were chosen. Then, data were analyzed through frequency counts, percentages, measures of central tendencies, and Pearson’s and Spearman rho correlations. Collaborators’ length of collaboration ranged from seven to twenty years. Furthermore, six out of seven of the collaborators were involved in the task of 'emergency, rescue, and communication'. For the other aspect of the antecedents, the history of previous collaboration efforts ranked as the highest rated motivation for collaboration. In line with this, the top communication dimension is the governance while perceived effectiveness garnered the highest overall average among the perceived outcomes of collaboration. Results also showed that the collaborators highly rely on formal communication channels. Meetings and memos were the most commonly used communication channels throughout all tasks under the four phases of MIM. Additionally, although collaborators have a high view towards their co-collaborators, they still rely on MCME to act as their manager in coordinating with one another indirectly. Based on the correlation analysis, antecedent (motivations)-outcome relationship generally had positive relationships. However, for the process (communication dimensions)-outcome relationship, both positive and negative relationships were observed. In conclusion, this study exhibited the same trend with existing literature which also used the same framework. For the antecedent-outcome relationship, it can be deduced that MCME, as the main organizer of MIM, can focus on these variables to achieve their desired outcomes because of the positive relationships. For the process-outcome relationship, MCME should also take note that there were negative relationships where an increase in the said communication dimension may result in a decrease in the desired outcome. Recommendations for further study include a methodology that contains: complete enumeration or any parametric sampling, a researcher-administered survey, and direct observations. These might require additional funding, but all may yield to richer data.Keywords: antecedent-outcome relationship, carrying capacity, organizational communication, process-outcome relationship
Procedia PDF Downloads 122483 Nurse Participation for the Economical Effectiveness in Medical Organizations
Authors: Alua Masalimova, Dameli Sulubecova, Talgat Isaev, Raushan Magzumova
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The usual relation to nurses of heads of medical organizations in Kazakhstan is to use them only for per performing medical manipulations, but new economic conditions require the introduction of nursing innovations. There is an increasing need for managers of hospital departments and regions of ambulatory clinics to ensure comfortable conditions for doctors, nurses, aides, as well as monitoring marketing technology (the needs and satisfaction of staff work, the patient satisfaction of the department). It is going to the past the nursing activities as physician assistant performing his prescriptions passively. We are suggesting a model for the developing the head nurse as the manager on the example of Blood Service. We have studied in the scientific-production center of blood transfusion head nurses by the standard method of interviewing for involvement in coordinating the flow of information, promoting the competitiveness of the department. Results: the average age of the respondents 43,1 ± 9,8, female - 100%; manager in the Organization – 9,3 ± 10,3 years. Received positive responses to the knowledge of the nearest offices in providing similar medical service - 14,2%. The cost of similar medical services in other competitive organizations did not know 100%, did a study of employee satisfaction Division labour-85,7% answered negatively, the satisfaction donors work staff studied in 50.0% of cases involved in attracting paid Services Division showed a 28.5% of the respondent. Participation in management decisions medical organization: strategic planning - 14,2%, forming analysis report for the year – 14,2%, recruitment-30.0%, equipment-14.2%. Participation in the social and technical designing workplaces Division staff showed 85,0% of senior nurses. Participate in the cohesion of the staff of the Division method of the team used the 10.0% of respondents. Further, we have studied the behavioral competencies for senior sisters: customer focus – 20,0% of respondents have attended, the ability to work in a team – 40,0%. Personal qualities senior nurses were apparent: sociability – 80,0%, the ability to manage information – 40,0%, to make their own decisions - 14,2%, 28,5% creativity, the desire to improve their professionalism – 50,0%. Thus, the modern market conditions dictate this organization, which works for the rights of economic management; include the competence of the post of the senior nurse knowledge and skills of Marketing Management Department. Skills to analyses the information collected and use of management offers superior medical leadership organization. The medical organization in the recruitment of the senior nurse offices take into account personal qualities: flexibility, fluency of thinking, communication skills and ability to work in a team. As well as leadership qualities, ambition, high emotional and social intelligence, that will bring out the medical unit on competitiveness within the country and abroad.Keywords: blood service, head nurse, manager, skills
Procedia PDF Downloads 241482 An Approach to Addressing Homelessness in Hong Kong: Life Story Approach
Authors: Tak Mau Simon Chan, Ying Chuen Lance Chan
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Homelessness has been a popular and controversial debate in Hong Kong, a city which is densely populated and well-known for very expensive housing. The constitution of the homeless as threats to the community and environmental hygiene is ambiguous and debatable in the Hong Kong context. The lack of an intervention model is the critical research gap thus far, aside from the tangible services delivered. The life story approach (LSA), with its unique humanistic orientation, has been well applied in recent decades to depict the needs of various target groups, but not the homeless. It is argued that the life story approach (LSA), which has been employed by health professionals in the landscape of dementia, and health and social care settings, can be used as a reference in the local Chinese context through indigenization. This study, therefore, captures the viewpoints of service providers and users by constructing an indigenous intervention model that refers to the LSA in serving the chronically homeless. By informing 13 social workers and 27 homeless individuals in 8 focus groups whilst 12 homeless individuals have participated in individual in-depth interviews, a framework of LSA in homeless people is proposed. Through thematic analysis, three main themes of their life stories was generated, namely, the family, negative experiences and identity transformation. The three domains solidified framework that not only can be applied to the homeless, but also other disadvantaged groups in the Chinese context. Based on the three domains of family, negative experiences and identity transformation, the model is applied in the daily practices of social workers who help the homeless. The domain of family encompasses familial relationships from the past to the present to the speculated future with ten sub-themes. The domain of negative experiences includes seven sub-themes, with reference to the deviant behavior committed. The last domain, identity transformation, incorporates the awareness and redefining of one’s identity and there are a total of seven sub-themes. The first two domains are important components of personal histories while the third is more of an unknown, exploratory and yet to-be-redefined territory which has a more positive and constructive orientation towards developing one’s identity and life meaning. The longitudinal temporal dimension of moving from the past – present - future enriches the meaning making process, facilitates the integration of life experiences and maintains a more hopeful dialogue. The model is tested and its effectiveness is measured by using qualitative and quantitative methods to affirm the extent that it is relevant to the local context. First, it contributes to providing a clear guideline for social workers who can use the approach as a reference source. Secondly, the framework acts as a new intervention means to address problem saturated stories and the intangible needs of the homeless. Thirdly, the model extends the application to beyond health related issues. Last but not least, the model is highly relevant to the local indigenous context.Keywords: homeless, indigenous intervention, life story approach, social work practice
