Search results for: hospital waste management (HWM)
5338 Building a Composite Approach to Employees' Motivational Needs by Combining Cognitive Needs
Authors: Alexis Akinyemi, Laurene Houtin
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Measures of employee motivation at work are often based on the theory of self-determined motivation, which implies that human resources departments and managers seek to motivate employees in the most self-determined way possible and use strategies to achieve this goal. In practice, they often tend to assess employee motivation and then adapt management to the most important source of motivation for their employees, for example by financially rewarding an employee who is extrinsically motivated, and by rewarding an intrinsically motivated employee with congratulations and recognition. Thus, the use of motivation measures contradicts theoretical positioning: theory does not provide for the promotion of extrinsically motivated behaviour. In addition, a corpus of social psychology linked to fundamental needs makes it possible to personally address a person’s different sources of motivation (need for cognition, need for uniqueness, need for effects and need for closure). By developing a composite measure of motivation based on these needs, we provide human resources professionals, and in particular occupational psychologists, with a tool that complements the assessment of self-determined motivation, making it possible to precisely address the objective of adapting work not to the self-determination of behaviours, but to the motivational traits of employees. To develop such a model, we gathered the French versions of the cognitive needs scales (need for cognition, need for uniqueness, need for effects, need for closure) and conducted a study with 645 employees of several French companies. On the basis of the data collected, we conducted a confirmatory factor analysis to validate the model, studied the correlations between the various needs, and highlighted the different reference groups that could be used to use these needs as a basis for interviews with employees (career, recruitment, etc.). The results showed a coherent model and the expected links between the different needs. Taken together, these results make it possible to propose a valid and theoretically adjusted tool to managers who wish to adapt their management to their employees’ current motivations, whether or not these motivations are self-determined.Keywords: motivation, personality, work commitment, cognitive needs
Procedia PDF Downloads 1135337 Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression amongst HIV-Infected Prisoners in South Ethiopia: A Prospective Cohort Study
Authors: Terefe Fuge, George Tsourtos , Emma Miller
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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression
Procedia PDF Downloads 1295336 Application of Principal Component Analysis and Ordered Logit Model in Diabetic Kidney Disease Progression in People with Type 2 Diabetes
Authors: Mequanent Wale Mekonen, Edoardo Otranto, Angela Alibrandi
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Diabetic kidney disease is one of the main microvascular complications caused by diabetes. Several clinical and biochemical variables are reported to be associated with diabetic kidney disease in people with type 2 diabetes. However, their interrelations could distort the effect estimation of these variables for the disease's progression. The objective of the study is to determine how the biochemical and clinical variables in people with type 2 diabetes are interrelated with each other and their effects on kidney disease progression through advanced statistical methods. First, principal component analysis was used to explore how the biochemical and clinical variables intercorrelate with each other, which helped us reduce a set of correlated biochemical variables to a smaller number of uncorrelated variables. Then, ordered logit regression models (cumulative, stage, and adjacent) were employed to assess the effect of biochemical and clinical variables on the order-level response variable (progression of kidney function) by considering the proportionality assumption for more robust effect estimation. This retrospective cross-sectional study retrieved data from a type 2 diabetic cohort in a polyclinic hospital at the University of Messina, Italy. The principal component analysis yielded three uncorrelated components. These are principal component 1, with negative loading of glycosylated haemoglobin, glycemia, and creatinine; principal component 2, with negative loading of total cholesterol and low-density lipoprotein; and principal component 3, with negative loading of high-density lipoprotein and a positive load of triglycerides. The ordered logit models (cumulative, stage, and adjacent) showed that the first component (glycosylated haemoglobin, glycemia, and creatinine) had a significant effect on the progression of kidney disease. For instance, the cumulative odds model indicated that the first principal component (linear combination of glycosylated haemoglobin, glycemia, and creatinine) had a strong and significant effect on the progression of kidney disease, with an effect or odds ratio of 0.423 (P value = 0.000). However, this effect was inconsistent across levels of kidney disease because the first principal component did not meet the proportionality assumption. To address the proportionality problem and provide robust effect estimates, alternative ordered logit models, such as the partial cumulative odds model, the partial adjacent category model, and the partial continuation ratio model, were used. These models suggested that clinical variables such as age, sex, body mass index, medication (metformin), and biochemical variables such as glycosylated haemoglobin, glycemia, and creatinine have a significant effect on the progression of kidney disease.Keywords: diabetic kidney disease, ordered logit model, principal component analysis, type 2 diabetes
Procedia PDF Downloads 305335 Tackling Inequalities in Regional Health Care: Accompanying an Inter-Sectoral Cooperation Project between University Medicine and Regional Care Structures
Authors: Susanne Ferschl, Peter Holzmüller, Elisabeth Wacker
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Ageing populations, advances in medical sciences and digitalization, diversity and social disparities, as well as the increasing need for skilled healthcare professionals, are challenging healthcare systems around the globe. To address these challenges, future healthcare systems need to center on human needs taking into account the living environments that shape individuals’ knowledge of and opportunities to access healthcare. Moreover, health should be considered as a common good and an integral part of securing livelihoods for all people. Therefore, the adoption of a systems approach, as well as inter-disciplinary and inter-sectoral cooperation among healthcare providers, are essential. Additionally, the active engagement of target groups in the planning and design of healthcare structures is indispensable to understand and respect individuals’ health and livelihood needs. We will present the research project b4 – identifying needs | building bridges | developing health care in the social space, which is situated within this reasoning and accompanies the cross-sectoral cooperation project Brückenschlag (building bridges) in a Bavarian district. Brückenschlag seeks to explore effective ways of health care linking university medicine (Maximalversorgung | maximum care) with regional inpatient, outpatient, rehabilitative, and preventive care structures (Regionalversorgung | regional care). To create advantages for both (potential) patients and the involved cooperation partners, project b4 qualitatively assesses needs and motivations among professionals, population groups, and political stakeholders at individual and collective levels. Besides providing an overview of the project structure as well as of regional population and healthcare characteristics, the first results of qualitative interviews conducted with different health experts will be presented. Interviewed experts include managers of participating hospitals, nurses, medical specialists working in the hospital and registered doctors operating in practices in rural areas. At the end of the project life and based on the identified factors relevant to the success -and also for failure- of participatory cooperation in health care, the project aims at informing other districts embarking on similar systems-oriented and human-centered healthcare projects. Individuals’ health care needs in dependence on the social space in which they live will guide the development of recommendations.Keywords: cross-sectoral collaboration in health care, human-centered health care, regional health care, individual and structural health conditions
Procedia PDF Downloads 1005334 A Family Development Approach to Understanding the Transfer of Family Business Ownership
Authors: Susan Lanz, Gary T. Burke, Omid Omidvar
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The intention to transfer ownership control across family generations is acknowledged to be central to developing a theoretical understanding of how family businesses differ and are distinct as a business group. However, in practice, most business-owning families face challenges to transfer their business ownership from one family generation to the next. To date, researchers have paid little attention to how and when ownership is passed across family generations and what the dynamics of such transitions are. This is primarily due to the prevailing assumption that ownership transfer is an unimportant and legalistic issue that occurs within a wider family management succession process. Yet, the limited evidence available suggests that family ownership transfer occurs inside and outside of the management succession process and is a difficult process for business-owning families to navigate. As a result, many otherwise viable family businesses are closing, leading to unnecessary loss of jobs and knowledge. This qualitative paper examines how family members understand and navigate the ownership transfer process. This study uses an inductive qualitative research design, conducted through in-depth interviews within eight business-owning families. It draws on family development theory and shows how a wide range of family-related events and dynamics outside of family business involvement underlie and shape the ownership transfer process. The findings extend the theory on how these events trigger ownership transfer and how they shape the ownership meanings held within business-owning families. This study found that ownership transfer meanings extend beyond that of transferring the legal control and financial appropriation rights of shareholders. The study concludes there are three different stages in the process of ownership transfer -symbolic, re-balancing, and protectionist. Each stage creates distinct family social constructions of the rights of family members to hold business ownership, and each stage occurs within a specific family development phase.Keywords: business-owning family, family development theory, ownership transfer, process
Procedia PDF Downloads 1525333 Genetic and Virulence Diversity among Alternaria carthami Isolates of India
Authors: Garima Anand, Rupam Kapoor
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Alternaria leaf spot caused by Alternaria carthami is one of the most devastating diseases of safflower. It has resulted in huge losses in crop production and cultivation leading to a fall out of India’s rank as the leading producer of safflower in the world. Understanding the diversity of any pathogen is essential for its management and for the development of disease control strategies. The diversity of A. carthami was therefore analysed on the basis of biochemical, pathogenicity and genetic lines using ISSR markers. Collections and isolations of 95 isolates of A. carthami were made from major safflower producing states of India. Virulence was analysed to evaluate the pathogenic potential of these isolates. The isolates from Bijapur, Dharwad districts (Karnataka), and Parbhani and Solapur districts (Maharashtra) were found to be highly virulent. The virulence assays showed low virulence levels (42%) for the largest part of the population. Biochemical characterization to assess aggressiveness of these isolates was done by estimating the activity of cell wall degrading enzymes where isolates from districts Dharwad, Bijapur of Karnataka and districts Parbhani and Latur of Maharashtra were found to be most aggressive. Genetic diversity among isolates of A. carthami was determined using eighteen ISSR markers. Distance analysis using neighbour joining method and PCoA analysis of the ISSR profiles divided the isolates into three sub-populations. The most virulent isolates clustered in one group in the dendrogram. The study provided no evidence for geographical clustering indicating that isolates are randomly spread across the states, signifying the high potential of the fungus to adapt to diverse regions. The study can, therefore, aid in the breeding and deployment of A. carthami resistant safflower varieties and in the management of Alternaria leaf spot disease.Keywords: alternaria leaf spot, genetic diversity, pathogenic potential, virulence
Procedia PDF Downloads 2495332 Efficacy of Coconut Shell Pyrolytic Oil Distillate in Protecting Wood Against Bio-Deterioration
Authors: K. S. Shiny, R. Sundararaj
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Coconut trees (Cocos nucifera L.) are grown in many parts of India and world because of its multiple utilities. During pyrolysis, coconut shells yield oil, which is a dark thick liquid. Upon simple distillation it produces a more or less colourless liquid, termed coconut shell pyrolytic oil distillate (CSPOD). This manuscript reports and discusses the use of coconut shell pyrolytic oil distillate as a potential wood protectant against bio-deterioration. Since botanical products as ecofriendly wood protectant is being tested worldwide, the utilization of CPSOD as wood protectant is of great importance. The efficacy of CSPOD as wood protectant was evaluated as per Bureau of Indian Standards (BIS) in terms of its antifungal, antiborer, and termiticidal activities. Specimens of Rubber wood (Hevea brasiliensis) in six replicate each for two treatment methods namely spraying and dipping (48hrs) were employed. CSPOD was found to impart total protection against termites for six months compared to control under field conditions. For assessing the efficacy of CSPOD against fungi, the treated blocks were subjected to the attack of two white rot fungi Tyromyces versicolor (L.) Fr. and Polyporus sanguineus (L.) G. Mey and two brown rot fungi, Polyporus meliae (Undrew.) Murrill. and Oligoporus placenta (Fr.) Gilb. & Ryvarden. Results indicated that treatment with CSPOD significantly protected wood from the damage caused by the decay fungi. Efficacy of CSPOD against wood borer Lyctus africanus Lesne was carried out using six pairs of male and female beetles and it gave promising results in protecting the treated wood blocks when compared to control blocks. As far as the treatment methods were concerned, dip treatment was found to be more effective when compared to spraying. The results of the present investigation indicated that CSPOD is a promising botanical compound which has the potential to replace synthetic wood protectants. As coconut shell, pyrolytic oil is a waste byproduct of coconut shell charcoal industry, its utilization as a wood preservative will expand the economic returns from such industries.Keywords: coconut shell pyrolytic oil distillate, eco-friendly wood protection, termites, wood borers, wood decay fungi
