Search results for: private health facilities
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11331

Search results for: private health facilities

10671 Ranking of Managerial Parameters Impacting upon Performance of Football Referees in Iran

Authors: Mohammad Reza Boromand, Masoud Moradi, Amin Eskandari

Abstract:

The present study attempts to determine ranking of managerial parameters impacting upon performance of football referees in Iran. The population consisted of all referees in Leagues 1, 2 and 3 as well as super league of Iran (N=273), of which we selected 160 referees and assistant referees in 2013-2014. A research-designed questionnaire was used for data collection which was divided into two sections: (1) Demographic details (age range, Marital status, employment, refereeing experience, education level, refereeing level and proficiency) and (2) items related to parameters impacting upon performance of referees (structural parameters, operational parameters, environmental parameters, temporal parameters, economic parameters, facilities and tools, personal performance and performance evaluation). Internal consistency was calculated by Cronbach's alpha (r=0.85). For data analysis, we performed Freedman's Test and used SPSS software (α>0.05), along with descriptive statistics. The findings showed the following ranking for the above-mentioned managerial parameters: Facilities and tools, personal performance, economic parameters, structural parameters, operational parameters, environmental parameters, temporal parameters, and performance evaluation.

Keywords: Iran, football referees, managerial parameters, performance

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10670 Air Quality Health Index in Windsor, Canada, and the Impact of Regional Scale Transport

Authors: Xiaohong Xu, Tianchu Zhang, Yangfan Chen, Rongtai Tan

Abstract:

In Canada, Air Quality Health Index (AQHI) is a scale designed to help residences understand the impact of air quality on human health. In Ontario, Canada, AQHI was implemented in June 2015. This study investigated temporal variability of daily AQHI and impact of regional transport on AQHI in Windsor, Ontario, Canada from 2016 to 2019. During 2016–2019, 1428 daily AQHIs were recorded in Windsor Downtown Station. Among those, the AQHIs were at the low health risk level (AQHI = 1, 2 or 3) in 82% of days, only a few days at high risk level (AQHI = 7), the rest were at moderate health risk level (AQHI = 4, 5, 6), indicating air quality in Windsor was fairly good with relatively low health risk. The annual mean AQHI value decreased from 2.95 in 2016 to 2.81 in 2019, demonstrating the improvement of air quality. Half of the days, AQHI were 3 regardless of season. AQHI was higher in the warm season (3.1) than in the cold season (2.6) due to more frequent moderate risk days (27%, AQHI = 4) in warm season and more frequent low risk days (42%, AQHI = 2) in the cold season. Among the three pollutants considered in AQHI calculation, O3 was the most frequently reported dominant contributor to daily AQHI (88% of days), followed by NO2 (12%), especially in the cold season, with small contribution from PM2.5 (<1%). In the past two decades, NO2 concentrations had decreased significantly and O3 concentrations had increased, resulting in daily AQHI being less reliance on NO2 (from 51% of days being the primary contributor during 2003–2010 to 12% during 2016–2019) and more on O3 concentrations (49% to 88%). Trajectory analysis found that AQHI ≤ 3 days were closely associated with air masses from the north and northwest, whereas AQHI > 3 days were closely associated with air masses from the west and southwest. This is because northerly flows brought in clear air mass owing to less industrial facilities, while polluted air masses were transported from the south of Windsor, where several industrial states of the US were located. Overall, O3 concentrations dictate the daily AQHI values, the seasonal variability of AQHI, and the impact of regional transport on AQHI in Windsor. This makes further reductions of AQHI challenging because O3 concentrations are likely to continue increasing due to weakened consumption of O3 by NO owing to decreasing NO emissions and more hot days because of climate change. The predominant and increasing contribution of O3 to AQHI calls for more effective control measures to mitigate O3 pollution and its impact on human health and the environment.

Keywords: air quality, Air Quality Health Index (AQHI), hysplit, regional transport, windsor

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10669 Mentoring of Health Professionals to Ensure Better Child-Birth and Newborn Care in Bihar, India: An Intervention Study

Authors: Aboli Gore, Aritra Das, Sunil Sonthalia, Tanmay Mahapatra, Sridhar Srikantiah, Hemant Shah

Abstract:

AMANAT is an initiative, taken in collaboration with the Government of Bihar, aimed at improving the Quality of Maternal and Neonatal care services at Bihar’s public health facilities – those offering either the Basic Emergency Obstetric and Neonatal care (BEmONC) or Comprehensive Emergency Obstetric and Neonatal care (CEmONC) services. The effectiveness of this program is evaluated by conducting cross-sectional assessments at the concerned facilities prior to (baseline) and following completion (endline) of intervention. Direct Observation of Delivery (DOD) methodology is employed for carrying out the baseline and endline assessments – through which key obstetric and neonatal care practices among the Health Care Providers (especially the nurses) are assessed quantitatively by specially trained nursing professionals. Assessment of vitals prior to delivery improved during all three phases of BEmONC and all four phases of CEmONC training with statistically significant improvement noted in: i) pulse measurement in BEmONC phase 2 (9% to 68%), 3 (4% to 57%) & 4 (14% to 59%) and CEmONC phase 2 (7% to 72%) and 3 (0% to 64%); ii) blood pressure measurement in BEmONC phase 2 (27% to 84%), 3 (21% to 76%) & 4 (36% to 71%) and CEmONC phase 2 (23% to 76%) and 3 (2% to 70%); iii) fetal heart rate measurement in BEmONC phase 2 (10% to 72%), 3 (11% to 77%) & 4 (13% to 64%) and CEmONC phase 1 (24% to 38%), 2 (14% to 82%) and 3 (1% to 73%); and iv) abdominal examination in BEmONC phase 2 (14% to 59%), 3 (3% to 59%) & 4 (6% to 56%) and CEmONC phase 1 (0% to 24%), 2 (7% to 62%) & 3 (0% to 62%). Regarding infection control, wearing of apron, mask and cap by the delivery conductors improved significantly in all BEmONC phases. Similarly, the practice of handwashing improved in all BEmONC and CEmONC phases. Even on disaggregation, the handwashing showed significant improvement in all phases but CEmONC phase-4. Not only the positive practices related to handwashing improved but also negative practices such as turning off the tap with bare hands declined significantly in the aforementioned phases. Significant decline was also noted in negative maternal care practices such as application of fundal pressure for hastening the delivery process and administration of oxytocin prior to delivery. One of the notable achievement of AMANAT is an improvement in active management of the third stage of labor (AMTSL). The overall AMTSL (including administration of oxytocin or other uterotonics uterotonic in proper dose, route and time along with controlled cord traction and uterine massage) improved in all phases of BEmONC and CEmONC mentoring. Another key area of improvement, across phases, was in proper cutting/clamping of the umbilical cord. AMANAT mentoring also led to improvement in important immediate newborn care practices such as initiation of skin-to-skin care and timely initiation of breastfeeding. The next phase of the mentoring program seeks to institutionalize mentoring across the state that could potentially perpetuate improvement with minimal external intervention.

Keywords: capacity building, nurse-mentoring, quality of care, pregnancy, newborn care

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10668 Numerical Investigation of Gas Leakage in RCSW-Soil Combinations

Authors: Mahmoud Y. M. Ahmed, Ahmed Konsowa, Mostafa Sami, Ayman Mosallam

Abstract:

Fukushima nuclear accident (Japan 2011) has drawn attention to the issue of gas leakage from hazardous facilities through building boundaries. The rapidly increasing investments in nuclear stations have made the ability to predict, and prevent, gas leakage a rather crucial issue both environmentally and economically. Leakage monitoring for underground facilities is rather complicated due to the combination of Reinforced Concrete Shear Wall (RCSW) and soil. In the framework of a recent research conducted by the authors, the gas insulation capabilities of RCSW-soil combination have been investigated via a lab-scale experimental work. Despite their accuracy, experimental investigations are expensive, time-consuming, hazardous, and lack for flexibility. Numerically simulating the gas leakage as a fluid flow problem based on Computational Fluid Dynamics (CFD) modeling approach can provide a potential alternative. This novel implementation of CFD approach is the topic of the present paper. The paper discusses the aspects of modeling the gas flow through porous media that resemble the RCSW both isolated and combined with the normal soil. A commercial CFD package is utilized in simulating this fluid flow problem. A fixed RCSW layer thickness is proposed, air is taken as the leaking gas, whereas the soil layer is represented as clean sand with variable properties. The variable sand properties include sand layer thickness, fine fraction ratio, and moisture content. The CFD simulation results almost demonstrate what has been found experimentally. A soil layer attached next to a cracked reinforced concrete section plays a significant role in reducing the gas leakage from that cracked section. This role is found to be strongly dependent on the soil specifications.

Keywords: RCSW, gas leakage, Pressure Decay Method, hazardous underground facilities, CFD

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10667 Fate of Sustainability and Land Use Array in Urbanized Cities

Authors: Muhammad Yahaya Ubale

Abstract:

Substantial rate of urbanization as well as economic growth is the tasks and prospects of sustainability. Objectives of the paper are: to ascertain the fate of sustainability in urbanized cities and; to identify the challenges of land use array in urbanized cities. Methodology engaged in this paper employed the use of secondary data where articles, conference proceedings, seminar papers and literature materials were effectively used. The paper established the fact that while one thinks globally, it is reciprocal to act locally if at all sustainability should be achieved. The speed and scale of urbanization must be equal to natural and cost-effective deliberations. It also discovered a podium that allows a city to work together as an ideal conglomerate, engaging all city departments as a source of services, engaging residents, businesses, and contractors. It also revealed that city should act as a leader and partner within an urban region, engaging senior government officials, utilities, rural settlements, private sector stakeholders, NGOs, and academia. Cities should assimilate infrastructure system design and management to enhance efficiency of resource flows in an urban area. They should also coordinate spatial development; integrate urban forms and urban flows, combine land use, urban design, urban density, and other spatial attributes with infrastructural development. Finally, by 2050, urbanized cities alone could be consuming 140 billion tons of minerals, ores, fossil fuels and biomass annually (three times its current rate of consumption), sustainability can be accomplished through land use control, limited access to finite resources, facilities, utilities and services as well as property right and user charge.