Procedia PDF Downloads 295481 Contribution to the Study of Automatic Epileptiform Pattern Recognition in Long Term EEG Signals
Authors: Christine F. Boos, Fernando M. Azevedo
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Electroencephalogram (EEG) is a record of the electrical activity of the brain that has many applications, such as monitoring alertness, coma and brain death; locating damaged areas of the brain after head injury, stroke and tumor; monitoring anesthesia depth; researching physiology and sleep disorders; researching epilepsy and localizing the seizure focus. Epilepsy is a chronic condition, or a group of diseases of high prevalence, still poorly explained by science and whose diagnosis is still predominantly clinical. The EEG recording is considered an important test for epilepsy investigation and its visual analysis is very often applied for clinical confirmation of epilepsy diagnosis. Moreover, this EEG analysis can also be used to help define the types of epileptic syndrome, determine epileptiform zone, assist in the planning of drug treatment and provide additional information about the feasibility of surgical intervention. In the context of diagnosis confirmation the analysis is made using long term EEG recordings with at least 24 hours long and acquired by a minimum of 24 electrodes in which the neurophysiologists perform a thorough visual evaluation of EEG screens in search of specific electrographic patterns called epileptiform discharges. Considering that the EEG screens usually display 10 seconds of the recording, the neurophysiologist has to evaluate 360 screens per hour of EEG or a minimum of 8,640 screens per long term EEG recording. Analyzing thousands of EEG screens in search patterns that have a maximum duration of 200 ms is a very time consuming, complex and exhaustive task. Because of this, over the years several studies have proposed automated methodologies that could facilitate the neurophysiologists’ task of identifying epileptiform discharges and a large number of methodologies used neural networks for the pattern classification. One of the differences between all of these methodologies is the type of input stimuli presented to the networks, i.e., how the EEG signal is introduced in the network. Five types of input stimuli have been commonly found in literature: raw EEG signal, morphological descriptors (i.e. parameters related to the signal’s morphology), Fast Fourier Transform (FFT) spectrum, Short-Time Fourier Transform (STFT) spectrograms and Wavelet Transform features. This study evaluates the application of these five types of input stimuli and compares the classification results of neural networks that were implemented using each of these inputs. The performance of using raw signal varied between 43 and 84% efficiency. The results of FFT spectrum and STFT spectrograms were quite similar with average efficiency being 73 and 77%, respectively. The efficiency of Wavelet Transform features varied between 57 and 81% while the descriptors presented efficiency values between 62 and 93%. After simulations we could observe that the best results were achieved when either morphological descriptors or Wavelet features were used as input stimuli.Keywords: Artificial neural network, electroencephalogram signal, pattern recognition, signal processing
Procedia PDF Downloads 528480 Data Calibration of the Actual versus the Theoretical Micro Electro Mechanical Systems (MEMS) Based Accelerometer Reading through Remote Monitoring of Padre Jacinto Zamora Flyover
Authors: John Mark Payawal, Francis Aldrine Uy, John Paul Carreon
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This paper shows the application of Structural Health Monitoring, SHM into bridges. Bridges are structures built to provide passage over a physical obstruction such as rivers, chasms or roads. The Philippines has a total of 8,166 national bridges as published on the 2015 atlas of the Department of Public Works and Highways (DPWH) and only 2,924 or 35.81% of these bridges are in good condition. As a result, PHP 30.464 billion of the 2016 budget of DPWH is allocated on roads and/or bridges maintenance alone. Intensive spending is owed to the present practice of outdated manual inspection and assessment, and poor structural health monitoring of Philippine infrastructures. As the School of Civil, Environmental, & Geological Engineering of Mapua Institute of Technology (MIT) continuous its well driven passion in research based projects, a partnership with the Department of Science and Technology (DOST) and the DPWH launched the application of Structural Health Monitoring, (SHM) in Padre Jacinto Zamora Flyover. The flyover is located along Nagtahan Boulevard in Sta. Mesa, Manila that connects Brgy. 411 and Brgy. 635. It gives service to vehicles going from Lacson Avenue to Mabini Bridge passing over Legarda Flyover. The flyover is chosen among the many located bridges in Metro Manila as the focus of the pilot testing due to its site accessibility, and complete structural built plans and specifications necessary for SHM as provided by the Bureau of Design, BOD department of DPWH. This paper focuses on providing a method to calibrate theoretical readings from STAAD Vi8 Pro and sync the data to actual MEMS accelerometer readings. It is observed that while the design standards used in constructing the flyover was reflected on the model, actual readings of MEMS accelerometer display a large difference compared to the theoretical data ran and taken from STAAD Vi8 Pro. In achieving a true seismic response of the modeled bridge or hence syncing the theoretical data to the actual sensor reading also called as the independent variable of this paper, analysis using single degree of freedom (SDOF) of the flyover under free vibration without damping using STAAD Vi8 Pro is done. The earthquake excitation and bridge responses are subjected to earthquake ground motion in the form of ground acceleration or Peak Ground Acceleration, PGA. Translational acceleration load is used to simulate the ground motion of the time history analysis acceleration record in STAAD Vi8 Pro.Keywords: accelerometer, analysis using single degree of freedom, micro electro mechanical system, peak ground acceleration, structural health monitoring
Procedia PDF Downloads 319479 Supermarket Shoppers Perceptions to Genetically Modified Foods in Trinidad and Tobago: Focus on Health Risks and Benefits
Authors: Safia Hasan Varachhia, Neela Badrie, Marsha Singh
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Genetic modification of food is an innovative technology that offers a host of benefits and advantages to consumers. Consumer attitudes towards GM food and GM technologies can be identified a major determinant in conditioning market force and encouraging policy makers and regulators to recognize the significance of consumer influence on the market. This study aimed to investigate and evaluate the extent of consumer awareness, knowledge, perception and acceptance of GM foods and its associated health risks and benefit in Trinidad and Tobago, West Indies. The specific objectives of this study were to (determine consumer awareness to GM foods, ascertain their perspectives on health and safety risks and ethical issues associated with GM foods and determine whether labeling of GM foods and ingredients will influence consumers’ willingness to purchase GM foods. A survey comprising of a questionnaire consisting of 40 questions, both open-ended and close-ended was administered to 240 shoppers in small, medium and large-scale supermarkets throughout Trinidad between April-May, 2015 using convenience sampling. This survey investigated consumer awareness, knowledge, perception and acceptance of GM foods and its associated health risks/benefits. The data was analyzed using SPSS 19.0 and Minitab 16.0. One-way ANOVA