Search results for: obstacles to healthcare accessibility
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2859

Search results for: obstacles to healthcare accessibility

1839 Online Dietary Management System

Authors: Kyle Yatich Terik, Collins Oduor

Abstract:

The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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1838 Exploring the Role of Private Commercial Banks in Increasing Small and Medium Size Enterprises’ Financial Accessibility in Developing Countries: A Study in Bangladesh

Authors: Khondokar Farid Ahmmed, Robin Bown

Abstract:

It is widely recognized that the formal financing of Small and Medium Size Enterprises (SMEs) by Private Commercial Banks (PCBs) is restricted. Due to changing financial market competition, SMEs are now important customers to PCBs in the member countries of the Asian Development Bank (ADB). Various initiatives in enhancing the efficiency of risk assessment of PCBs have failed in increasing financing accessibility in the traditional financing system where information asymmetry is a key constraint. In this circumstance, PCBs need to undertake a holistic approach. Holistic approach refers to methods that attempt to fundamentally change established traditions. To undertake holistic approach, this study intends to find the entire established financing culture between PCBs and SMEs in a new lens beyond the tradition on the basis of two basic questions: “What is the traditional lending culture between PCBs and SMEs” and “What could be potential role of PCBs to develop that culture where focusing on SME financing to PCBs". This study considered formal SME financing in Bangladesh by focusing on SMEs applying for their first loan. Bangladesh is a member country of ADB. The data collection method is semi-structured and we utilized face-to-face interviews with in-depth branch managers, higher officials and owner-managers of SME customers of PCBs and higher officials of SME Foundation and the Bangladesh central bank. Discourse analysis method was used for data analysis on the frame of thematic discussion fully based on participants’ views. The research found that branch managers and loan officers have a high level of power in assessing and financing decision-making. There is a changing attitude in PCB sector in requiring flexible collateral assets. Branch managers (Loan Officers) consider value of business prospect of owner-mangers as complementary of collateral assets. However, the study found the assessment process of business prospect is entirely unstructured and linked with socio-cultural settings that does not support PCBs’ changing manner in terms of collateral requirement. The study redefined and classified collateral assets to include all financing constructs in a structure. The degree of value of the collateral assets determines the degree of business prospects. This study suggested applying an outside classroom-learning paradigm such as “knowledge tour” to enhance the value of the kinds of collateral assets. This is the scope of PCBs in increasing SMEs’ financing eligibility in win-win basis. The findings and proposition could be effective in other ADB member countries and audiences in the field.

Keywords: CCA, financing, information asymmetry, PCA, PCB, financing

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1837 Integrated Mass Rapid Transit (MRT) and Bus System in Singapore: MRT Ridership and the Provision of Feeder Bus Services

Authors: Devansh Jain, Shu Ting Goh

Abstract:

With the aim of improving the quality of life of people of Singapore with provision of better transport services, Land and Transport Authority Singapore recently published its Master Plan 2013. The major objectives mentioned in the plan were to make a comprehensive public transport network with better quality Mass Rapid Transit, bus services along with cycling and walking. MRT is the backbone of the transport system in Singapore, and to promote and increase the MRT ridership, good accessibility to access the MRT stations is a necessity. The aim of this paper is to investigate the relationship between MRT ridership and the provision of feeder bus services in Singapore planning areas and also to understand the hub and spoke model adopted by Singapore for provision of transport services. The findings of the study will lead to conclusions made from the Regression model developed by the various factors affecting MRT ridership, and hence will benefit to enhance the services provided by the system.