Procedia PDF Downloads 3625331 Review of Malaria Diagnosis Techniques
Authors: Lubabatu Sada Sodangu
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Malaria is a major cause of death in tropical and subtropical nations. Malaria cases are continually rising as a result of a number of factors, despite the fact that the condition is now treatable using effective methods. In this situation, quick and effective diagnostic methods are essential for the management and control of malaria. Malaria diagnosis using conventional methods is still troublesome, hence new technologies have been created and implemented to get around the drawbacks. The review describes the currently known malaria diagnostic techniques, their strengths and shortcomings.Keywords: malaria, technique, diagnosis, Africa
Procedia PDF Downloads 495330 Review of Malaria Diagnosis Techniques
Authors: Lubabatu Sada Sodangi
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Malaria is a major cause of death in tropical and subtropical nations. Malaria cases are continually rising as a result of a number of factors, despite the fact that the condition is now treatable using effective methods. In this situation, quick and effective diagnostic methods are essential for the management and control of malaria. Malaria diagnosis using conventional methods is still troublesome; hence, new technologies have been created and implemented to get around the drawbacks. The review describes the currently known malaria diagnostic techniques, their strengths, and shortcomings.Keywords: malaria, technique, diagnosis, Africa
Procedia PDF Downloads 545329 Rethinking the Air Quality Health Index: Harmonizing Health Protection and Climate Mitigation
Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau
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Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.Keywords: air quality management, air quality health index, health risk management, air pollution
Procedia PDF Downloads 665328 Effects of Irrigation Scheduling and Soil Management on Maize (Zea mays L.) Yield in Guinea Savannah Zone of Nigeria
Authors: I. Alhassan, A. M. Saddiq, A. G. Gashua, K. K. Gwio-Kura
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The main objective of any irrigation program is the development of an efficient water management system to sustain crop growth and development and avoid physiological water stress in the growing plants. Field experiment to evaluate the effects of some soil moisture conservation practices on yield and water use efficiency (WUE) of maize was carried out in three locations (i.e. Mubi and Yola in the northern Guinea Savannah and Ganye in the southern Guinea Savannah of Adamawa State, Nigeria) during the dry seasons of 2013 and 2014. The experiment consisted of three different irrigation levels (7, 10 and 12 day irrigation intervals), two levels of mulch (mulch and un-mulched) and two tillage practices (no tillage and minimum tillage) arranged in a randomized complete block design with split-split plot arrangement and replicated three times. The Blaney-Criddle method was used for measuring crop evapotranspiration. The results indicated that seven-day irrigation intervals and mulched treatment were found to have significant effect (P>0.05) on grain yield and water use efficiency in all the locations. The main effect of tillage was non-significant (P<0.05) on grain yield and WUE. The interaction effects of irrigation and mulch were significant (P>0.05) on grain yield and WUE at Mubi and Yola. Generally, higher grain yield and WUE were recorded on mulched and seven-day irrigation intervals, whereas lower values were recorded on un-mulched with 12-day irrigation intervals. Tillage exerts little influence on the yield and WUE. Results from Ganye were found to be generally higher than those recorded in Mubi and Yola; it also showed that an irrigation interval of 10 days with mulching could be adopted for the Ganye area, while seven days interval is more appropriate for Mubi and Yola.Keywords: irrigation, maize, mulching, tillage, savanna
Procedia PDF Downloads 2065327 The Relationship between the Competence Perception of Student and Graduate Nurses and Their Autonomy and Critical Thinking Disposition
Authors: Zülfiye Bıkmaz, Aytolan Yıldırım
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This study was planned as a descriptive regressive study in order to determine the relationship between the competency levels of working nurses, the levels of competency expected by nursing students, the critical thinking disposition of nurses, their perceived autonomy levels, and certain socio demographic characteristics. It is also a methodological study with regard to the intercultural adaptation of the Nursing Competence Scale (NCS) in both working and student samples. The sample of the study group of nurses at a university hospital for at least 6 months working properly and consists of 443 people filled out questionnaires. The student group, consisting of 543 individuals from the 4 public university nursing 3rd and 4th grade students. Data collection tools consisted of a questionnaire prepared in order to define the socio demographic, economic, and personal characteristics of the participants, the ‘Nursing Competency Scale’, the ‘Autonomy Subscale of the Sociotropy – Autonomy Scale’, and the ‘California Critical Thinking Disposition Inventory’. In data evaluation, descriptive statistics, nonparametric tests, Rasch analysis and correlation and regression tests were used. The language validity of the ‘NCS’ was performed by translation and back translation, and the context validity of the scale was performed with expert views. The scale, which was formed into its final structure, was applied in a pilot application from a group consisting of graduate and student nurses. The time constancy of the test was obtained by analysis testing retesting method. In order to reduce the time problems with the two half reliability method was used. The Cronbach Alfa coefficient of the scale was found to be 0.980 for the nurse group and 0.986 for the student group. Statistically meaningful relationships between competence and critical thinking and variables such as age, gender, marital status, family structure, having had critical thinking training, education level, class of the students, service worked in, employment style and position, and employment duration were found. Statistically meaningful relationships between autonomy and certain variables of the student group such as year, employment status, decision making style regarding self, total duration of employment, employment style, and education status were found. As a result, it was determined that the NCS which was adapted interculturally was a valid and reliable measurement tool and was found to be associated with autonomy and critical thinking.Keywords: nurse, nursing student, competence, autonomy, critical thinking, Rasch analysis
