Search results for: quality care
5950 The Path to Customer Satisfaction and Loyalty Improvement
Authors: Mehrnoosh Askarizadeh
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The foundation of all marketing is composed by relations. Thus, all marketing activities concentrated to establish, develop and maintain successful relational exchanges. By building strong relational bonds, relationship marketing improves customer loyalty resulting in improved firm performance. Relationship marketing is a strategically important tool to use to obtain and secure the result of customer’s loyalty, which leads to higher competitiveness and also enhanced satisfaction among the customers. The study revealed that there subsist significant relationships between customer satisfaction and loyalty. It is recognized that with improvement of customer satisfaction a firm will find customers that are more loyal. Based it, firm managers are advised to satisfy and better manage their relationships through quality product and service offerings to their customers as a competitive policy in the marketplace. These offerings are required to meet or surpass consumers’ expectations.Keywords: customer loyalty, customer satisfaction, trend, relationship marketing
Procedia PDF Downloads 4815949 Endometriosis-Associated Ovarian Cancer: Clinical and Pathological Pattern
Authors: I. Ramalho, S. Campos, M. Dias
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Introduction: Endometriosis may play a role in the pathogenesis of ovarian cancer (OC), however, the risk and prognosis have not been well established. The association between these two pathologies could have an important impact on prevention and early diagnosis of OC. Objective: To analyze the prevalence of endometriosis associated ovarian cancer and related clinical, epidemiological and histopathological issues. Design: We conducted a retrospective case series analysis of patients diagnosed with endometriosis and ovarian cancer in the Gynecology Department of Coimbra University Hospital Center since 2006 to 2015. Methods: We collected data from women diagnosed with ovarian cancer, with anatomopathology records reporting findings of endometriosis in ovarian cancer patients. Patients were retrieved from the pathological records and appropriate medical records were retrospectively reviewed. Statistical analysis was performed using SPSS 22.0. Results: Histological evidence of endometriosis was found in 17 out of 261 patients diagnosed with ovarian cancer (OC) (6.51%). The most usual symptoms were pelvic pain, abdominal distension, asthenia, ascites, weight loss and nausea. Mean age at diagnosis was 61.2 ± 15.1, 41-86 years old, 33.3% were pre-menopausal patients and cancer stage distribution was predominantly stage I (31.3%) and stage III (56.3%). OC occurred unilaterally in 14 patients and 2 patients were diagnosed with a synchronous ovarian and endometrial cancer. Regarding histological type, 10 OC were classified as clear cell carcinoma (CCC), 4 endometrioid carcinomas (EC) and 3 mixed type (clear cell and endometrioid). Four ovarian carcinomas presumably arose from endometriomas: 3 CCC and 1 EC. Conclusions: In accordance with previous studies, clear cell was the most common pathological type in endometriotic patients, followed by endometrioid carcinomas, and two rare synchronous ovarian and endometrial carcinomas were registered. Although endometriosis association to OC is uncommon, endometriosis should be managed with special care in order to early diagnosis.Keywords: endometriosis, histology, observational study, ovarian cancer
Procedia PDF Downloads 2325948 Uptake and Determinants of Rabies Pre-exposure Prophylaxis among At-Risk Travelers
Authors: Florian Lienert, Peter Costa, Caroline Aurensan, Elaine Melander
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Introduction: Rabies pre-exposure prophylaxis (PrEP) can be given before travel and simplifies post-exposure prophylaxis (PEP). We studied the knowledge about rabies, the uptake of PrEP, and reasons for deciding for or against PrEP in at-risk travelers. We also examined how healthcare professionals (HCPs) counsel on rabies prevention. Methods: On behalf of Bavarian Nordic, Ipsos MORI conducted two online surveys in the USA. Fieldwork from February 24th to April 23rd, 2021, 689 participants aged 18-85 years, visited one of 91 endemic rabies countries in the past 3 years for at least one week, involved in at least 1 of 7 at-risk activities, heard of rabies, positive towards vaccination and chose to take part (surveyed travelers). Secondly, 76 HCPs, with responsibility for advising/ making decisions about vaccination requirements for their patients, personally recommend or prescribe vaccines for rabies, positive towards vaccination and chose to take part (surveyed HCPs). Results: A minority (36%) of surveyed travelers classified rabies as a life-threatening disease. A third of surveyed HCPs (37%) did not discuss rabies vaccination with at-risk travelers, 18% discussed only PEP, 23% only PrEP and 22% both. A minority (21%) of surveyed travelers reported having received rabies vaccination since they were 18. Among those participants (n=145), the most common reasons for deciding to get PrEP were for their own peace of mind (35%) and following an HCP recommendation (32%). Of those who decided not to receive the rabies vaccine (n=319), the most common reasons were that they did not think their risk of rabies was sufficient (23%) and that the HCP did not suggest it (23%). Conclusions: The survey demonstrated knowledge gaps around rabies and low PrEP coverage among surveyed travelers. It also highlighted the role of HCP recommendations and showed that most HCPs did not discuss PrEP with at-risk travelers.Keywords: rabies, pre-exposure prophylaxis, travel, travel health, post-travel care, rabies treatment, vaccine, post-exposure, prophylaxis, at-risk, education, PrEP, PEP
Procedia PDF Downloads 1855947 Population Change and Migration in Istanbul Metropolitan Area: Tarlabaşı Case
Authors: Gulsen Yilmaz