Keywords: quality of life, public transport, mass rapid transit, ridership

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1836 Implementing Universal Design for Learning in Social Work Education

Authors: Kaycee Bills

Abstract:

Action research is a method of inquiry useful in solving social problems in social work. This study seeks to address a significant problem: higher education’s use of traditional instructional methods in social work education. Ineffective techniques, such as lecturing, fail to account for students’ variable learning needs. In contrast to traditional pedagogy, universal design for learning (UDL) is a robust framework that '[improves] and [optimizes] teaching and learning for all people' (CAST, 2018), including students with disabilities. For this project, the research team interviewed the UDL and Accessibility Specialist at their institution for two reasons: (1) to learn how to implement UDL practices in their classrooms, and in turn, (2) to motivate other faculty members at their institution to consider enacting UDL principles. A thematic analysis of the interview’s transcript reveals themes relevant to practicing UDL. Implications for future practice, as well as the researcher’s reflections on the research process, are shared in the discussion section.

Keywords: disabilities, higher education, inclusive education, universal design for learning

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1835 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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1834 How to Reach Adolescents Vulnerable for Suicidal Behaviour: A Qualitative Study

Authors: Birgit Reime, Sonja Gscheidle, Toni Hübener, Lara Hübener

Abstract:

Suicide in individuals under 30 years is a global public health concern. The objective of this study was to identify strategies for the prevention of suicide and suicidal behavior preferred by adolescents and young adults who are vulnerable to suicidal behavior and by relevant experts. Using semi-structured interviews with n= 17 adolescents and young adults (18-25 years of age) and with n= 11 experts from relevant fields, we have applied an inductive approach and applied thematic content analysis. Six strategies for suicide prevention in young individuals were reported. These were digital solutions with appealing designs, anonymous support, trained peer support, spiritual support, improving existing structures, and raising suicide literacy. Accessibility of anonymous digital support may contribute to suicide prevention in young people.

Keywords: suicide prevention, adolescents, E-health, Germany

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1833 Awareness, Attitude and Perception of the Farmers towards Adaptation to Climate Change: A Case Study in Kedah Malaysia

Authors: Rafia Afroz

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This article examines the perceptions, consciousness and attitudes of farmers on climate change in Kedah Malaysia. To reach the objectives of this study, a survey was conducted on 350 farmers and the collected data were used to perform multiple regression analysis. The results show that factors such as age, farm income, farm experience, limited agricultural prevalence, inadequacies in credit availability and farm size are factors influencing adjustment practices. Moreover, farmers have a positive attitude through adaptation strategies that are appropriate for climate change issues. However, the study found that various adaptation barriers prevented farmers from implementing climate change adjustment policies. At present, Malaysia does not seem to have a specific policy aimed at counteracting the impacts and productivity of climate change on individual sectors. For this reason, the findings of this study will help policymakers to comply with an appropriate policy framework that takes into account the best fit alignment strategies that can come across all relevant obstacles.

Keywords: climate change, adaptation, awareness, perception, attitude

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1832 Artificial Intelligence in Duolingo

Authors: Elana Mahboub, Lamar Bakhurji, Hind Alhindi, Sara Alesayi

Abstract:

Duolingo is a revolutionary language learning platform that offers an interactive and accessible learning experience. Its gamified approach makes language learning engaging and enjoyable, with a diverse range of languages available. The platform's adaptive learning system tailors lessons to individual proficiency levels, ensuring a personalized and efficient learning journey. The incorporation of multimedia elements enhances the learning experience and promotes practical language application. Duolingo's success is attributed to its mobile accessibility, offering basic access to language courses for free, with optional premium features for those seeking additional resources. Research shows positive outcomes for users, and the app's global impact extends beyond individual learning to formal language education initiatives. Duolingo is a transformative force in language education, breaking down barriers and making language learning an attainable goal for millions worldwide.

