Search results for: indicators of care quality

Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer

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Authors: Manal Ahmed, Amal Shehata, Shereen Deeb

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The study's purpose was to determine the effect of the perioperative protocol of care on clinical outcomes among patients undergoing coronary artery bypass graft. Subjects: A sample of 100 adult patients who were planned for coronary artery bypass graft, were selected and divided alternatively and randomly into two equal groups (50 study -50 control).The study was carried out at National heart Institute in Cairo and open heart surgical intensive care unit in Shebin El-Kom Teaching Hospital. Instruments: Four instruments were used for data collection: Interviewing questionnaire, dyspnea analogue scale, Biophysiological measurement instrument, and Compliance assessment sheet. Results: There were statistically significant differences between both groups regarding most respiratory system assessment findings at discharge. More than two-thirds of the study group of the current study had a continuous and regular commitment to diet regimen, which ranked first followed by the compliance of daily living activities then quitting smoking. Conclusions: The perioperative protocol of care has a significant improving effect on respiratory findings, dyspnea degree, duration of mechanical ventilation, length of hospital stay, compliance to diet, therapeutic regimen, daily living activities, and quit smoking among study group undergoing CABG. Recommendations: Perioperative protocol of care should be carried out for CABG patients at open-heart surgical units as well as an illustrative colored booklet about CAD, CABG and perioperative care should be available and distributed to all CABG patients.

Keywords: perioperative, effect, clinical outcomes, coronary artery, bypass graft, protocol of care

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Authors: Tarek K. Jalouta, Jolietta R. Holliman, Kathryn R. Burke, Kathleen M. Bewley-Thomas

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Background: Chronic hepatitis C virus (HCV) infection is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. In the United States, HCV screening awareness, treatment, and linkage to care are under continues ascending progress. However, still millions of people are asymptomatically infected and undiagnosed yet. Through this community mission, we sought to identify the best and the newest strategies to identify those infected people to educate them, link them to care and cure them. Methods: We have identified patients that did not have a prior HCV screening in our Electronic medical record (EMR) including all our different hospital locations (South Suburban Chicago, Northern, Western and Central Indiana). Providing education to all Primary care/Gastroenterology/Infectious diseases providers and staff in the clinic to increase awareness of the HCV screening. Health-related quality of life, chronic clinical complications, and demographics data were collected for each patient. All outcomes of HCV antibody-reactive and HCV RNA–positive results were identified and statistically analyzed. Results: From July 2016 to July 2018 we screened 35,720 individuals of birth cohort in our different Franciscan’s health medical centers. Of the screened population, 986 (2.7%) individuals were HCV AB-reactive. Of those, 319 (1%) patients were HCV RNA-positive, and 264 patients were counseled and linked to providers. 34 patients initiated anti-HCV therapy with successful treatment. Conclusions: Our HCV screening augmentation project considered the largest screening program in the Midwest. Augmenting the HCV screening process through creating a Best Practice Alert (BPA) in the EMR (Epic Sys.) and point of care testing could be helpful. Although continued work is required, our team is working on increase screening through adding HCV test to CBC-Panels in Emergency Department settings, phone calls to all birth cohort individuals through Robo-Calling System aimed to reach 75,000 individuals by 2019. However, a better linkage to care and referral monitoring system to all HCV RNA positive patients is still needed, and access to therapy, especially for uninsured patients, is challenging.

Keywords: chronic hepatitis C, chronic hepatitis C treatment, chronic hepatitis C screening, chronic hepatitis C prevention, liver cancer

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Authors: Chang Liu, Hanwen Zhang, Vikash Sharma, Don Eliseo Lucerno-Prisno III, Emmanuel Yujuico, Maulik Chokshi, Prashanthi Krishnakumar, Bach Xuan Tran, Giang Thu Vu, Kamilla Anna Pinter, Shenglan Tang

