Search results for: healthcare policy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5314

Search results for: healthcare policy

4684 Risk Management in Healthcare Sector in Turkey: A Dental Hospital Case Study

Authors: Pırıl Tekin, Rızvan Erol

Abstract:

Risk management has become very important and popular in developing countries in recent years. Especially making patient and employee health and safety issues compulsory in the hospitals, raised the number of studies in Turkey. Also risk management become more important for hospital senior management from clinics to the laboratories. Because quality is really important to be chosen for both patients to consult and employees to prefer to work. And also risk management studies can lead to hospital management team about future works and methods. By this point of view, this study is the risk assessment carried out in the biggest dental hospital in the south part of Turkey. This study was conducted as a research case study, covering two different health care place; A Clinic and A Laboratory. It shows that the problems in this dental hospital and how it can solve all.

Keywords: risk management, healthcare, dental hospital, quality management

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4683 Intrinsic Contradictions in Entrepreneurship Development and Self-Development

Authors: Revaz Gvelesiani

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The problem of compliance between the state economic policy and entrepreneurial policy of businesses is primarily manifested in the contradictions related to the congruence between entrepreneurship development and self-development strategies. Among various types (financial, monetary, social, etc.) of the state economic policy aiming at the development of entrepreneurship, economic order policy is of special importance. Its goal is to set the framework for both public and private economic activities and achieve coherence between the societal value system and the formation of the economic order framework. Economic order policy, in its turn, involves intrinsic contradiction between the social and the competitive order. Competitive order is oriented on the principle of success, while social order _ on the criteria of need satisfaction, which contradicts, at least partly, to the principles of success. Thus within the economic order policy, on the one hand, the state makes efforts to form social order and expand its frontiers, while, on the other hand, market is determined to establish functioning competitive order and ensure its realization. Locating the adequate spaces for and setting the rational border between the state (social order) and the private (competitive order) activities, represents the phenomenon of the decisive importance from the entrepreneurship development strategy standpoint. In the countries where the above mentioned spaces and borders are “set” correctly, entrepreneurship agents (small, medium-sized and large businesses) achieve great success by means of seizing the respective segments and maintaining the leading positions in the internal, the European and the world markets for a long time. As for the entrepreneurship self-development strategy, above all, it involves: •market identification; •interactions with consumers; •continuous innovations; •competition strategy; •relationships with partners; •new management philosophy, etc. The analysis of compliance between the entrepreneurship strategy and entrepreneurship culture should be the reference point for any kind of internationalization in order to avoid shocks of cultural nature and the economic backwardness. Stabilization can be achieved only when the employee actions reflect the existing culture and the new contents of culture (targeted culture) is turned into the implicit consciousness of the personnel. The future leaders should learn how to manage different cultures. Entrepreneurship can be managed successfully if its strategy and culture are coherent. However, not rarely enterprises (organizations) show various forms of violation of both personal and team actions. If personal and team non-observances appear as the form of influence upon the culture, it will lead to global destruction of the system and structure. This is the entrepreneurship culture pathology that complicates to achieve compliance between the entrepreneurship strategy and entrepreneurship culture. Thus, the intrinsic contradictions of entrepreneurship development and self-development strategies complicate the task of reaching compliance between the state economic policy and the company entrepreneurship policy: on the one hand, there is a contradiction between the social and the competitive order within economic order policy and on the other hand, the contradiction exists between entrepreneurship strategy and entrepreneurship culture within entrepreneurship policy.

Keywords: economic order policy, entrepreneurship, development contradictions, self-development contradictions

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4682 Burnout among Healthcare Workers in Poland during the COVID-19 Pandemic