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Istanbul’s population has jumped by over 1 million in the past four years, to a level surpassing the overall population of 64 provinces in the country, according to data from the Turkish Statistical Institute (TÜİK). In this paper, Istanbul's population change and migration effects can be examined in detail Tarlabasi neighborhood cultural center of the city of Istanbul, Istiklal Street, which is located a few hundred meters away. Tarlabasi the end of the nineteenth century in the historic district with built in the early twentieth century, there are four or five storey historic buildings. Tarlabasi, here come from southeastern Turkey and the illegal African immigrants living in Roma origin by the Kurds as a residential area is used. In this area to improve the quality of life for urban renewal projects have been initiated. The aim of this paper is to explore the spatial effects of demographic change and migration with Tarlabasi example.Keywords: migration, immigration, Tarlabaşı, urban transformation
Procedia PDF Downloads 5155946 Making Permanent Supportive Housing Work for Vulnerable Populations
Authors: Olayinka Ariba, Abe Oudshoorn, Steve Rolfe, Carrie Anne Marshall, Deanna Befus, Jason Gilliland, Miranda Crockett, Susana Caxaj, Sarah McLean, Amy Van Berkum, Natasha Thuemler
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Background: Secure housing is a platform for health and well-being. Those who struggle with housing stability have complex life and health histories and often require some support services such as the provision of permanent supportive housing. Poor access to supportive resources creates an exacerbation of chronic homelessness, particularly affecting individuals who need immediate access to mental health and addiction supports. This paper presents the first phase of a three-part study examining how on-site support impacts housing stability for recently-re-housed persons. Method: This study utilized a community-based participatory research methodology. Twenty in-depth interviews were conducted with permanent supportive housing residents from a single-site dwelling. Interpretative description analysis was used to draw common themes and understand the experiences and challenges of housing support. Results: Three interconnected themes were identified: 1) Available and timely supports; 2) Affordability; and 3) Community, but with independence as desired. These interconnected components are helping residents transition from homelessness or long-term mental health inpatient care to live in the community. Despite some participant concerns about resident conflicts, staff availability, and affordability, this has been a welcome and successful move for most. Conclusion: Supportive housing is essential for successful tenancies as a platform for health and well-being among Canada’s most vulnerable and, from the perspective of persons recently re-housed, permanent supportive housing is a worthwhile investment.Keywords: homelessness, supportive housing, rehoused, housing stability
Procedia PDF Downloads 1115945 Explaining the Role of Iran Health System in Polypharmacy among the Elderly
Authors: Mohsen Shati, Seyede Salehe Mortazavi, Seyed Kazem Malakouti, Hamidreza Khanke Fazlollah Ahmadi
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Taking unnecessary or excessive medication or using drugs with no indication (polypharmacy) by people of all ages, especially the elderly, is associated with increased adverse drug reactions (ADR), medical errors, hospitalization and escalating the costs. It may be facilitated or impeded by the healthcare system. In this study, we are going to describe the role of the health system in the practice of polypharmacy in Iranian elderly. In this Inductive qualitative content analysis using Graneheim and Lundman methods, purposeful sample selection until saturation has been made. Participants have been selected from doctors, pharmacists, policy-makers and the elderly. A total of 25 persons (9 men and 16 women) have participated in this study. Data analysis after incorporating codes with similar characteristics revealed 14 subcategories and six main categories of the referral system, physicians’ accessibility, health data management, drug market, laws enforcement, and social protection. Some of the conditions of the healthcare system have given rise to polypharmacy in the elderly. In the absence of a comprehensive specialty and subspecialty referral system, patients may go to any physician office so may well be confused about numerous doctors' prescriptions. Electronic records not being prepared for the patients, failure to comply with laws, lack of robust enforcement for the existing laws and close surveillance are among the contributing factors. Inadequate insurance and supportive services are also evident. Age-specific care providing has not yet been institutionalized, while, inadequate specialist workforce playing a major role. So, one may not ignore the health system as contributing factor in designing effective interventions to fix the problem.Keywords: elderly, polypharmacy, health system, qualitative study
Procedia PDF Downloads 1535944 Physiotherapy Assessment of People with Neurological Conditions in Australia: A National Survey of Clinical Practice
Authors: Jill Garner, Belinda Lange, Sheila Lennon, Maayken van den Berg
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Currently, there are approximately one billion people worldwide affected by a neurological condition. Many of whom are assessed and treated by a physiotherapist in a variety of settings. There is a lack of consensus in the literature related to what is clinically assessed by physiotherapists in people with neurological conditions. This study aimed to explore assessment in people with neurological conditions, including how health care setting, experience, and therapeutic approach, may influence neurological assessment. A national survey targeted Australian physiotherapists who assess adults with neurological conditions as part of their clinical practice. The survey consisted of 39 questions and was distributed to physiotherapists through the Australian Physiotherapy Association, and Chief Allied Health Officers across Australia and advertised on the National Neurological Physiotherapy Facebook page. In total, 395 