Keywords: duolingo, artificial intelligence, artificial intelligence in duolingo, benefit of artificial intelligence

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1831 Risk Factors for Acute Respiratory Infection Among Children Under Five in Tanzania: A Systematic Review and Analysis of the 2015 Demographic and Health Survey for Tanzania

Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

Abstract:

It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

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1830 Determine the Optimal Path of Content Adaptation Services with Max Heap Tree

Authors: Shilan Rahmani Azr, Siavash Emtiyaz

Abstract:

Recent development in computing and communicative technologies leads to much easier mobile accessibility to the information. Users can access to the information in different places using various deceives in which the care variety of abilities. Meanwhile, the format and details of electronic documents are changing each day. In these cases, a mismatch is created between content and client’s abilities. Recently the service-oriented content adaption has been developed which the adapting tasks are dedicated to some extended services. In this method, the main problem is to choose the best appropriate service among accessible and distributed services. In this paper, a method for determining the optimal path to the best services, based on the quality control parameters and user preferences, is proposed using max heap tree. The efficiency of this method in contrast to the other previous methods of the content adaptation is related to the determining the optimal path of the best services which are measured. The results show the advantages and progresses of this method in compare of the others.

Keywords: service-oriented content adaption, QoS, max heap tree, web services

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1829 The Importance and Feasibility of Hospital Interventions for Patient Aggression and Violence Against Physicians in China: A Delphi Study

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

Abstract:

Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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1828 The Efficacy of Open Educational Resources in Students’ Performance and Engagement

Authors: Huda Al-Shuaily, E. M. Lacap

Abstract:

Higher Education is one of the most essential fundamentals for the advancement and progress of a country. It demands to be as accessible as possible and as comprehensive as it can be reached. In this paper, we succeeded to expand the accessibility and delivery of higher education using an Open Educational Resources (OER), a freely accessible, openly licensed documents, and media for teaching and learning. This study creates a comparative design of student’s academic performance on the course Introduction to Database and student engagement to the virtual learning environment (VLE). The study was done in two successive semesters - one without using the OER and the other is using OER. In the study, we established that there is a significant increase in student’s engagement in VLE in the latter semester compared to the former. By using the latter semester’s data, we manage to show that the student’s engagement has a positive impact on students’ academic performance. Moreso, after clustering their academic performance, the impact is seen higher for students who are low performing. The results show that these engagements can be used to potentially predict the learning styles of the student with a high degree of precision.

Keywords: EDM, learning analytics, moodle, OER, student-engagement

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1827 A Background Subtraction Based Moving Object Detection Around the Host Vehicle

Authors: Hyojin Lim, Cuong Nguyen Khac, Ho-Youl Jung

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In this paper, we propose moving object detection method which is helpful for driver to safely take his/her car out of parking lot. When moving objects such as motorbikes, pedestrians, the other cars and some obstacles are detected at the rear-side of host vehicle, the proposed algorithm can provide to driver warning. We assume that the host vehicle is just before departure. Gaussian Mixture Model (GMM) based background subtraction is basically applied. Pre-processing such as smoothing and post-processing as morphological filtering are added.We examine “which color space has better performance for detection of moving objects?” Three color spaces including RGB, YCbCr, and Y are applied and compared, in terms of detection rate. Through simulation, we prove that RGB space is more suitable for moving object detection based on background subtraction.

Keywords: gaussian mixture model, background subtraction, moving object detection, color space, morphological filtering

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1826 Students' Attitudes Towards Seeking Psychological Help

Authors: Gudelj Petra, Franic Ema, Kolega Maja

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Mental health is crucial for personal, social, and socio-economic development, becoming an increasingly relevant topic, especially in the post-global pandemic era. One vulnerable demographic comprises students who, during the pandemic, faced challenges such as adapting to new educational methods, societal or residential changes, heightened stress, responsibilities, and entering the job market. These life challenges proved insurmountable for some individuals during this phase. This research aimed to examine students' attitudes towards individuals seeking psychological help. By gaining a better understanding of young people's perceptions of seeking psychological assistance, a clearer insight into how to make psychological support more accessible and acceptable can be achieved. A questionnaire was completed by 210 students from various disciplines at the University of Zagreb. At the same time, the majority of students express a positive attitude towards seeking psychological help, a very small percentage reported having sought it. One of the most common obstacles to seeking appropriate help was a lack of financial means, with the most significant motivators being the positive experiences of those who sought help and an affordable cost.