Keywords: sustainability, land use array, urbanized cities, fate of sustainability and perseverance

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10666 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education

Authors: Salman Imran, Chris Healey

Abstract:

Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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10665 Adoption of Lean Thinking and Service Improvement for Care Home Service

Authors: Chuang-Chun Chiou

Abstract:

Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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10664 Shakespeare’s Sister and the Crisis of Women’s Autonomy: A Critical Analysis of a Room of One’s Own

Authors: Ali Mohammadi

Abstract:

This study explored the root causes of women's lack of writing in literature by digging into Virginia Woolf's A Room of One’s Own. Virginia Woolf was the pioneer of feminist literary criticism in the 20th century. She was hugely preoccupied, throughout her writing life, with the role of women in history and with the relationship between women and fiction. Besides, she wrote continuously about the difficulties of women's writing and of writing as a woman. This research aims to mirror a number of key arguments concerning women’s issues: the social and economic conditions necessary for writing; the problem of a tradition of women's writing; the concept of a 'female sentence' articulating women's voices and values and the idea of the androgynous aesthetic in which an author would be able to write free from an awareness of their sex as male or female. Woolf was very wary of making any definitive assertions about women's writing, or at least in terms of its style or form. Indeed, much of the essay is taken up with her reflections on the lack of women's writing over the history of English literature. It was concluded that the reason for this absence of female writing does not just spring from the deficiency of genius, but of material circumstances and facilities. Additionally, the demands of the domestic household, the poverty of education available to women, and the laws that denied married women’s ownership of funds or property made it virtually impossible for women to take up writing as a profession.

Keywords: autonomy, facilities, genius, literature, women

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10663 “Who Will Marry Me?”: The Marital Status of Disabled Women in India

Authors: Sankalpa Satapathy

Abstract:

The stigma attached to disability is very high in India and given its patriarchal society women and their interests have always been pushed to the background. The identity of disabled women is compromised under the social construction of disability which lowers their self-esteem and hampers their development. Disability policies in India have focused on provision of educational and employment opportunities to make them economically productive members of the society. This preoccupation with the materialistic spheres of lives of the disabled has led to a neglect of the private sphere concerning intimate social relationships and motherhood. This paper seeks to bring to forefront the private lives of disabled women. Semi-structured in-depth interviews were conducted with twenty seven women with physical disability (congenital/acquired) from Odisha, a state in India. Sampling was done in a manner to include women from various strata of the society to allow meaningful analysis. In a society where paramount importance is attached to wifehood and motherhood, the chances of marriage for disabled women were very low compared to disabled men. Majority believed that marriage and having a family was meant for non disabled women and had decided against getting married. Socialization process was found to be a major factor in determining the ideas and aspirations of disabled women. They were clearly sidelined by their families on the issue of marriage. Education and employment levels did not seem to increase the appeal of disabled women to prospective suitors. But not all the women interviewed were closed to the idea of intimate relationships and marriage. Disabled women who were married or hoped to get married in future were found to have a better body image and greater self motivation. It is interesting to understand the means by which these women, who have been brought up to internalize ideas of their unattractiveness, undesirability, asexuality and inability to care, established identities which have so long been denied to them. With these stories of personal triumphs an attempt is made for reclamation of private spheres which have been abandoned by disability policies and make them gender sensitive.

Keywords: disability, gender, marriage, relationships

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10662 Between Dark and Light: The Construction and the Exclusion of Memory of Prison Heritage in Post-Soviet Period

Authors: Guo Cyuan Deng

Abstract:

This study represents how the Soviet-occupied dark memory in Baltic countries were interpreted and represented by examining the way of management of prison heritage. Based on the formulation of a dark-tourism spectrum which Philip Stone proposed, the Patarei prison in Estonia and the Karosta prison in Latvia are compared, and it is thought that both prisons, which had experienced similar colonial history, face different tourism operation in the present. The former is being run by NGO and remain the situation of “empty" by art intervening. However, the Estonia government attempt to get the operation of museum and transform it to anti-Soviet museum in order show national identity. By contrast, the latter is being managed by private company, whom transformed the prison to "dark fun factories" by entertainment activities in order to private capital accumulation. Moreover, it is not only indicated that both prisons exclude the minority's memory, but also the flaws of dark-tourism spectrum which divide the dark and light are discussed. Finally, given the nature and function of dark heritage, the concept "le métro" is used to supplement Stone's spectrum.

