Search results for: 2005).National Digital Library of Theses and Dissertations in Taiwan。 [5] Chun-Mo Wu (2007).The Effects of Perceived Risk and Service Quality on Purchase Intention - an Example of Taipei City Long-Term Care Facilities. (Master's dissertation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 36434

Search results for: 2005).National Digital Library of Theses and Dissertations in Taiwan。 [5] Chun-Mo Wu (2007).The Effects of Perceived Risk and Service Quality on Purchase Intention - an Example of Taipei City Long-Term Care Facilities. (Master's dissertation

35444 Exploring Methods for Urbanization of 'Village in City' in China: A Case Study of Hangzhou

Authors: Yue Wang, Fan Chen

Abstract:

After the economic reform in 1978, the urbanization in China has grown fast. It urged cities to expand in an unprecedented high speed. Villages around were annexed unprepared, and it turned out to be a new type of community called 'village in city.' Two things happened here. First, the locals gave up farming and turned to secondary industry and tertiary industry, as a result of losing their land. Secondly, attracted by the high income in cities and low rent here, plenty of migrants came into the community. This area is important to a city in rapid growth for providing a transitional zone. But thanks to its passivity and low development, 'village in city' has caused lots of trouble to the city. Densities of population and construction are both high, while facilities are severely inadequate. Unplanned and illegal structures are built, which creates a complex mixed-function area and leads to a bad residential area. Besides, the locals have a strong property right consciousness for the land. It holds back the transformation and development of the community. Although the land capitalization can bring significant benefits, it’s inappropriate to make a great financial compensation to the locals, and considering the large population of city migrants, it’s important to explore the relationship among the 'village in city,' city immigrants and the city itself. Taking the example of Hangzhou, this paper analyzed the developing process, functions spatial distribution, industrial structure and current traffic system of 'village in city.' Above the research on the community, this paper put forward a common method to make urban planning through the following ways: adding city functions, building civil facilities, re-planning functions spatial distribution, changing the constitution of local industry and planning new traffic system. Under this plan, 'village in city' finally can be absorbed into cities and make its own contribution to the urbanization.

Keywords: China, city immigrant, urbanization, village in city

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35443 Psychological Impacts of Over-the-Top Services on Consumer Behaviors during the COVID-19 Pandemic

Authors: Hector Liu, Chih-Ming Tsai

Abstract:

Consumer behaviors in the subscription of over-the-top (OTT) media services have substantially changed because of the COVID-19 pandemic; hence, this study aims to determine the factors affecting subscription intentions. The increased usage of OTT media, particularly in the lockdowns during the COVID-19 pandemic, has intensified the competition between both global and local streaming providers. While studies have discussed antecedents accounting for this change, they have paid limited attention to the psychological factors that shape consumer behavior in using OTT services. Given the changes in consumers’ psychological states during the pandemic, this study seeks to fill the research gap by integrating the expectancy-value model to provide insights into the key gratifications that consumers seek and obtain and that have affected their subscription to OTT services. This study proposes a theoretical model and assesses this framework on data collected from 1,068 OTT service users in Taiwan. The results strengthen the literature by indicating a clear growth in the popularity and subscription of OTT services because of the COVID-19 lockdowns as well as factors such as perceived quality and satisfaction, which influence behavioral intentions for OTT services. Most crucially, however, OTT viewers who acquired a sense of belonging, a sense of being accompanied, and a sense of reduction in anxiety due to being quarantined and in lockdown show a higher tendency to continue their subscriptions to their OTT services of choice during the pandemic. With consumer behavior trends forever changed by the COVID-19 pandemic, the implications from this study provide OTT service platforms with an opportunity to capitalize on their current and potential customers’ changing desires, demands, and factors for a continued subscription.

Keywords: consumer behavior, COVID-19, expectancy-value model, OTT media services

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35442 Factors and Impact of the Intention to Adopt Online Purchases in Africa: The Moderating Effect of Culture

Authors: Mefoute Badiang Alphonse, Emile Saker Nkwei

Abstract:

This study examines the factors determining the adoption of online purchases among customers and the influence of cultural variables in an African context. The research is based on a combination of the technology acceptance model (IS/IT). The hypotheses are tested using the structural equation method (PLS) on a sample of 446 individuals. The findings show that: (1) rational perception variables are influential factors affecting users’ intentions to adopt online purchases; (2) it is established that cultural factors have an impact on online purchases in the context of the study. Customers who value physical interaction are more likely to make purchases online, although mostly for hedonic reasons. Additionally, the relationship between utilitarian expectations and purchase intention depends on the level of conformity to the group. Implications and limitations of the research are formulated.

Keywords: Africa, cultural variables, online purchases, rational perception

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35441 The Access to the City in the Medellín Urban Experience

Authors: Mansilla, Juan Camilo

Abstract:

According to many studies, public space in the cities of Global South is constantly morcellated and captured by a multiplicity of actors in a permanent struggle for power. This imposed public space restricts the access to services and political actions to many inhabitants. The author has conducted several focus group sessions using video in a reflective mode with low-income communities in Medellín, Colombia in order to study how people in this city are shift from a physical public space to a hybrid public space shaped by internet. Beyond the fragmented city and the violent urban context manifested by participants, these activities have highlighted how the access to the city is currently going through a dialectic movement between the physical and the digital space. The purpose of this article is to make explicit the link between this hybrid public space and the boundaries of exclusion in the city. Urban marginality is closely related with the idea of access and space. Low-income communities in Medellín assume the digital realm like a “not controlled space” of resistance, where alternative ways of expression like hip hop movement, graffiti, dance, video and virtual communities produce effective changes in the physical realm.