Authors: Zbigniew Izdebski, Alicja Kozakiewicz, Maciej Białorudzki, Joanna Mazur

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Work is an extremely important part of everyone's life and affects functioning in daily life. Healthcare workers (HCW) are suffering from negative actions in and out of the workplace, such as harassment, abuse, long working hours, mental suffering, exhaustion, and professional burnout. Staff burnout is detrimental not only in terms of individual employees but also to working with patients and to the healthcare institution as a whole. The purpose of this study was to explore the level of professional burnout among HCW working in medical institutions during the COVID-19 pandemic in Poland. The extent to which selected sociodemographic factors and perceived stress increase the risk of professional burnout was assessed. In addition, the frequency of use of professional psychological help and less formal support groups by HCW in relation to the level of professional burnout was presented. The survey was conducted as part of a larger project on the humanization of medicine and clinical communication from February-April 2022. This study used a self-administered online survey (CAWI) technique and PAPI (pen and paper interview) technique. The BAT-12 scale was used to measure burnout, the PSS-4 scale was used to measure stress, and questions formulated by the research team were also used. For the purpose of analysis, the sample was limited to 2196 HCWs who worked on a daily basis with patients during the COVID-19 pandemic. Frequency distributions were analyzed, and multivariate logistic regression was performed. The mean scores (scores) of job burnout as measured by the BAT-12 scale ranged among the professional groups from 2.15(0.69) to 2.30 (0.69) and remained highest for the nurses' group. The groups differed significantly in levels of burnout (chi-sq=17.719; d.f.=8; p<0.023). In the final model, raised stress most likely increased the risk of burnout (OR=3.88; 95%CI <3.13-3.81>; p<0,001). Other significant predictors of burnout included: traumatic work-related experience (OR=1.91, p<0.001), mobbing (OR=1.83, p<0.001), and a higher workload than before the pandemic (OR=1.41, p=0.002). Only 7% of respondents decided to use various forms of psychological support during the pandemic. HCW experiences challenges in dealing with an unpredictable pandemic. Limited preparedness can lead to physical and psychological problems such as high-stress levels, anxiety, fear, helplessness, hopelessness, anger and stigma. The workload can lead to professional burnout, as well as threaten patient safety.

Keywords: burnout, work, healthcare, healthcare worker, stress

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4681 A Multidimensional Analysis of English as a Medium of Instruction in Algerian Higher Education: Policy, Practices and Attitudes

Authors: Imene Medfouni

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In the context of postcolonial Algeria, language policy, language planning as well as language attitudes have recently stirred up contested debates in higher education system. This linguistic and politically-oriented conflict have constantly created a complex environment for learning. In the light of this observation, English language situates itself at the core of this debate with respects to its international status and potential influences. This presentation is based on ongoing research that aims to gain a better understanding of the introduction of English as a medium of instruction (EMI) in a postcolonial context, marked by multilingualism and language conflict. This research offers interesting insights to critically explore EMI from different perspectives: policy, practices, and attitudes. By means of methodological triangulation, this research integrates a mixed approach, whereby the sources of data triangulation will be elicited from the following methods: classroom observations, document analysis, focus groups, questionnaires and interviews. Preliminary findings suggest that English language might not replace French status in Algerian universities because of the latter strong presence and diffusion within Algerian linguistic landscape.

Keywords: English as a lingua franca, English as a medium of instruction, language policy and planning, multilingualism, postcolonial contexts, World Englishes

Procedia PDF Downloads 258
4680 Analysis of Residents’ Travel Characteristics and Policy Improving Strategies

Authors: Zhenzhen Xu, Chunfu Shao, Shengyou Wang, Chunjiao Dong

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To improve the satisfaction of residents' travel, this paper analyzes the characteristics and influencing factors of urban residents' travel behavior. First, a Multinominal Logit Model (MNL) model is built to analyze the characteristics of residents' travel behavior, reveal the influence of individual attributes, family attributes and travel characteristics on the choice of travel mode, and identify the significant factors. Then put forward suggestions for policy improvement. Finally, Support Vector Machine (SVM) and Multi-Layer Perceptron (MLP) models are introduced to evaluate the policy effect. This paper selects Futian Street in Futian District, Shenzhen City for investigation and research. The results show that gender, age, education, income, number of cars owned, travel purpose, departure time, journey time, travel distance and times all have a significant influence on residents' choice of travel mode. Based on the above results, two policy improvement suggestions are put forward from reducing public transportation and non-motor vehicle travel time, and the policy effect is evaluated. Before the evaluation, the prediction effect of MNL, SVM and MLP models was evaluated. After parameter optimization, it was found that the prediction accuracy of the three models was 72.80%, 71.42%, and 76.42%, respectively. The MLP model with the highest prediction accuracy was selected to evaluate the effect of policy improvement. The results showed that after the implementation of the policy, the proportion of public transportation in plan 1 and plan 2 increased by 14.04% and 9.86%, respectively, while the proportion of private cars decreased by 3.47% and 2.54%, respectively. The proportion of car trips decreased obviously, while the proportion of public transport trips increased. It can be considered that the measures have a positive effect on promoting green trips and improving the satisfaction of urban residents, and can provide a reference for relevant departments to formulate transportation policies.