Procedia PDF Downloads 3885326 Chronic Fatigue Syndrome/Myalgic Encephalomyelitis in Younger Children: A Qualitative Analysis of Families’ Experiences of the Condition and Perspective on Treatment
Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley
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Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment
Procedia PDF Downloads 1345325 A Digital Health Approach: Using Electronic Health Records to Evaluate the Cost Benefit of Early Diagnosis of Alpha-1 Antitrypsin Deficiency in the UK
Authors: Sneha Shankar, Orlando Buendia, Will Evans
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Alpha-1 antitrypsin deficiency (AATD) is a rare, genetic, and multisystemic condition. Underdiagnosis is common, leading to chronic pulmonary and hepatic complications, increased resource utilization, and additional costs to the healthcare system. Currently, there is limited evidence of the direct medical costs of AATD diagnosis in the UK. This study explores the economic impact of AATD patients during the 3 years before diagnosis and to identify the major cost drivers using primary and secondary care electronic health record (EHR) data. The 3 years before diagnosis time period was chosen based on the ability of our tool to identify patients earlier. The AATD algorithm was created using published disease criteria and applied to 148 known AATD patients’ EHR found in a primary care database of 936,148 patients (413,674 Biobank and 501,188 in a single primary care locality). Among 148 patients, 9 patients were flagged earlier by the tool and, on average, could save 3 (1-6) years per patient. We analysed 101 of the 148 AATD patients’ primary care journey and 20 patients’ Hospital Episode Statistics (HES) data, all of whom had at least 3 years of clinical history in their records before diagnosis. The codes related to laboratory tests, clinical visits, referrals, hospitalization days, day case, and inpatient admissions attributable to AATD were examined in this 3-year period before diagnosis. The average cost per patient was calculated, and the direct medical costs were modelled based on the mean prevalence of 100 AATD patients in a 500,000 population. A deterministic sensitivity analysis (DSA) of 20% was performed to determine the major cost drivers. Cost data was obtained from the NHS National tariff 2020/21, National Schedule of NHS Costs 2018/19, PSSRU 2018/19, and private care tariff. The total direct medical cost of one hundred AATD patients three years before diagnosis in primary and secondary care in the UK was £3,556,489, with an average direct cost per patient of £35,565. A vast majority of this total direct cost (95%) was associated with inpatient admissions (£3,378,229). The DSA determined that the costs associated with tier-2 laboratory tests and inpatient admissions were the greatest contributors to direct costs in primary and secondary care, respectively. This retrospective study shows the role of EHRs in calculating direct medical costs and the potential benefit of new technologies for the early identification of patients with AATD to reduce the economic burden in primary and secondary care in the UK.Keywords: alpha-1 antitrypsin deficiency, costs, digital health, early diagnosis
Procedia PDF Downloads 1605324 Finite Element Modeling of Aortic Intramural Haematoma Shows Size Matters
Authors: Aihong Zhao, Priya Sastry, Mark L Field, Mohamad Bashir, Arvind Singh, David Richens
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Objectives: Intramural haematoma (IMH) is one of the pathologies, along with acute aortic dissection, that present as Acute Aortic Syndrome (AAS). Evidence suggests that unlike aortic dissection, some intramural haematomas may regress with medical management. However, intramural haematomas have been traditionally managed like acute aortic dissections. Given that some of these pathologies may regress with conservative management, it would be useful to be able to identify which of these may not need high risk emergency intervention. A computational aortic model was used in this study to try and identify intramural haematomas with risk of progression to aortic dissection. Methods: We created a computational model of the aorta with luminal blood flow. Reports in the literature have identified 11 mm as the radial clot thickness that is associated with heightened risk of progression of intramural haematoma. Accordingly, haematomas of varying sizes were implanted in the modeled aortic wall to test this hypothesis. The model was exposed to physiological blood flows and the stresses and strains in each layer of the aortic wall were recorded. Results: Size and shape of clot were seen to affect the magnitude of aortic stresses. The greatest stresses and strains were recorded in the intima of the model. When the haematoma exceeded 10 mm in all dimensions, the stress on the intima reached breaking point. Conclusion: Intramural clot size appears to be a contributory factor affecting aortic wall stress. Our computer simulation corroborates clinical evidence in the literature proposing that IMH diameter greater than 11 mm may be predictive of progression. This preliminary report suggests finite element modelling of the aortic wall may be a useful process by which to examine putative variables important in predicting progression or regression of intramural haematoma.Keywords: intramural haematoma, acute aortic syndrome, finite element analysis,
Procedia PDF Downloads 4275323 Marketing in the Fashion Industry and Its Critical Success Factors: The Case of Fashion Dealers in Ghana
Authors: Kumalbeo Paul Kamani
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Marketing plays a very important role in the success of any firm since it represents the means through which a firm can reach its customers and also promotes its products and services. In fact, marketing aids the firm in identifying customers who the business can competitively serve, and tailoring product offerings, prices, distribution, promotional efforts, and services towards those customers. Unfortunately, in many firms, marketing has been reduced to merely advertisement. For effective marketing, firms must go beyond this often-limited function of advertisement. In the fashion industry in particular, marketing faces challenges due to its peculiar characteristics. Previous research for instance affirms the idiosyncrasy and peculiarities that differentiate the fashion industry from other industrial areas. It has been documented that the fashion industry is characterized seasonal intensity, short product life cycles, the difficulty of competitive differentiation, and long time for companies to reach financial stability. These factors are noted to pose obstacles to the fashion entrepreneur’s endeavours and can be the reasons that explain their low survival rates. In recent times, the fashion industry has been described as a market that is accessible market, has low entry barriers, both in terms of needed capital and skills which have all accounted for the burgeoning nature of startups. Yet as already stated, marketing is particularly challenging in the industry. In particular, areas such as marketing, branding, growth, project planning, financial and relationship management might represent challenges for the fashion entrepreneur but that have not been properly addressed by previous research. It is therefore important to assess marketing strategies of fashion firms and