investigated the effects categories of supermarkets and knowledge scores on shoppers’ awareness, knowledge, perception and acceptance of GM foods. Linear Regression tested whether demographic variables (category of supermarket, age of consumer, level of were useful predictors of consumer’s knowledge of GM foods). More than half of respondents (64.3%) were aware of GM foods and GM technologies, 28.3% of consumers indicated the presence of GM foods in local supermarkets and 47.1% claimed to be knowledgeable of GM foods. Furthermore, significant associations (P < 0.05) were observed between demographic variables (age, income, and education), and consumer knowledge of GM foods. Also, significant differences (P < 0.05) were observed between demographic variables (education, gender, and income) and consumer knowledge of GM foods. In addition, age, education, gender and income (P < 0.05) were useful predictors of consumer knowledge of GM foods. There was a contradiction as whilst 35% of consumers considered GM foods safe for consumption, 70% of consumers were wary of the unknown health risks of GM foods. About two-thirds of respondents (67.5%) considered the creation of GM foods morally wrong and unethical. Regarding GM food labeling preferences, 88% of consumers preferred mandatory labeling of GM foods and 67% of consumers specified that any food product containing a trace of GM food ingredients required mandatory GM labeling. Also, despite the declaration of GM food ingredients on food labels and the reassurance of its safety for consumption by food safety and regulatory institutions, the majority of consumers (76.1%) still preferred conventionally produced foods over GM foods. The study revealed the need to inform shoppers of the presence of GM foods and technologies, present the scientific evidence as to the benefits and risks and the need for a policy on labeling so that informed choices could be taken.Keywords: genetically modified foods, income, labeling consumer awareness, ingredients, morality and ethics, policy
Procedia PDF Downloads 327478 Seismic Assessment of Flat Slab and Conventional Slab System for Irregular Building Equipped with Shear Wall
Authors: Muhammad Aji Fajari, Ririt Aprilin Sumarsono
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Particular instability of structural building under lateral load (e.g earthquake) will rise due to irregularity in vertical and horizontal direction as stated in SNI 03-1762-2012. The conventional slab has been considered for its less contribution in increasing the stability of the structure, except special slab system such as flat slab turned into account. In this paper, the analysis of flat slab system at Sequis Tower located in South Jakarta will be assessed its performance under earthquake. It consists of 6 floors of the basement where the flat slab system is applied. The flat slab system will be the main focus in this paper to be compared for its performance with conventional slab system under earthquake. Regarding the floor plan of Sequis Tower basement, re-entrant corner signed for this building is 43.21% which exceeded the allowable re-entrant corner is 15% as stated in ASCE 7-05 Based on that, the horizontal irregularity will be another concern for analysis, otherwise vertical irregularity does not exist for this building. Flat slab system is a system where the slabs use drop panel with shear head as their support instead of using beams. Major advantages of flat slab application are decreasing dead load of structure, removing beams so that the clear height can be maximized, and providing lateral resistance due to lateral load. Whilst, deflection at middle strip and punching shear are problems to be detail considered. Torsion usually appears when the structural member under flexure such as beam or column dimension is improper in ratio. Considering flat slab as alternative slab system will keep the collapse due to torsion down. Common seismic load resisting system applied in the building is a shear wall. Installation of shear wall will keep the structural system stronger and stiffer affecting in reduced displacement under earthquake. Eccentricity of shear wall location of this building resolved the instability due to horizontal irregularity so that the earthquake load can be absorbed. Performing linear dynamic analysis such as response spectrum and time history analysis due to earthquake load is suitable as the irregularity arise so that the performance of structure can be significantly observed. Utilization of response spectrum data for South Jakarta which PGA 0.389g is basic for the earthquake load idealization to be involved in several load combinations stated on SNI 03-1726-2012. The analysis will result in some basic seismic parameters such as period, displacement, and base shear of the system; besides the internal forces of the critical member will be presented. Predicted period of a structure under earthquake load is 0.45 second, but as different slab system applied in the analysis then the period will show a different value. Flat slab system will probably result in better performance for the displacement parameter compare to conventional slab system due to higher contribution of stiffness to the whole system of the building. In line with displacement, the deflection of the slab will result smaller for flat slab than a conventional slab. Henceforth, shear wall will be effective to strengthen the conventional slab system than flat slab system.Keywords: conventional slab, flat slab, horizontal irregularity, response spectrum, shear wall
Procedia PDF Downloads 190477 Barriers for Sustainable Consumption of Antifouling Products in the Baltic Sea
Authors: Bianca Koroschetz, Emma Mäenpää
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The purpose of this paper is to study consumer practices and meanings of different antifouling methods in order to identify the main barriers for sustainable consumption of antifouling products in the Baltic Sea. The Baltic Sea is considered to be an important tourism area. More than 3.5 million leisure boaters use the sea for recreational boating. Most leisure boat owners use toxic antifouling paint to keep barnacles from attaching to the hull. Attached barnacles limit maneuverability and add drag which in turn increases fuel costs. Antifouling paint used to combat barnacles causes particular problems, as the use of these products continuously adds to the distribution of biocides in the coastal ecosystem and leads to the death of marine organisms. To keep the Baltic Sea as an attractive tourism area measures need to be undertaken to stop the pollution coming from toxic antifouling paints. The antifouling market contains a wide range of environment-friendly alternative products such as a brush wash for boats, hand scrubbing devices, hull covers and boat lifts. Unfortunately, not a lot of boat owners use these environment-friendly alternatives and instead prefer the use of the traditional toxic copper paints. We ask “Why is the unsustainable consumption of toxic paints still predominant when there is a big range of environment-friendly alternatives available? What are the barriers for sustainable consumption?” Environmental psychology has concentrated on developing models of human behavior, including the main factors that influence pro-environmental behavior. The main focus of these models was directed to the individual’s attitudes, principals, and beliefs. However, social practice theory emphasizes the importance to study practices, as they have a stronger explanatory power than attitude-behavior to explain unsustainable consumer behavior. Thus, the study focuses on describing the material, meaning and competence of antifouling practice in order to understand the social and cultural embeddedness of the practice. Phenomenological interviews were conducted with boat owners using antifouling products such as paints and alternative methods. This data collection was supplemented with participant observations in marinas. Preliminary results indicate that different factors such as costs, traditions, advertising, frequency of use, marinas and application of method impact on the consumption of antifouling products. The findings have shown that marinas have a big influence on the consumption of antifouling goods. Some marinas are very active in supporting the sustainable consumption of antifouling products as for example in Stockholm area several marinas subsidize costs for using environmental friendly alternatives or even forbid toxic paints. Furthermore the study has revealed that environmental friendly methods are very effective and do not have to be more expensive than painting with toxic paints. This study contributes to a broader understanding why the unsustainable consumption of toxic paints is still predominant when a big range of environment-friendly alternatives exist. Answers to this phenomenon will be gained by studying practices instead of attitudes offering a new perspective on environmental issues.Keywords: antifouling paint, Baltic Sea, boat tourism, sustainable consumption