respondents consented to the survey from all states within Australia. Most respondents were female (85.4%) with a mean (SD) age of 35.7 years. Respondents reported working clinically in acute, community, outpatients, and community settings. Stroke was the most assessed condition (58.0%). There is variability in domains assessed by Australian physiotherapists, with common inclusions of balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, coordination, activity tolerance, postural alignment and symmetry and upper limb. There is little evidence to support what physiotherapists assess in practice, in different settings, and in different states within Australia and not enough information to develop a decision tree regarding what is important for assessment in different settings. Further research is needed to explore this area and develop a consensus around best practices.Keywords: physiotherapy, neurological, assessment, domains
Procedia PDF Downloads 975943 Impact of Collieries on Groundwater in Damodar River Basin
Authors: Rajkumar Ghosh
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The industrialization of coal mining and related activities has a significant impact on groundwater in the surrounding areas of the Damodar River. The Damodar River basin, located in eastern India, is known as the "Ruhr of India" due to its abundant coal reserves and extensive coal mining and industrial operations. One of the major consequences of collieries on groundwater is the contamination of water sources. Coal mining activities often involve the excavation and extraction of coal through underground or open-pit mining methods. These processes can release various pollutants and chemicals into the groundwater, including heavy metals, acid mine drainage, and other toxic substances. As a result, the quality of groundwater in the Damodar River region has deteriorated, making it unsuitable for drinking, irrigation, and other purposes. The high concentration of heavy metals, such as arsenic, lead, and mercury, in the groundwater has posed severe health risks to the local population. Prolonged exposure to contaminated water can lead to various health problems, including skin diseases, respiratory issues, and even long-term ailments like cancer. The contamination has also affected the aquatic ecosystem, harming fish populations and other organisms dependent on the river's water. Moreover, the excessive extraction of groundwater for industrial processes, including coal washing and cooling systems, has resulted in a decline in the water table and depletion of aquifers. This has led to water scarcity and reduced availability of water for agricultural activities, impacting the livelihoods of farmers in the region. Efforts have been made to mitigate these issues through the implementation of regulations and improved industrial practices. However, the historical legacy of coal industrialization continues to impact the groundwater in the Damodar River area. Remediation measures, such as the installation of water treatment plants and the promotion of sustainable mining practices, are essential to restore the quality of groundwater and ensure the well-being of the affected communities. In conclusion, the coal industrialization in the Damodar River surrounding has had a detrimental impact on groundwater. This research focuses on soil subsidence induced by the over-exploitation of ground water for dewatering open pit coal mines. Soil degradation happens in arid and semi-arid regions as a result of land subsidence in coal mining region, which reduces soil fertility. Depletion of aquifers, contamination, and water scarcity are some of the key challenges resulting from these activities. It is crucial to prioritize sustainable mining practices, environmental conservation, and the provision of clean drinking water to mitigate the long-lasting effects of collieries on the groundwater resources in the region.Keywords: coal mining, groundwater, soil subsidence, water table, damodar river
Procedia PDF Downloads 855942 Trace Metals in Natural Bottled Water on Montenegrin Market and Comaparison with Tap Water in Podgorica
Authors: Katarina Živković, Ivana Joksimović
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Many different chemicals may occur in drinking water and cause significant human health risks after prolonged periods of exposure. In particular concern are contaminants that have cumulative toxic properties, such as heavy metals. This investigation was done to clarify concerns about chemical quality and safety of drinking tap water in Podgorica. For comparison, all available natural bottled water on Montenegrin market were bought. All samples (bottled water and tap water from Podgorica) were analyzed using ICP –OES on contents of Al, Cd, Pb, Cu, Zn,Cr, Fe, As and Mn. All results compared with the maximum concentration levels allowed by international standards and World Health Organization (WHO) guidelines. The results of analysis showed that all trace of heavy metals were very low and in same time below MCL according to WHO and International standard.Keywords: inductively coupled plasma - optical emission spectrometry (ICP-OES), Montenegro (Podgorica), natural bottled water, tap water , trace of heavy metal
Procedia PDF Downloads 4585941 A Cross-Sectional Evaluation of the Lack of Racial, Sexual, and Gender Diversity among Top Dermatologist Influencers on TikTok
Authors: Madison Meyer