Keywords: dark tourism, prison heritage, Post-Soviet, Baltic countries, national identities

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10661 Sexual and Reproductive Health through a Screen

Authors: Sohayla Khaled El Fakahany

Abstract:

Cultural and structural limitations and conservative social norms have direct effects on the availability of sources of sexual and reproductive health and rights (SRHR) in the Arab Region. Nevertheless, SRHR advocates, healthcare providers, and organizations have created online spaces like websites, blogs, and social media platforms to increase people’s access and ability to share information, experiences, and services. While these efforts help increase the accessibility to information and services, they also create and reflect inequalities based on limited internet access. Furthermore, these emergent ways of sharing and raising awareness online cannot be seen as a substitute for the urgent need for public healthcare systems and services to address SRHR issues in Arab states. This research aims to analyze the impact of the increasing importance of the role of social media platforms and technologies in the dissemination of SRHR-related information online to the youth as well as the associated inequalities of access. It also seeks to assess the effects and inequalities of the dependence on online platforms, which should be complementary to public and private SRHR services. The theoretical framework adopts Asef Bayat’s concept of social non-movements to analyze how collective mobilization around SRHR issues is exercised in repressive and conservative settings in the Arab region. Using digital ethnography of four prominent digital platforms and a qualitative survey of people aged 18-30 years, the research draws attention to the urgent need for better access to knowledge and services around gender, bodily autonomy, and sexual and reproductive health in the Arab region.

Keywords: sexual and reproductive health and rights, social non-movements, digital platforms, Arab region

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10660 Origins of Chicago Common Brick: Examining a Masonry Shell Encasing a New Ando Museum

Authors: Daniel Joseph Whittaker

Abstract:

This paper examines the broad array of historic sites from which Chicago common brick has emerged, and the methods this brick has been utilized within and around a new hybrid structure recently completed-and periodically opened to the public, as a private art, architecture, design, and social activism gallery space. Various technical aspects regarding the structural and aesthetic reuse methods of salvaged brick within the interior and exterior of this new Tadao Ando-designed building in Lincoln Park, Chicago, are explored. This paper expands specifically upon the multiple possible origins of Chicago common brick, as well as the extant brick currently composing the surrounding alley which is integral to demarcating the southern site boundary of the old apartment building now gallery. Themes encompassing Chicago’s archeological and architectural history, local resource extraction, and labor practices permeate this paper’s investigation into urban, social and architectural history and building construction technology advancements through time.

Keywords: masonry construction, history brickmaking, private museums, Chicago Illinois, Tadao Ando

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10659 Conceptual Model Design for E-Readiness of Entrepreneurial City Case Study: Entrepreneurial Cities in Iran

Authors: Mohsen Yaghmoor, Sima Radmanesh, Ameneh Gholami

Abstract:

Cities are the principal ground for manifestation of an information society. To create an entrepreneurial city, it is required that just and equal access to opportunities are provided for all segments of the city and technologies are intelligently employed. Furthermore, it is necessary for us to be electronically ready in all political, economic, social, cultural, and technological aspects. Also e-city creates enormous potentials and opportunities for development of the entrepreneurial city. After improvement of e-readiness for establishment of entrepreneurial e-city, potentials, and capitals of the city become productive and more suitable opportunities are offered to citizens, state sectors, and private sectors in order to become entrepreneurs. To create and develop an entrepreneurial city, we need to have readiness to detection and creation of entrepreneurial opportunities and finally exploitation of these opportunities which, in turn, lead to use of entrepreneurial events and their quality in the city. In this model, the quality of entrepreneurial events, the productivity of activities, the necessity of reducing the digital gap, positive and active attendance in information society and compatibility and aligning with the global society are emphasized. In an entrepreneurial city, citizens are not help seekers, private sector is not passive, and the government is entrepreneurial.

Keywords: e-city, e-readiness, entrepreneurial city, entrepreneurial events, technological entrepreneurship

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10658 Recent Policy Changes in Israeli Early Childhood Frameworks: Hope for the Future

Authors: Yaara Shilo

Abstract:

Early childhood education and care (ECEC)in Israel has undergone extensive reform and now requires daycare centers to meet internationally recognized professional standards. Since 1948, one of the aims of childcare facilities was to enable women’s participation in the workforce.A 1965 law grouped daycare centers for young children with facilities for the elderly and for disabled persons under the same authority. In the 1970’s, ECEC leaders sought to change childcare from proprietary to educational facilities. From 1976 deliberations in the Knesset regarding appropriate attribution of ECEC frameworks resulted in their being moved to various authorities that supported women’s employment: Ministries of Finance, Industry, and Commerce, as well as the Welfare Department. Prior to 2018, 75% of infants and toddlers in institutional care were in unlicensed and unsupervised settings. Legislative processes accompanied the conceptual change to an eventual appropriate attribution of ECEC frameworks. Position papers over the past two decades resulted in recommendations for standards conforming to OECD regulations. Simultaneous incidents of child abuse, some resulting in death, riveted public attention to the need for adequate government supervision, accelerating the legislative process. Appropriate care for very young children must center on quality interactions with caregivers, thus requiring adequate staff training. Finally, in 2018 a law was passed stipulating standards for staff training, proper facilities, child-adult ratios, and safety measures. The Ariav commission expanded training to caregivers for ages 0-3. Transfer of the ECEC to the Ministry of Education ensured establishment of basic training. Groundwork created by new legislation initiated professional development of EC educators for ages 0-3. This process should raise salaries and bolster the system’s ability to attract quality employees. In 2022 responsibility for ECEC ages 0-3 was transferred from the Ministry of Finance to the Ministry of Education, shifting emphasis from proprietary care to professional considerations focusing on wellbeing and early childhood education. The recent revolutionary changes in ECEC point to a new age in the care and education of Israel’s youngest citizens. Implementation of international standards, adequate training, and professionalization of the workforce focus on the child’s needs.

Keywords: policy, early childhood, care and education, daycare, development

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10657 Construction Strategy of Urban Public Space in Driverless Era

Authors: Yang Ye, Hongfei Qiu, Yaqi Li

Abstract:

The planning and construction of traditional cities are oriented by cars, which leads to the problems of insufficient urban public space, fragmentation, and low utilization efficiency. With the development of driverless technology, the urban structure will change from the traditional single-core grid structure to the multi-core model. In terms of traffic organization, with the release of land for traffic facilities, public space will become more continuous and integrated with traffic space. In the context of driverless technology, urban public reconstruction is characterized by modularization and high efficiency, and its planning and layout features accord with points (service facilities), lines (smart lines), surfaces (activity centers). The public space of driverless urban roads will provide diversified urban public facilities and services. The intensive urban layout makes the commercial public space realize the functions of central activities and style display, respectively, in the interior (building atrium) and the exterior (building periphery). In addition to recreation function, urban green space can also utilize underground parking space to realize efficient dispatching of shared cars. The roads inside the residential community will be integrated into the urban landscape, providing conditions for the community public activity space with changing time sequence and improving the efficiency of space utilization. The intervention of driverless technology will change the thinking of traditional urban construction and turn it into a human-oriented one. As a result, urban public space will be richer, more connected, more efficient, and the urban space justice will be optimized. By summarizing the frontier research, this paper discusses the impact of unmanned driving on cities, especially urban public space, which is beneficial for landscape architects to cope with the future development and changes of the industry and provides a reference for the related research and practice.

Keywords: driverless, urban public space, construction strategy, urban design

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10656 Assessment of Utilization of Provider Initiated HIV Testing and Counseling and Associated Factors among Adult out Patient Department Patients in Wonchi Woreda, South West Shoa Zone, Central Ethiopia

Authors: Dinka Fikadu, Mulugeta Shegaze

Abstract:

Background: Currently in health facility, provider-initiated human immunodeficiency virus testing is the key entry point to prevention, care, treatment and support services, but most people remains unaware of their HIV status due to various reasons. In many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. HIV, the virus that causes AIDS, “acquired immunodeficiency syndrome, "has become one of the world’s most serious health and development challenges. Reaching individuals with HIV who do not know their serostatus is a global public health priority. Objective: To assess utilization of provider initiated HIV testing and counseling and associated factors among adult outpatient department patients. Methods: Health facility based cross sectional study was conducted among 392 adult outpatient department patients in Wonchi woreda from February 24 to March 24 /2013. The study participant was recruited patients from all adult outpatient department patients of all four public health facilities of wonchi woreda using systematic sampling. A structured interviewer administered questionnaire was used to elicit all important variables from the study participants and multiple logistic regression analysis was used. Result: A total of 371 adult outpatient department patients aged between 15 to 64 years were actively participated in the study and 291(78.4%) of them utilized provider initiated HIV testing and counseling and 80(21.6%) of them refused. Knowledge on HIV is low in the study population; majority of the participants didn’t have comprehensive knowledge (64.7%) and (35.3%) fail to reject misconception about means of HIV transmission and prevention. Utilization of provider-initiated HIV testing and counseling were associated with divorced/widowed marital status[AOR (95%CI) = 0.32(0.15, 0.69)], being male sex [AOR (95%CI) =1.81(1.01, 3.24)], having comprehensive knowledge on HIV [AOR (95%CI) =0.408(0.220,0.759)],having awareness about provider initiated HIV testing and counseling [AOR(95%CI) =2.89(1.48,5.66)] and receiving test on HIV before[AOR (95%CI)=4.15(2.30, 7.47)]. Conclusion: Utilization of provider initiated HIV testing and counseling among adult outpatient departments in wonchi woreda public health facility was [(78.4%)].Strengthening health information through mass media and peer education on HIV to address barrier to testing in the community such as low awareness on PITC, to increase up take of PITC among adult OPD patients.