Procedia PDF Downloads 192476 3D CFD Model of Hydrodynamics in Lowland Dam Reservoir in Poland
Authors: Aleksandra Zieminska-Stolarska, Ireneusz Zbicinski
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Introduction: The objective of the present work was to develop and validate a 3D CFD numerical model for simulating flow through 17 kilometers long dam reservoir of a complex bathymetry. In contrast to flowing waters, dam reservoirs were not emphasized in the early years of water quality modeling, as this issue has never been the major focus of urban development. Starting in the 1970s, however, it was recognized that natural and man-made lakes are equal, if not more important than estuaries and rivers from a recreational standpoint. The Sulejow Reservoir (Central Poland) was selected as the study area as representative of many lowland dam reservoirs and due availability of a large database of the ecological, hydrological and morphological parameters of the lake. Method: 3D, 2-phase and 1-phase CFD models were analysed to determine hydrodynamics in the Sulejow Reservoir. Development of 3D, 2-phase CFD model of flow requires a construction of mesh with millions of elements and overcome serious convergence problems. As 1-phase CFD model of flow in relation to 2-phase CFD model excludes from the simulations the dynamics of waves only, which should not change significantly water flow pattern for the case of lowland, dam reservoirs. In 1-phase CFD model, the phases (water-air) are separated by a plate which allows calculations of one phase (water) flow only. As the wind affects velocity of flow, to take into account the effect of the wind on hydrodynamics in 1-phase CFD model, the plate must move with speed and direction equal to the speed and direction of the upper water layer. To determine the velocity at which the plate will move on the water surface and interacts with the underlying layers of water and apply this value in 1-phase CFD model, the 2D, 2-phase model was elaborated. Result: Model was verified on the basis of the extensive flow measurements (StreamPro ADCP, USA). Excellent agreement (an average error less than 10%) between computed and measured velocity profiles was found. As a result of work, the following main conclusions can be presented: •The results indicate that the flow field in the Sulejow Reservoir is transient in nature, with swirl flows in the lower part of the lake. Recirculating zones, with the size of even half kilometer, may increase water retention time in this region •The results of simulations confirm the pronounced effect of the wind on the development of the water circulation zones in the reservoir which might affect the accumulation of nutrients in the epilimnion layer and result e.g. in the algae bloom. Conclusion: The resulting model is accurate and the methodology develop in the frame of this work can be applied to all types of storage reservoir configurations, characteristics, and hydrodynamics conditions. Large recirculating zones in the lake which increase water retention time and might affect the accumulation of nutrients were detected. Accurate CFD model of hydrodynamics in large water body could help in the development of forecast of water quality, especially in terms of eutrophication and water management of the big water bodies.Keywords: CFD, mathematical modelling, dam reservoirs, hydrodynamics
Procedia PDF Downloads 400475 Efficient Treatment of Azo Dye Wastewater with Simultaneous Energy Generation by Microbial Fuel Cell
Authors: Soumyadeep Bhaduri, Rahul Ghosh, Rahul Shukla, Manaswini Behera
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The textile industry consumes a substantial amount of water throughout the processing and production of textile fabrics. The water eventually turns into wastewater, where it acts as an immense damaging nuisance due to its dye content. Wastewater streams contain a percentage ranging from 2.0% to 50.0% of the total weight of dye used, depending on the dye class. The management of dye effluent in textile industries presents a formidable challenge to global sustainability. The current focus is on implementing wastewater treatment technology that enable the recycling of wastewater, reduce energy usage and offset carbon emissions. Microbial fuel cell (MFC) is a device that utilizes microorganisms as a bio-catalyst to effectively treat wastewater while also producing electricity. The MFC harnesses the chemical energy present in wastewater by oxidizing organic compounds in the anodic chamber and reducing an electron acceptor in the cathodic chamber, thereby generating electricity. This research investigates the potential of MFCs to tackle this challenge of azo dye removal with simultaneously generating electricity. Although MFCs are well-established for wastewater treatment, their application in dye decolorization with concurrent electricity generation remains relatively unexplored. This study aims to address this gap by assessing the effectiveness of MFCs as a sustainable solution for treating wastewater containing azo dyes. By harnessing microorganisms as biocatalysts, MFCs offer a promising avenue for environmentally friendly dye effluent management. The performance of MFCs in treating azo dyes and generating electricity was evaluated by optimizing the Chemical Oxygen Demand (COD) and Hydraulic Retention Time (HRT) of influent. COD and HRT values ranged from 1600 mg/L to 2400 mg/L and 5 to 9 days, respectively. Results showed that the maximum open circuit voltage (OCV) reached 648 mV at a COD of 2400 mg/L and HRT of 5 days. Additionally, maximum COD removal of 98% and maximum color removal of 98.91% were achieved at a COD of 1600 mg/L and HRT of 9 days. Furthermore, the study observed a maximum power density of 19.95 W/m3 at a COD of 2400 mg/L and HRT of 5 days. Electrochemical analysis, including linear sweep voltammetry (LSV), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were done to find out the response current and internal resistance of the system. To optimize pH and dye concentration, pH values were varied from 4 to 10, and dye concentrations ranged from 25 mg/L to 175 mg/L. The highest voltage output of 704 mV was recorded at pH 7, while a dye concentration of 100 mg/L yielded the maximum output of 672 mV. This study demonstrates that MFCs offer an efficient and sustainable solution for treating azo dyes in textile industry wastewater, while concurrently generating electricity. These findings suggest the potential of MFCs to contribute to environmental remediation and sustainable development efforts on a global scale.Keywords: textile wastewater treatment, microbial fuel cell, renewable energy, sustainable wastewater treatment
Procedia PDF Downloads 19474 Using Human-Centred Service Design and Partnerships as a Model to Promote Cross-Sector Social Responsibility in Disaster Resilience: An Australian Case Study
Authors: Keith Diamond, Tracy Collier, Ciara Sterling, Ben Kraal