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Background and Aims: Globally, many health systems focus on hospital-based healthcare models targeting acute care and disease treatment, which are not effective in addressing the challenges of ageing populations, chronic conditions, multi-morbidities, and increasingly unhealthy lifestyles. Recently, integrated care programs on chronic diseases have been developed, piloted, and implemented to meet such challenges. However, integrated care programs in the Asia-Pacific region vary in the levels of integration from linkage to coordination to full integration. This study aims to identify and analyze existing cases of integrated care in the Asia-Pacific region and identify the facilitators and barriers in order to improve existing cases and inform future cases. Methods: The study is a comparative study, with a combination approach of desk-based research and key informant interviews. The selected countries included in this study represent a good mix of lower-middle income countries (the Philippines, India, Vietnam, and Fiji), upper-middle income country (China), and high-income country (Singapore) in the Asia-Pacific region. Existing integrated care programs were identified through the scoping review approach. Trigger, history, general design, beneficiaries, and objectors were summarized with barriers and facilitators of integrated care based on key informant interviews. Representative case(s) in each country were selected and comprehensively analyzed through deep-dive case studies. Results: A total of 87 existing integrated care programs on chronic diseases were found in all countries, with 44 in China, 21 in Singapore, 12 in India, 5 in Vietnam, 4 in the Philippines, and 1 in Fiji. 9 representative cases of integrated care were selected for in-depth description and analysis, with 2 in China, the Philippines, and Vietnam, and 1 in Singapore, India, and Fiji. Population aging and the rising chronic disease burden have been identified as key drivers for almost all the six countries. Among the six countries, Singapore has the longest history of integrated care, followed by Fiji, the Philippines, and China, while India and Vietnam have a shorter history of integrated care. Incentives, technologies, education, and performance evaluation would be crucial for developing strategies for implementing future programs and improve already existing programs. Conclusion: Integrated care is important for addressing challenges surrounding the delivery of long-term care. To date, there is an increasing trend of integrated care programs on chronic diseases in the Asia-Pacific region, and all six countries in our study set integrated care as a direction for their health systems transformation.

Keywords: integrated healthcare, integrated care delivery, chronic diseases, Asia-Pacific region

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Authors: Chris Nelson

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Quality and excellence are qualitative topics that are usually addressed based on knowledge and past experience from leadership and those in charge of the organization. The significance of this study is to highlight the differences and similarities between these two mindsets and how an operational staff can most appropriately use them in the workplace. Quality and excellence are two words that are talked about a lot in the manufacturing world. Buzzwords such as operational excellence, quality controls, and efficiencies are discussed in the boardroom as well on the shop floor. These terms are used quite frequently and with good reasons. When a person visits their favorite local restaurant, They go because 1) they like the food and 2) the people are some of the greatest individuals to be around. With that in mind, they know they always put out quality food. They do not always go because the quality of the food is far superior than other restaurants. But the quality of ingredients always meets their expectations. When they compare them to the term excellence, they are disappointed. The food never looks like the pictures on the menu. But when have you ever been to a restaurant where the food looks the same as on the menu? For them, when evaluating which buzzword to use as a guiding star, its simple: excellence. The corporation can accomplish these goals by operating at a standard that far exceeds customer’s wants and needs.

Keywords: industrial engineering, innovation, management and technology, logistics and scheduling, six sigma

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Authors: Pawinee Sorawech

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The purpose of this study was to investigate the quality improvement of painting assignments for grade 4-6 students by using PDCA cycle. This study employed a qualitative technique. Suan Sunandha Rajabhat University and its demonstration school were selected as the area of study. An in-depth interview was utilized. The findings revealed that model of PDCA cycle was a proper model to increase the quality of painting assignments for grade 4-6 students. The six steps of improvement included: studying the PDCA model, setting up a plan, determining the scope of work, creating a strategy, developing a quality for painting assignment, and coming up with a handbook for a quality improvement of painting assignment.

Keywords: quality, painting assignments, PDCA cycle, grade 4-6 students

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Authors: Cesar Eduardo Hernández Curiel, Victor Hugo Benítez Baltazar, Jesús Horacio Pacheco Ramírez

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This paper is devoted to present the advances in the design of a prototype that is able to supervise the complex behavior of water quality parameters such as pH and temperature, via a real-time monitoring system. The current water quality tests that are performed in government water quality institutions in Mexico are carried out in problematic locations and they require taking manual samples. The water samples are then taken to the institution laboratory for examination. In order to automate this process, a water quality monitoring system based on wireless sensor networks is proposed. The system consists of a sensor node which contains one pH sensor, one temperature sensor, a microcontroller, and a ZigBee radio, and a base station composed by a ZigBee radio and a PC. The progress in this investigation shows the development of a water quality monitoring system. Due to recent events that affected water quality in Mexico, the main motivation of this study is to address water quality monitoring systems, so in the near future, a more robust, affordable, and reliable system can be deployed.