Keywords: mental health, students, psychological support, attitudes

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1825 Health Services for Women Refugees: A Quantitative Exploratory Study in Ottawa, Canada

Authors: Kholoud Sheba

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Women refugees expectedly are physical, socially and mentally vulnerable due to their past traumatic experiences and their novel circumstances in their receiving countries. They may have a wide range of general, mental, and reproductive health problems, but reportedly avoid visiting health care facilities owing to complex elements. Women refugees are usually unfamiliar with their new country health system and unable to navigate it efficiently. They have limited English language skills, which makes it even harder to access culturally insensitive health services. This study examines barriers to health care for refugee women in Ottawa and offers suggestions to address these challenges. Drawing from culturally congruent health care models in Canada, the United Kingdom, and some parts of the United States, this study highlights the importance of cultivating compassion in the provision of health care for women refugees as a way of addressing some of the disparities in health care in Canada. To address the study purpose, a survey questionnaire was designed and pretested questionnaire and was administrated using SurveyMonkey, a paid source survey application, over a period of two weeks. Snowballing sampling procedures were used to recruit the participants. Data was measured using frequencies, percentages, t-test, ANOVA, and chi-square. The test of significance is set at p < .05. The study asked how refugees perceive their experience in accessing and navigating public health services in Ottawa; what challenges refugees face with healthcare in Canada, and, if gender is related to refugees’ perceptions of the health care system they are forced to use? Results show refugees perceived their experience accessing the healthcare services in Canada to be a positive experience and the health providers to be culturally sensitive and allowing enough time listening to their complaints. The language stood tall in their barriers accessing the services due to low English proficiency and the need for interpretation services to encourage them attending the services.

Keywords: women refugee, access barriers, Ottawa, resettlement

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1824 Chaos Cryptography in Cloud Architectures with Lower Latency

Authors: Mohammad A. Alia

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With the rapid evolution of the internet applications, cloud computing becomes one of today’s hottest research areas due to its ability to reduce costs associated with computing. Cloud is, therefore, increasing flexibility and scalability for computing services in the internet. Cloud computing is Internet based computing due to shared resources and information which are dynamically delivered to consumers. As cloud computing share resources via the open network, hence cloud outsourcing is vulnerable to attack. Therefore, this paper will explore data security of cloud computing by implementing chaotic cryptography. The proposal scenario develops a problem transformation technique that enables customers to secretly transform their information. This work proposes the chaotic cryptographic algorithms have been applied to enhance the security of the cloud computing accessibility. However, the proposed scenario is secure, easy and straightforward process. The chaotic encryption and digital signature systems ensure the security of the proposed scenario. Though, the choice of the key size becomes crucial to prevent a brute force attack.

Keywords: chaos, cloud computing, security, cryptography

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1823 Covid-19 Frontliners Survey: Assessing Complications and Quality of Life in Health Care Workers in District Swat, Khyber Pakhtunkhwa, Pakistan

Authors: Mohsin Shahab, Shagufta Rehmat, Faisal F. Khan

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Background: The global COVID-19 pandemic has generated health problems worldwide. Health care workers are the front-line warriors against the pandemic. The aim of this study was to find out the prevalence of COVID-19 (7th May 2021 to 3rd August 2021) amongst Health Care Workers (HCWs) and to assess the complications associated with it and its effects on their quality of life. Material and Method: The study was conducted in healthcare facilities which serve as pandemic hospitals in district Swat. A total of 140 healthcare workers, who were employed in the COVID-19 health care facilities, including the department of Pulmonology, Intensive Care Unit (ICU), and COVID-19 wards. Participants were tested for COVIID-19 using RT PCR test. A Case Report Form (CRF) for conditions during and post COVID-19 was filled to assess the complications and quality of life of health care workers. Results: A total of 140 Health Care Workers were studied, out of which 40% were doctors, 22% nursing staff, 17% paramedic staff, 9% cleaning staff, lab technologist 6%, 2% operation theater staff, administration staff, and pharmacist. The respondents were also investigated for pre-existing illness prior to SARS-CoV-2 infection, hypertension was the most prevalent, followed by chronic heart diseases and neurological disorders. Fever was the most common symptom, recorded 76.42% in the participants, while 55.71% of participants had dry cough, 55% had a sore throat, following by chest pain 43.56%. Reinfection rate was 10%, with chest pain being recorded in 85.71%. Post disease complication analysis showed that 47.14% of the participants were diagnosed with a new diagnosis after the COVID-19 recovery. Pulmonological diseases were recorded the most as a new diagnosis in, followed by gastrointestinal and psychological problems. Conclusions: The results of the study illustrates how COVID-19 has affected the overall health and quality of life of HCWs in District Swat of Khyber Pakhtunkhwa, Pakistan.