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The increased frequency and intensity of disaster events in the Asia-Pacific region is likely to require organisations to better understand how their initiatives, and the support they provide to their customers, intersect with other organisations aiming to support communities in achieving disaster resilience. While there is a growing awareness that disaster response and recovery rebuild programmes need to adapt to more integrated, community-led approaches, there is often a discrepancy between how programmes intend to work and how they are collectively experienced in the community, creating undesired effects on community resilience. Following Australia’s North Queensland Monsoon Disaster of 2019, this research set out to understand and evaluate how the service and support ecosystem impacted on the local community’s experience and influenced their ability to respond and recover. The purpose of this initiative was to identify actionable, cross-sector, people-centered improvements that support communities to recover and thrive when faced with disaster. The challenge arose as a group of organisations, including utility providers, banks, insurers, and community organisations, acknowledged that improving their own services would have limited impact on community wellbeing unless the other services people need are also improved and aligned. The research applied human-centred service design methods, typically applied to single products or services, to design a new way to understand a whole-of-community journey. Phase 1 of the research conducted deep contextual interviews with residents and small business owners impacted by the North Queensland Monsoon and qualitative data was analysed to produce community journey maps that detailed how individuals navigated essential services, such as accommodation, finance, health, and community. Phase 2 conducted interviews and focus groups with frontline workers who represented industries that provided essential services to assist the community. Data from Phase 1 and Phase 2 of the research was analysed and combined to generate a systems map that visualised the positive and negative impacts that occurred across the disaster response and recovery service ecosystem. Insights gained from the research has catalysed collective action to address future Australian disaster events. The case study outlines a transformative way for sectors and industries to rethink their corporate social responsibility activities towards a cross-sector partnership model that shares responsibility and approaches disaster response and recovery as a single service that can be designed to meet the needs of communities.Keywords: corporate social responsibility, cross sector partnerships, disaster resilience, human-centred design, service design, systems change
Procedia PDF Downloads 154473 The Impact of Economic Status on Health Status in the Context of Bangladesh
Authors: Md. S. Sabuz
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Bangladesh, a South Asian developing country, has achieved a remarkable breakthrough in health indicators during the last four decades despite immense income inequality. This phenomenon results in the mystical exclusion of marginalized people from obtaining health care facilities. However, the persistence of exclusion of the disadvantaged remains troubling. Exclusion occurs from occupational inferiority, pay and wage differences, educational backwardness, gender disparity to urban-rural complexity and eliminate the unprivileged from seeking and availing the health services. Evidence from Bangladesh shows that many sick people prefer to die at home without securing medical services because in previous times they were not treated well, not because the medical facilities were inadequate or antediluvian but the socio-economic class allows them to receive obdurate treatment. Furthermore, government and policymakers have given enormous emphasis on infrastructural development and achieving health indicators instead of ensuring quality services and inclusiveness of people from all spheres. Therefore, it is high time to address the issues concerning this and highlight the impact of economic status on health status in a sociological perspective. The objective of this study is to consider ways of assessing and exploring the impact of economic status for instance: occupational status, pay and wage variable, on health status in the context of Bangladesh. The hypotheses are that there are a significant number of factors affecting economic status which are impactful for health status eventually, but acute income inequality is a prominent factor. Illiteracy, gender disparity, remoteness, incredibility on services, superior costs, superstition etc. are the dominant indicators behind the economic factors influencing the health status. The chosen methodologies are a qualitative and quantitative approaches to accomplish the research objectives. Secondary sources of data will be used to conduct the study. Surveys will be conducted on the people who have ever been through the health care facilities and people from the different socio-economic and cultural backgrounds. Focus group discussions will be conducted to acquire the data from different cultural and regional citizens. The findings show that 48% of people who are from disadvantaged communities have been deprived of proper health care facilities. The general reasons behind this are the higher cost of medicines and other equipment. A significant number of people are unaware of the appropriate facilities. It was found that the socio-economic variables are the main influential factors that work as the driving force for both economic dimension and health status. Above all regional variables and gender, dimensions have an enormous effect on determining the health status of an individual or community. Amidst many positive achievements for example decrease in the child mortality rate, an increase in the immunization programs of the child etc., the inclusiveness of all classes of people in health care facilities has been overshadowed in Bangladesh. However, this phenomenon along with the socio-economic and cultural phenomena significantly demolishes the quality and inclusiveness of the health status of people.Keywords: cultural context of health, economic status, gender and health, rural health care
Procedia PDF Downloads 212472 India’s Energy Transition, Pathways for Green Economy
Authors: B. Sudhakara Reddy
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In modern economy, energy is fundamental to virtually every product and service in use. It has been developed on the dependence of abundant and easy-to-transform polluting fossil fuels. On one hand, increase in population and income levels combined with increased per capita energy consumption requires energy production to keep pace with economic growth, and on the other, the impact of fossil fuel use on environmental degradation is enormous. The conflicting policy objectives of protecting the environment while increasing economic growth and employment has resulted in this paradox. Hence, it is important to decouple economic growth from environmental degeneration. Hence, the search for green energy involving affordable, low-carbon, and renewable energies has become global priority. This paper explores a transition to a sustainable energy system using the socio-economic-technical scenario method. This approach takes into account the multifaceted nature of transitions which not only require the development and use of new technologies, but also of changes in user behaviour, policy and regulation. The scenarios that are developed are: baseline business as usual (BAU) as well as green energy (GE). The baseline scenario assumes that the current trends (energy use, efficiency levels, etc.) will continue in future. India’s population is projected to grow by 23% during 2010 –2030, reaching 1.47 billion. The real GDP, as per the model, is projected to grow by 6.5% per year on average between 2010 and 2030 reaching US$5.1 trillion or $3,586 per capita (base year 2010). Due to increase in population and GDP, the primary energy demand will double in two decades reaching 1,397 MTOE in 2030 with the share of fossil fuels remaining around 80%. The increase in energy use corresponds to an increase in energy intensity (TOE/US $ of GDP) from 0.019 to 0.036. The carbon emissions are projected to increase by 2.5 times from 2010 reaching 3,440 million tonnes with per capita emissions of 2.2 tons/annum. However, the carbon intensity (tons per US$ of GDP) decreases from 0.96 to 0.67. As per GE scenario, energy use will reach 1079 MTOE by 2030, a saving of about 30% over BAU. The penetration rate of renewable energy resources will reduce the total primary energy demand by 23% under GE. The reduction in fossil fuel demand and focus on clean energy will reduce the energy intensity to 0.21 (TOE/US$ of GDP) and carbon intensity to 0.42 (ton/US$ of GDP) under the GE scenario. The study develops new ‘pathways out of poverty’ by creating more than 10 million jobs and thus raise the standard of living of low-income people. Our scenarios are, to a great extent, based on the existing technologies. The challenges to this path lie in socio-economic-political domains. However, to attain a green economy the appropriate policy package should be in place which will be critical in determining the kind of investments that will be needed and the incidence of costs and benefits. These results provide a basis for policy discussions on investments, policies and incentives to be put in place by national and local governments.Keywords: energy, renewables, green technology, scenario
