Search results for: barriers in disability care

Authors: Walter Rafael Ramos Villanueva

Abstract:

The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.

Keywords: caregiving, dementia, literature, parentified children

Procedia PDF Downloads 171

Authors: Raheb Mirzanamadi, João Patrício

Abstract:

Asphalt rubber (AR) was initially developed in Sweden in the 1960s by replacing crumb rubber (CR) as aggregates in asphalt pavement. The AR produced by this method had better mechanical properties than conventional asphalt pavement but was very expensive. Since then, different technologies and methods have been developed to use CR in asphalt pavements, including blending CR with bitumen at a high temperature in the mixture, called the wet method, and blending CR with bitumen in the refinery, called the terminal blending method. In 2006, the wet method was imported from the USA to Sweden to evaluate the potential of using AR on Swedish roads. 154 km AR roads were constructed by the wet method in Sweden. The evaluation showed that the AR had, in most cases, better mechanical performance than conventional asphalt pavements. However, the terrible smoke and smell led the Swedish Transport Administration (STA) to stop using AR in Sweden. Today, there are few focuses on AR, despite its good mechanical properties and environmental aspects. Hence, there is a need to study the drives and barriers of using AR mixture in Sweden. The aims of this paper are: (i) to study drivers and barriers of using AR pavements in Sweden and (ii) to discover knowledge gaps for further research in this area. The study was done using a literature review and completed by interviews with experts, including three researchers from Swedish National Road and Transport Research Institute (VTI) and two experts from STA. The results showed that AR can be an alternative not only for conventional asphalt pavement but also for polymer modified asphalt (PMA) due to the same mechanical properties but the lower cost for production. New technologies such as terminal blending and using warm mix asphalt (WMA) methods can lead to reducing the energy and temperature during production processes. From this study, it is found that there is not enough experience and knowledge about AR in Sweden, and more research is needed, including the lifespan of AR, mechanical properties of AR using new technologies, and the impact of AR on spreading and leaching substances into nature. More studies can lead to standardization of using AR in Sweden, a potential solution for the use of end-of-life tyres, with better mechanical properties and lower costs, in comparison with conventional asphalt pavements and PMA.

Keywords: asphalt rubber, crumb rubber, terminal blending method, wet method

Procedia PDF Downloads 78

Authors: Marie Kristel A. Gabawa

Abstract:

The accessibility of health programs, specifically family planning programs and maternal and child health care (FP/MCH), are generally low in urban poor communities. Moreover, most of FP/MCH programs are directed toward medical terms that are usually not included in ideation of the body of urban poor dwellers. This study aims to explore the beliefs on reproduction that will encompass, but not limited to, beliefs on conception, pregnancy, and maternal and child health care. The site of study will be the 2 barangays of North Bay Boulevard South 1 (NBBS1) and North Bay Boulevard South 2 (NBBS2). These 2 barangays are the nearest residential community within the Navotas Fish Port Complex (NFPC). Data gathered will be analyzed using grounded-theory method of analysis, with the theories of cultural materialism and equity feminism as foundation. Survey questionnaires, key informant interviews, and focus group discussions will be utilized in gathering data. Further, the presentation of data will be recommended to health program initiators and use the data gathered as a tool to customize FP/MCH programs to the perception and beliefs of women residing in NBBS1and NBBS2, and to aid any misinformation for FP/MCH techniques.

Keywords: beliefs on reproduction, fish port community, family planning, maternal and child health care, Navotas

Procedia PDF Downloads 258

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

Abstract:

This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

Procedia PDF Downloads 185

Authors: Chung-Yuan Wang, Min Hsu, Bo-Ya Juan, Hsiv Ching Lin, Hsveh Min Lin, Hsiu-Fang Yeh

Abstract:

The success of Taiwan's National Health Insurance (NHI) system attracts widespread praise from the international society. However, the availability of medical care in a emote area is limited. Without the convenient public transportation system and mature social welfare policy, these people are difficult to regain their health and prevent disability. Preterm children have more risk to get development delay. Preterm children in a remote area have the human right to get rehabilitation resources as those in the city area. Therefore, the aim of this study was to show the importance of development screening to preterm children in a remote area and a tract the government to notice the issue. In Pingtung, children who are suspected development delay would be suggested to take a skillful screening evaluation in our hospital. Those preterm children (within 1-year-old) visited our pediatric clinic would also be referred to take the development evaluation. After the physiatrist’s systemic evaluation, the subjects would be scheduled to take the development evaluation. Gross motor, fine motor, speech comprehension/expression and mental study were included. The evaluation was in-charged by a physical therapist, occupational therapy, speech therapist and pediatric psychologist. The tools were Peabody developmental scale, Bayley Scales of Infant and Toddler Development (Bayley-III) and Wechsler Preschool & Primary Scale of Intelligence-Revised (WPPSI-R). In 2013, 459 children received the service in our hospital. Among these children, fifty-seven were noted with preterm baby history (gestation within 37 weeks). Thirty-six of these preterm children, who had never receive development evaluation, were included in this study. Thirty-six subjects (twenty-six male and ten female) were included. Nineteen subjects were found development delay. Six subjects were found suspected development delay. In gross motor, six subjects were development delay and eight were suspected development delay. In fine motor, five subjects were development delay and three were suspected development delay. In speech, sixteen subjects were development delay and six were suspected development delay. In our study, through the provision of development evaluation service, 72.2% preterm baby were found their development delay or suspected delay. They need further early intervention rehabilitation service. We made their parents realize that when development delay was recognized at the early stage, they are often reversible. No only the patients but also their families were improved their health status. The number of the subjects was limited in our study. Further study might be needed. Compared with 770 physical therapist (PT) and 370 occupational therapy (OT) in Taipei, there are only 108 PT and 54 OT in Pingtung. Further, there are much fewer therapists working on the field of pediatric rehabilitation. Living healthy is a human's right, no matter where does he live. For those development delay children in remote area, particularly preterm children, early detection, and early intervention rehabilitation service could play an important role in decreasing their disability and improving their quality of life. Through this study, we suggest the government to add more national resources on the development evaluation to preterm children in a remote area.

Keywords: development, early intervention, preterm children, rehabilitation

Procedia PDF Downloads 438

Authors: Sehrish Ather

Abstract:

Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

Procedia PDF Downloads 107

Authors: Saeed Sayyad Hagh Shomar

Abstract:

Traffic congestion pricing as one of the demand management strategies constrains expenditure to network users so that it helps reduction in traffic congestion and environment pollution like air pollution. Despite the development of congestion pricing schemes for traffic in our country, the matters of traditional toll collection, drivers’ waste of time and delay in traffic are still widespread. Electronic toll collection as a part of the intelligent transportation system provides the possibility of collecting tolls without car-stop and traffic disruption. Unlike the satisfying outcomes of using intelligent systems in congestion pricing schemes, implementation costs and technological problems are the barriers in these schemes. In this research first, a variety of electronic pay toll systems and their components are introduced then their functional usage is discussed. In the following, by analyzing and comparing the barriers, limitations and advantages, the selection criteria of intelligent systems are described and the results show that the choice of the best technology depends on the various parameters which, by examining them, it is concluded that in a long-term run and by providing the necessary conditions, DSRC technology as the main system in the schemes and ANPR as a major backup system of the main one can be employed.

Keywords: congestion pricing, electronic toll collection, intelligent systems, technology, traffic

Procedia PDF Downloads 608

Authors: B. Daee, H. M. El Naggar

Abstract:

This paper presents an experimental study on structural performance of an innovative noise barrier consisting of poly-block, light polyurethane foam (LPF) and polyurea. This wall system (flexi-wall) is intended to be employed as a vertical extension to existing sound barriers in an accelerated construction method. To aid in the wall design, several mechanical tests were conducted on LPF specimens and two full-scale walls were then fabricated employing the same LPF material. The full-scale walls were subjected to lateral loading in order to establish their lateral resistance. A cyclic fatigue test was also performed on a full-scale flexi-wall in order to evaluate the performance of the wall under a repetitive loading condition. The result of the experiments indicated the suitability of flexi-wall in accelerated construction and confirmed that the structural performance of the wall system under lateral loading is satisfactory for the sound barrier application. The experimental results were discussed and a preliminary design procedure for application of flexi-wall in sound barrier applications was also developed.