the factors influencing their success. This study generally sought to examine marketing strategies of fashion dealers in Ghana and their critical success factors. The study employed the quantitative survey research approach. A total of 120 fashion dealers were sampled. Questionnaires were used as instrument of data collection. Data collected was analysed using quantitative techniques including descriptive statistics and Relative Importance Index. The study revealed that the marketing strategies used by fashion apparels are text messages using mobile phones, referrals, social media marketing, and direct marketing. Results again show that the factors influencing fashion marketing effectiveness are strategic management, marketing mix (product, price, promotion etc), branding and business development. Policy implications are finally outlined. The study recommends among others that there is a need for the top management executive to craft and adopt marketing strategies that enable that are compatible with the fashion trends and the needs of the customers. This will improve customer satisfaction and hence boost market penetration. The study further recommends that the fashion industry in Ghana should seek to ensure that fashion apparels accommodate the diversity and the cultural setting of different customers to meet their unique needs.Keywords: marketing, fashion, industry, success factors
Procedia PDF Downloads 325322 Guests’ Satisfaction and Intention to Revisit Smart Hotels: Qualitative Interviews Approach
Authors: Raymond Chi Fai Si Tou, Jacey Ja Young Choe, Amy Siu Ian So
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Smart hotels can be defined as the hotel which has an intelligent system, through digitalization and networking which achieve hotel management and service information. In addition, smart hotels include high-end designs that integrate information and communication technology with hotel management fulfilling the guests’ needs and improving the quality, efficiency and satisfaction of hotel management. The purpose of this study is to identify appropriate factors that may influence guests’ satisfaction and intention to revisit Smart Hotels based on service quality measurement of lodging quality index and extended UTAUT theory. Unified Theory of Acceptance and Use of Technology (UTAUT) is adopted as a framework to explain technology acceptance and use. Since smart hotels are technology-based infrastructure hotels, UTATU theory could be as the theoretical background to examine the guests’ acceptance and use after staying in smart hotels. The UTAUT identifies four key drivers of the adoption of information systems: performance expectancy, effort expectancy, social influence, and facilitating conditions. The extended UTAUT modifies the definitions of the seven constructs for consideration; the four previously cited constructs of the UTAUT model together with three new additional constructs, which including hedonic motivation, price value and habit. Thus, the seven constructs from the extended UTAUT theory could be adopted to understand their intention to revisit smart hotels. The service quality model will also be adopted and integrated into the framework to understand the guests’ intention of smart hotels. There are rare studies to examine the service quality on guests’ satisfaction and intention to revisit in smart hotels. In this study, Lodging Quality Index (LQI) will be adopted to measure the service quality in smart hotels. Using integrated UTAUT theory and service quality model because technological applications and services require using more than one model to understand the complicated situation for customers’ acceptance of new technology. Moreover, an integrated model could provide more perspective insights to explain the relationships of the constructs that could not be obtained from only one model. For this research, ten in-depth interviews are planned to recruit this study. In order to confirm the applicability of the proposed framework and gain an overview of the guest experience of smart hotels from the hospitality industry, in-depth interviews with the hotel guests and industry practitioners will be accomplished. In terms of the theoretical contribution, it predicts that the integrated models from the UTAUT theory and the service quality will provide new insights to understand factors that influence the guests’ satisfaction and intention to revisit smart hotels. After this study identifies influential factors, smart hotel practitioners could understand which factors may significantly influence smart hotel guests’ satisfaction and intention to revisit. In addition, smart hotel practitioners could also provide outstanding guests experience by improving their service quality based on the identified dimensions from the service quality measurement. Thus, it will be beneficial to the sustainability of the smart hotels business.Keywords: intention to revisit, guest satisfaction, qualitative interviews, smart hotels
Procedia PDF Downloads 2005321 Dynamics of Hepatitis B Infection Prevention Practices among Pregnant Women Attending Antenatal Care in Central Uganda Using the Constructs of Information-Motivation-Behavioral Skills Model: A Case of Lubaga Hospital Kampala
Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah
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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices
Procedia PDF Downloads 845320 Assessment of the Efficacy of Routine Medical Tests in Screening Medical Radiation Staff in Shiraz University of Medical Sciences Educational Centers
Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri
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Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.Keywords: blood cell count, mandatory testing, occupational exposure, radiation
Procedia PDF Downloads 4535319 The Relationships among Self-Efficacy, Critical Thinking and Communication Skills Ability in Oncology Nurses for Cancer Immunotherapy in Taiwan
Authors: Yun-Hsiang Lee
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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy
Procedia PDF Downloads 975318 The Effectiveness of Incidental Physical Activity Interventions Compared to Other Interventions in the Management of People with Low Back Pain: A Systematic Review and Meta-Analysis
Authors: Hosam Alzahrani, Martin Mackey, Emmanuel Stamatakis, Marina B. Pinheiro, Manuela Wicks, Debra Shirley
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Objective: To investigate the effectiveness of incidental (non-structured) physical activity interventions compared with other commonly prescribed interventions for the management of people with low back pain (LBP). Methods: We performed a systematic review with meta-analyses of eligible randomized controlled trials obtained by searching Medline, Scopus, CINAHL, EMBASE, and CENTRAL. This review considered trials investigating the effect of incidental physical activity interventions compared to other interventions in people aged 18 years or over, diagnosed with non-specific LBP. Analyses were conducted separately for short-term (≤3 months), intermediate-term (> 3 and < 12 months), and long-term (≥ 12 months), for each outcome. The analyses were conducted using the weighted mean difference (WMD). The overall quality of evidence was assessed using the GRADE system. Meta-analyses were only performed for pain and disability outcomes as there was insufficient data on the other outcomes. Results: For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term; however, the pooled results favored incidental physical activity at intermediate-term (WMD= -6.05, 95% CI: -10.39 to -1.71, p=0.006) and long-term (WMD= -6.40 95% CI: -11.68 to -1.12, p=0.02) follow-ups among participants with chronic LBP. The overall quality of evidence was rated “moderate quality” based on the GRADE system. Conclusion: The incidental physical activity intervention provided intermediate and long disability relief for people with chronic LBP, although this improvement was small and not likely to be clinically important.Keywords: physical activity, incidental, low back pain, systematic review, meta-analysis