Keywords: SARS-CoV-2, COVID-19, HCW's, symptoms, questionnaire, post COVID-19

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1822 Evaluation of Urban Parks Based on POI Data: Taking Futian District of Shenzhen as an Example

Authors: Juanling Lin

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The construction of urban parks is an important part of eco-city construction, and the intervention of big data provides a more scientific and rational platform for the assessment of urban parks by identifying and correcting the irrationality of urban park planning from the macroscopic level and then promoting the rational planning of urban parks. The study builds an urban park assessment system based on urban road network data and POI data, taking Futian District of Shenzhen as the research object, and utilizes the GIS geographic information system to assess the park system of Futian District in five aspects: park spatial distribution, accessibility, service capacity, demand, and supply-demand relationship. The urban park assessment system can effectively reflect the current situation of urban park construction and provide a useful exploration for realizing the rationality and fairness of urban park planning.

Keywords: urban parks, assessment system, POI, supply and demand

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1821 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya

Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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1820 Autonomy in Healthcare Organisations: A Comparative Case Study of Middle Managers in England and Iran

Authors: Maryam Zahmatkesh

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Middle managers form a significant occupational category in organisations. They undertake a vital role, as they sit between the operational and strategic roles. Traditionally they were acting as diplomat administrators, and were only in power to meet the demands of professionals. Following the introduction of internal market, in line with the principles of New Public Management, middle managers have been considered as change agents. More recently, in the debates of middle managers, there is emphasis on entrepreneurialism and enacting strategic role. It was assumed that granting autonomy to the local organisations and the inception of semi-autonomous hospitals (Foundation Trusts in England and Board of Trustees in Iran) would give managers more autonomy to act proactively and innovatively. This thesis explores the hospital middle managers’ perception of and responses to public management reforms (in particular, hospital autonomy) in England and Iran. In order to meet the aims of the thesis, research was undertaken within the interpretative paradigm, in line with social constructivism. Data were collected from interviews with forty-five middle managers, observational fieldwork and documentary analysis across four teaching university hospitals in England and Iran. The findings show the different ways middle managers’ autonomy is constrained in the two countries. In England, middle managers have financial and human recourses, but their autonomy is constrained by government policy and targets. In Iran, middle managers are less constrained by government policy and targets, but they do not have financial and human resources to exercise autonomy. Unbalanced autonomy causes tension and frustration for middle managers. According to neo-institutional theory, organisations are deeply embedded within social, political, economic and normative settings that exert isomorphic and internal population-level pressures to conform to existing and established modes of operation. Health systems which are seeking to devolve autonomy to middle managers must appreciate the multidimensional nature of the autonomy, as well as the wider environment that organisations are embedded, if they are about to improve the performance of managers and their organisations.

Keywords: autonomy, healthcare organisations, middle managers, new public management

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1819 Advances in Medication Reconciliation Tools

Authors: Zixuan Liu, Xin Zhang, Kexin He

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In the context of widespread prevalence of multiple diseases, medication safety has become a highly concerned issue affecting patient safety. Medication reconciliation plays a vital role in preventing potential medication risks. However, in medical practice, medication reconciliation faces various challenges, and there is a wide variety of medication reconciliation tools, making the selection of appropriate tools somewhat difficult. The article introduces and analyzes the currently available medication reconciliation tools, providing a reference for healthcare professionals to choose and apply the appropriate medication reconciliation tools.