Procedia PDF Downloads 248471 Strategies for Conserving Ecosystem Functions of the Aravalli Range to Combat Land Degradation: Case of Kishangarh and Tijara Tehsil in Rajasthan, India
Authors: Saloni Khandelwal
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The Aravalli hills are one of the oldest and most distinctive mountain chains of peninsular India spanning in around 692 Km. More than 60% of it falls in the state of Rajasthan and influences ecological equilibrium in about 30% of the state. Because of natural and human-induced activities, physical gaps in the Aravallis are increasing, new gaps are coming up, and its physical structure is changing. There are no strict regulations to protect and monitor the Aravallis and no comprehensive research and study has been done for the enhancement of ecosystem functions of these ranges. Through this study, various factors leading to Aravalli’s degradation are identified and its impacts on selected areas are analyzed. A literature study is done to identify factors responsible for the degradation. To understand the severity of the problem at the lowest level, two tehsils from different districts in Rajasthan, which are the most affected due to illegal mining and increasing physical gaps are selected for the study. Case-1 of three-gram panchayats in Kishangarh Tehsil of Ajmer district focuses on the expanding physical gaps in the Aravalli range, and case-2 of three-gram panchayats in Tijara Tehsil of Alwar district focuses on increasing illegal mining in the Aravalli range. For measuring the degradation, physical, biological and social indicators are identified through literature review and for both the cases analysis is done on the basis of these indicators. Primary survey and focus group discussions are done with villagers, mining owners, illegal miners, and various government officials to understand dependency of people on the Aravalli and its importance to them along with the impact of degradation on their livelihood and environment. From the analysis, it has been found that green cover is continuously decreasing in both cases, dense forest areas do not exist now, the groundwater table is depleting at a very fast rate, soil is losing its moisture resulting in low yield and shift in agriculture. Wild animals which were easily seen earlier are now extinct. Cattles of villagers are dependent on the forest area in the Aravalli range for food, but with a decrease in fodder, their cattle numbers are decreasing. There is a decrease in agricultural land and an increase in scrub and salt-affected land. Analysis of various national and state programmes, acts which were passed to conserve biodiversity has been done showing that none of them is helping much to protect the Aravalli. For conserving the Aravalli and its forest areas, regional level and local level initiatives are required and are proposed in this study. This study is an attempt to formulate conservation and management strategies for the Aravalli range. These strategies will help in improving biodiversity which can lead to the revival of its ecosystem functions. It will also help in curbing the pollution at the regional and local level. All this will lead to the sustainable development of the region.Keywords: Aravalli, ecosystem, LULC, Rajasthan
Procedia PDF Downloads 135470 The Location of Park and Ride Facilities Using the Fuzzy Inference Model
Authors: Anna Lower, Michal Lower, Robert Masztalski, Agnieszka Szumilas
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Contemporary cities are facing serious congestion and parking problems. In urban transport policy the introduction of the park and ride system (P&R) is an increasingly popular way of limiting vehicular traffic. The determining of P&R facilities location is a key aspect of the system. Criteria for assessing the quality of the selected location are formulated generally and descriptively. The research outsourced to specialists are expensive and time consuming. The most focus is on the examination of a few selected places. The practice has shown that the choice of the location of these sites in a intuitive way without a detailed analysis of all the circumstances, often gives negative results. Then the existing facilities are not used as expected. Methods of location as a research topic are also widely taken in the scientific literature. Built mathematical models often do not bring the problem comprehensively, e.g. assuming that the city is linear, developed along one important communications corridor. The paper presents a new method where the expert knowledge is applied to fuzzy inference model. With such a built system even a less experienced person could benefit from it, e.g. urban planners, officials. The analysis result is obtained in a very short time, so a large number of the proposed location can also be verified in a short time. The proposed method is intended for testing of car parks location in a city. The paper will show selected examples of locations of the P&R facilities in cities planning to introduce the P&R. The analysis of existing objects will also be shown in the paper and they will be confronted with the opinions of the system users, with particular emphasis on unpopular locations. The research are executed using the fuzzy inference model which was built and described in more detail in the earlier paper of the authors. The results of analyzes are compared to documents of P&R facilities location outsourced by the city and opinions of existing facilities users expressed on social networking sites. The research of existing facilities were conducted by means of the fuzzy model. The results are consistent with actual users feedback. The proposed method proves to be good, but does not require the involvement of a large experts team and large financial contributions for complicated research. The method also provides an opportunity to show the alternative location of P&R facilities. The performed studies show that the method has been confirmed. The method can be applied in urban planning of the P&R facilities location in relation to the accompanying functions. Although the results of the method are approximate, they are not worse than results of analysis of employed experts. The advantage of this method is ease of use, which simplifies the professional expert analysis. The ability of analyzing a large number of alternative locations gives a broader view on the problem. It is valuable that the arduous analysis of the team of people can be replaced by the model's calculation. According to the authors, the proposed method is also suitable for implementation on a GIS platform.Keywords: fuzzy logic inference, park and ride system, P&R facilities, P&R location
Procedia PDF Downloads 322469 Quantitative Analysis Of Traffic Dynamics And Violation Patterns Triggered By Cruise Ship Tourism In Victoria, British Columbia
Authors: Muhammad Qasim, Laura Minet