Keywords: noise barrier, polyurethane foam, accelerated construction, full-scale experiment

Procedia PDF Downloads 290

Authors: Martin Leroux, Sylvain Brisebois

Abstract:

Eating a meal is among the Activities of Daily Living, but it takes a lot of time and effort for people with physical or functional limitations. Dedicated technologies are cumbersome and not portable, while general-purpose assistive robots such as wheelchair-based manipulators are too hard to control for elaborate continuous motion like eating. Eating with such devices has not previously been automated, since there existed no description of a feeding motion for uncontrolled environments. In this paper, we introduce a feeding mode for assistive manipulators, including a mathematical description of trajectories for motions that are difficult to perform manually such as gathering and scooping food at a defined/desired pace. We implement these trajectories in a sequence of movements for a semi-automated feeding mode which can be controlled with a very simple 3-button interface, allowing the user to have control over the feeding pace. Finally, we demonstrate the feeding mode with a JACO robotic arm and compare the eating speed, measured in bites per minute of three eating methods: a healthy person eating unaided, a person with upper limb limitations or disability using JACO with manual control, and a person with limitations using JACO with the feeding mode. We found that the feeding mode allows eating about 5 bites per minute, which should be sufficient to eat a meal under 30min.

Keywords: assistive robotics, automated feeding, elderly care, trajectory design, human-robot interaction

Procedia PDF Downloads 161

Authors: Ahmet E. Osmanlioglu

Abstract:

In this study, natural bentonite was used as natural clay material and samples were taken from the Kalecik district in Ankara. In this research, bentonite is the subject of an analysis from standpoint of assessing the basic properties of engineered barriers with respect to the buffer material. Bentonite and sand mixtures were prepared for tests. Some of clay minerals give relatively higher hydraulic conductivity and lower swelling pressure. Generally, hydraulic conductivity of these type clays is lower than <10-12 m/s. The hydraulic properties of clay-sand mixtures are evaluated to design engineered barrier specifications. Hydraulic conductivities of bentonite-sand mixture were found in the range of 1.2x10-10 to 9.3x10-10 m/s. Optimum B/S mixture ratio was determined as 35% in terms of hydraulic conductivity and mechanical stability. At the second stage of this study, all samples were compacted into cylindrical shape molds (diameter: 50 mm and length: 120 mm). The strength properties of compacted mixtures were better than the compacted bentonite. In addition, the larger content of the quartz sand in the mixture has the greater thermal conductivity.

Keywords: engineered barriers, mechanical stability, clay, nuclear waste disposal

Procedia PDF Downloads 382

Authors: Ali Mahamat

Abstract:

This paper explores the application of Functional Communication Training (FCT) as an intervention to decrease maladaptive behaviors among individuals diagnosed with Intellectual Disability (ID) and Autism Spectrum Disorders (ASD) within an extensive support needs residential program. Evidence suggests that FCT can be ef ective in promoting positive behavioral changes and enhancing communication skills in this population. The prevalence of maladaptive behaviors in individuals with ID and ASD is a significant concern for caregivers and professionals in residential programs. These behaviors can include aggression, self-injury, and disruptive activities, which can impede the individual's quality of life. Functional Communication Training (FCT) has been identified as a potential solution to these challenges, providing individuals with the communication skills needed to express their needs and desires effectively. Method: A quasi-experimental design was used to investigate the effectiveness of FCT in a residential setting for individuals with ID and ASD. Participants included individuals with varying degrees of ID and ASD who exhibited maladaptive behaviors. A baseline was established for each participant's behavior before introducing FCT as an intervention. The FCT intervention involved teaching the individuals alternative, functionally equivalent communication behaviors to replace maladaptive behaviors. The training was implemented in the participants' natural environment and was incorporated into their daily routines. The intervention period lasted for six months, with follow-ups conducted at three months and six months post-intervention.Results indicated a significant decrease in maladaptive behaviors for individuals who received the FCT intervention. In addition, an enhancement in communication skills was observed, with the majority of participants demonstrating an increased ability to express their needs and desires appropriately. The findings of this study provide support for the effectiveness of FCT in reducing maladaptive behaviors in individuals with ID and ASD in a residential setting. Moreover, the study highlights the importance of incorporating functional communication skills training in the daily routines of these individuals. By providing these individuals with an effective means of communication, FCT not only reduces the occurrence of maladaptive behaviors but also improves the quality of life for these individuals. However, future research should explore the long-term effects of FCT and consider the influence of individual differences on the effectiveness of the intervention.