Keywords: pH measurement, water quality monitoring, wireless sensor networks, ZigBee

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Authors: Rajendra Singh, Krishna Mondal, Chandranath Chatterjee

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The water, energy, and food (WEF) nexus describes the interconnectedness of these three essential elements of human life. Each of these three sectors depends on the others. India's expanding population, urbanization, and industrialization make WEF nexus management difficult. Coupling and coordination degrees can be used as indicators of a complex system's level of sustainable development. Thus, coupling and coordination of WEF sectors in India are essential for achieving Sustainable Development Goals (SDGs) 2 (zero hunger), 6 (clean water and sanitation), and 7 (affordable and clean energy). This study used a newly developed WEF nexus model and the concept of coupling coordination degree model to examine the coupling and coordination degrees of the WEF nexus at India's sub-national scale (States/Union Territories (UTs)) for the years 2011 and 2021. Results indicate that the WEF nexus coupling degree was reasonably stable among the Indian States/UTs in both years, with all having a coupling degree above 0.90, indicating high-quality coupling. However, the degree of coordination varied spatially and temporally from ‘primary development’ to ‘quality development’ for the Indian States/UTs. In 2021, it went from 53% to 14% intermediate development and 44% to 83% good development compared to 2011. Most Indian States/UTs developed SDG2 more than SDG6 and SDG7. This study also suggests that most States/UTs must implement WEF-related policies and programmes effectively to achieve quality coordinated WEF nexus development. This study may help administrators and policymakers identify States/UTs that need more attention to implement existing or new policies for achieving SDGs 2, 6, and 7.

Keywords: WEF nexus model, Pardee-RAND WEF nexus, sustainable development, policy

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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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

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Authors: Nagendra P. Luitel, Mark J. D. Jordans

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Globally, there is a significant gap between the number of individuals in need of mental health care and those who actually receive treatment. The evidence is accumulating that mental health services can be delivered effectively by primary health care workers through community-based programs and task-sharing approaches. Changing the role of specialist mental health workers from service delivery to building clinical capacity of the primary health care (PHC) workers could help in reducing treatment gap in low and middle-income countries (LMICs). We developed a comprehensive mental health care plan in 2012 and evaluated its feasibility and effectiveness over the past three years. Initially, a mixed method formative study was conducted for the development of mental health care plan (MHCP). Routine monitoring and evaluation data, including client flow and reports of satisfaction, were obtained from beneficiaries (n=135) during the pilot-testing phase. Repeated community survey (N=2040); facility detection survey (N=4704) and the cohort study (N=576) were conducted for evaluation of the MHCP. The resulting MHCP consists of twelve packages divided over the community, health facility, and healthcare organization platforms. Detection of mental health problems increased significantly after introducing MHCP. Service implementation data support the real-life applicability of the MHCP, with reasonable treatment uptake. Currently, MHCP has been implemented in the entire Chitwan district where over 1400 people (438 people with depression, 406 people with psychosis, 181 people with epilepsy, 360 people with alcohol use disorder and 51 others) have received mental health services from trained health workers. Key barriers were identified and addressed, namely dissatisfaction with privacy, perceived burden among health workers, high drop-out rates and continue the supply of medicines. The results indicated that involvement of PHC workers in detection and management of mental health problems is an effective strategy to minimize treatment gap on mental health care in Nepal.