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Dermatological conditions are one of the most viewed medical subjects on the social media platform TikTok, resulting in the rise of several prominent American board-certified dermatologists as influencers. Notably, dermatology is one of the least diverse specialties. This cross-sectional study aimed to assess individuals’ preferences related to race, gender, and sexual identity of doctors in terms of dermatology-related information on TikTok and which group posts more reliable information. This study qualitatively and quantitatively evaluated the racial, gender, and sexual diversity of the top 55 dermatologist influencers on TikTok based on their follower count. The DISCERN tool was used to determine the reliability of consumer health content based on a score ranging from 1-5. Among the top 55 dermatologist influencers, African American (54,241.60) and Latinx (6,696) groups had the lowest mean number of followers compared to Caucasian (1,046,298.50) and Asian (1,403,393.50) physicians. Latinx and African American dermatologists had the highest DISCERN scores of 2 and 1.9, respectively. None of the physicians identified as a different gender or as LGBTQIA+ in any racial category. There is a considerable lack of minority dermatologist influencers on TikTok, especially Latinx, African American, and LGBTQIA+ physicians. The lack of diversity in the dermatology specialty can lead to inequitable care and health outcomes for racial/ethnic, gender, and sexual minority patient populations. This study’s findings also suggest Latinx and African American dermatologists post more reliable content compared with their Caucasian and Asian counterparts.Keywords: dermatology, social media, sexual and gender minorities, racial minorities, skin of color, tiktok
Procedia PDF Downloads 835940 Points of View on Turkish Trade Marks by Foreigners Living in Konya
Authors: İmran Ugur, Zulfiye Acar
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Trade marks are composed of figures, signs or symbols such as logos, colours and designs to be formed for service or products to be different from their counterparts. However, trade marks have nowadays a large meaning that defines its classical description. It has an understanding that pioneers novelties by forming the perception of quality, being emotional constituents and leading to links to their consumers. While entering different markets all over the world, Turkish trade marks are encountering a new type of consumers in Turkey migrating from different countries. Most of these new consumers meet Turkish trade marks for the first time. The present study was performed to investigate the perception of Turkish trade marks living in Konya. How these consumers look at the trade marks of clothes, food, beverages, GSM operators and whiteware appliances, and perceive these trade marks were tried to be determined. Which trade marks they chose according to their preferences, and the awareness of Turkish trade marks were evaluated in the study.Keywords: brand, brand awareness, culture, trade marks
Procedia PDF Downloads 3815939 LaPEA: Language for Preprocessing of Edge Applications in Smart Factory
Authors: Masaki Sakai, Tsuyoshi Nakajima, Kazuya Takahashi
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In order to improve the productivity of a factory, it is often the case to create an inference model by collecting and analyzing operational data off-line and then to develop an edge application (EAP) that evaluates the quality of the products or diagnoses machine faults in real-time. To accelerate this development cycle, an edge application framework for the smart factory is proposed, which enables to create and modify EAPs based on prepared inference models. In the framework, the preprocessing component is the key part to make it work. This paper proposes a language for preprocessing of edge applications, called LaPEA, which can flexibly process several sensor data from machines into explanatory variables for an inference model, and proves that it meets the requirements for the preprocessing.Keywords: edge application framework, edgecross, preprocessing language, smart factory
Procedia PDF Downloads 1515938 Strategies of Spatial Optimization for Open Space in the Old-Age Friendly City: An Investigation of the Behavior of the Elderly in Xicheng Square in Hangzhou
Authors: Yunxiang Fang
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With the aging trend continuing to accelerate, open space is important for the daily life of the elderly, and its old-age friendliness is worthy of attention. Based on behavioral observation and literature research, this paper studies the behavior of the elderly in urban open space. Through the investigation, classification and quantitative analysis of the activity types, time characteristics and spatial behavior order of the elderly in Xicheng Square in Hangzhou, it summarizes the square space suitable for the psychological needs, physiology and activity needs of the elderly, combined with the basis of literature research. Finally, the suggestions for the improvement of the old-age friendship of Xicheng Square are put forward, from the aspects of microclimate, safety and accessibility, space richness and service facility quality.Keywords: behavior characteristics, old-age friendliness, open space, square
Procedia PDF Downloads 1765937 Predictive Factors of Healthcare-Associated Infections and Antibiotic Use Patterns: A Cross-Sectional Survey at the Charles Nicolle Hospital of Tunis
Authors: Nouira Mariem, Ennigrou Samir
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Background and aims: Healthcare-associated infections (HAI) represent a major public health problem worldwide. They represent one of the most serious adverse events in health care. The objectives of our study were to estimate the prevalence of HAI at the Charles Nicolle Hospital (CNH) and to identify the main associated factors as well as to estimate the frequency of antibiotic use. Methods: It was a cross-sectional study at the CNH with a unique passage per department (October-December 2018). All patients present at the wards for more than 48 hours were included. All patients from outpatient consultations, emergency, and dialysis departments were not included. The site definitions of infections proposed by the Centers for Disease Control and Prevention (CDC) were used. Only clinically and/or microbiologically confirmed active HAIs were included. Results: A total of 318 patients were included, with a mean age of 52 years and a sex ratio (female/male) of 1.05. A total of 41 patients had one or more active HAIs, corresponding to a prevalence of 13.1% (95% CI: 9.3%-16.9%). The most frequent site infections were urinary tract infections and pneumonia. Multivariate analysis among adult patients (>=18 years) (n=261) revealed that infection on admission (p=0.01), alcoholism (p=0.01), high blood pressure (p=0.008), having at least one invasive device inserted (p=0.004), and history of recent surgery (p=0.03), increased the risk of HAIs significantly. More than 1 of 3 patients (35.4%) were under antibiotics on the day of the survey, of which more than half (57.4%) were under two or more types of antibiotics. Conclusion: The prevalence of HAIs and antibiotic prescriptions at the CNH were considerably high. An infection prevention and control committee, as well as the development of an antibiotic stewardship program with continuous monitoring using repeated prevalence surveys, must be implemented to limit the frequency of these infections effectively.Keywords: prevalence, healthcare associated infection, antibiotic, Tunisia