Keywords: utilization, human immune deficiency, testing, provider, initiate

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10655 Generating Biogas from Municipal Kitchen Waste: An Experience from Gaibandha, Bangladesh

Authors: Taif Rocky, Uttam Saha, Mahobul Islam

Abstract:

With a rapid urbanisation in Bangladesh, waste management remains one of the core challenges. Turning municipal waste into biogas for mass usage is a solution that Bangladesh needs to adopt urgently. Practical Action with its commitment to challenging poverty with technological justice has piloted such idea in Gaibandha. The initiative received immense success and drew the attention of policy makers and practitioners. We believe, biogas from waste can highly contribute to meet the growing demand for energy in the country at present and in the future. Practical Action has field based experience in promoting small scale and innovative technologies. We have proven track record in integrated solid waste management. We further utilized this experience to promote waste to biogas at end users’ level. In 2011, we have piloted a project on waste to biogas in Gaibandha, a northern secondary town of Bangladesh. With resource and support from UNICEF and with our own innovative funds we have established a complete chain of utilizing waste to the renewable energy source and organic fertilizer. Biogas is produced from municipal solid waste, which is properly collected, transported and segregated by private entrepreneurs. The project has two major focuses, diversification of biogas end use and establishing a public-private partnership business model. The project benefits include Recycling of Wastes, Improved institutional (municipal) capacity, Livelihood from improved services and Direct Income from the project. Project risks include Change of municipal leadership, Traditional mindset, Access to decision making, Land availability. We have observed several outcomes from the initiative. Up scaling such an initiative will certainly contribute for sustainable cleaner and healthier urban environment and urban poverty reduction. - It reduces the unsafe disposal of wastes which improve the cleanliness and environment of the town. -Make drainage system effective reducing the adverse impact of water logging or flooding. -Improve public health from better management of wastes. -Promotes usage of biogas replacing the use of firewood/coal which creates smoke and indoor air pollution in kitchens which have long term impact on health of women and children. -Reduce the greenhouse gas emission from the anaerobic recycling of wastes and contributes to sustainable urban environment. -Promote the concept of agroecology from the uses of bio slurry/compost which contributes to food security. -Creates green jobs from waste value chain which impacts on poverty alleviation of urban extreme poor. -Improve municipal governance from inclusive waste services and functional partnership with private sectors. -Contribute to the implementation of 3R (Reduce, Reuse, Recycle) Strategy and Employment Creation of extreme poor to achieve the target set in Vision 2021 by Government of Bangladesh.

Keywords: kitchen waste, secondary town, biogas, segregation

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10654 Factors Associated with the Use of Long-Acting Reversible Contraceptive Methods among Women of Reproductive Age 15-49 Years in Jinja District

Authors: Helen Nelly Naiga, Christopher Garimoi Orach

Abstract:

Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

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10653 Emerging Issues of Non-Communicable Diseases among Older Persons in India

Authors: Dhananjay W. Bansod, Santosh Phad

Abstract:

Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.

Keywords: NCD, well-being, older person, India

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10652 Factors Relating to Travel Behavior at the Floating Market of Thai Tourists

Authors: Siri-orn Champatong

Abstract:

The purpose of this research was to study factors that were related with travel behaviors of Thai tourists at the Ayothaya Floating Market, Phra Nakhon Sri Ayutthaya. The quantitative research was conducted with 400 samples of Thai tourists traveling to the Ayothaya Floating Market. The Questionnaire was a tool used to collect data, and the statistics used for data analysis were mean and Pearson product moment correlation coefficient. The results found that Thai tourists focused on attraction, easy access and facilities of the tourist spot at a high level. In addition, they gave priority to the marketing mix in the dimension of products, price, and distribution channels at a high level as well. For marketing promotion, it was at the moderate level. The results of hypothesis testing revealed that factors related to the attractions of the tourist destination, easy access to the tourist destination, the facilities of the tourist spot, and product and price of the marketing mix were associated with travel behaviors in the aspect of the number of visits used and the budget on tourism.

Keywords: floating market, marketing mix, tourism attractions, travelling behavior

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10651 Private Decisions, Public Results: German Business Action in Response to the Refugee Crisis

Authors: O. M. van den Broek

Abstract:

This article examines how large German companies have responded to the 2014 refugee crisis. It challenges the assumption that the historical legacy of implicit CSR in Germany would lead to low levels of business response through CSR channels. Instead, and building on institutional CSR and the converging forces of globalization, this article argues that the urgency of a humanitarian crisis creates incentives, in the absence of formal institutional arrangement, for explicit CSR responses. This explorative research encompasses the 53 German companies presented on 2015 Forbes2000. A qualitative content analysis of corporate websites was supplemented with inquiry e-mails. Results indicate considerable evidence for the main hypothesis, showing a vast majority of companies responding to the refugee crisis. Levels of engagement varied, depending on the phase of the crisis, from core-business activities to non-integrated action. The high level of partnerships with the state and other non-state actors indicates a quest for enhanced legitimacy in the face of an absent democratic mandate.