Keywords: functional communication training, intellectual disability, autism spectrum disorders, maladaptive behavior, residential program

Procedia PDF Downloads 25

Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

Abstract:

The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

Procedia PDF Downloads 197

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, J.C. Mairesse Siluk, I. F. Minello, F. dos Santos de Oliveira

Abstract:

Background: Although palliative care policies and services have been developed, research in this area continues to lag. An integrated model of palliative care is suggested, which includes complementary and alternative services aimed at improving the well-being of patients and their families. The palliative aquatics care multi-device (AuBento) uses several electromagnetic techniques to decrease pain and promote well-being through relaxation and interaction among patients, specialists, and family members. Aim: The scope of this paper is to present a preliminary design study of a device capable of exploring the various existing theories on the biomedical application of magnetic fields. This will be achieved by standardizing clinical data collection with sensory integration, and adding new therapeutic options to develop an advanced palliative aquatics care, innovating in symptom and pain management. Methods: The research methodology was based on the Work Package Methodology for the development of projects, separating the activities into seven different Work Packages. The theoretical basis was carried out through an integrative literature review according to the specific objectives of each Work Package and provided a broad analysis, which, together with the multiplicity of proposals and the interdisciplinarity of the research team involved, generated consistent and understandable complex concepts in the biomedical application of magnetic fields for palliative care. Results: Aubento ambience was idealized with restricted electromagnetic exposure (avoiding data collection bias) and sensory integration (allowing relaxation associated with hydrotherapy, music therapy, and chromotherapy or like floating tank). This device has a multipurpose configuration enabling classic or exploratory options on the use of the biomedical application of magnetic fields at the researcher's discretion. Conclusions: Several patients in diverse therapeutic contexts may benefit from the use of magnetic fields or fluids, thus validating the stimuli to clinical research in this area. A device in controlled and multipurpose environments may contribute to standardizing research and exploring new theories. Future research may demonstrate the possible benefits of the aquatics care multi-device AuBento to improve the well-being and symptom control in palliative care patients and their families.

Keywords: advanced palliative aquatics care, magnetic field therapy, medical device, research design

Procedia PDF Downloads 127

Authors: Elin Mordal, Meseret Tsegaye, Hirut Gemeda, Ingeborg Ulvund

Abstract:

Background: Even the rural-urban gap in the provision of skilled care during childbirth has narrowed, developing countries have the highest percentage of maternal deaths. More important than uncovering deficiencies during pregnancy, is preventing situations of risk during childbirth. The aim of this study was to identify factors women in the rural area consider before they decide where to give birth. Methods: This study utilizes a qualitative descriptive design based on individual interviews with 25 women of childbearing age who has given birth at least once, where women who delivered both at home and a health centre were included. Data collection took place in rural areas around Hawassa Zuriya Worda in Ethiopia February 2015. To identify conditions associated to where women prefer to give birth a thematic analysis was carried out. Result: Experienced risks regarding child birth were the most common reason for women and their families to seek help from skilled birth attendants. Decision-making and planning were identified as a major factor contributing to where women give birth. The women’s position and responsibilities pointed to the fact that women's role is mainly to take care of children and manage the household, while husbands, mother in laws and the elderly are the family members who take most of the decisions. This includes decision about where women give birth. The infrastructure also influences where women choose to give birth. Conclusion: To further improve childbirth care in Hawassa Zuriya Worda it’s important that women get positive experiences, and are met in a safe and supportive way at Health Centers. Challenges appear to women’s autonomy, quality aspects, and infrastructure.

Keywords: childbirth, women, health care utilization, Hawassa Zuriya Worda, Ethiopia, rural area

Procedia PDF Downloads 200

Authors: Markus Feufel, Friederike Kendel, Caren Hilger, Selamawit Woldai

Abstract:

Since the corona pandemic, the use of video consultation has increased remarkably. For vulnerable groups such as oncological patients, the advantages seem obvious. But how does video consultation potentially change the doctor-patient relationship compared to face-to-face consultation? Which barriers may hinder the effective use of this consultation format in practice? We are presenting first results from a mixed-methods field study, funded by Federal Ministry of Health, which will provide the basis for a hands-on guide for both physicians and patients on how to improve the quality of video consultations. We use a quasi-experimental design to analyze qualitative and quantitative differences between face-to-face and video consultations based on video recordings of N = 64 actual counseling sessions (n = 32 for each consultation format). Data will be recorded from n = 32 gynecological and n = 32 urological cancer patients at two clinics. After the consultation, all patients will be asked to fill out a questionnaire about their consultation experience. For quantitative analyses, the counseling sessions will be systematically compared in terms of verbal and nonverbal communication patterns. Relative frequencies of eye contact and the information exchanged will be compared using 𝝌2 -tests. The validated questionnaire MAPPIN'Obsdyad will be used to assess the expression of shared decision-making parameters. In addition, semi-structured interviews will be conducted with n = 10 physicians and n = 10 patients experienced with video consultation, for which a qualitative content analysis will be conducted. We will elaborate the comprehensive methodological approach we used to compare video vs. face-to-face consultations and present first evidence on how video consultations change the doctor-patient interaction. We will also outline possible barriers of video consultations and best practices on how they may be overcome. Based on the results, we will present and discuss recommendations outlining best practices for how to prepare and conduct high-quality video consultations from the perspective of both physicians and patients.

Keywords: video consultation, patient-doctor-relationship, digital applications, technical barriers

Procedia PDF Downloads 138

Authors: Ummuhan Bas Aslan, Sehmus Aslan

Abstract:

Objective: Physical disability includes impairments, activity limitations, and participation restrictions. Individuals with physical disabilities have lower self-esteem compared non-disabled people. Self-esteem is widely accepted as a key indicator of emotional stability and adjustment to life demands. There is very limited study to investigate the effect of sports on self-esteem in physically disabled people. The aim of the present study was to evaluate of self-esteem in physically disabled adults who participated in sports. Methods: Fifty physically disabled adults who participated in sports aged between 18 to 35 years participated in the study. Self-esteem of the participants was assessed by Rosenberg Self-Esteem Scale. The scale is a 10-item measure of global self-esteem. The higher score on the scale indicates greater self-esteem. Scores between 15 and 25 are the normal range of and scores below 15 suggest low self-esteem. Results: Average age of participants was 25.18±6.20 years. 58% of the participants were 23 (46.0%) of the participants were wheelchair users, 8 (16.0%) were mobile with a walking aid and 19 (38.0%) were mobile without a walking aid. The length of physically disabled adults had been participating in their sports (basketball: 54%, athleticism: 32%, volleyball: 6%, cycling: 6%) was 4.94±3.86 years. The average Rosenberg Self-Esteem Scale score of the participants was 21.88 ±4.34. Conclusions: Our results suggest that physically disabled adults who participated in sports have the healthy level of self-esteem. Participating in sports could have positive effects on self-esteem in that physically, disabled people. There is needed future comparative studies on this topic.

Keywords: adult, physical disability, self-esteem, sport

Procedia PDF Downloads 264

Authors: Juliet Sorensen, Anna Maitland

Abstract:

Introduction: Characterized by lack of water and sanitation, food insecurity, and low access to hospitals and clinics, informal urban settlements in Lagos, Nigeria have very poor health outcomes. With little education and a general inability to demand basic rights, these communities are often disempowered and isolated from understanding, claiming, or owning their health needs. Utilizing community-based participatory research characterized by interdisciplinary, cross-cultural partnerships, evidence-based assessments, and both primary and secondary source research, a holistic health education and advocacy program was developed in Lagos to address health barriers for targeted communities. This includes a first of its kind guide formulated to teach community-based health educators how to transmit health information to low-literacy Nigerian audiences while supporting behavior change models and social support mechanisms. This paper discusses the interdisciplinary contributions to developing a health education program while also looking at the need for greater beneficiary ownership and implementation of health justice and access. Methods: In March 2016, an interdisciplinary group of medical, legal, and business graduate students and faculty from Northwestern University conduced a Health Needs Assessment (HNA) in Lagos with a partner and a local non-governmental organization. The HNA revealed that members of informal urban communities in Lagos were lacking basic health literacy, but desired to remedy this lacuna. Further, the HNA revealed that even where the government mandates specific services, many vulnerable populations are unable to access these services. The HNA concluded that a program focused on education, advocacy, and organizing around anatomy, maternal and sexual health, infectious disease and malaria, HIV/AIDS, emergency care, and water and sanitation would respond to stated needs while also building capacity in communities to address health barriers. Results: Based on the HNA, including both primary and secondary source research on integrated health education approaches and behavior change models and responsive, adaptive material development, a holistic program was developed for the Lagos partners and first implemented in November 2016. This program trained community-nominated health educators in adult, low-literacy, knowledge exchange approaches, utilizing information identified by communities as a priority. After a second training in March 2017, these educators will teach community-based groups and will support and facilitate behavior change models and peer-support methods around basic issues like hand washing and disease transmission. They will be supported by community paralegals who will help ensure that newly trained community groups can act on education around access, such as receiving free vaccinations, maternal health care, and HIV/AIDS medicines. Materials will continue to be updated as needs and issues arise, with a focus on identifying best practices around health improvements that can be shared across these partner communities. Conclusion: These materials are the first of their kind, and address a void of health information and understanding pervasive in informal-urban Lagos communities. Initial feedback indicates high levels of commitment and interest, as well as investment by communities in these materials, largely because they are responsive, targeted, and build community capacity. This methodology is an important step in dignity-based health justice solutions, albeit in the process of refinement.