Keywords: mental health, Nepal, primary care, treatment gap

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Authors: Ankita Srivastava, Yogesh K. Garg

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Housing provides comforts and well being leading towards the quality of life. Earlier research had established that landscape elements enhance the residents’ quality of life through its significant experiences occur due to their presence in the housing. This paper tries to identify the preference of landscape elements that enhance residents’ quality of life living in the apartment. Hence, landscape elements that can be planned in the open spaces of housing and quality of life components were identified from the secondary data sources. Experts’ were asked to identify the quality of life components with respect to landscape elements. A questionnaire survey of residents’ living in the apartment housing in Bhopal, India was conducted. The statistical analysis of survey data facilitated to explore the preference of landscape elements for the quality of life in the apartment housing. The final ranking compiled from the experts’ opinion, residents’ perception as well as factor analysis results to have an insight of the preference of landscape elements for the quality of life living in the apartment. Preference of landscape elements present in the paper may provide an overview of planning for apartment housing that may be used by architects, planners and developers for enhancing residents’ quality of life.

Keywords: landscape elements, quality of life, residents, housing

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Authors: Purnomo Yustianto, Robin Doss, Novianto B. Kurniawan Suhardi

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Since its inception, the design activities of Service Oriented Architecture (SOA) has been guided with aspects from the Service Design Principles (SDP), such as cohesion, granularity, loose coupling, discoverability, and autonomy, etc. The goal of this paper is two folds. The first is to examine the position of SDP within the context of software quality, and the second is to reframe the aspects of SDP into a more concise terms and relations. This paper is divided into four parts, in which after the introduction, a review on related software quality is provided to determine the quality context of SDP. The third part reviews the original SDP and offers a relation model among the SDP aspects. The fourth part explores the design quality metrics available for SOA and proposes a relationship representing the design quality. Among the aspects of design principles, the cohesion and coupling aspect is determined to be the two important aspects for achieving reusability of a service.

Keywords: SOA, software quality, service design principle, reusability, cohesion, coupling

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Authors: Haidong Li, Weishou Shen, Guoping Lv, Tao Wang

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Aiming to overcome the limitation of the application of traditional remote sensing (RS) technique in the mine eco-environmental monitoring, in this paper, we first classified the eco-environmental damages caused by mining activities and then introduced the principle, classification and characteristics of the Light Detection and Ranging (LiDAR) technique. The potentiality of LiDAR technique in the mine eco-environmental monitoring was analyzed, particularly in extracting vertical structure parameters of vegetation, through comparing the feasibility and applicability of traditional RS method and LiDAR technique in monitoring different types of indicators. The application situation of LiDAR technique in extracting typical mine indicators, such as land destruction in mining areas, damage of ecological integrity and natural soil erosion. The result showed that the LiDAR technique has the ability to monitor most of the mine eco-environmental indicators, and exhibited higher accuracy comparing with traditional RS technique, specifically speaking, the applicability of LiDAR technique on each indicator depends on the accuracy requirement of mine eco-environmental monitoring. In the item of large mine, LiDAR three-dimensional point cloud data not only could be used as the complementary data source of optical RS, Airborne/Satellite LiDAR could also fulfill the demand of extracting vertical structure parameters of vegetation in large areas.

Keywords: LiDAR, mine, ecological damage, monitoring, traditional remote sensing technique

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Authors: Shiksha Thakur, Rashmi Jain

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Maternal health is the most crucial element in the primary health care delivery system of any healthy society. We aware that the maternal health situation in India has been a cause of concern for us, in spite of the rapidly progressing socio-economic environment overall. India has realized impressive gains in Mother & Child survival over the last two decades. MMR as per 2012-2013 in India is 167 as per MMR bulletin, though there are variations between states in the Country. In 2013, an estimated 2,89,000 women worldwide died from complications arising from pregnancy & childbirth. In view of the above facts, a study was conducted in Indore to analyse the maternal health status among urban slums and non-slums women.

Keywords: antenatal care, postnatal care, JSY, maternal health, child health, reproductive health

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Authors: C. Puangsawat, C. Limotai, P. Srikhachin