Keywords: access to the city, hybrid public space, low-income communities, Medellín, urban marginality

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35440 Dietary Pattern and Risk of Breast Cancer Among Women:a Case Control Study

Authors: Huma Naqeeb

Abstract:

Epidemiological studies have shown the robust link between breast cancer and dietary pattern. There has been no previous study conducted in Pakistan, which specifically focuses on dietary patterns among breast cancer women. This study aims to examine the association of breast cancer with dietary patterns among Pakistani women. This case-control research was carried in multiple tertiary care facilities. Newly diagnosed primary breast cancer patients were recruited as cases (n = 408); age matched controls (n = 408) were randomly selected from the general population. Data on required parameters were systematically collected using subjective and objective tools. Factor and Principal Component Analysis (PCA) techniques were used to extract women’s dietary patterns. Four dietary patterns were identified based on eigenvalue >1; (i) veg-ovo-fish, (ii) meat-fat-sweet, (iii) mix (milk and its products, and gourds vegetables) and (iv) lentils - spices. Results of the multiple regressions were displayed as adjusted odds ratio (Adj. OR) and their respective confidence intervals (95% CI). After adjusted for potential confounders, veg-ovo-fish dietary pattern was found to be robustly associated with a lower risk of breast cancer among women (Adj. OR: 0.68, 95%CI: (0.46-0.99, p<0.01). The study findings concluded that attachment to the diets majorly composed of fresh vegetables, and high quality protein sources may contribute in lowering the risk of breast cancer among women.

Keywords: breast cancer, dietary pattern, women, principal component analysis

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35439 Transforming Personal Healthcare through Patient Engagement: An In-Depth Analysis of Tools and Methods for the Digital Age

Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

Abstract:

Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

Procedia PDF Downloads 88
35438 Internet Impulse Buying: A Study Based on Stimulus-Organism-Response Theory

Authors: Pui-Lai To, Yi-Jing Tsai

Abstract:

As the advance of e-commerce technologies, the consumers buying behavior have changed. The focus on consumer buying behavior has already shifted from physical space to the cyberspace, which impulse buying is a major issue of concern. This study examines the stimulus effect of web environment on the consumer's emotional states, and in turn, affecting the urge of impulse buying based on a stimulus-organism-response (S-O-R) theory. Website ambiance and website service quality are the two stimulus variables. The study also explores the effects and the moderator effects of contextual variables and individual characteristic variables on the web environment, the emotional states and the urge of impulse buying. A total of 328 valid questionnaires were collected. Structural equation modeling was used to test the research hypothesis. This study found that both website ambiance and website service quality have a positive effect on consumer emotion, which in turn positively affect the urge of impulse buying. Consumer’s trait of impulse buying has a positive effect on the urge of impulse buying. Consumer’s hedonic motivation has a positive effect on both emotion state and the urge of impulse buying. On the other hand, the study found that money available for the consumer would positively affect consumer's emotion state and time available for the consumer would negatively affect the relationship between website service quality and consumer emotion. The result of this study validates Internet impulse buying behavior based on the S-O-R theory. This study also suggests that having a good website atmosphere and service quality is important to influencing consumers’ emotion and increasing the likelihood of consumer purchasing. The study could serve as a basis for the future research regarding online consumer behavior.

Keywords: emotion state, impulse buying, stimulus-organism-response, the urge of impulse buying

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35437 Estimation of Service Quality and Its Impact on Market Share Using Business Analytics

Authors: Haritha Saranga

Abstract:

Service quality has become an important driver of competition in manufacturing industries of late, as many products are being sold in conjunction with service offerings. With increase in computational power and data capture capabilities, it has become possible to analyze and estimate various aspects of service quality at the granular level and determine their impact on business performance. In the current study context, dealer level, model-wise warranty data from one of the top two-wheeler manufacturers in India is used to estimate service quality of individual dealers and its impact on warranty related costs and sales performance. We collected primary data on warranty costs, number of complaints, monthly sales, type of quality upgrades, etc. from the two-wheeler automaker. In addition, we gathered secondary data on various regions in India, such as petrol and diesel prices, geographic and climatic conditions of various regions where the dealers are located, to control for customer usage patterns. We analyze this primary and secondary data with the help of a variety of analytics tools such as Auto-Regressive Integrated Moving Average (ARIMA), Seasonal ARIMA and ARIMAX. Study results, after controlling for a variety of factors, such as size, age, region of the dealership, and customer usage pattern, show that service quality does influence sales of the products in a significant manner. A more nuanced analysis reveals the dynamics between product quality and service quality, and how their interaction affects sales performance in the Indian two-wheeler industry context. We also provide various managerial insights using descriptive analytics and build a model that can provide sales projections using a variety of forecasting techniques.