Keywords: neural network, travel characteristics analysis, transportation choice, travel sharing rate, traffic resource allocation

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4679 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning

Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu

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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.

Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.

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4678 Hospital Beds: Figuring and Forecasting Patient Population Arriving at Health Care Research Institute, Illustrating Roemer's Law

Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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4677 Border Trade Policy to Promote Thailand - Myanmar Mae Sai, Chiang Rai Province

Authors: Sakapas Saengchai, Pichamon Chansuchai

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Research Thai- Myanmar Border Trade Promotion Policy, Mae Sai District, Chiang Rai Province The objectives of this study were to study the policy of promoting Thai- Myanmar border trade in Mae Sai district, Chiang Rai province. And suitable models for the development of border trade in Mae Sai. Chiang Rai province This research uses qualitative methodology. The method of collecting data from research papers. Participatory Observation In-depth interviews in which the information is important, the governor of Chiang Rai. Chiang Rai Customs Service Executive Office of Mae Sai Immigration Bureau Maesai Chamber of Commerce and Private Entrepreneurs By specific sampling Data analysis uses content analysis. The study indicated that Border Trade Promotion Policy The direction taken by the government to focus on developing 1. Security is further reducing crime. Smuggling and human trafficking Including the preparation to protect people from terrorism and natural disasters. And cooperation with Burma on border security. 2. The development of wealth is the promotion of investment. The transport links, logistics value chain. Products and services across the Thai-Myanmar border. Improve the regulations and laws to promote fair trade. Convenient and fast 3. Sustainable development is the ability to generate income, quality of life of people in the Thai border to increase continuously. By using balanced natural resources, production and consumption are environmentally friendly. Which featured the participation of all sectors of the public and private sectors in the region to drive the development of the border with Thailand. Chiang Rai province To be more competitive .

Keywords: Border, Trade, Policy, Promote

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4676 Healthcare in COVID-19 and It’s Impact on Children with Cochlear Implants

Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

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4675 The Role of Trust in International Relations– Examining India’s Gujaral Doctrine and South Asian Politics

Authors: Bhavana Mahajan

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International Relations is a discipline of paradoxes. The State is the dominant political institution, yet little attention has been accorded to why individual countries behave the way they do with the theoretical analysis dismissing the State as a reactionary monolith – thus States either play to “quest for power” or to “systemic” forces. However, States do behave as and are influenced by agents when interacting with international structures as well as with other states. While questions on “competitive power politics” and “trust” have been examined and developed to a fair extent by International Relations theorists in the post 1990s period, their application to the domain of South Asian politics is limited and little research, if any, examines the conduct of foreign policy beyond rational choice. This paper is an initial attempt to marry these theoretical insights with the foreign policy exercised by India especially the case of the “Gujral Doctrine, as one of “non-reciprocal accommodation”. Ignoring the view that such a policy move can be viewed as political “feinting” or deception, it is noteworthy that India even made the first move in terms of defining its role as one who “trusts” rather than one who “seeks” to trust, given the country’s geo-strategic context and threat perceptions.

Keywords: India’s foreign policy, South Asia, social constructivism, English school, trusting relationships, Gujral Doctrine, rationality

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4674 Investigation of the Relationship between Government Expenditure and Country’s Economic Development in the Context of Sustainable Development

Authors: Lina Sinevičienė

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Arising problems of countries’ public finances, social and demographic changes motivate scientific and policy debates on public spending size, structure and efficiency in order to meet the changing needs of society and business. The concept of sustainable development poses new challenges for scientists and policy-makers in the field of public finance. This paper focuses on the investigation of the relationship between government expenditure and country’s economic development in the context of sustainable development. Empirical analysis focuses on the data of the European Union (except Croatia and Luxemburg) countries. The study covers 2003 – 2012 years, using annual cross-sectional data. Summarizing the research results, it can be stated that governments should pay more attention to the needs that ensure sustainable development in the long-run when formulating public expenditure policy, particularly in the field of environment protection.

Keywords: economic development, economic growth, government expenditure, sustainable development

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4673 Government Credit Card in State Financial Management: Public Sector Innovation in Indonesia

Authors: Paramita Nur Kurniati, Stanislaus Riyanta

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In the midst of the heightened usage of electronic money (e-money), Indonesian government expenditure is yet governed through cash-basis transactions. This conventional system brings about a number of potential risks and obstacles to operational conduct, including state financial liquidity issue. Consequently, Ministry of Finance is currently establishing the cashless payment methods for State Budget (APBN). Included in those advance methods is credit card facility as a government expenditure payment scheme. This policy is one of the innovations within the public sector learned from other countries’ best practices. Moreover, this particular method is already prominent within the private-sector realm. Qualitative descriptive analysis technique is implemented to evaluate the contemporary innovation of using government credit card in the path towards cashless society. This approach is expected to generate several benefits for the government, particularly in minimizing corruption within the state financial management. Effective coordination among policy makers and policy implementers is essential for the success of this policy’s exercise, without neglecting prudence and public transparency aspects. Government credit card usage shall be the potent resolution for enhancing the government’s overall public service performance.