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Victoria (BC), Canada, is a major cruise ship destination, attracting over 600,000 tourists annually. Residents of the James Bay neighborhood, home to the Ogden Point cruise terminal, have expressed concerns about the impacts of cruise ship activity on local traffic, air pollution, and safety compliance. This study evaluates the effects of cruise ship-induced traffic in James Bay, focusing on traffic flow intensification, density surges, changes in traffic mix, and speeding violations. To achieve these objectives, traffic data was collected in James Bay during two key periods: May, before the peak cruise season, and August, during full cruise operations. Three Miovision cameras captured the vehicular traffic mix at strategic entry points, while nine traffic counters monitored traffic distribution and speeding violations across the network. Traffic data indicated an average volume of 308 vehicles per hour during peak cruise times in May, compared to 116 vehicles per hour when no ships were in port. Preliminary analyses revealed a significant intensification of traffic flow during cruise ship "hoteling hours," with a volume increase of approximately 10% per cruise ship arrival. A notable 86% surge in taxi presence was observed on days with three cruise ships in port, indicating a substantial shift in traffic composition, particularly near the cruise terminal. The number of tourist buses escalated from zero in May to 32 in August, significantly altering traffic dynamics within the neighborhood. The period between 8 pm and 11 pm saw the most significant increases in traffic volume, especially when three ships were docked. Higher vehicle volumes were associated with a rise in speed violations, although this pattern was inconsistent across all areas. Speeding violations were more frequent on roads with lower traffic density, while roads with higher traffic density experienced fewer violations, due to reduced opportunities for speeding in congested conditions. PTV VISUM software was utilized for fuzzy distribution analysis and to visualize traffic distribution across the study area, including an assessment of the Level of Service on major roads during periods before and during the cruise ship season. This analysis identified the areas most affected by cruise ship-induced traffic, providing a detailed understanding of the impact on specific parts of the transportation network. These findings underscore the significant influence of cruise ship activity on traffic dynamics in Victoria, BC, particularly during peak periods when multiple ships are in port. The study highlights the need for targeted traffic management strategies to mitigate the adverse effects of increased traffic flow, changes in traffic mix, and speed violations, thereby enhancing road safety in the James Bay neighborhood. Further research will focus on detailed emissions estimation to fully understand the environmental impacts of cruise ship activity in Victoria.Keywords: cruise ship tourism, air quality, traffic violations, transport dynamics, pollution
Procedia PDF Downloads 21468 A Comparative Study of the Impact of the Total Fertility Rate (TFR) on Trends in the Second Demographic Transition in Rwanda
Authors: Etienne Gatera
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Many studies have been conducted on SDT. Most of them focus on developed countries because of influencing factors such as; education, health, labor force, female labor force participation, industrialization, urbanization and migration. However, this thesis project paper aims to assess the impact of the total fertility rate (TFR) on the trends of the SDR in Rwanda. We will mainly be based in Rwanda after the 1994 genocide. Rwanda is located in East Africa, with approximately 13 million inhabitants. Thus, after the 1994 Tutsi genocide. The population growth rate exploded out of control with 6.17 children per woman in 1995. However, it's declined to 4.2 in 2014-2015 and declining to 4.1% in 2019-2020. Respectively with 3.4 children per woman in urban areas and 4.3 in rural areas. According to the National Institute of Statistics of Rwanda. Rwanda's population is expected to continue to grow for the rest of the century and reach 33.35 million people in 2099, with 2.1 children per woman in 2050. However, this project document aims to demonstrate the impact of the TFR on SDT trends in Rwanda. Thus, the decline in the TFR in Rwanda began with the introduction of family planning practices, which now account for 47.5% in 2019. Childbearing with three children for rural women compared to two children in the city, the increase in Divorce and separation caused by the behavior called "Kuza n'ijoro" or "coming at night" similar to cohabitation in developed countries. The decline in remarriage is caused by single mothers behavior who prefer to raise their children rather than remarry. Therefore, the study used probability sampling with (Stratified random sampling) method with a survey questionnaire of 1067 respondents in the 5 Districts (3 in rural areas and two in urban areas), with the target group of women Age between 15-49. The study demonstrated that the age of marriage in rural areas is two years higher than in urban areas. Divorce is more common in urban is with 6.2% with 5.2% in rural areas. However, separation is more common in rural areas than in urban areas, with a lower rate of 3%, due to the higher system called "Kuza n'ijoro" or "come at night", similar to cohabitation in developed countries. The study revealed that more than 85% of divorced people prefer to remain single, which confirms the low remarriage rate. Childbearing has started to decrease, especially for young singles in urban areas, due to the economic situation, with national statistics showing that unemployment in the youth community is still 16% higher. Therefore, the study concluded by confirming the hypothesis based on the results of the TFR indicators such as marriage, remarriage, divorce, separation, divorce, Kuza n'ijoro, childbearing] and abortion. The study consists of four sections, an introduction and background, a review of the literature, a description of the data and methodology, an analysis of the data, discussion results and a conclusion.Keywords: Kuza n'ijoro, Rwanda, second demographic transition (SDT), total fertility rate (TFR)
Procedia PDF Downloads 169467 Automated System: Managing the Production and Distribution of Radiopharmaceuticals
Authors: Shayma Mohammed, Adel Trabelsi
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Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.Keywords: automated system, management, radiopharmacy, technical papers
Procedia PDF Downloads 155466 Climate Change Law and Transnational Corporations
Authors: Manuel Jose Oyson
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The Intergovernmental Panel on Climate Change (IPCC) warned in its most recent report for the entire world “to both mitigate and adapt to climate change if it is to effectively avoid harmful climate impacts.” The IPCC observed “with high confidence” a more rapid rise in total anthropogenic greenhouse gas emissions (GHG) emissions from 2000 to 2010 than in the past three decades that “were the highest in human history”, which if left unchecked will entail a continuing process of global warming and can alter the climate system. Current efforts, however, to respond to the threat of global warming, such as the United Nations Framework Convention on Climate Change and the Kyoto Protocol, have focused on states, and fail to involve Transnational Corporations (TNCs) which are responsible for a vast amount of GHG emissions. Involving TNCs in the search for solutions to climate change is consistent with an acknowledgment by contemporary international law that there is an international role for other international persons, including TNCs, and departs from the traditional “state-centric” response to climate change. Putting the focus of GHG emissions away from states recognises that the activities of TNCs “are not bound by national borders” and that the international movement of goods meets the needs of consumers worldwide. Although there is no legally-binding instrument that covers TNC activities or legal responsibilities generally, TNCs have increasingly been made legally responsible under international law for violations of human rights, exploitation of workers and environmental damage, but not for climate change damage. Imposing on TNCs a legally-binding obligation to reduce their GHG emissions or a legal liability for climate change damage is arguably formidable and unlikely in the absence a recognisable source of obligation in international law or municipal law. Instead a recourse to “soft law” and non-legally binding instruments may be a way forward for TNCs to reduce their GHG emissions and help in addressing climate change. Positive effects have been noted by various studies to voluntary approaches. TNCs have also in recent decades voluntarily committed to “soft law” international agreements. This development reflects a growing recognition among corporations in general and TNCs in particular of their corporate social responsibility (CSR). While CSR used to be the domain of “small, offbeat companies”, it has now become part of mainstream organization. The paper argues that TNCs must voluntarily commit to reducing their GHG emissions and helping address climate change as part of their CSR. One, as a serious “global commons problem”, climate change requires international cooperation from multiple actors, including TNCs. Two, TNCs are not innocent bystanders but are responsible for a large part of GHG emissions across their vast global operations. Three, TNCs have the capability to help solve the problem of climate change. Assuming arguendo that TNCs did not strongly contribute to the problem of climate change, society would have valid expectations for them to use their capabilities, knowledge-base and advanced technologies to help address the problem. It would seem unthinkable for TNCs to do nothing while the global environment fractures.Keywords: climate change law, corporate social responsibility, greenhouse gas emissions, transnational corporations