Keywords: service quality, product quality, automobile industry, business analytics, auto-regressive integrated moving average

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35436 Study on the Effect of Different Media on Green Roof Water Retention

Authors: Chen Zhi-Wei, Hsieh Wei-Fang

Abstract:

Taiwan annual rainfall is global average of 2.5 times, plus city excessive development, green constantly to reduced, instead of is big area of artificial base disc, makes Taiwan rainy season during occurred of storm cannot timely of emissions, led to flood constantly, and rain also cannot was retained again using, led to city hydrological balance suffered damage, and to Regulation city of by brings of negative effect, increased green covered rate became most effective of method, and city land limited, so roof green gradually became a alternative program. Green roofs have become one of the Central and local government policy initiatives for urban development, in foreign countries, such as the United States, and Japan, and Singapore etc. Development of roof greening as an important policy, has become a trend of the times. In recent years, many experts and scholars are also on the roof greening all aspects of research, mostly for green roof for the environmental impact of benefits, such as: carbon reduction, cooling, thermostat, but research on the benefits of green roofs under water cut but it is rare. Therefore, this research literature from green roof in to view and analyze what kind of medium suitable for roof greening and use of green base plate combination simulated green roof structure, via different proportions of the medium with water retention plate and drainage board, experiment with different planting base plate combination of water conservation performance. Research will want to test the effect of roof planting base mix, promotion of relevant departments and agencies in future implementation of green roofs, prompted the development of green roofs, which in the end Taiwan achieve sustainable development of the urban environment help.

Keywords: thin-layer roof greening and planting medium, water efficiency

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35435 Examining How the Institutional Policies Affect LGBT Residents Living in Long-Term Care

Authors: Peter Brink

Abstract:

Much of the research examining sexuality in long-term care focus on individual experiences, specifically their past, present, and future lived experiences. We know little about long-term care home policies, how they relate to the LGBT community, or how accommodating long-term care homes are to the LGBT+ community. In many ways, residents who identify as LGBT+ have been invisible in long-term care homes. Up until the not-to-distant past, homosexuality was illegal, and discrimination was acceptable. Canada’s LGBT population has also suffered because of the HIV/AIDS epidemic. For these and other reasons, members of the LGBT community might resist entering long-term care or attempt to keep their sexuality secret. The goal of any long-term care home is to be a welcoming place, to display signs of inclusion, and to help residents and staff feel that they are embraced. From the perspective of the long-term care home, it is possible that many of these facilities do not necessarily see the need to mention gender identity or sexual orientation in their welcoming materials. However, from the perspective of the invisible minority, it may be important that these homes be more than just welcoming. This study examined the role of institutional policies in long-term care for residents who identify as LGBT.

Keywords: long-term care, LGBT, HIV/AIDS, policy

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35434 Urban Growth Outside the Walled City of Tripoli, Libya: Two Colonial Approaches

Authors: Fathia Elmenghawi

Abstract:

The transformation of cities under colonial rule has received a great deal of scholarly work. Colonizers interpret their colonies differently and many urban and planning approaches can be traced. This paper focuses on the colonial approaches of urban expansion in the city of Tripoli, Libya during two colonial periods, the late Ottomans and the Italians, from the 1830s to 1940s. Both had perceived their approaches to the city’s expansion as means of practicing dominance over the colonized under the disguise of facilitating the process of modernization of the city. This research uses a historical method that based on archival documents such as maps, photos, and publications to uncover the planning practices followed by the two colonizers. The findings indicate that despite the similar intentions that both colonizers had when they expanded the city, one striking difference was distinguished, which is how the Ottomans and the Italians planned to treat the Walled City as, respectively, either a context for expansion or as merely remains to marginalize.

Keywords: colonial urban planning, Italian colonization, Ottoman provinces, walled city

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35433 Taiwanese Pre-Service Elementary School EFL Teachers’ Perception and Practice of Station Teaching in English Remedial Education

Authors: Chien Chin-Wen

Abstract:

Collaborative teaching has different teaching models and station teaching is one type of collaborative teaching. Station teaching is not commonly practiced in elementary school English education and introduced in language teacher education programs in Taiwan. In station teaching, each teacher takes a small part of instructional content, working with a small number of students. Students rotate between stations where they receive the assignments and instruction from different teachers. The teachers provide the same content to each group, but the instructional method can vary based upon the needs of each group of students. This study explores thirty-four Taiwanese pre-service elementary school English teachers’ knowledge about station teaching and their competence demonstrated in designing activities for and delivering of station teaching in an English remedial education to six sixth graders in a local elementary school in northern Taiwan. The participants simultaneously enrolled in this Elementary School English Teaching Materials and Methods class, a part of an elementary school teacher education program in a northern Taiwan city. The instructor (Jennifer, pseudonym) in this Elementary School English Teaching Materials and Methods class collaborated with an English teacher (Olivia, pseudonym) in Maureen Elementary School (pseudonym), an urban elementary school in a northwestern Taiwan city. Of Olivia’s students, four male and two female sixth graders needed to have remedial English education. Olivia chose these six elementary school students because they were in the lowest 5 % of their class in terms of their English proficiency. The thirty-four pre-service English teachers signed up for and took turns in teaching these six sixth graders every Thursday afternoon from four to five o’clock for twelve weeks. While three participants signed up as a team and taught these six sixth graders, the last team consisted of only two pre-service teachers. Each team designed a 40-minute lesson plan on the given language focus (words, sentence patterns, dialogue, phonics) of the assigned unit. Data in this study included the KWLA chart, activity designs, and semi-structured interviews. Data collection lasted for four months, from September to December 2014. Data were analyzed as follows. First, all the notes were read and marked with appropriate codes (e.g., I don’t know, co-teaching etc.). Second, tentative categories were labeled (e.g., before, after, process, future implication, etc.). Finally, the data were sorted into topics that reflected the research questions on the basis of their relevance. This study has the following major findings. First of all, the majority of participants knew nothing about station teaching at the beginning of the study. After taking the course Elementary School English Teaching Materials and Methods and after designing and delivering the station teaching in an English remedial education program to six sixth graders, they learned that station teaching is co-teaching, and that it includes activity designs for different stations and students’ rotating from station to station. They demonstrated knowledge and skills in activity designs for vocabulary, sentence patterns, dialogue, and phonics. Moreover, they learned to interact with individual learners and guided them step by step in learning vocabulary, sentence patterns, dialogue, and phonics. However, they were still incompetent in classroom management, time management, English, and designing diverse and meaningful activities for elementary school students at different English proficiency levels. Hence, language teacher education programs are recommended to integrate station teaching to help pre-service teachers be equipped with eight knowledge and competences, including linguistic knowledge, content knowledge, general pedagogical knowledge, curriculum knowledge, knowledge of learners and their characteristics, pedagogical content knowledge, knowledge of education content, and knowledge of education’s ends and purposes.