Keywords: cashless basis, cashless society, government credit card, public sector innovation

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4672 Elevating Healthcare Social Work: Implementing and Evaluating the (Introduction, Subjective, Objective, Assessment, Plan, Summary) Documentation Model

Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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4671 Determinants of Healthcare Team Effectiveness in Subterranean Settings: A Mixed-Methods Study

Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

Abstract:

Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

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4670 Ranking of Inventory Policies Using Distance Based Approach Method

Authors: Gupta Amit, Kumar Ramesh, P. C. Tewari

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Globalization is putting enormous pressure on the business organizations specially manufacturing one to rethink the supply chain in innovative manners. Inventory consumes major portion of total sale revenue. Effective and efficient inventory management plays a vital role for the successful functioning of any organization. Selection of inventory policy is one of the important purchasing activities. This paper focuses on selection and ranking of alternative inventory policies. A deterministic quantitative model-based on Distance Based Approach (DBA) method has been developed for evaluation and ranking of inventory policies. We have employed this concept first time for this type of the selection problem. Four inventory policies Economic Order Quantity (EOQ), Just in Time (JIT), Vendor Managed Inventory (VMI) and monthly policy are considered. Improper selection could affect a company’s competitiveness in terms of the productivity of its facilities and quality of its products. The ranking of inventory policies is a multi-criteria problem. There is a need to first identify the selection criteria and then processes the information with reference to relative importance of attributes for comparison. Criteria values for each inventory policy can be obtained either analytically or by using a simulation technique or they are linguistic subjective judgments defined by fuzzy sets, like, for example, the values of criteria. A methodology is developed and applied to rank the inventory policies.

Keywords: inventory policy, ranking, DBA, selection criteria

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4669 English as a Foreign Language for Deaf Students in the K-12 Schools in Turkey: A Policy Analysis

Authors: Cigdem Fidan

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Deaf students in Turkey generally do not have access to foreign language classes. However, the knowledge of foreign languages, especially English, is important for them to access knowledge and other opportunities in the globalizing world. In addition, learning any language including foreign languages is a basic linguistic human right. This study applies critical discourse analysis to examine language ideologies, perceptions of deafness and current language and education policies used for deaf education in Turkey. The findings show that representation of deafness as a disability in policy documents, ignorance the role of sign languages in education and lack of policies that support foreign language education for the deaf may result in inaccessibility of foreign language education for deaf students in Turkey. The paper concludes with recommendations for policymakers, practitioners, and advocates for the deaf.

Keywords: deaf learners, English as a foreign language, language policy, linguistic human rights

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4668 An Investigation of the Relevant Factors of Unplanned Readmission within 14 Days of Discharge in a Regional Teaching Hospital in South Taiwan

Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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4667 Non-Physician Medical Worker Experience during the COVID-19 Pandemic

Authors: William Mahony, L. Jacqueline Hirth, Richard Rupp, Sandra Gonzalez, Roger Zoorob

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Background: The impact of the COVID-19 pandemic on physicians has been considered by many researchers, but less is known about non-physician healthcare workers. The aim of this study is to examine the association of COVID-19 safety training and communication with stress. Methods: A 91-item online survey was distributed, starting January 2, 2021, to non-physician healthcare workers, including physician assistants, nurse practitioners, and medical assistants (MAs) in the United States through email and social media. A $1 donation was made to the Red Cross for each completed survey. The survey consisted of demographics, occupational questions, and perceived stress (perceived stress scale, PSS). Items on the PSS were combined for an overall score and categorized according to the severity of perceived stress. Chi-square tests were performed for bivariate analyses of categorical variables. Results: Of the 284 participants consenting to complete the survey, 197 participants completed the full survey. MAs made up most of the sample at 79%. Among all respondents, 47% had moderate PSS scores (scored between 14 and 26), and 51% had severe PSS scores (scored between 27 and 40). Unvaccinated participants reported statistically significantly lower levels of perceived stress (p = 0.002). Performing tasks outside of typical job responsibilities was not associated with PSS scores (p = .667). Discussion: Non-physician healthcare workers demonstrated a high level of perceived stress overall. The association between vaccination status and perceived stress should be examined in order to evaluate whether vaccination levels could be improved with further education about the virus and associated risks.