Procedia PDF Downloads 895936 Prevalence and Occupational Factors Associated with Low Back Pain among the Female Garment Workers: A Cross-Sectional Study in Bangladesh
Authors: Fazle Rabbi, Mashuda Khanom Tithi, Tasnim Mirza, Sanjida Rowshan Anannya, Ahmed Hossain
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Background: Low Back Pain (LBP) is one of the common health problems among the garment workers that causes workers absenteeism from the work. The purpose of the study is to identify the association between occupational factors and LBP among the female garment workers in Bangladesh. Materials and Methods: A cross-sectional study was conducted with 487 female garment workers from three compliant garment factories of Bangladesh. Face-to-face interview on four different LBP measures along with questions on socio-demographic, occupational, and physical factors were used to collect the data. Result: The prevalence rates for LBP lasts for at least one day during the last six months, chronic pain, intense pain, and seeking medical care for LBP were found 63.04%, 38.60%, 13.76%, and 18.89%, respectively among the female garments workers. The multivariate logistic regression analysis indicates that duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) are positively associated with LBP. Besides, age, BMI, family income, marital status and number of children are also found positively associated with the LBP measures. Conclusion: The prevalence of LBP among female garment workers in Bangladesh is found high. The duration of employment (>5 years), regular weight bearing and extended weekly working hours (>48 hours) play a significant role in developing LBP among the female workers. Factories need to consider training programs on the appropriate technique of weight bearing. It is also important to conduct regular screening programs to identify LBP, especially with married, overweight/obese and older age group to reduce the occurrence of LBP.Keywords: Bangladesh, garment workers, low back pain, occupational health
Procedia PDF Downloads 2035935 Characteristics of Asphalt Mixtures with Cocoa Shell Ash as Filler
Authors: Muhammad Nur Hidayat, Muksalmina, Chairul Fajar
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An alternative to improve the quality of asphalt as a pavement material is to use modified asphalt with the addition of cocoa shell ash as a filler. This research aims to determine the effect of asphalt mixture and cocoa shell ash after testing the physical properties of asphalt. The method used was experimental by testing the physical properties of asphalt. The results showed that the optimum asphalt content of the cocoa husk ash mixture was 2%, with an asphalt penetration value of 60.03 mm. The result of the asphalt softening point test was 51.0°C. Asphalt ductility test results in 144 cm. Asphalt specific gravity test result 1.076 gr/ml. Asphalt weight loss test results in 0.0183%. In conclusion, cocoa shell ash has an effect on asphalt characteristics, namely increasing stability, flexibility and fatigue resistance.Keywords: cocoa husk ash, asphalt characteristics, physical properties testing, filler
Procedia PDF Downloads 395934 Associations Between Psychological Distress and COVID-19 Disease Course: A Retrospective Cohort Study of 3084 Cases in Belgium
Authors: Gwendy Darras, Mattias Desmet
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Previous research showed that psychological distress has a negative impact on the disease course of viral infections. For COVID-19, the same association was observed in small samples of specific segments of the population (e.g. health care workers). The present study presents a more refined analysis of this association, measuring a broader spectrum of psychological distress in a large sample (n=3084) of the general Flemish population. Several types of psychological distress (state, trait and health anxiety, depression, intra-, and interpersonal stress) are registered throughout three periods: one year before the contamination, one week before the contamination, and during the contamination. In doing so, validated scales such as DASS-21, IIP-32, and FCV-19S are used. Furthermore, the course of COVID-19 is registered in several ways: number of symptoms, number of days sick leave due to COVID-19, and number of days the symptoms have lasted. Also, different control variables such as vaccination status, medical and psychological history are taken into account. Statistical analysis shows that all types of psychological distress are positively correlated with the severity of the COVID-19 disease course. Anxiety during the contamination shows the strongest correlation, but psychological distress one year before the onset of COVID-19 was still significantly associated with the worsening of the disease course. As the assessment of the latter type of distress happened before the onset of the COVID-19 disease course, retrospective bias resulting in artificial associations between self-reported stress and COVID-19 severity is unlikely to have impacted the observations. In view of possible future pandemics, it is important to focus on general stress and anxiety reduction in the general population as soon as possible. It is also advisable to minimize the use of stress-inducing messages to encourage the population to adhere to the measures issued during a pandemic.Keywords: anxiety, COVID-19, depression, psychoneuroimmunology, psychological distress, stress