Keywords: co-teaching, competence, knowledge, pre-service teachers, station teaching

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35432 Home-Based Care with Follow-Up at Outpatient Unit or Community-Follow-Up Center with/without Food Supplementation and/or Psychosocial Stimulation of Children with Moderate Acute Malnutrition in Bangladesh

Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown

Abstract:

Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.

Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food

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35431 Human Health Risks Assessment of Particulate Air Pollution in Romania

Authors: Katalin Bodor, Zsolt Bodor, Robert Szep

Abstract:

The particulate matter (PM) smaller than 2.5 μm are less studied due to the limited availability of PM₂.₅, and less information is available on the health effects attributable to PM₁₀ in Central-Eastern Europe. The objective of the current study was to assess the human health risk and characterize the spatial and temporal variation of PM₂.₅ and PM₁₀ in eight Romanian regions between the 2009-2018 and. The PM concentrations showed high variability over time and spatial distribution. The highest concentration was detected in the Bucharest region in the winter period, and the lowest was detected in West. The relative risk caused by the PM₁₀ for all-cause mortality varied between 1.017 (B) and 1.025 (W), with an average 1.020. The results demonstrate a positive relative risk of cardiopulmonary and lung cancer disease due to exposure to PM₂.₅ on the national average 1.26 ( ± 0.023) and 1.42 ( ± 0.037), respectively.

Keywords: PM₂.₅, PM₁₀, relative risk, health effect

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35430 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

Abstract:

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

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35429 Maternal Awareness of Sudden Infant Death Syndrome: A Jordanian Study

Authors: Nemeh Ahmad Al-Akour, Ibrahem Alfaouri

Abstract:

Objective: To examine the level of maternal awareness of SIDS and its prevention amongst Jordanian mothers in the north of Jordan, as well as to determine their SIDS-related infant care practices. Design: A cross-sectional design. Setting: The study was conducted in maternal out-patients clinics of two teaching hospitals and three maternal and child health clinic in three major health care centers in Northern Jordan. Participants: A total of 356 mothers of infants attending the maternal and child health clinics were included in this study. Measurements and findings: A self-administered questionnaire was used for collecting data study. In this study, 64%of mothers didn’t hear about SIDS, while only 7% of mothers were able to identify factors risk-reducing recommendations. Avoidance of prone sleeping was the most frequently identified recommendation (5%). There were 67.7% of mothers who put their infant in a lateral position to sleep, 61% used soft mattress surface for their babies sleep and 25.8% who shared a bed with their babies. Employed mother, mothers of higher age, and mothers living within a nuclear family were the only factors associated with maternal awareness of SIDS. Friends were the highest a source of knowledge of SIDS for mothers (44.7%). Key conclusions: There was a low level of awareness of SIDS and its associated risk factor among the mothers in Jordan. The mothers' misconception about smoking and sleeping position for their infants requires further efforts. Implications for practice: To ensure raising awareness of infant care practice regarding SIDS, a national educational intervention on SIDS risk reduction strategies and recommendations is necessary for maintaining a low rate of SIDS in the population.

Keywords: bed sharing, infant care, Jordan, sleep position, sudden infant death

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35428 Carl Wernicke and the Origin of Neurolinguistics in Breslau: A Case Study in the Domain of the History of Linguistics

Authors: Aneta Daniel

Abstract:

The subject of the study is the exploration of the origins and dynamics of the development of language studies, which have been labelled as neurolinguistics. It is worth mentioning that the origins of neurolinguistics are to be found in the research conducted by German scientists before the Second World War in Breslau Universität (presently Wroclaw). The dominant figure in these studies was professor Carl Wernicke, whose students continued and creatively developed projects of their master within this area. Professor Carl Wernicke, a German physician, anatomist, psychiatrist, and neuropathologist, is primarily known for his influential research on aphasia. His research, as well as those conducted by professor Paul Broca, has led to breakthroughs in the location of brain functions, particularly speech. Years later the theses of the pioneers of cognitive neurology (Carl Wernicke and Paul Broca) were developed by other neurolinguists. The main objective of the investigation is the reconstruction of the group of scientists –the students of Carl Wernicke– who contributed to the development of neurolinguistics. The scholars were mainly neurologists and psychiatrists and dealt with the branch of science that had not been named neurolinguistics at that time. The profiles of the scholars will be analysed and presented as the members of the group of researchers who have contributed to the breakthroughs in psychology and neuroscience. The research material consists of archival records documenting the research of professor Carl Wernicke and the researchers from Breslau (presently Wroclaw) which is one of the fastest growing cities in Europe. In 1870, when Carl Wernicke became the medical doctor, Breslau was full of cultural events: festivals and circus shows were held in the city center. Today we can come back to these events due to 'Breslauer Zeitung (1870)', which precisely describes all the events that took place on particular days. It is worth noting that those were the beginnings of antisemitism in Breslau. Many theses and articles that have survived in the libraries in Wroclaw and all over the world contribute to the development of neuroscience. The history of research on the brain and speech analysis, including the history of psychology and neuroscience, areas from which neurolinguistics is derived, will be presented.

Keywords: Aphasia, brain injury, Carl Wernicke, language, neurolinguistics

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35427 Attitudes of Young Adults with Physical Disabilities towards Occupational Preferences

Authors: Limor Gadot, Orly Sarid

Abstract:

Integration of young adults with disabilities (YAWD) into workplaces provides an opportunity for social and occupational mobility, enabling them to financial independence. To enhance integration, it is important to understand their occupational preferences as well as the factors that influencing it such as demographic variables, self-assessed health, beliefs about work, subjective norms, and self-efficacy. Planned behavior theory was chosen as a basis for this study. A cross-sectional study, based on preliminary sample of 37 YAWD who have been recognized by the National Insurance Institute and are engaged in a year of national service. The finding shows that most of the participants were single (97%) women (60%); average age was 22(+ 2) years, approximately half were secular. Most of the participants had disabilities resulting from CP (96%). Self-assessed health was correlated positively and significantly with behavioral intentions to work in the free market (r = .33, p = .05), and significant negative correlation with behavioral intentions to work in supported settings (r =.-40, p = .01), and sheltered settings (r =-.36, p = .03): individuals who perceived themselves as having more severe disabilities showed a greater tendency to choose a workplace with more rehabilitative inputs. Furthermore, women showed a greater tendency than men to perceive their disability as impairing their future intention to work: t (36) = 2.23, p < .05. Beliefs about work were positively associated with normative beliefs (r = .308, p = .06). The findings indicate that, especially with women, perceptions of health are related to occupational preferences. Moreover, the findings indicate that the relationship between subjective norms about work and normative beliefs about integrating in a workplace that prevail in the individual's environment affects occupational preferences. The contribution of the study lies in the development of new responses and interventions to encourage adults with disabilities to work.

Keywords: young adults, disabilities, work preferences, occupational preferences

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35426 Linking Information Systems Capabilities for Service Quality: The Role of Customer Connection and Environmental Dynamism

Authors: Teng Teng, Christos Tsinopoulos

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The purpose of this research is to explore the link between IS capabilities, customer connection, and quality performance in the service context, with investigation of the impact of firm’s stable and dynamic environments. The application of Information Systems (IS) has become a significant effect on contemporary service operations. Firms invest in IS with the presumption that they will facilitate operations processes so that their performance will improve. Yet, IS resources by themselves are not sufficiently 'unique' and thus, it would be more useful and theoretically relevant to focus on the processes they affect. One such organisational process, which has attracted a lot of research attention by supply chain management scholars, is the integration of customer connection, where IS-enabled customer connection enhances communication and contact processes, and with such customer resources integration comes greater success for the firm in its abilities to develop a good understanding of customer needs and set accurate customer. Nevertheless, prior studies on IS capabilities have focused on either one specific type of technology or operationalised it as a highly aggregated concept. Moreover, although conceptual frameworks have been identified to show customer integration is valuable in service provision, there is much to learn about the practices of integrating customer resources. In this research, IS capabilities have been broken down into three dimensions based on the framework of Wade and Hulland: IT for supply chain activities (ITSCA), flexible IT infrastructure (ITINF), and IT operations shared knowledge (ITOSK); and focus on their impact on operational performance of firms in services. With this background, this paper addresses the following questions: -How do IS capabilities affect the integration of customer connection and service quality? -What is the relationship between environmental dynamism and the relationship of customer connection and service quality? A survey of 156 service establishments was conducted, and the data analysed to determine the role of customer connection in mediating the effects of IS capabilities on firms’ service quality. Confirmatory factor analysis was used to check convergent validity. There is a good model fit for the structural model. Moderating effect of environmental dynamism on the relationship of customer connection and service quality is analysed. Results show that ITSCA, ITINF, and ITOSK have a positive influence on the degree of the integration of customer connection. In addition, customer connection positively related to service quality; this relationship is further emphasised when firms work in a dynamic environment. This research takes a step towards quelling concerns about the business value of IS, contributing to the development and validation of the measurement of IS capabilities in the service operations context. Additionally, it adds to the emerging body of literature linking customer connection to the operational performance of service firms. Managers of service firms should consider the strength of the mediating role of customer connection when investing in IT-related technologies and policies. Particularly, service firms developing IS capabilities should simultaneously implement processes that encourage supply chain integration.