Procedia PDF Downloads 1515317 The Research of Hand-Grip Strength for Adults with Intellectual Disability
Authors: Haiu-Lan Chin, Yu-Fen Hsiao, Hua-Ying Chuang, Wei Lee
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An adult with intellectual disability generally has insufficient physical activity which is an important factor leading to premature weakness. Studies in recent years on frailty syndrome have accumulated substantial data about indicators of human aging, including unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity. Of these indicators, hand-grip strength can be seen as a predictor of mortality, disability, complications, and increased length of hospital stay. Hand-grip strength in fact provides a comprehensive overview of one’s vitality. The research is about the investigation on hand-grip strength of adults with intellectual disabilities in facilities, institutions and workshops. The participants are 197 male adults (M=39.09±12.85 years old), and 114 female ones (M=35.80±8.2 years old) so far. The aim of the study is to figure out the performance of their hand-grip strength, and initiate the setting of training on hand-grip strength in their daily life which will decrease the weakening on their physical condition. Test items include weight, bone density, basal metabolic rate (BMR), static body balance except hand-grip strength. Hand-grip strength was measured by a hand dynamometer and classified as normal group ( ≧ 30 kg for male and ≧ 20 kg for female) and weak group ( < 30 kg for male, < 20 kg for female)The analysis includes descriptive statistics, and the indicators of grip strength fo the adults with intellectual disability. Though the research is still ongoing and the participants are increasing, the data indicates: (1) The correlation between hand-grip strength and degree of the intellectual disability (p ≦. 001), basal metabolic rate (p ≦ .001), and static body balance (p ≦ .01) as well. Nevertheless, there is no significant correlation between grip strength and basal metabolic rate which had been having significant correlation with hand-grip strength. (2) The difference between male and female subjects in hand-grip strength is significant, the hand-grip strength of male subjects (25.70±12.81 Kg) is much higher than female ones (16.30±8.89 Kg). Compared to the female counterparts, male participants indicate greater individual differences. And the proportion of weakness between male and female subjects is also different. (3) The regression indicates the main factors related to grip strength performance include degree of the intellectual disability, height, static body balance, training and weight sequentially. (4) There is significant difference on both hand-grip and static body balance between participants in facilities and workshops. The study supports the truth about the sex and gender differences in health. Nevertheless, the average hand-grip strength of left hand is higher than right hand in both male and female subjects. Moreover, 71.3% of male subjects and 64.2% of female subjects have better performance in their left hand-grip which is distinctive features especially in low degree of the intellectual disability.Keywords: adult with intellectual disability, frailty syndrome, grip strength, physical condition
Procedia PDF Downloads 1715316 Optimizing Energy Efficiency: Leveraging Big Data Analytics and AWS Services for Buildings and Industries
Authors: Gaurav Kumar Sinha
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In an era marked by increasing concerns about energy sustainability, this research endeavors to address the pressing challenge of energy consumption in buildings and industries. This study delves into the transformative potential of AWS services in optimizing energy efficiency. The research is founded on the recognition that effective management of energy consumption is imperative for both environmental conservation and economic viability. Buildings and industries account for a substantial portion of global energy use, making it crucial to develop advanced techniques for analysis and reduction. This study sets out to explore the integration of AWS services with big data analytics to provide innovative solutions for energy consumption analysis. Leveraging AWS's cloud computing capabilities, scalable infrastructure, and data analytics tools, the research aims to develop efficient methods for collecting, processing, and analyzing energy data from diverse sources. The core focus is on creating predictive models and real-time monitoring systems that enable proactive energy management. By harnessing AWS's machine learning and data analytics capabilities, the research seeks to identify patterns, anomalies, and optimization opportunities within energy consumption data. Furthermore, this study aims to propose actionable recommendations for reducing energy consumption in buildings and industries. By combining AWS services with metrics-driven insights, the research strives to facilitate the implementation of energy-efficient practices, ultimately leading to reduced carbon emissions and cost savings. The integration of AWS services not only enhances the analytical capabilities but also offers scalable solutions that can be customized for different building and industrial contexts. The research also recognizes the potential for AWS-powered solutions to promote sustainable practices and support environmental stewardship.Keywords: energy consumption analysis, big data analytics, AWS services, energy efficiency
Procedia PDF Downloads 585315 Effect of Extracorporeal Shock Wave Therapy on Post Burn Scars
Authors: Mahmoud S. Zaghloul, Mohammed M. Khalaf, Wael N. Thabet, Haidy N. Asham
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Background. Hypertrophic scarring is a difficult problem for burn patients, and scar management is an essential aspect of outpatient burn therapy. Post-burn pathologic scars involve functional and aesthetic limitations that have a dramatic influence on the patient’s quality of life. The aim was to investigate the use of extracorporeal shock wave therapy (ESWT), which targets the fibroblasts in scar tissue, as an effective modality for scar treatment in burn patients. Subjects and methods: forty patients with post-burn scars were assigned randomly into two equal groups; their ages ranged from 20-45 years. The study group received ESWT and traditional physical therapy program (deep friction massage, stretching exercises). The control group received traditional physical therapy program (deep friction massage, stretching exercises). All groups received two sessions per week for six successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure scar thickness using ultrasonography and Vancouver Scar Scale (VSS) was completed before and after treatment. Results: Post-treatment results showed that there was a significant improvement difference in scar thickness in both groups in favor of the study group. Percentage of improvement in scar thickness in the study group was 42.55%, while it was 12.15% in the control group. There was also a significant improvement difference between results obtained using VSS in both groups in favor of the study group. Conclusion: ESWT is effective in management of pathologic post burn scars.Keywords: extracorporeal shock wave therapy, post-burn scars, ultrasonography, Vancouver scar scale