Keywords: community health educators, interdisciplinary and cross cultural partnerships, health justice and access, Nigeria

Procedia PDF Downloads 247

Authors: Kyung Min Kwom, Young Joo Lee

Abstract:

Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

Procedia PDF Downloads 231

Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

Abstract:

The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

Procedia PDF Downloads 88

Authors: Yasàlu Haruna

Abstract:

In every transaction, the use of language is central regardless of form or complexity if any meaning is expected to be harvested therefrom. Students constituting a population group in the learning landscape of Nigeria occupy a central position with a propensity to excel or otherwise in the context of communication, especially in the learning process and social interaction. The nature or quantum of anxiety or confidence in speaking a second language is not only peculiar to societies where the second language is not an official language but to a degree, the linguistic gap created by adoption and adaptation syndrome manifests in created anxiety or lack of confidence especially where mastery of a spoken language becomes a major challenge. This paper explores the manner in which linguistic complexity and cultural barriers combine to widen the adaptation and adoption gap. In much the same way, typical issues of pronouncement, intonation and accent difficulties are vital variables that explain the root cause of anxiety. Using a combination of primary and secondary sources of data expressed in questionnaires, key informant interviews and other available data, the paper concludes that the non-integration of anxiety possibility into the education delivery framework has left a lot to be needed in cultivating second language speakers among students of Nigerian Colleges of Education. In addition, cultural barriers and the absence of integration interfaces in the course of learning within and outside the classroom contribute to further widening the gap. Again, colleagues/mates/conversation partners' mastery of a second language remains a contributory factor largely due to the quality of the preparatory school system in many parts of the country. The paper recommends that national policies and frameworks must be reviewed to consider integration windows where culture and conversation partner deficiencies can be remedied through educational events such as debates, quizzes and symposia; improvements can be attained while commercial advertisements are tailored towards seeking for adoption of second language in commerce and major cultural activities.

Keywords: cultural barriers, integration, college of education and adaptation, second language

Procedia PDF Downloads 90

Authors: Deirdre Mc Grath, Joanne Reid

Abstract:

Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

Procedia PDF Downloads 183

Authors: Cara Williams

Abstract:

This paper considers the media’s role in formulating a dominant social deviance paradigm and medicalised portrayal of disabled people and examines how those representations of impairment reinforce the personal tragedy view that underpins the social value given to the category of disability. According to a materialist perspective, the personal tragedy medical model approach condemns disabled people to live an inferior 'life apart', socially excluded and prevented from living as fully participating citizens on an equal basis to non-disabled people. Commonly, disabled people are portrayed as a person who needs to be cured in order to achieve a better 'quality of life'; otherwise stories center on deviance, criminality or scrounger. Media representations have consistently used negative language and images that reinforce the personal tragedy 'deficient' view of disability. The systematic misrepresentation within film, literature, TV and other art forms have validated a process about what it means to be 'normal' and how 'difference' and 'identity' are interpreted. The impact of these stereotyped disabling images for disabled people is a barrier not experienced by many other oppressed minority groups. Applying a materialist analysis, this paper contends that the impact on audience’s perceptions of impaired bodies and minds, and the harmful effects on disabled people can be linked with agenda setting theory - the relationship between the media and the political agenda.