Keywords: COVID-19, SARS-Cov-2, nursing, public health

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4666 The Efficacy of Government Strategies to Control COVID 19: Evidence from 22 High Covid Fatality Rated Countries

Authors: Imalka Wasana Rathnayaka, Rasheda Khanam, Mohammad Mafizur Rahman

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TheCOVID-19 pandemic has created unprecedented challenges to both the health and economic states in countries around the world. This study aims to evaluate the effectiveness of governments' decisions to mitigate the risks of COVID-19 through proposing policy directions to reduce its magnitude. The study is motivated by the ongoing coronavirus outbreaks and comprehensive policy responses taken by countries to mitigate the spread of COVID-19 and reduce death rates. This study contributes to filling the knowledge by exploiting the long-term efficacy of extensive plans of governments. This study employs a Panel autoregressive distributed lag (ARDL) framework. The panels incorporate both a significant number of variables and fortnightly observations from22 countries. The dependent variables adopted in this study are the fortnightly death rates and the rates of the spread of COVID-19. Mortality rate and the rate of infection data were computed based on the number of deaths and the number of new cases per 10000 people.The explanatory variables are fortnightly values of indexes taken to investigate the efficacy of government interventions to control COVID-19. Overall government response index, Stringency index, Containment and health index, and Economic support index were selected as explanatory variables. The study relies on the Oxford COVID-19 Government Measure Tracker (OxCGRT). According to the procedures of ARDL, the study employs (i) the unit root test to check stationarity, (ii) panel cointegration, and (iii) PMG and ARDL estimation techniques. The study shows that the COVID-19 pandemic forced immediate responses from policymakers across the world to mitigate the risks of COVID-19. Of the four types of government policy interventions: (i) Stringency and (ii) Economic Support have been most effective and reveal that facilitating Stringency and financial measures has resulted in a reduction in infection and fatality rates, while (iii) Government responses are positively associated with deaths but negatively with infected cases. Even though this positive relationship is unexpected to some extent in the long run, social distancing norms of the governments have been broken by the public in some countries, and population age demographics would be a possible reason for that result. (iv) Containment and healthcare improvements reduce death rates but increase the infection rates, although the effect has been lower (in absolute value). The model implies that implementation of containment health practices without association with tracing and individual-level quarantine does not work well. The policy implication based on containment health measures must be applied together with targeted, aggressive, and rapid containment to extensively reduce the number of people infected with COVID 19. Furthermore, the results demonstrate that economic support for income and debt relief has been the key to suppressing the rate of COVID-19 infections and fatality rates.

Keywords: COVID-19, infection rate, deaths rate, government response, panel data

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4665 Improving Health Workers’ Well-Being in Cittadella Hospital (Province of Padua), Italy

Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

Abstract:

A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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4664 Community Engagement Policy for Decreasing Childhood Lead Poisoning in Philadelphia

Authors: Hasibe Caballero-Gomez, Richard Pepino

Abstract:

Childhood lead poisoning is an issue that continues to plague major U.S. cities. Lead poisoning has been linked to decreases in academic achievement and IQ at levels as low as 5 ug/dL. Despite efforts from the Philadelphia Health Department to curtail systemic childhood lead poisoning, children continue to be identified with elevated blood lead levels (EBLLs) above the CDC reference level for diagnosis. This problem disproportionately affects low-income Black communities. At the moment, remediation is costly, and with the current policies in place, comprehensive remediation seems unrealistic. This research investigates community engagement policy and the ways pre-exisiting resources in target communities can be adjusted to decrease childhood lead poisoning. The study was done with two methods: content analysis and case studies. The content analysis includes 12 interviews from stakeholders and five published policy recommendations. The case studies focus on Baltimore, Chicago, Rochester, and St. Louis, four cities with significant childhood lead poisoning. Target communities were identified by mapping five factors that indicate a higher risk for lead poisoning. Seven priority zipcodes were identified for the model developed in this study. For these urban centers, 28 policy solutions and suggestions were identified, with three being identified at least four times in the content analysis and case studies. These three solutions create an interdependent model that offers increased community awareness and engagement with the issue that could potentially improve health and social outcomes for at-risk children.