Procedia PDF Downloads 2525314 The Debureaucratization Strategy for the Portuguese Health Service through Effective Communication
Authors: Fernando Araujo, Sandra Cardoso, Fátima Fonseca, Sandra Cavaca
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A debureaucratization strategy for the Portuguese Health Service was assumed by the Executive Board of the SNS, in deep articulation with the Shared Services of the Ministry of Health. Two of the main dimensions were focused on sick leaves (SL), that transform primary health care (PHC) in administrative institutions, limiting access to patients. The self-declaration of illness (SDI) project, through the National Health Service Contact Centre (SNS24), began on May 1, 2023, and has already resulted in the issuance of more than 300,000 SDI without the need to allocate resources from the National Health Service (NHS). This political decision allows each citizen, in a maximum 2 times/year, and 3 days each time, if ill, through their own responsibility, report their health condition in a dematerialized way, and by this way justified the absence to work, although by Portuguese law in these first three days, there is no payment of salary. Using a digital approach, it is now feasible without the need to go to the PHC and occupy the time of the PHC only to obtain an SL. Through this measure, bureaucracy has been reduced, and the system has been focused on users, improving the lives of citizens and reducing the administrative burden on PHC, which now has more consultation times for users who need it. The second initiative, which began on March 1, 2024, allows the SL to be issued in emergency departments (ED) of public hospitals and in the health institutions of the social and private sectors. This project is intended to allow the user who has suffered a situation of acute urgent illness and who has been observed in an ED of a public hospital or in a private or social entity no longer need to go to PHC only to apply for the respective SL. Since March 1, 54,453 SLs have been issued, 242 in private or social sector institutions and 6,918 in public hospitals, of which 134 were in ED and 47,292 in PHC. This approach has proven to be technically robust, allows immediate resolution of problems and differentiates the performance of doctors. However, it is important to continue to qualify the proper functioning of the ED, preventing non-urgent users from going there only to obtain SL. Thus, in order to make better use of existing resources, it was operationalizing this extension of its issuance in a balanced way, allowing SL to be issued in the ED of hospitals only to critically ill patients or patients referred by INEM, SNS24, or PHC. In both cases, an intense public campaign was implemented to explain the way it works and the benefits for patients. In satisfaction surveys, more than 95% of patients and doctors were satisfied with the solutions, asking for extensions to other areas. The administrative simplification agenda of the NHS continues its effective development. For the success of this debureaucratization agenda, the key factors are effective communication and the ability to reach patients and health professionals in order to increase health literacy and the correct use of NHS.Keywords: debureaucratization strategy, self-declaration of illness, sick leaves, SNS24
Procedia PDF Downloads 535313 Community Perceptions on Honey Quality in Tobacco Growing Areas in Kigoma Region, Tanzania
Authors: Pilly Kagosi, Cherestino Balama
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Beekeeping plays major role in improving biodiversity, increasing household income, and crop production through pollination. Tobacco farming is also the main source of household income for smallholder farmers. In Kigoma, production of Tobacco has increased and is perceived to threaten honey quality. The study explored the perception of the community on quality of honey in tobacco and non tobacco growing areas. The study was conducted in Kigoma Region, Tanzania. District and Villages were purposively sampled based on large numbers of people dealing with beekeeping activities and tobacco farming. Socioeconomic data were collected and analysed using Statistical Package for Social Sciences and content analysis. The perception of stakeholders on honey quality was analysed using Likert scale. Majority of the respondents agreed that tobacco farming greatly affects honey quality because honey from beehives near tobacco farms test bitter and sometimes irritating, which was associated with nicotine content and agrochemicals applied to tobacco crops. Though they cannot differentiate honey bitterness from agrochemicals and bee fodders. Furthermore, it was revealed that chemicals applied to tobacco and vegetables have negative effect on the bees and honey quality. Respondents believe that setting bee hives near tobacco farms might contaminate honey and therefore affect its quality. Beekeepers are not aware of the nicotine content from other bee fodders like miombo of which do not have any effect on human beings. Actually, tobacco farming does not affect beekeeping activities in issue of quality when farmers follow proper management of tobacco flowers and proper handling of honey. Though, big challenge in tobacco farming is chemically applied to the crops and harvest bee fodders for curing tobacco. The study recommends training to community on proper management of tobacco and proper handling of bee products.Keywords: community, honey, perceptions, tobacco
Procedia PDF Downloads 1415312 CRM Cloud Computing: An Efficient and Cost Effective Tool to Improve Customer Interactions
Authors: Gaurangi Saxena, Ravindra Saxena
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Lately, cloud computing is used to enhance the ability to attain corporate goals more effectively and efficiently at lower cost. This new computing paradigm “The Cloud Computing” has emerged as a powerful tool for optimum utilization of resources and gaining competitiveness through cost reduction and achieving business goals with greater flexibility. Realizing the importance of this new technique, most of the well known companies in computer industry like Microsoft, IBM, Google and Apple are spending millions of dollars in researching cloud computing and investigating the possibility of producing interface hardware for cloud computing systems. It is believed that by using the right middleware, a cloud computing system can execute all the programs a normal computer could run. Potentially, everything from most simple generic word processing software to highly specialized and customized programs designed for specific company could work successfully on a cloud computing system. A Cloud is a pool of virtualized computer resources. Clouds are not limited to grid environments, but also support “interactive user-facing applications” such as web applications and three-tier architectures. Cloud Computing is not a fundamentally new paradigm. It draws on existing technologies and approaches, such as utility Computing, Software-as-a-service, distributed computing, and centralized data centers. Some companies rent physical space to store servers and