Procedia PDF Downloads 875933 Patient Advocates to Improve Access to Justice in Involuntary Hospitalisation
Authors: Zuzana Durajova, Natasa Diatkova, Shreya Bhardwaj
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This paper introduces the project START, its activities, goals, evaluation and final results. Over the past few decades, the legal discourse surrounding mental health has resulted in improvement in patient rights (in Netherlands, etc.), the appointment of Ombudspersons for psychiatric patients (in Austria, Sweden) and facilitating the participation of patients in decision-making processes. Czech legislation already recognizes the position of “patient’s advocate” as a person of trust. However, this instrument is not very widely known and rarely used in practice. In the pilot study of the project, legal training for patient advocacy is provided to persons with experience with mental health problems/psychiatric hospitalization chosen from a Czech-based NGO. These persons (patient advocates) visit patients in involuntary hospitalization in one closed ward in the chosen psychiatric institution. During visits, the patient advocates inform patients about their legal standing, their procedural rights and also offer them individual support in contacting their counsel, family members etc. To understand the effect of the intervention, qualitative interviews and participant observations are conducted with the patients, advocates, the hospital management and staff and other identifiable stakeholders, such as government officials responsible for mental health care reform. The interviews are held before, during and after the intervention (support from patient advocates in hospitals). Given the ethical quandaries arising from using psychiatric wards as a field setting, we assume a participatory approach to ensure respect for patient boundaries and dignity. Through this project, we seek to establish a profession of patient advocates based on professional standards.Keywords: patient advocacy, involuntary hospitalization, Czech Republic, patient Rights, professionalization
Procedia PDF Downloads 2005932 Aquatic Sediment and Honey of Apis mellifera as Bioindicators of Pesticide Residues
Authors: Luana Guerra, Silvio C. Sampaio, Vladimir Pavan Margarido, Ralpho R. Reis
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Brazil is the world's largest consumer of pesticides. The excessive use of these compounds has negative impacts on animal and human life, the environment, and food security. Bees, crucial for pollination, are exposed to pesticides during the collection of nectar and pollen, posing risks to their health and the food chain, including honey contamination. Aquatic sediments are also affected, impacting water quality and the microbiota. Therefore, the analysis of aquatic sediments and bee honey is essential to identify environmental contamination and monitor ecosystems. The aim of this study was to use samples of honey from honeybees (Apis mellifera) and aquatic sediment as bioindicators of environmental contamination by pesticides and their relationship with agricultural use in the surrounding areas. The sample collections of sediment and honey were carried out in two stages. The first stage was conducted in the Bituruna municipality region in the second half of the year 2022, and the second stage took place in the regions of Laranjeiras do Sul, Quedas do Iguaçu, and Nova Laranjeiras in the first half of the year 2023. In total, 10 collection points were selected, with 5 points in the first stage and 5 points in the second stage, where one sediment sample and one honey sample were collected for each point, totaling 20 samples. The honey and sediment samples were analyzed at the Laboratory of the Paraná Institute of Technology, with ten samples of honey and ten samples of sediment. The selected extraction method was QuEChERS, and the analysis of the components present in the sample was performed using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). The pesticides Azoxystrobin, Epoxiconazole, Boscalid, Carbendazim, Haloxifope, Fomesafen, Fipronil, Chlorantraniliprole, Imidacloprid, and Bifenthrin were detected in the sediment samples from the study area in Laranjeiras do Sul, Paraná, with Carbendazim being the compound with the highest concentration (0.47 mg/kg). The honey samples obtained from the apiaries showed satisfactory results, as they did not show any detection or quantification of the analyzed pesticides, except for Point 9, which had the fungicide tebuconazole but with a concentration5931 The Standardization of Colorado Schools to Offer Opportunity Through Equal Education
Authors: Heather Caldwell
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In 1915, state superintendent, Mary C.C. Bradford initiated a state standardization plan in order to improve the quality of schools and the educational experience for all children in Colorado. This plan would change the schools, improving them and offering more opportunities for children, teachers, and the community. In a state where geography limited opportunity to make all schools equal and brought challenges to state school leaders to improve education throughout the state, the leadership prevailed and worked together with local schools and school leaders to make drastic improvements in the curriculum. This paper will discuss this plan and will highlight key contributions to this standardization plan that improved opportunities for all students in the state of Colorado through these educational initiatives.Keywords: history of education, standardization, curriculum, state superintendent, women in education
Procedia PDF Downloads 585930 National Project 'Environment' of Russian Federation as a Management Tool in Achieving SDGs
Authors: Ekaterina Posokhova, Boris Gavrilov