Keywords: customer connection, environmental dynamism, information systems capabilities, service quality, service supply chain

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35425 Medication Errors in a Juvenile Justice Youth Development Center

Authors: Tanja Salary

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This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies

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35424 Sleep Quality as Perceived by Critically Ill Patients at El Manial University Hospitals

Authors: Mohamed Adel Ahmed, Warda Youssef Morsy , Hanaa Ali El Feky

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Background: Literature review cited that sleep is absolutely essential for surviving and reclamation of the quality of life. Critically ill patients often have poor sleep quality with prolonged sleep latency, sleep fragmentation, decreased sleep efficiency and frequent arousals. Nurses have a unique role for the early diagnosis of sleep disorders, decreasing stressors levels and providing the necessary environmental regulations to create a therapeutic ambiance. The aim of the study: to assess perceived sleep quality and identify factors affecting sleep quality among adult critically ill patients At El Manial University Hospital. Research Design: A descriptive exploratory design was utilized. Research questions: a) how do adult critically ill patients perceive sleep quality in the Critical Care Department of El Manial University Hospital? b) What are the factors affecting sleep quality among adult critically ill patients at El Manial University Hospital? Setting: selected critical and cardiac care units at El Manial University Hospital. Sample: A samples of convenience consisting of 100 adult male and female patients were included in the study. Tools of data collection: tool 1: Socio-demographic and Medical Data Sheet, tool 2: Modified St Mary's Hospital Sleep Questionnaire tool 3: Factors Affecting Sleep Quality Questionnaire among ICU Patients Results: The current study revealed that 76.0% of the studied sample had lack of sleep disturbance before hospitalization. However, 84 % had sleep disturbances during ICU stay, of these more than two-thirds (67 %) had moderate sleep disturbance. Presence of strange and bad odors, noise, having pain, fear of death and a loud voice produced by the ICU personnel had the most significant negative impact on patients’ sleep in percentage of 52.4, 50, 61.9, 45.2, 52.4, respectively. Conclusion: Sleep disturbances in the ICU are multifactorial, and ICU patients’ perceived degrees of sleep disturbance as a moderate. Recommendations: Based on findings of the present study, the following are recommended to be done by ICU nurses; create a healing ICU environment that should incorporate noise, light and temperature controls; decrease stimuli during night time hours to promote regulation of the circadian rhythm, allow usage of sleeping aids such as relaxing music, eye patches and earplugs into their daily nursing practice; cluster nursing activities and eliminate non-essential treatments during night time hours to allow uninterrupted sleep periods of at least 90 minutes to complete one sleep cycle , and minimize staff conversation, alarm noise and light during the quiet night time hours.

Keywords: sleep quality, critically ill, patients, perception

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35423 The Effects of Mobile Communication on the Nigerian Populace

Authors: Chapman Eze Nnadozie

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Communication, the activity of conveying information, remains a vital resource for the growth and development of any given society. Mobile communication, popularly known as global system for mobile communication (GSM) is a globally accepted standard for digital cellular communication. GSM, which is a wireless technology, remains the fastest growing communication means worldwide. Indeed, mobile phones have become a critical business tool and part of everyday life in both developed and developing countries. This study examines the effects of mobile communication on the Nigerian populace. The methodology used in this study is the survey research method with the main data collection tool as questionnaires. The questionnaires were administered to a total of seventy respondents in five cities across the country, namely: Aba, Enugu, Bauchi, Makurdi, and Lagos. The result reveals that though there is some quality of service issues, mobile communication has very significant positive efforts on the economic and social development of the Nigerian populace.

Keywords: effect, mobile communication, populace, GSM, wireless technology, mobile phone

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35422 Evaluation and Risk Assessment of Heavy Metals Pollution Using Edible Crabs, Based on Food Intended for Human Consumption

Authors: Nayab Kanwal, Noor Us Saher

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The management and utilization of food resources is becoming a big issue due to rapid urbanization, wastage and non-sustainable use of food, especially in developing countries. Therefore, the use of seafood as alternative sources is strongly promoted worldwide. Marine pollution strongly affects marine organisms, which ultimately decreases their export quality. The monitoring of contamination in marine organisms is a good indicator of the environmental quality as well as seafood quality. Monitoring the accumulation of chemical elements within various tissues of organisms has become a useful tool to survey current or chronic levels of heavy metal exposure within an environment. In this perspective, this study was carried out to compare the previous and current levels (Year 2012 and 2014) of heavy metals (Cd, Pb, Cr, Cu and Zn) in crabs marketed in Karachi and to estimate the toxicological risk associated with their intake. The accumulation of metals in marine organisms, both essential (Cu and Zn) and toxic (Pb, Cd and Cr), natural and anthropogenic, is an actual food safety issue. Significant (p>0.05) variations in metal concentrations were found in all crab species between the two years, with most of the metals showing high accumulation in 2012. For toxicological risk assessment, EWI (Estimated weekly intake), Target Hazard quotient (THQ) and cancer risk (CR) were also assessed and high EWI, Non- cancer risk (THQ < 1) showed that there is no serious threat associated with the consumption of shellfish species on Karachi coast. The Cancer risk showed the highest risk from Cd and Pb pollution if consumed in excess. We summarize key environmental health research on health effects associated with exposure to contaminated seafood. It could be concluded that considering the Pakistan coast, these edible species may be sensitive and vulnerable to the adverse effects of environmental contaminants; more attention should be paid to the Pb and Cd metal bioaccumulation and to toxicological risks to seafood and consumers.