Keywords: patient safety, medication reconciliation, tools, review

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1818 The Development of Chinese Film Market as Factor of Change in Global Hollywood

Authors: Marcin Adamczak

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The growth of Chinese film market and its dynamic incomparable to any other historical phenomenon has already made China the second world market and potential future leader in 2-3 years period. The growing power of Chines box-office and its future prospects is then the crucial and potentially disturbing factor for persistence of global Hollywood reality. The paper is based on market statistical data. The main findings of the analysis are defining of essential obstacles for the development of Chinese market and its foreign expansion. However, the new strategies employed by the industry (acquisitions of cinema chains abroad, blockbuster made with the involvement of figures from Hollywood star system, coproduction ties within Pacific basin) could be a successful remedy for current shortcomings. The main factor for development will be wider economical framework and maintenance of growth pace. The future state of Chinese film market will be one of the main factors shaping global film culture and film market in following decades of XXI century.

Keywords: production studies, film market, Chinese film market, distribution

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1817 The Influences of Nurses’ Satisfaction on the Patient Satisfaction with and Loyalty to Korean University Hospitals

Authors: Sung Hee Ahn, Ju Rang Han

Abstract:

Background: With increasing importance in healthcare organization on patient satisfaction and nurses’ job satisfaction, many studies have been conducted. But no research has been administered how nurses’ satisfaction with healthcare organization influence patient satisfaction and loyalty. Purpose: This study aims to conceptualize nurses‘ satisfaction, patient satisfaction with and patient loyalty to hospitals using a hypothetical linear structural equation model, and to identify the significance of path coefficients and goodness of fit index of the structural equation model as well. Method: A total of 2,079 nurses and 6,776 patients recruited from 5 university hospitals in South Korea participated in this study. The data on nurses, including ward nurses and outpatient nurses, were collected from June 24th to July 12th, at the 204 departments of the 5 hospitals through an on-line survey. The data on the patients, including both inpatients and outpatients, were collected from September 30th to October 24th, 2013 at the 5 hospitals using a structured questionnaire. The variable of nurses’ satisfaction was measured using a scale evaluating internal client satisfaction, which is used in SSM Health Care System in the US. Patient satisfaction with the hospital and nurses and patient loyalty were measured by assessing the patient’s intention to revisit and to recommending the hospital to others using a visual analogue scale. The data were analyzed using SPSS version 21.0 and AMOS version 21.0. Result: The hypothetical model was fairly good in terms of goodness of fit (χ2= 64.897 (df=24, p <. 001), GFI=. 906, AGFI=.823, CFI=.921, NFI=.951, NNFI=.952. RMSEA=.114). The significance of path coefficients includes followings 1)The nurses’ satisfaction has significant influence on the patient satisfaction with nurses. 2)The patient satisfaction with nurses has significant influence on the patient satisfaction with the hospital. 3)The patient satisfaction with the hospital has significant influence on the patients’ revisit intention. 4)The patient satisfaction with the hospital has significant influence on the patients’ intention to the recommendations of the hospital. Conclusion: These results provide several practical implications to hospital administrators, who should incorporate ways of improving nurses' and patients' satisfaction with the hospital into their health care marketing strategies.

Keywords: linear structural equation model, loyalty, nurse, patient satisfaction

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1816 A Curricular Approach to Organizational Mentoring Programs: The Integrated Mentoring Curriculum Model

Authors: Christopher Webb

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This work presents a new model of mentoring in an organizational environment and has important implications for both practice and research, the model frames the organizational environment as organizational curriculum, which includes the elements that affect learning within the organization. This includes the organizational structure and culture, roles within the organization, and accessibility of knowledge. The program curriculum includes the elements of the mentoring program, including materials, training, and scheduled events for the program participants. The term dyadic curriculum is coined in this work. The dyadic curriculum describes the participation, behavior, and identities of the pairs participating in mentorships. This also includes the identity work of the participants and their views of each other. Much of this curriculum is unprescribed and is unique within each dyad. It describes how participants mediate the elements of organizational and program curricula. These three curricula interact and affect each other in predictable ways. A detailed example of a mentoring program framed in this model is provided.