Keywords: at-risk populations, community engagement, environmental justice, policy translation

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4663 Exploring Factors Related to Unplanning Readmission of Elderly Patients in Taiwan

Authors: Hui-Yen Lee, Hsiu-Yun Wei, Guey-Jen Lin, Pi-Yueh Lee Lee

Abstract:

Background: Unplanned hospital readmissions increase healthcare costs and have been considered a marker of poor healthcare performance. The elderly face a higher risk of unplanned readmission due to elderly-specific characteristics such as deteriorating body functions and the relatively high incidence of complications after treatment of acute diseases. Purpose: The aim of this study was exploring the factors that relate to the unplanned readmission of elderly within 14 days of discharge at our hospital in southern Taiwan. Methods: We retrospectively reviewed the medical records of patients aged ≥65 years who had been re-admitted between January 2018 and December 2018.The Charlson Comorbidity score was calculated using previous used method. Related factors that affected the rate of unplanned readmission within 14 days of discharge were screened and analyzed using the chi-squared test and logistic regression analysis. Results: This study enrolled 829 subjects aged more than 65 years. The numbers of unplanned readmission patients within 14 days were 318 cases, while those did not belong to the unplanned readmission were 511 cases. In 2018, the rate of elderly patients in unplanned 14 days readmissions was 38.4%. The majority patients were females (166 cases, 52.2%), with an average age of 77.6 ± 7.90 years (65-98). The average value of Charlson Comorbidity score was 4.42±2.76. Using logistic regression analysis, we found that the gastric or peptic ulcer (OR=1.917 , P< 0.002), diabetes (OR= 0.722, P< 0.043), hemiplegia (OR= 2.292, P< 0.015), metastatic solid tumor (OR= 2.204, P< 0.025), hypertension (OR= 0.696, P< 0.044), and skin ulcer/cellulitis (OR= 2.747, P< 0.022) have significantly higher risk of 14-day readmissions. Conclusion: The results of the present study may assist the healthcare teams to understand the factors that may affect unplanned readmission in the elderly. We recommend that these teams give efficient approach in their medical practice, provide timely health education for elderly, and integrative healthcare for chronic diseases in order to reduce unplanned readmissions.

Keywords: unplanning readmission, elderly, Charlson comorbidity score, logistic regression analysis

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4662 Implementation and Use of Person-Centered Care in Europe: A Literature Review

Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom

Abstract:

Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.

Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care

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4661 The Application of Internet of Things in Healthcare: Building an Interconnected Health Environment

Authors: Quinn Au, Amedeo Carmine, Tauheed Khan Mohd

Abstract:

The Internet of Things (IoT) is emerging as a new development in information technology in recent years, with the potential to improve convenience and efficiency in life. Following the rise of IoT, the Social Internet of Things (SIoT) is another new development in which the benefits of connectivity and user-friendliness from social network services (SNS) are its main features. With the introduction of IoT, the world will be much more modernized, convenient, and industrialized. This paper will discuss the applications of IoT in different sectors such as healthcare services, education, and lifestyle. The privacy challenges that IoT still poses to user data will also be discussed. Finally, an empirical study to evaluate the number of active installed IoT connections in recent years demonstrates the increase in usage of IoT regardless of the privacy challenges. The study also examines some types of IoT devices that are being preferred in the market and predictions from researchers about IoT in the upcoming years.

Keywords: IoT, health care, robotics, social Internet of Things

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4660 When the Rubber Hits the Road: The Enactment of Well-Intentioned Language Policy in Digital vs. In Situ Spaces on Washington, DC Public Transportation

Authors: Austin Vander Wel, Katherin Vargas Henao

Abstract:

Washington, DC, is a city in which Spanish, along with several other minority languages, is prevalent not only among tourists but also those living within city limits. In response to this linguistic diversity and DC’s adoption of the Language Access Act in 2004, the Washington Metropolitan Area Transit Authority (WMATA) committed to addressing the need for equal linguistic representation and established a five-step plan to provide the best multilingual information possible for public transportation users. The current study, however, strongly suggests that this de jure policy does not align with the reality of Spanish’s representation on DC public transportation–although perhaps doing so in an unexpected way. In order to investigate Spanish’s de facto representation and how it contrasts with de jure policy, this study implements a linguistic landscapes methodology that takes critical language-policy as its theoretical framework (Tollefson, 2005). Specifically concerning de facto representation, it focuses on the discrepancies between digital spaces and the actual physical spaces through which users travel. These digital vs. in situ conditions are further analyzed by separately addressing aural and visual modalities. In digital spaces, data was collected from WMATA’s website (visual) and their bilingual hotline (aural). For in situ spaces, both bus and metro areas of DC public transportation were explored, with signs comprising the visual modality and recordings, driver announcements, and interactions with metro kiosk workers comprising the aural modality. While digital spaces were considered to successfully fulfill WMATA’s commitment to representing Spanish as outlined in the de jure policy, physical spaces show a large discrepancy between what is said and what is done, particularly regarding the bus system, in addition to the aural modality overall. These discrepancies in situ spaces place Spanish speakers at a clear disadvantage, demanding additional resources and knowledge on the part of residents with limited or no English proficiency in order to have equal access to this public good. Based on our critical language-policy analysis, while Spanish is represented as a right in the de jure policy, its implementation in situ clearly portrays Spanish as a problem since those seeking bilingual information can not expect it to be present when and where they need it most (Ruíz, 1984; Tollefson, 2005). This study concludes with practical, data-based steps to improve the current situation facing DC’s public transportation context and serves as a model for responding to inadequate enactment of de jure policy in other language policy settings.

Keywords: Urban landscape, language access, critical-language policy, spanish, public transportation

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4659 Umkhonto Wesizwe as the Foundation of Post-Apartheid South Africa’s Foreign Policy and International Relations.

Authors: Bheki R. Mngomezulu

Abstract:

The present paper cogently and systematically traces the history of Umkhonto Wesizwe (MK) and identifies its important role in shaping South Africa’s post-apartheid foreign policy and international relations under black leadership. It provides the political and historical contexts within which we can interpret and better understand South Africa’s controversial ‘Quiet Diplomacy’ approach to Zimbabwe’s endemic political and economic crises, which have dragged for too long. On 16 December 1961, the African National Congress (ANC) officially launched the MK as its military wing. The main aim was to train liberation fighters outside South Africa who would return into the country to topple the apartheid regime. Subsequently, the ANC established links with various countries across Africa and the globe in order to solicit arms, financial resources and military training for its recruits into the MK. Drawing from archival research and empirical data obtained through oral interviews that were conducted with some of the former MK cadres, this paper demonstrates how the ANC forged relations with a number of countries that were like-minded in order to ensure that its dream of removing the apartheid government became a reality. The findings reveal that South Africa’s foreign policy posture and international relations after the demise of apartheid in 1994 built on these relations. As such, even former and current socialist countries that were frowned upon by the Western world became post-apartheid South Africa’s international partners. These include countries such as Cuba and China, among others. Even countries that were not recognized by the Western world as independent states received good reception in post-apartheid South Africa’s foreign policy agenda. One of these countries is Palestine. Within Africa, countries with questionable human rights records such as Nigeria and Zimbabwe were accommodated in South Africa’s foreign policy agenda after 1994. Drawing from this history, the paper concludes that it would be difficult to fully understand and appreciate South Africa’s foreign policy direction and international relations after 1994 without bringing the history and the politics of the MK into the equation. Therefore, the paper proposes that the utilitarian role of history should never be undermined in the analysis of a country’s foreign policy direction and international relations. Umkhonto Wesizwe and South Africa are used as examples to demonstrate how such a link could be drawn through archival and empirical evidence.

Keywords: African National Congress, apartheid, foreign policy, international relations

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4658 Global Analysis of Modern Economic Sanctions

Authors: I. L. Yakushev

Abstract:

Economic sanctions are an integral part of the foreign policy repertoire of States. Increasingly, States and international organizations are resorting to sanctions to address a variety of issues -from fighting corruption to preventing the use of nuclear weapons. Over time, the ways in which economic sanctions have been used have changed, especially over the past two decades. In the late 1990s, the recognition of the humanitarian harm of economic sanctions and the "War on Terrorism" after the events of September 11, 2001, led to serious changes in the structure and mechanisms of their application. Questions about how these coercive tools work, when they are applied, what consequences they have, and when they are successful are still being determined by research conducted in the second half of the 20th century. The conclusions drawn from past cases of sanctions may not be fully applicable to the current sanctions policy. In the second half of the 20th century, most cases of sanctions were related to the United States, and it covered restrictions on international trade. However, over the past two decades, the European Union, the United Nations, and China have also been the main initiators of sanctions. Modern sanctions include targeted and financial restrictions and are applied against individuals, organizations, and companies. Changing the senders, targets, stakeholders, and economic instruments used in the sanctions policy has serious implications for effectiveness and results. The regulatory and bureaucratic infrastructure necessary to implement and comply with modern economic sanctions has become more reliable. This evolution of sanctions has provided the scientific community with an opportunity to study new issues of coercion and return to the old ones. The economic sanctions research program should be developed to be relevant for understanding the application of modern sanctions and their consequences.