Keywords: cancer risk, edible crabs, heavy metals pollution, risk assessment

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35421 Changes in Cognition of Elderly People: A Longitudinal Study in Kanchanaburi Province, Thailand

Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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35420 Quantitative Research on the Effects of Following Brands on Twitter on Consumer Brand Attitude

Authors: Yujie Wei

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Twitter uses a variety of narrative methods (e.g., messages, featured videos, music, and actual events) to strengthen its cultivation effect. Consumers are receiving mass-produced brand stores or images made by brand managers according to strict market specifications. Drawing on the cultivation theory, this quantitative research investigates how following a brand on Twitter for 12 weeks can cultivate their attitude toward the brand and influence their purchase intentions. We conducted three field experiments on Twitter to test the cultivation effects of following a brand for 12 weeks on consumer attitude toward the followed brand. The cultivation effects were measured by comparing the changes in consumer attitudes before and after they have followed a brand over time. The findings of our experiments suggest that when consumers are exposed to a brand’s stable, pervasive, and recurrent tweets on Twitter for 12 weeks, their attitude toward a brand can be significantly changed, which confirms the cultivating effects on consumer attitude. Also, the results indicate that branding activities on Twitter, when properly implemented, can be very effective in changing consumer attitudes toward a brand, increasing the purchase intentions, and increasing their willingness to spread the word-of-mouth for the brand on social media. The cultivation effects are moderated by brand type and consumer age. The research provides three major marketing implications. First, Twitter marketers should create unique content to engage their brand followers to change their brand attitude through steady, cumulative exposure to the branding activities on Twitter. Second, there is a significant moderating effect of brand type on the cultivation effects, so Twitter marketers should align their branding content with the brand type to better meet the needs and wants of consumers for different types of brands. Finally, Twitter marketers should adapt their tweeting strategies according to the media consumption preferences of different age groups of their target markets. This empirical research proves that content is king.

Keywords: tweeting, cultivation theory, consumer brand attitude, purchase intentions, word-of-mouth

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35419 Influence of Telkom Membership Card Customer Perceived Value on Retaining PT. Telkom Indonesia's Customer in 2013-2014

Authors: Eka Yuliana, Siska Shabrina Julyan

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The competitive environment and high customer’s churn rate in telecommunication industries lead Indonesian telecommunication companies become strive to offer products with more value. Offering product with more value can encourage customers to keep using the companies product. One of way to retain customer is give a membership card to the customers as practiced by PT. Telkom by giving Telkom Membership Card to PT. Telkom loyal customer. This study aims to determine the influence of Telkom Membership Card customer perceived value on retaining PT. Telkom Indonesia’s customer in 2013-2014 by using quantitative method with causal study. Analythical technique used in this study is Structural Equation Modelling (SEM) to test the causal relationship with 216 owner of Telkom Membership Card in Indonesia. This study conclude that: (i) Customer perceived value on Telkom Membership Card is located in fair value zone, (ii) PT. Telkom efforts in order to retain the customers is classified as good, (iii) Customer perceived value is influencing the effort to retain the customer with the probability value less than 0.05 and level of influence 69%. Based on result of this study, PT. Telkom should (i) Improve Telkom Membership Card’s promotion because not all customer of PT. Telkom have the membership card. (iia) Adding Telkom Membership Card’s benefit such as discount at various merchant (iib) Making call center for member of Telkom Membership Card (iii) PT. Telkom should be ensure availability of their service. (iv) PT. Telkom should make a priority to customer who have telkom membership card and offers a better service.For future research should be use different variables.

Keywords: customer perceived value, customer retention, marketing, relationship marketing

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35418 Tsunami Disasters Preparedness among the Coastal Residence in Penang, Malaysia

Authors: A. R. Shakura, A. B. Elistina, M. S. Aini, S. Norhasmah, A. Fakhru’l-Razi

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Tsunami 2004 was an unforeseeable event that caught Malaysia of guard resulting with 68 losses of lives and with an estimated economic loss of about 55.15billion US dollar. Scientists predict that if the earthquake epicentre originates from the Andaman-Nicobar region, the coastal population of Penang will have about 30 minutes to evacuate to safety. Thus, a study was conducted to enhance resiliency of Penang community as the area was the worst affected region during 2004 tsunami disaster. This paper is intended to examine the factors that influence intention to prepare for future tsunami among the coastal residence in Penang. The differences in the level of intention to prepare were also examined between those who experience and did not experience the 2004 tsunami. This study utilized a cross-sectional research design using a survey method. A total of 503 respondents were chosen systematically and data gathered were analysed using SPSS. Both genders, male and female were equally represented with a mean age of 44 years. Data indicated that the level of intention to prepare for tsunami disaster was moderate (M=3.72) with no significant difference in intention to prepare between those who had experienced or had not experienced the 2004 tsunami. Subsequently, results from a multiple regression analysis found that sense of community to be the most influential factor followed by subjective norm, trust, positive outcome expectancy and risk perception, explaining the 57% variance in intention to prepare. These factors reflect the influence of the collectivistic culture in Malaysia whereby households plus communities have a central role in encouraging each other. Therefore, the findings highlights the potential of adopting a community based disaster risk management as recommended by the United Nations International Strategy Disaster Reduction (UNISDR) which encompasses the cooperation between the local community and relevant stakeholders in preparing for future tsunami disaster.