Procedia PDF Downloads 349465 Implementing Quality Improvement Projects to Enhance Contraception and Abortion Care Service Provision and Pre-Service Training of Health Care Providers
Authors: Munir Kassa, Mengistu Hailemariam, Meghan Obermeyer, Kefelegn Baruda, Yonas Getachew, Asnakech Dessie
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Improving the quality of sexual and reproductive health services that women receive is expected to have an impact on women’s satisfaction with the services, on their continued use and, ultimately, on their ability to achieve their fertility goals or reproductive intentions. Surprisingly, however, there is little empirical evidence of either whether this expectation is correct, or how best to improve service quality within sexual and reproductive health programs so that these impacts can be achieved. The Recent focus on quality has prompted more physicians to do quality improvement work, but often without the needed skill sets, which results in poorly conceived and ultimately unsuccessful improvement initiatives. As this renders the work unpublishable, it further impedes progress in the field of health care improvement and widens the quality chasm. Moreover, since 2014, the Center for International Reproductive Health Training (CIRHT) has worked diligently with 11 teaching hospitals across Ethiopia to increase access to contraception and abortion care services. This work has included improving pre-service training through education and curriculum development, expanding hands-on training to better learn critical techniques and counseling skills, and fostering a “team science” approach to research by encouraging scientific exploration. This is the first time this systematic approach has been applied and documented to improve access to high-quality services in Ethiopia. The purpose of this article is to report initiatives undertaken, and findings concluded by the clinical service team at CIRHT in an effort to provide a pragmatic approach to quality improvement projects. An audit containing nearly 300 questions about several aspects of patient care, including structure, process, and outcome indicators was completed by each teaching hospital’s quality improvement team. This baseline audit assisted in identifying major gaps and barriers, and each team was responsible for determining specific quality improvement aims and tasks to support change interventions using Shewart’s Cycle for Learning and Improvement (the Plan-Do-Study-Act model). To measure progress over time, quality improvement teams met biweekly and compiled monthly data for review. Also, site visits to each hospital were completed by the clinical service team to ensure monitoring and support. The results indicate that applying an evidence-based, participatory approach to quality improvement has the potential to increase the accessibility and quality of services in a short amount of time. In addition, continued ownership and on-site support are vital in promoting sustainability. This approach could be adapted and applied in similar contexts, particularly in other African countries.Keywords: abortion, contraception, quality improvement, service provision
Procedia PDF Downloads 220464 Understanding the Cause(S) of Social, Emotional and Behavioural Difficulties of Adolescents with ADHD and Its Implications for the Successful Implementation of Intervention(S)
Authors: Elisavet Kechagia
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Due to the interplay of different genetic and environmental risk factors and its heterogeneous nature, the concept of attention deficit hyperactivity disorder (ADHD) has shaped controversy and conflicts, which have been, in turn, reflected in the controversial arguments about its treatment. Taking into account recent well evidence-based researches suggesting that ADHD is a condition, in which biopsychosocial factors are all weaved together, the current paper explores the multiple risk-factors that are likely to influence ADHD, with a particular focus on adolescents with ADHD who might experience comorbid social, emotional and behavioural disorders (SEBD). In the first section of this paper, the primary objective was to investigate the conflicting ideas regarding the definition, diagnosis and treatment of ADHD at an international level as well as to critically examine and identify the limitations of the two most prevailing sets of diagnostic criteria that inform current diagnosis, the American Psychiatric Association’s (APA) diagnostic scheme, DSM-V, and the World Health Organisation’s (WHO) classification of diseases, ICD-10. Taking into consideration the findings of current longitudinal studies on ADHD association with high rates of comorbid conditions and social dysfunction, in the second section the author moves towards an investigation of the transitional points −physical, psychological and social ones− that students with ADHD might experience during early adolescence, as informed by neuroscience and developmental contextualism theory. The third section is an exploration of the different perspectives of ADHD as reflected in individuals’ with ADHD self-reports and the KENT project’s findings on school staff’s attitudes and practices. In the last section, given the high rates of SEBDs in adolescents with ADHD, it is examined how cognitive behavioural therapy (CBT), coupled with other interventions, could be effective in ameliorating anti-social behaviours and/or other emotional and behavioral difficulties of students with ADHD. The findings of a range of randomised control studies indicate that CBT might have positive outcomes in adolescents with multiple behavioural problems, hence it is suggested to be considered both in schools and other community settings. Finally, taking into account the heterogeneous nature of ADHD, the different biopsychosocial and environmental risk factors that take place during adolescence and the discourse and practices concerning ADHD and SEBD, it is suggested how it might be possible to make sense of and meaningful improvements to the education of adolescents with ADHD within a multi-modal and multi-disciplinary whole-school approach that addresses the multiple problems that not only students with ADHD but also their peers might experience. Further research that would be based on more large-scale controls and would investigate the effectiveness of various interventions, as well as the profiles of those students who have benefited from particular approaches and those who have not, will generate further evidence concerning the psychoeducation of adolescents with ADHD allowing for generalised conclusions to be drawn.Keywords: adolescence, attention deficit hyperctivity disorder, cognitive behavioural theory, comorbid social emotional behavioural disorders, treatment
Procedia PDF Downloads 317463 Developing Geriatric Oral Health Network is a Public Health Necessity for Older Adults
Authors: Maryam Tabrizi, Shahrzad Aarup
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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.Keywords: geriatric, oral health, project echo, chronic disease, oral health
Procedia PDF Downloads 173