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Bio-psycho-social caring was required for promoting the quality of life of the patients with epilepsy (PWE), despite controlled seizures. Multifaceted issues emerge at the epilepsy clinic. Unpredicted seizures, antiepileptic drug compliance problems/adverse effects, psychiatric, and social problems are all needed to be explored and managed. The Nursing Service System (NSS) at the tertiary epilepsy clinic (TEC) was consequently developed for improving the clinical care for PWE. Case manager concept was integrated as the framework guiding the processes and strategies used for developing the NSS as well as the roles of the multidisciplinary team at the clinic. This study aimed to report the outcomes of the developed NSS integrated case manager concept. The processes of our developed NSS program included 1) screening for patient’s problems using questionnaire prior to seeing epileptologists i.e., assessing the patient’s risk to develop acute seizures at the clinic, issues related to medication use, and uncovered psychiatric and social problems; and 2) assigning the patients at risk to be evaluated and managed by appropriate team. Nurses specializing in epilepsy in coordination with the multidisciplinary team implemented the NSS to promote coordinated work among the team which consists of epileptologists, nurses, pharmacists, psychologists, and social workers. Determination of the role of each person and their responsibilities along with joint care plan were clearly established. One year after implementation, the rate of acute seizure occurrence at the clinic was decreased, and satisfactory feedback from the patients was received. In order to achieve an optimal goal to promote self-management behaviors in PWE, continuing the NSS and systematic assessment of its effectiveness is required.

Keywords: case manager concept, nursing service system, patients with epilepsy, quality of life

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Authors: Moh Hanif Mubarok, Muhammad Rivai

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The public's response to quality rice is very high. So it is necessary to set minimum standards in checking the quality of rice. Most rice quality measurements still use manual methods, which are prone to errors due to limited human vision and the subjectivity of testers. So, a gas detection system can be a solution that has high effectiveness and subjectivity for solving current problems. The use of gas sensors in testing rice quality must pay attention to several parameters. The parameters measured in this research are the percentage of rice water content, gas concentration, output voltage, and measurement time. Therefore, this research was carried out to identify carbon dioxide (CO₂), nitrous oxide (N₂O) and methane (CH₄) gases in rice quality using a series of gas sensors using the Neural Network method.

Keywords: carbon dioxide, dinitrogen oxide, methane, semiconductor gas sensor, neural network

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Authors: Mohammadreza Mohebbi, Masoumeh Sanagou

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The ability to predict clinical outcomes is of great importance to physicians and clinicians. A number of different methods have been used in an effort to accurately predict these outcomes. These methods include the development of scoring systems based on multivariate statistical modelling, and models involving the use of classification and regression trees. The process usually consists of two consecutive phases, namely model development and external validation. The model development phase consists of building a multivariate model and evaluating its predictive performance by examining calibration and discrimination, and internal validation. External validation tests the predictive performance of a model by assessing its calibration and discrimination in different but plausibly related patients. A motivate example focuses on prediction modeling using a sample of patients undergone coronary artery bypass graft (CABG) has been used for illustrative purpose and a set of primary considerations for evaluating prediction model studies using specific quality indicators as criteria to help stakeholders evaluate the quality of a prediction model study has been proposed.

Keywords: clinical prediction models, clinical decision rule, prognosis, external validation, model calibration, biostatistics

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Authors: Chipo Mugova, Zuko Mjobo

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The aim of this study was to evaluate the cost of quality (COQ) at a local foundry business to identify the contribution of its units and processes to quality costs within the foundry’s operations. The foundry selected for detailed case study is one of major businesses that have been targeted by the government to produce components for building and re-furbishing wagons and trains. The study aimed at identifying areas in the foundry’s processes in which investment needs to be made to reduce quality costs. This is in alignment with government’s vision of promoting local business to support local markets leading to creation of jobs, and hence reduction of unemployment rate in South Africa. The methodology adopted used cost of quality models. Results from the study indicated that internal failure costs were significantly higher than all other cost of quality categories, taking more than 60% of the business’s income.

Keywords: appraisal costs, cost of quality, failure costs, local content, prevention costs

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Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein

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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.

Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health

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Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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Authors: Fatima Faraz

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BACKGROUND: While Artificial intelligence (AI) provides new opportunities across a wide variety of industries, healthcare is no exception. AI can lead to advancements in how the healthcare system functions and improves the quality of patient care. Developing countries like Pakistan are lagging in the implementation of AI-based solutions in healthcare. This demands increased knowledge and AI literacy among health care professionals. OBJECTIVES: To assess the level of awareness among medical students and faculty about AI in preparation for teaching AI basics and data science applications in clinical practice in an integrated medical curriculum. METHODS: An online 15-question semi-structured questionnaire, previously tested and validated, was delivered among participants through convenience sampling. The questionnaire composed of 3 parts: participant’s background knowledge, AI awareness, and attitudes toward AI applications in medicine. RESULTS: A total of 182 students and 39 faculty members from Rawalpindi Medical University, Pakistan, participated in the study. Only 26% of students and 46.2% of faculty members responded that they were aware of AI topics in clinical medicine. The major source of AI knowledge was social media (35.7%) for students and professional talks and colleagues (43.6%) for faculty members. 23.5% of participants answered that they personally had a basic understanding of AI. Students and faculty (60.1%) were interested in AI in patient care and teaching domain. These findings parallel similar published AI survey results. CONCLUSION: This survey concludes interest among students and faculty in AI developments and technology applications in healthcare. Further studies are required in order to correctly fit AI in the integrated modular curriculum of medical education.

Keywords: medical education, data science, artificial intelligence, curriculum

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Authors: Monika Trzaskowska, Dorota Zielinska, Anna Lepecka, Katarzyna Neffe-Skocinska, Beata Bilska, Marzena Tomaszewska, Danuta Kolozyn-Krajewska

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Microbiological quality and food safety are important food characteristics. Regulation (EU) No 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers introduces the obligation to provide information on the 'use-by' date or the date of minimum durability (DMD). The second term is the date until which the properly stored or transported foodstuff retains its physical, chemical, microbiological and organoleptic properties. The date should be preceded by 'best before'. It is used for durable products, e.g., pasta. In relation to reducing food losses, the question may be asked whether products with the date of minimum durability currently declared retain quality and safety beyond this. The aim of the study was to assess the sensory quality and microbiological safety of selected cereal products, i.e., pasta and millet after DMD. The scope of the study was to determine the markers of microbiological quality, i.e., the total viable count (TVC), the number of bacteria from the Enterobacteriaceae family and the number of yeast and mold (TYMC) on the last day of DMD and after 1 and 3 months of storage. In addition, the presence of Salmonella and Listeria monocytogenes was examined on the last day of DMD. The sensory quality of products was assessed by quantitative descriptive analysis (QDA), the intensity of 14 differentiators and overall quality were defined and determined. In the tested samples of millet and pasta, no pathogenic bacteria Salmonella and Listeria monocytogenes were found. The value of the distinguishing features of selected quality and microbiological safety indicators on the last DMD day was in the range of about 3-1 log cfu/g. This demonstrates the good microbiological quality of the tested food. Comparing the products, a higher number of microorganisms was found in the samples of millet. After 3 months of storage, TVC decreased in millet, while in pasta, it was found to increase in value. In both products, the number of bacteria from the Enterobacretiaceae family decreased. In contrast, the number of TYMCs increased in samples of millet, and in pasta decreased. The intensity of sensory characteristic in the studied period varied. It remained at a similar level or increased. Millet was found to increase the intensity and flavor of 'cooked porridge' 3 months after DMD. Similarly, in the pasta, the smell and taste of 'cooked pasta' was more intense. To sum up, the researched products on the last day of the minimum durability date were characterized by very good microbiological and sensory quality, which was maintained for 3 months after this date. Based on these results, the date of minimum durability of tested products could be extended. The publication was financed on the basis of an agreement with the National Center for Research and Development No. Gospostrateg 1/385753/1/NCBR/2018 for the implementation and financing of the project under the strategic research and development program 'social and economic development of Poland in the conditions of globalizing markets – GOSPOSTRATEG - acronym PROM'.

Keywords: date of minimum durability, food losses, food quality and safety, millet, pasta

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Authors: Najib Ahmad Marzuki, Che Su Mustaffa, Johana Johari, Nur Haffiza Rahaman

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The purpose of this paper is to examine the effects and relationship of stress and social support towards the quality of life among flood victims in Malaysia. A total of 764 respondents took part in the survey via random sampling. The depression, anxiety, and stress scales were utilized to measure stress while The Multidimensional Scale of Perceived Social Support was used to measure the quality of life. The findings of this study indicate that there were significant correlations between variables in the study. The findings show a significant negative relation between stress and quality of life, and significant positive correlations between support from family as well as support from friends with the quality of life. Stress and support from family were found to be significant predictors and influences the quality of life among flood victims.