Keywords: global analysis, economic sanctions, targeted sanctions, foreign policy, domestic policy, United Nations, European Union, USA, economic pressure

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4657 Effect of Non-Tariff Measures to Indonesian Shrimp Export in International Market: Case of Sanitary and Phytosanitary and Technical Barriers to Trade

Authors: Muhammad Khaliqi, Amzul Rifin, Andriyono Kilat Adhi

Abstract:

The non-tariff policy could make Indonesian shrimp exports decrease in the international market. This research was aimed to analyze factors affecting Indonesia's exports of shrimp and the impact of SPS and TBT policy on Indonesian shrimp. Factors affecting the exports of Indonesian shrimp were estimated using gravity model. The results showed the GDP of exporters and exchange rate, have a negative influence against the export of Indonesia’s shrimp exports. The GDP of the importers and trade cost have a positive influence against the export of shrimp Indonesia while the SPS policy and TBT don’t affect Indonesia's exports of shrimp in the international market.

Keywords: gravity model, international trade, non-tariff measure, sanitary and phytosanitary, shrimp, technical barriers to trade

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4656 The Gap between Curriculum, Pedagogy, and National Standards of Vietnamese English Language Teacher Education

Authors: Thi Phuong Lan Nguyen

Abstract:

Vietnamese English Language Teacher Education (ELTE) has been changing a lot in response to the rapidly evolving socio-economic context requirements. The Vietnamese government assigns the Ministry of Education and Training (MOET) primary tasks to have policy changes to prepare for ELTE development in the globalization and socialization process. Many educational policies have been made to develop ELTE, however, they seem not to address the new global or social demands. The issue is that there are still significant disparities between the national policy and the institutional implementation. This study is to investigate the alignment between ELTE institutional curriculum, pedagogies, and MOET standards. This study used a mixed-method with the data sources from policy documents, a survey, and 33 interviews conducted with the lecturers and administrators from eleven Vietnamese ELTE institutions. The data have been analysed to understand the gap between policy and practice. The initial findings are (i) a low alignment of curriculum and language proficiency standards and (ii) a moderate alignment between curriculum and future-career skills standards. Many pedagogical challenges have been found. In order to address these gaps, it is necessary for the curriculum to be standards-based designed. It is also vital for professional development in order to improve the quality teaching. The study offers multiple perspectives on a complex issue. The study is meaningful not only to educational governance, but also to teaching practitioners, English language researchers, and English language learners. The significance lies in its relevance to English teaching careers across all parts of Vietnam, it yet remains relevant to ELTE in other countries teaching English as a foreign language.

Keywords: alignment, curriculum, educational policy, English language teaching, pedagogy, standards

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4655 Project Financing and Poverty Trends in the Islamic Development Bank Member Countries

Authors: Sennanda Musa, Ahmed Mutunzi Kitunzi, Gerald Kasigwa, Ismail Kintu

Abstract:

This paper is an analysis of the empirical relationship between project financing by Islamic Development Bank (IsDB) and the poverty trends in the context of countries benefiting from IsDB. Specifically, the study seeks to find out whether there is a statistically significant relationship between the project financing dollar amounts by IsDB (PF) and the GNI Per Capita, PPP of 57 countries for the years 2002 to 2021. The research is a longitudinal, desk-top triangulation of correlation, regression, hypothesis-testing employing the linear dynamic panel data GMM model as an estimator of the empirical relationships between the key variables of the study. The study results show that there is a significant positive relationship between the PF dollar amounts from the IsDB and the GNI Per Capita, PPP in these 57 countries. Therefore, countries that receive higher PF dollar amounts from the IsDB, generally have more GNI Per Capita, PPP (less poverty) than their counterparts. It is, therefore, recommendable for countries to formulate policies that facilitate Islamically financed projects to mitigate poverty. This paper develops policy discussions regarding allocation of political attention to the policy topics on poverty mitigation, and their relation to financing projects Islamically, thus generate information on policy choices regarding the Islamic financing alternative.

Keywords: gross-national-income, IsDB-project-financing, public policy, poverty

Procedia PDF Downloads 89