Keywords: corporate social responsibility (CSR), implicit versus explicit CSR, public-private partnerships, European refugee crisis

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10650 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

Abstract:

Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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10649 Credit Cooperatives: A Factor for Improving the Sustainable Management of Private Forests

Authors: Todor Nickolov Stoyanov

Abstract:

Cooperatives are present in all countries and in almost all sectors, including agriculture, forestry, food, finance, health, marketing, insurance and credit. Strong cooperatives are able to overcome many of the difficulties faced by private owners. Cooperatives use seven principles, including the 'Community Concern" principle, which enables cooperatives to work for the sustainable development of the community. The members of cooperatives may use different systems for generating year-round employment and for receiving sustainable income through performing different forestry activities. Various methods are used during the preparation of the report. These include literature reviews, statistics, secondary data and expert interviews. The members of the cooperatives are benefits exclusively from increasing the efficiency of the various products and from the overall yield of the harvest, and ultimately from achieving better profit through cooperative efforts. Cooperatives also use other types of activities that are an additional opportunity for cooperative income. There are many heterogeneous activities in the production and service sectors of the forest cooperatives under consideration. Some cooperatives serve dairies, distilleries, woodworking enterprises, tourist homes, hotels and motels, shops, ski slopes, sheep breeding, etc. Through the revenue generated by the activity, cooperatives have the opportunity to carry out various environmental and protective activities - recreation, water protection, protection of endangered and endemic species, etc., which in the case of small-scale forests cannot be achieved and the management is not sustainable. The conclusions indicate the results received in the analysis. Cooperative management of forests and forest lands gives higher incomes to individual owners. The management of forests and forest lands through cooperatives helps to carry out different environmental and protective activities. Cooperative forest management provides additional means of subsistence to the owners of poor forest lands. Cooperative management of forests and forest lands support owners to implement the forest management plans and to apply sustainable management of these territories.

Keywords: cooperative, forestry, forest owners, principles of cooperation

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10648 Energy Box Programme in the Netherlands

Authors: B. E. Weber, N. Vrielink, M. G. Rietbergen

Abstract:

This paper explores the long-term effects of the Energy Box trajectory on households in the private rental sector, specifically households experiencing energy poverty. The concept of energy poverty has been getting increasing attention among policymakers over the past few years. In the Netherlands, as far as we know, there are no national policies on alleviating energy poverty, which negatively impacts energy-poor households. The Energy Box can help households experiencing energy poverty by stimulating them to improve the energy efficiency of their home by changing their energy-saving behavior. Important long-term effects are that respondents indicate that they live in a more environmentally friendly way and that they save money on their energy bills. Households feel engaged with the concept of energy-saving and can see the benefits of changing their energy-saving behavior. Respondents perceived the Energy Box as a means to live more environmentally friendly, instead of it solely being a means to save money on energy bills. The findings show that most respondents signed up for the Energy Box are interested in energy-saving as a lifestyle choice instead of a financial choice, which would likely be the case for households experiencing energy poverty.

Keywords: energy-saving behavior, energy poverty, poverty, private rental sector

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10647 Impact of Sociocultural Factors on Management and Utilization of Solid Waste in Ibadan Metropolis, Nigeria

Authors: Olufunmilayo Folaranmi

Abstract:

This research was carried out to examine the impact of socio-cultural factors on the management and utilization of solid waste in Ibadan Metropolis. A descriptive survey research design was adopted for the study while a systematic and stratified random sampling technique was used to select 300 respondents which were categorized into high, middle and low-density areas. Four hypothesis were tested using chi-square test on variables of unavailability of waste disposal facilities and waste management, negligence of contractors to liaise with community members, lack of adequate environmental education and waste management and utilization, low level of motivation of sanitation workers with solid wastes management, lack of community full participation with solid waste management and utilization. Results showed that significant effect of waste disposal facilities on solid waste management and utilization (X2 +16.6, P < .05). Also, there is a significant relationship between negligence of the contractors to liaise with community elites with improper disposal (X2 = 87.5, P < .05). The motivation of sanitation workers is significantly related to solid waste management (X2 = 70.4, P < .05). Adequate environmental education and awareness influenced solid waste management. There was also a significant relationship between lack of community participation with waste management disposal and improper waste disposal. Based on the findings from the study it was recommended that the quality of life in urban centers should be improved, social welfare of the populace enhanced and environment should be adequately attended to. Poverty alleviation programmes should be intensified and made to live beyond the life of a particular administration, micro-credit facilities should be available to community members to promote their welfare. Lastly, sustained environmental education programmes for citizens at all levels of education, formal and informal through the use of agencies like Ethical and Attitudinal Reorientation Commission (EARCOM) and the National Orientation Agency (NOA).