Keywords: stress, social support, quality of life, flood victims

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Authors: Isabelle Gobatto

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Based on an anthropological approach, this paper explores the medical profession and the construction of medical practices by considering the multiform articulations between structural poverty and the production of care from a low-resource francophone West African country, Burkina Faso. This country is considered in its exemplary dimension of culturally differentiated countries of the African continent that share the same situation of structural poverty. The objective is to expose the effects of structural poverty on the ways of constructing professional knowledge and thinking about the sense of the medical profession. If doctors are trained to have the same capacities in South and West countries, which are to treat and save lives whatever the cultural contexts of the practice of medicine, the ways of investing their role and of dealing with this context of action fracture the homogenization of the medical profession. In the line of anthropology of biomedicine, this paper outlines the complex effects of structural poverty on health care, care relations, and the moral economy of doctors. The materials analyzed are based on an ethnography including two temporalities located thirty years apart (1990-1994 and 2020-2021), based on long-term observations of care practices conducted in healthcare institutions, interviews coupled with the life histories of physicians. The findings reveal that disabilities faced by doctors to deliver care are interpreted as policy gaps, but they are also considered by physicians as constitutive of the social and cultural characteristics of patients, making their capacities and incapacities in terms of accompanying caregivers in the production of care. These perceptions have effects on know-how, structured around the need to act even when diagnoses are not made so as not to see patients desert health structures if the costs of care are too high for them. But these interpretations of highly individualizing dimensions of these difficulties place part of the blame on patients for the difficulties in using learned knowledge and delivering effective care. These situations challenge the ethics of caregivers but also of ethnologists. Firstly because the interpretations of disabilities prevent caregivers from considering vulnerabilities of care as constituting a common condition shared with their patients in these health systems, affecting them in an identical way although in different places in the production of care. Correlatively, these results underline that these professional conceptions prevent the emergence of a figure of victim, which could be shared between patients and caregivers who, together, undergo working and care conditions at the limit of the acceptable. This dimension directly involves politics. Secondly, structural poverty and its effects on care challenge the ethics of the anthropologist who observes caregivers producing, without intent to arm, experiences of care marked by an ordinary violence, by not giving them the care they need. It is worth asking how anthropologists could get doctors to think in this light in west-African societies.

Keywords: Africa, care, ethics, poverty

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Authors: Mariela Edith Arboit

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The main goal of the project is to explore the evolution possibilities of the morphological indicators of the built environment, including those resulting from progressive soil occupation, due to the relentless growth of the city’s population and subsequent increase in building density and solar access reduction per built unit. Two alternative normative proposals, Conventional Proposal (CP) and Alternative Proposal (AP), are compared. In addition, temporal scenarios of the city’s evolution process are analyzed, starting from the reference situation of existing, high-density built-up areas, and simulating their possible morphological outcomes on theoretical medium (30 yr.) and long (60 yr.) terms, as a result of the massive implementation of either regulation in the long run. The results obtained demonstrate that the Alternative Proposal (AP) presents higher mean values of predicted solar potential expressed by the Volumetric Insolation Factor total (VIFtot) for both time periods and services. Regarding environmental aspects, the different impacts of either alternative on the urban landscape quality seem to favor the AP proposal. Its deserved detailed assessment is also presently being developed through a quanti-qualitative methodology.

Keywords: building morphology, environmental quality, solar energy, urban sustainability

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Authors: K. Pankaj, R. K. Chaudhary, B. P. Mishra, S. Kochar