databases because they don’t have it available on site. Cloud computing gives these companies the option of storing data on someone else’s hardware, removing the need for physical space on the front end. Prominent service providers like Amazon, Google, SUN, IBM, Oracle, Salesforce etc. are extending computing infrastructures and platforms as a core for providing top-level services for computation, storage, database and applications. Application services could be email, office applications, finance, video, audio and data processing. By using cloud computing system a company can improve its customer relationship management. A CRM cloud computing system may be highly useful in delivering a sales team a blend of unique functionalities to improve agent/customer interactions. This paper attempts to first define the cloud computing as a tool for running business activities more effectively and efficiently at a lower cost; and then it distinguishes cloud computing with grid computing. Based on exhaustive literature review, authors discuss application of cloud computing in different disciplines of management especially in the field of marketing with special reference to use of cloud computing in CRM. Study concludes that CRM cloud computing platform helps a company track any data, such as orders, discounts, references, competitors and many more. By using CRM cloud computing, companies can improve its customer interactions and by serving them more efficiently that too at a lower cost can help gaining competitive advantage.Keywords: cloud computing, competitive advantage, customer relationship management, grid computing
Procedia PDF Downloads 3045311 Safe Disposal of Pyrite Rich Waste Rock Using Alkali Phosphate Treatment
Authors: Jae Gon Kim, Yongchan Cho, Jungwha Lee
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Acid rock drainage (ARD) is generated by the oxidation of pyrite (FeS₂) contained in the excavated rocks upon its exposure to atmosphere and is an environmental concern at construction site due to its high acidity and high concentration of toxic elements. We developed the safe disposal method with the reduction of ARD generation by an alkali phosphate treatment. A pyrite rich andesite was collected from a railway construction site. The collected rock sample was crushed to be less than 3/8 inches in diameter using a jaw crusher. The crushed rock was filled in an acryl tube with 20 cm in diameter and 40 cm in height. Two treatments for the ARD reduction were conducted with duplicates: 1) the addition of 10mM KH₂PO₄_3% NaHCO₃ and 2) the addition of 10mM KH₂PO₄_3% NaHCO₃ and ordinary portland cement (OPC) on the top of the column. After the treatments, 500 ml of distilled water added to each column for every week for 3 weeks and then the column was flushed with 1,500 ml of distilled water in the 4th week. The pH, electrical conductivity (EC), concentrations of anions and cations of the leachates were monitored for 10 months. The pH of the leachates from the untreated column showed 2.1-3.7, but the leachates from the columns treated with the alkali phosphate solution with or without the OPC addition showed pH 6.7–8.9. The leachates from the treated columns had much lower concentrations of SO₄²⁻ and toxic elements such as Al, Mn, Fe and heavy metals than those from the untreated columns. However, the leachates from the treated columns had a higher As concentration than those from the untreated columns. There was no significant difference in chemical property between the leachates from the treated columns with and without the OPC addition. The chemistry of leachates indicates that the alkali phosphate treatment decreased the oxidation of sulfide and neutralized the acidic pore water. No significant effect of the OPC addition on the leachate chemistry has shown during 10-month experiment. However, we expect a positive effect of the OPC addition on the reduction of ARD generation in terms of long period. According to the results of this experiment, the alkali phosphate treatment of sulfide rich rock can be a promising technology for the safe disposal method with the ARD reduction.Keywords: acid rock drainage, alkali phosphate treatment, pyrite rich rock, safe disposal
Procedia PDF Downloads 1445310 Legal Problems with the Thai Political Party Establishment
Authors: Paiboon Chuwatthanakij
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Each of the countries around the world has different ways of management and many of them depend on people to administrate their country. Thailand, for example, empowers the sovereignty of Thai people under constitution; however, our Thai voting system is not able to flow fast enough under the current Political management system. The sovereignty of Thai people is addressing this problem through representatives during current elections, in order to set a new policy for the countries ideology to change in the House and the Cabinet. This is particularly important in a democracy to be developed under our current political institution. The Organic Act on Political Parties 2007 is the establishment we have today that is causing confrontations within the establishment. There are many political parties that will soon be abolished. Many political parties have already been subsidized. This research study is to analyze the legal problems with the political party establishment under the Organic Act on Political Parties 2007. This will focus on the freedom of each political establishment compared to an effective political operation. Textbooks and academic papers will be referenced from studies home and abroad. The study revealed that Organic Act on Political Parties 2007 has strict provisions on the political structure over the number of members and the number of branches involved within political parties system. Such operations shall be completed within one year; but under the existing laws the small parties are not able to participate with the bigger parties. The cities are capable of fulfilling small political party requirements but fail to become coalesced because the current laws won't allow them to be united as one. It is important to allow all independent political parties to join our current political structure. Board members can’t help the smaller parties to become a large organization under the existing Thai laws. Creating a new establishment that functions efficiently throughout all branches would be one solution to these legal problems between all political parties. With this new operation, individual political parties can participate with the bigger parties during elections. Until current political institutions change their system to accommodate public opinion, these current Thai laws will continue to be a problem with all political parties in Thailand.Keywords: coalesced, political party, sovereignty, elections
Procedia PDF Downloads 3065309 Collaborative Planning and Forecasting
Authors: Neha Asthana, Vishal Krishna Prasad
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Collaborative planning and forecasting are the innovative and systematic approaches towards productive integration and assimilation of data synergized into information. The changing and variable market dynamics have persuaded global business chains to incorporate collaborative planning and forecasting as an imperative tool. Thus, it is essential for the supply chains to constantly improvise, update its nature, and mould as per changing global environment.Keywords: information transfer, forecasting, optimization, supply chain management
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