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Priority national projects have become an essential phenomenon in the Russian Federation. Both regional and local government institutions and a significant part of the society have been involved in their implementation. The scale and multispectricity of the national projects give a reason to believe that their concept is beyond the scope of the individual state programs. The national project “environment” contains federal projects on waste management, water, and air quality, ecotourism development, and biodiversity conservation highlights the importance of the preservation and restoration of Volga River and Lake Baikal ecosystems. This study assesses the national projects according to their relativeness with the current SDGs (i.e., SGD 14 and 15), evaluates the methodology of the projects. The paper considers the peculiarities of the national projects as strategic management tools as well as the possibility of amending the project objective indicators. Conclusion on the effectiveness of NP in terms of achieving SDGs is provided.Keywords: management, SDP, russia, conservation, law
Procedia PDF Downloads 1475929 Glass and Polypropylene Combinations for Thermoplastic Preforms
Authors: Hireni Mankodi
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The textile preforms for thermoplastic composite play a key role in providing the mechanical properties and gives the idea about preparing combination of yarn from Glass, Basalt, Carbon as reinforcement and PP, PET, Nylon as thermoplastic matrix at yarn stage for preforms to improve the quality and performance of laminates. The main objectives of this work are to develop the hybrid yarn using different yarn manufacturing process and prepare different performs using hybrid yarns. It has been observed that the glass/pp combination give homogeneous distribution in yarn. The proportion varied to optimize the glass/pp composition. The different preform has been prepared with combination of hybrid yarn, PP, glass combination. Further studies will investigate the effect of glass content in fabric, effect of weave, warps and filling density, number of layer plays significant role in deciding mechanical properties of thermoplastic laminates.Keywords: thermoplastic, preform, laminates, hybrid yarn, glass
Procedia PDF Downloads 5845928 Breastfeeding Experiences of Nutritionist who are Mothers in Quito- Ecuador
Authors: Maria Jose Mendoza Gordillo
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Introduction: Research regarding breastfeeding is devoted to how essential breastfeeding is to guarantee wellbeing for the mother and the baby from a medical standpoint relegating the cultural, material and social barriers for breastfeeding. Consequently, worldwide breastfeeding rates are low, and Ecuador is not the exception, especially among working mothers. Worldwide, health care providers have low rates of breastfeeding due to several barriers to lactation, such as the work schedule, a lack of private places for pumping while at work, and negative emotions. Goals and Methods: This study aimed to explore how do Ecuadorian women embrace their identities as nutritionists and mothers within their breastfeeding experience. The primary data come from 20 synchronous semi-structured interviews, which follow a topic guide. The interviews were recorded and transcribed verbatim. The data analysis followed the Phronetic Iterative Approach. Results: Women shifted the preconceived idea of the ideal breastfeeding that came from the medicalized discourse of breastfeeding, and that was constructed in their training as nutritionists. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted through the experience of motherhood. When these women developed their identity as mothers, they understood that the ideal breastfeeding is different from the medicalized discourse. Although they have that clash between the ideal and the external reality, they continued breastfeeding their babies and those experiences made them improve their professional practice. Conclusions: The narratives that women shared illustrate how complex it was to manage the different roles and identities that they wanted to fulfill to keep their identity of a good mother who breastfeeds her baby and, at the same time, a good healthcare provider identity. The process of breastfeeding for this group of women who are mothers and healthcare professionals appears to be a unique relational and identity negotiation process.Keywords: breastfeeding, identity, nutritionist, qualitative
Procedia PDF Downloads 1835927 Influenza Vaccine Uptake Among Tunisian Physicians in the 2018-2019 Influenza Season
Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb
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Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake
Procedia PDF Downloads 1405926 Assessment of an ICA-Based Method for Detecting the Effect of Attention in the Auditory Late Response
Authors: Siavash Mirahmadizoghi, Steven Bell, David Simpson
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In this work a new independent component analysis (ICA) based method for noise reduction in evoked potentials is evaluated on for auditory late responses (ALR) captured with a 63-channel electroencephalogram (EEG) from 10 normal-hearing subjects. The performance of the new method is compared with a single channel alternative in terms of signal to noise ratio (SNR), the number of channels with an SNR above an empirically derived statistical critical value and an estimate of the effect of attention on the major components in the ALR waveform. The results show that the multichannel signal processing method can significantly enhance the quality of the ALR signal and also detect the effect of the attention on the ALR better than the single channel alternative.Keywords: auditory late response (ALR), attention, EEG, independent component analysis (ICA), multichannel signal processing
Procedia PDF Downloads 5065925 Use of Adjunctive Cannabinoids in Opioid Dosing for Patients with Chronic Pain
Authors: Kristina De Milt, Nicole Huang, Jihye Park