Keywords: disaster management, experience, intention to prepare, tsunami

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35417 Analysing the Moderating Effect of Customer Loyalty on Long Run Repurchase Intentions

Authors: John Akpesiri Olotewo

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One of the controversies in existing marketing literatures is on how to retain existing and new customers to have repurchase intention in the long-run; however, empirical answer to this question is scanty in existing studies. Thus, this study investigates the moderating effect of consumer loyalty on long-run repurchase intentions in telecommunication industry using Lagos State environs. The study adopted field survey research design using questionnaire to elicit responses from 250 respondents who were selected using random and stratified random sampling techniques from the telecommunication industry in Lagos State, Nigeria. The internal consistency of the research instrument was verified using the Cronbach’s alpha, the result of 0.89 implies the acceptability of the internal consistency of the survey instrument. The test of the research hypotheses were analyzed using Pearson Product Method of Correlation (PPMC), simple regression analysis and inferential statistics with the aid of Statistical Package for Social Science version 20.0 (SPSS). The study confirmed that customer satisfaction has a significant relationship with customer loyalty in the telecommunication industry; also Service quality has a significant relationship with customer loyalty to a brand; loyalty programs have a significant relationship with customer loyalty to a network operator in Nigeria and Customer loyalty has a significant effect on the long run repurchase intentions of the customer. The study concluded that one of the determinants of long term profitability of a business entity is the long run repurchase intentions of its customers which hinges on the level of brand loyalty of the customer. Thus, it was recommended that service providers in Nigeria should improve on factors like customer satisfaction, service quality, and loyalty programs in order to increase the loyalty of their customer to their brands thereby increasing their repurchase intentions.

Keywords: customer loyalty, long run repurchase intentions, brands, service quality and customer satisfaction

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35416 Evaluation of Associated Risk Factors and Determinants of near Miss Obstetric Cases at B.P. Koirala Institute of Health Sciences, Dharan

Authors: Madan Khadka, Dhruba Uprety, Rubina Rai

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Background and objective: In 2011, around 273,465 women died worldwide during pregnancy, childbirth or within 42 days after childbirth. Near-miss is recognized as the predictor of the level of care and maternal death. The objective of the study was to evaluate the associated risk factors of near-miss obstetric cases and maternal death. Material and Methods A Prospective Observational Study was done from August 1, 2014, to June 30, 2015, in Department of Obstetrics and Gynecology at BPKIHS hospital, tertiary care hospital in Eastern Nepal, Dharan. Case eligible by the 5-factor scoring system and WHO near miss criteria were evaluated. Risk factors included severe hemorrhage, hypertensive disorders, and a complication of abortion, ruptured uterus, medical/surgical condition and sepsis. Results: A total of 9,727 delivery were attended during the study period from August 2014 to June 2014. There were 6307 (71.5%) vaginal delivery and 2777(28.5%) caesarean section and 181 perinatal death with a total of 9,546 live birth. A total of 162 near miss was identified, and 16 maternal death occurred during the study. Maternal near miss rate of 16.6 per 1000 live birth, Women with life-threatening conditions (WLTC) of 172, Severe maternal outcome ratio of 18.64 per 1000 live birth, Maternal near-miss mortality ratio (MNM: 1 MD) 10.1:1, Mortality index (MI) of 8.98%. Risk factors were obstetric hemorrhage 27.8%, abortion/ectopic 27.2%, eclampsia 16%, medical/surgical condition 14.8%, sepsis 13.6%, severe preeclamsia 11.1%, ruptured uterus 3.1%, and molar pregnancy 1.9%. 19.75% were prim gravidae, with mean age 25.66 yrs, and cardiovascular and coagulation dysfunction as a major life threatening condition and sepsis (25%) was the major cause of mortality. Conclusion: Hemorrhage and hypertensive disorders are the leading causes of near miss event and sepsis as a leading cause of mortality. As near miss analysis indicates the quality of health care, it is worth presenting in national indices.

Keywords: abortion, eclampsia, hemorrhage, maternal mortility, near miss

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35415 Patient Service Improvement in Public Emergency Department Using Discrete Event Simulation

Authors: Dana Mohammed, Fatemah Abdullah, Hawraa Ali, Najat Al-Shaer, Rawan Al-Awadhi, , Magdy Helal

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We study the patient service performance at the emergency department of a major Kuwaiti public hospital, using discrete simulation and lean concepts. In addition to the common problems in such health care systems (over crowdedness, facilities planning and usage, scheduling and staffing, capacity planning) the emergency department suffered from several cultural and patient behavioural issues. Those contributed significantly to the system problems and constituted major obstacles in maintaining the performance in control. This led to overly long waiting times and the potential of delaying providing help to critical cases. We utilized the visual management tools to mitigate the impact of the patients’ behaviours and attitudes and improve the logistics inside the system. In addition a proposal is made to automate the date collection and communication within the department using RFID-based barcoding system. Discrete event simulation models were developed as decision support systems; to study the operational problems and assess achieved improvements. The simulation analysis resulted in cutting the patient delays to about 35% of their current values by reallocating and rescheduling the medical staff. Combined with the application of the visual management concepts, this provided the basis to improving patient service without any major investments.

Keywords: simulation, visual management, health care system, patient

Procedia PDF Downloads 456