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Introduction: Consultation-Liaison psychiatry is a branch of psychiatry that includes clinical service, teaching and research. A consultation-liaison psychiatrist plays a role in having an expert opinion and linking the patients to other medical professionals and the patient’s bio-psycho-social aspects that may be leading to his/her symptoms. Consultation-Liaison psychiatry has been recognised as 'The guardian of the holistic approach to the patient', underlining its pre-eminent role in the management of patients who are admitted in a tertiary care hospital. Aims/ Objectives: The aim of the study was to analyse the utilization of psychiatric services and reasons for referrals in a tertiary care hospital. Materials and Methods: The study was done in a tertiary care hospital. The study included all the cases referred from different Inpatient wards to the psychiatry department for consultation. The study was conducted on 300 patients over a 3 month period. International classification of diseases 10 was used to diagnose the referred cases. Results: The majority of the referral was from the Medical Intensive care unit (22%) followed by general medical wards (18.66%). Majority of the referral was taken for altered sensorium (24.66%), followed by low mood or unexplained medical symptoms (21%). Majority of the referrals had a diagnosis of alcohol withdrawal syndrome (21%) as per International classification of diseases criteria, followed by unipolar Depression and Anxiety disorder (~ 14%), followed by Schizophrenia (5%) and Polysubstance abuse (2.6%). Conclusions: Our study concludes the importance of utilization of consultation-liaison psychiatric services. Also, the study signifies the need for sensitization of our colleagues regarding psychiatric sign and symptoms from time to time and seek psychiatric consult timely to decrease morbidity.

Keywords: consultation-liaison, psychiatry, referral, tertiary care hospital

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Authors: Leena Wanganoo

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In this digital age with the mushrooming of online companies across the globe has led to an unprecedented new business model. The frequency of online purchasing varies across the globe, but trend shows a steep upward movement. From Generation X to the Millennial the consumer not only wants to order the product with the click of mouse but also very demanding service quality during pre to post-transaction stage. The existing research examines the impact of website quality on the on behavioral intentions in e-services customers and has not adequately recognized the quality of e-commerce logistics perceived by the customer.In order to address this gap, this study examines the relationship among the logistics service quality, satisfaction, and loyalty. Drawing upon a sample of 350 millennial customers from various regions of UAE will work within the framework of structural equation modeling (SEM). Finally, the study would use Importance-Performance analysis (IPA) to discuss the relations of the level of customers’ expected logistics service quality and level of customers’ perceived logistics serviced quality.

Keywords: logistics service quality, customer satisfaction, loyalty, electronic commerce

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Authors: Camila Lima, Murilo Andrade Valle, Patrícia Teixeira Leite Asano

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The growth in demand for electricity, caused by human development, depletion and environmental impacts caused by traditional sources of electricity generation have made new energy sources are increasingly encouraged and necessary for companies in the electricity sector. Based on this scenario, this paper assesses the negative environmental impacts associated with thermoelectric power plants in Brazil, pointing out the importance of using renewable energy sources, reducing environmental aggression. This article points out the existence of an energy alternative, wind energy, of the municipalities of São Paulo, represented by georeferenced maps with the help of GIS, using as a premise the indicators of sustainability and multicriteria analysis in the decision-making process.

Keywords: GIS (geographic information systems), multicriteria analysis, sustainability, wind energy

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Authors: Jevonte Abioye, Dylan Savary

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The aim of this research is to present a disaggregated geostatistical analysis of the subnational provincial trends of child mortality variation in Zimbabwe from a child health policy perspective. Soon after gaining independence in 1980, the government embarked on efforts towards promoting equitable health care, namely through the provision of primary health care. Government intervention programmes brought hope and promise, but achieving equity in primary health care coverage was hindered by previous existing disparities in maternal health care disproportionately concentrated in urban settings to the detriment of rural communities. The article highlights policies and programs adopted by the government during the millennium development goals period between 1990-2015 as a response to the inequities that characterised the country’s maternal health care. A longitudinal comparative method for a spatial variation on child mortality rates across provinces is developed based on geostatistical analysis. Cross-sectional and time-series data was extracted from the World Health Organisation (WHO) global health observatory data repository, demographic health survey reports, and previous academic and technical publications. Results suggest that although health care policy was uniform across provinces, not all provinces received the same antenatal and perinatal services. Accordingly, provincial rates of child mortality growth between 1994 and 2015 varied significantly. Evidence on the trends of child mortality rates and maternal health policies in Zimbabwe can be valuable for public child health policy planning and public service delivery design both in Zimbabwe and across developing countries pursuing the sustainable development agenda.

Keywords: antenatal care, perinatal care, infant mortality rate, neonatal mortality rate, under-five mortality rate, millennium development goals, sustainable development agenda

Procedia PDF Downloads 203