Keywords: management, social welfare, socio-cultural factors, solid waste

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10646 Implementing Internet of Things through Building Information Modelling in Order to Assist with the Maintenance Stage of Commercial Buildings

Authors: Ushir Daya, Zenadene Lazarus, Dimelle Moodley, Ehsan Saghatforoush

Abstract:

It was found through literature that there is a lack of implementation of the Internet of Things (IoT) incorporated into Building Information Modelling (BIM) in South Africa. The research aims to find if the implementation of IoT into BIM will make BIM more useful during the maintenance stage of buildings and assist facility managers when doing their job. The research will look at the existing problematic areas with building information modelling, specifically BIM 7D. This paper will look at the capabilities of IoT and what issues IoT will be able to resolve in BIM software, as well as how IoT into BIM will assist facility managers and if such an implementation will make a facility manager's job more efficient.

Keywords: internet of things, building information modeling, facilities management, structural health monitoring

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10645 Statistical Variability of Soil Parameters within the Copper Belt Region of the Democratic Republic of the Congo

Authors: Stephan P. Barkhuizen, Deon Greyling, Ryan J. Miller

Abstract:

The accurate determination of the engineering parameters of soil is necessary for the design of geotechnical structures, such as Tailings Storage Facilities. The shear strength and saturated permeability of soil and tailings samples obtained from 14 sites located in the copper belt in the Democratic Republic of the Congo have been tested at six commercial soil laboratories in South Africa. This study compiles a database of the test results proved by the soil laboratories. The samples have been categorised into clay, silt, and sand, based on the Unified Soil Classification System, with tailings kept separate. The effective friction angle (Φ’) and cohesion (c’) were interpreted from the stress paths, in s’:t space, obtained from triaxial tests. The minimum, lower quartile, median, upper quartile, and maximum values for Φ’,c’, and saturated hydraulic conductivity (k) have been determined for the soil sample. The objective is to provide statistics of the measured values of the engineering properties for the TSF borrow material, foundation soils and tailings of this region.

Keywords: Democratic Republic of the Congo, laboratory test work, soil engineering parameter variation, tailings storage facilities

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10644 Association of Work Pattern with the Well-Being and Happiness: Evidence from Married Women Working in Delhi, India

Authors: Kanchan Negi

Abstract:

Background: Modern work culture has driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and well-being (including happiness) in a sample of working women. Method: Primary data of 360 currently married women working in the education, health, banking and IT sector in Delhi, India, were analysed. Logistic regression was used to estimate physical and psychological well-being and happiness across work characteristics. Results: Relative to 35–40 hours/week, working longer related to poor well-being (ß=0.75, 95% CI 0.12 to 1.39). Compared with not working weekends, working most or all weekends is related to poor physical (ß=0.34, 95% CI 0.08 to 0.61) and psychological well-being (ß=0.50, 95% CI 0.20 to 0.79). Rigid work patterns (ß=0.17, 95% CI −0.09 to 0.42) are also related to poor well-being. Conclusion: Decreased well-being and unhappiness are significantly linked to strenuous and rigid work patterns, suggesting that modern work culture may contribute to poor well-being. Flexible timings, compensatory holidays, work-from-home, and daycare facilities for young ones must be welcomed by companies to ease the dual burden of homemakers and career makers.

Keywords: happiness, well-being, work pattern, working women

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10643 South African Multiple Deprivation-Concentration Index Quantiles Differentiated by Components of Success and Impediment to Tuberculosis Control Programme Using Mathematical Modelling in Rural O. R. Tambo District Health Facilities

Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo

Abstract:

Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.

Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa

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10642 Integration of Acoustic Solutions for Classrooms

Authors: Eyibo Ebengeobong Eddie, Halil Zafer Alibaba

Abstract:

The neglect of classroom acoustics is dominant in most educational facilities, meanwhile, hearing and listening is the learning process in this kind of facilities. A classroom should therefore be an environment that encourages listening, without an obstacles to understanding what is being taught. Although different studies have shown teachers to complain that noise is the everyday factor that causes stress in classroom, the capacity of individuals to understand speech is further affected by Echoes, Reverberation, and room modes. It is therefore necessary for classrooms to have an ideal acoustics to aid the intelligibility of students in the learning process. The influence of these acoustical parameters on learning and teaching in schools needs to be further researched upon to enhance the teaching and learning capacity of both teacher and student. For this reason, there is a strong need to provide and collect data to analyse and define the suitable quality of classrooms needed for a learning environment. Research has shown that acoustical problems are still experienced in both newer and older schools. However, recently, principle of acoustics has been analysed and room acoustics can now be measured with various technologies and sound systems to improve and solve the problem of acoustics in classrooms. These acoustic solutions, materials, construction methods and integration processes would be discussed in this paper.

Keywords: classroom, acoustics, materials, integration, speech intelligibility

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