Keywords: media, disabled people, political agenda, personal tragedy

Procedia PDF Downloads 144

Authors: Teresa Leary Handy

Abstract:

As awareness of the importance of diversity has increased in society, higher education has also begun to recognize the importance of supporting faculty of color. In the university setting, faculty women of color specifically encounter barriers that impact their level of job satisfaction, retention rates, and pedagogical practices. These barriers and challenges not only undermine faculty diversity efforts but also hinder the ability of colleges and universities to provide a supportive environment that fosters students' academic success and sense of belonging. Faculty who are marginalized and on the periphery in higher education institutions need support so that they can feel confident in building a student’s sense of belonging which can impact a student’s academic success and goal of earning a college degree. This study examined and sought to understand the importance of supporting faculty of color, specifically women faculty of color, and how this type of faculty support can impact student academic success and a student’s sense of belonging. The study furthered original research on strategies to move an institution forward on the equity spectrum to support belonging and inclusions as core culture elements.

Keywords: equity, inclusion, belonging, women, faculty support

Procedia PDF Downloads 66

Authors: Auni Idi Muhire

Abstract:

Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

Procedia PDF Downloads 277

Authors: Scott A. Abbott

Abstract:

This paper examines the increase in the occurrence of natural disasters worldwide and the need to support vulnerable communities in post-disaster recovery. Preparation and implementation of post-disaster recovery projects need to be improved to allow communities to recover infrastructure, housing, economically and socially following a catastrophe. With the continual rise in catastrophic events worldwide due to climate change, impacts on construction resources affect the ability for post-disaster recovery to be undertaken. This research focuses on case studies of catastrophic events in Queensland, Australia, to contribute to the body of knowledge and gain valuable insights on lessons learned from past events and how they have been managed. The aim of this research is to adopt qualitative data using semi-structured interviews from participants predominantly from the insurance sector to understand barriers that have previously and currently exist in post-disaster recovery. Existing literature was reviewed to reveal gaps in knowledge that needed to be tested. Qualitative data was collected and summarised from field research with the results analysed and discussed. Barriers that impacted post-disaster recovery included time, cost, and resource capability and capacity. Causal themes that impacted time and cost were identified as decision making, pre-planning, and preparedness, as well as effective communication across stakeholders. The research study applied a qualitative approach to the existing literature and case studies across Queensland, Australia, to identify existing and new barriers that impact post-disaster recovery. It was recommended to implement effective procurement strategies to assist in cost control; implement pre-planning and preparedness strategies across funder, contractor, and local governments; more effective and timely decision making to reduce time and cost impacts.

Keywords: construction recovery, cost, disaster recovery, resources, time

Procedia PDF Downloads 125

Authors: Mohamed M. Elsherbiny

Abstract:

Social Avoidance is one of the most important problems that face a good number of disabled students. It results from the negative attitudes of non-disabled students, teachers and others. Some of the past research has shown that non-disabled individuals hold negative attitudes toward persons with disabilities. The present study aims to alleviate Social Avoidance by applying the Cognitive Behavioral Intervention. 24 Blind students aged 19–24 (university students) were randomly chosen we compared an experimental group (consisted of 12 students) who went through the intervention program, with a control group (12 students also) who did not go through such intervention. We used the Social Avoidance and Distress Scale (SADS) to assess social anxiety and distress behavior. The author used many techniques of cognitive behavioral intervention such as modeling, cognitive restructuring, extension, contingency contracts, self-monitoring, assertiveness training, role play, encouragement and others. Statistically, T-test was employed to test the research hypothesis. Result showed that there is a significance difference between the experimental group and the control group after the intervention and also at the follow up stages of the Social Avoidance and Distress Scale. Also for the experimental group, there is a significance difference before the intervention and the follow up stages for the scale. Results showed that, there is a decrease in social avoidance. Accordingly, cognitive behavioral intervention program was successful in decreasing social avoidance for blind students.

Keywords: social avoidance, cognitive behavioral intervention, blind disability, disability

Procedia PDF Downloads 408

Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

Abstract:

Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

Procedia PDF Downloads 139

Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

Abstract:

Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

Procedia PDF Downloads 80

Authors: Vera Lúcia Raposo

Abstract:

The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

Procedia PDF Downloads 383

Authors: Hsin-Yi Lo, Chia-Yu Hsu

Abstract:

This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

Procedia PDF Downloads 79