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Opioids have been a mainstay of the treatment of chronic pain, but their overprescription and misuse have led to an opioid epidemic. Recently, as an attempt to decrease the number of opioids prescribed, the use of cannabinoid therapy has become an increasingly popular adjunctive chronic pain management choice among providers. This review of literature investigates the effects of adjunctive cannabinoids to opioids in the management of chronic pain. The nine articles are included in the literature review range from observational studies to meta-analyses published in the year 2016 and after. A majority of the studies showed a decrease in the need for opioids after adjunctive cannabinoids were introduced and, in some instances, the cessation of opioid consumption. More high-quality evidence is needed to further support this stance and providers should weigh the benefits and risks of adjunctive cannabinoids according to the clinical picture.Keywords: cannabis, chronic pain, opioids, pain management
Procedia PDF Downloads 2585924 Lessons Learnt from a Patient with Pseudohyperkalaemia Secondary to Polycythaemia Rubra Vera in a Neuro-ICU Patient Resulting in Dangerous Interventions: Lessons Learnt on Patient Safety Improvement
Authors: Dinoo Kirthinanda, Sujani Wijeratne
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Pseudohyperkalaemia is a common benign in vitro phenomenon caused by the release of potassium ions (K+) from cells during specimen processing. Analysis of haemolysed blood samples for predominantly intracellular electrolytes may lead to re-investigation and potentially harmful interventions. We report a case of a 52-year male with myeloproliferative disease manifested as Polycythaemia Rubra Vera, Hypertension and hypertensive nephropathy with stage 3 chronic kidney disease admitted to Neuro-intensive care unit (NICU) with an intra-cerebral haemorrhage secondary to hypertensive bleed. His initial blood investigations showed hyperkalemia with serum K+ 6.2 mmol/L yet the bedside arterial blood gas analysis yielded K+ of 4.6 mmol/L. The patient was however given hyperkalemia regime twice based on venous electrolyte analysis. The discrepancy between the bedside electrolyte analysis using arterial blood and venous blood prompted further evaluation. The 12 lead Electrocardiogram showed U waves and sinus bradycardia corresponding to the serum K+ of 2.8 mmol/L on arterial blood gas analysis. Immediate K+ replacement ensured the patient did not develop life-threatening cardiac complications. Pseudohyperkalaemia may pose diagnostic challenges in the absence of detectable haemolysis and should be suspected in susceptible patients with normal Electrocardiogram and Glomerular Filtration Rate to avoid potentially life-threatening interventions. When in doubt, rapid analysis of arterial blood gas may be useful for accurate quantification of potassium.Keywords: patient safety, pseudohyperkalaemia, haemolysis, myeloproliferative disorder
Procedia PDF Downloads 1575923 A Review on Upcycling: Current Body of Literature, Knowledge Gaps and a Way Forward
Authors: Kyungeun Sung
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Upcycling is a process in which used materials are converted into something of higher value and/or quality in their second life. It has been increasingly recognised as one promising means to reduce material and energy use and also to engender sustainable production and consumption. For this reason and other foreseeable benefits, the concept of upcycling has received more attention from numerous researchers and business practitioners in recent years. This has been seen in the growing number of publications on this topic since the 1990s. However, the overall volume of literature dealing with upcycling is still low and no major review has been presented. Therefore, in order to further establish this field, this paper analyses and summarises the current body of literature on upcycling, focusing on different definitions, trends in practices, benefits, drawbacks and barriers in a number of subject areas and gives suggestions for future research by illuminating knowledge gaps in the area of upcycling.Keywords: circular economy, cradle to cradle, sustainable production and consumption, upcycling, waste management
Procedia PDF Downloads 4235922 Toward a New Approach for Modeling Lean, Agile and Leagile Supply Chains
Authors: Bouchra Abdelilah, Akram El Korchi, Atmane Baddou
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With the very competitive business era that we witness nowadays, companies needs more that anytime to use all the resources they have in order to maximize performance and satisfy the customers’ needs. The changes occurring in the market business are often due to the variations of demand, which requires a very specific supply chain strategy. Supply chains aims to balance cost, quality, and service level and lead time. Still, managers are confused when faced with the strategies working the best for the supply chain: lean, agile and leagile. This paper presents a decision making tool that aims to assist the manager in choosing the supply chain strategy that suits the most his business, depending on the type of product and the nature of demand. Analyzing the different characteristics of supply chain will enable us to guide the manager to the suitable strategy between lean, agile and leagile.Keywords: supply chain, lean, agile, flexibility, performance
Procedia PDF Downloads 8635921 Culture of Argumentative Discourse Formation as an Inevitable Element of Professional Development of Foreign Language Teachers
Authors: Kuznetsova Tamara, Sametova Fauziya
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Modern period of educational development is characterized by various attempts in higher quality and effective result provision. Having acquired the modernized educational paradigm, our academic community placed the personality development through language and culture under the focus of primary research. The competency-based concept claims for professionally ready specialists who are capable of solving practical problems. In this sense, under the circumstances of the current development of Kazakhstani society, it is inevitable to form the ability to conduct argumentative discourse as the crucial element of intercultural communicative competence. This article particularly states the necessity of the culture of argumentative discourse formation presents theoretical background of its organization and aims at identifying important argumentative skills within educational process.Keywords: argumentative discourse, teaching process, skills, competency
Procedia PDF Downloads 366