Keywords: curriculum, mentoring, organizational learning and development, social learning

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1815 Mapping New Technologies for Sustainability along the Fashion Supply Chain

Authors: Hilde Heim

Abstract:

The textile industry is known for its swift adoption of innovations in fashion technology (Fash-Tech). The industry is also known for its harmful effects on the environment. Opportunely, Fash-Tech is expected to facilitate the turn towards more sustainable practice. However, although several technologies have the potential for advancing sustainable practice, many industry players, whether large or small, are confused and misinformed about Fash-Tech adoption, application, and impact. Through a visual poster presentation, this project aims to map global fashion innovations along the supply chain from fibre production to waste management, thus providing a clearer picture of numbers, scale, and adoption. While the project aims to identify Fash-Tech effectiveness in reaching sustainability goals, it also identifies areas of congestion as well as insufficiency in the accessibility of Fash-Tech. This project intends to help inform future decisions in business, investment, and policy for the advancement of sustainable practice.

Keywords: fashion technology, sustainability, supply chain, enterprise management

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1814 The Spatial Equity Assessment of Community-Based Elderly Care Facilities in Old Neighborhood of Chongqing

Authors: Jiayue Zhao, Hongjuan Wu, Guiwen Liu

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Old neighborhoods with a large elderly population depend on community-based elderly care facilities (community-based ECFs) for aging-in-place. Yet, due to scarce and scattered land, the facilities face inequitable distribution. This research uses spatial equity theory to measure the spatial equity of community-based ECFs in old neighborhoods. Field surveys gather granular data and methods, including coverage rate, Gini coefficient, Lorenz curve, and G2SFCA. The findings showed that coverage is substantial but does not indicate supply is a match to demand, nor does it imply superior accessibility. The key contributions are that structuring spatial equity framework considering elderly residents’ travel behavior. This study is dedicated to the international literature on spatial equity from the perspective of travel behavior and could provide valuable suggestions for the urban planning of old neighborhoods.

Keywords: community-based ECFs, elderly residents’ travel behavior, old neighborhoods, spatial equity

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1813 Intervening between Family Functioning and Depressive Symptoms: Effect of Deprivation of Liberty, Self-Efficacy and Differentiation of Self

Authors: Jasna Hrncic

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Poor family relations predict depression, but also to other mental health issues. Mediating effect of self-efficacy and differentiation of self and moderating effect of decreased accessibility and/or success of other adaptive and defensive mechanisms for overcoming social disadvantages could explain depression as a specific outcome of dysfunctional family relations. The present study analyzes the mediation effect of self-efficacy and differentiation of self from poor family functioning to depressive symptoms and the moderation effect of deprivation of liberty on the listed mediation effect. Deprivation of liberty has, as a general consequence, a decreased accessibility and/or success of many adaptive and defensive mechanisms. It is hypothesized that: 1) self-efficacy and differentiation of self will mediate between family functioning and depressiveness in the total sample, and 2) deprivation of liberty will moderate the stated relations. Cross-sectional study was conducted among 323 male juveniles in Serbia divided in three groups: 98 adolescents deprived of their liberty due to antisocial behavior (incarcerated antisocial group - IAG), 121 adolescents with antisocial behavior in their natural setting (antisocial control group - CAG) and 105 adolescents in general population (general control group - CGG). The CAG was included along with GCG to control the possible influence that comorbidity of antisocial behavior and depressiveness could have on results. Instruments for family relations assessment were: for a whole family of origin the emotional exchange scale and individuation scale from GRADIR by Knezevic, and for a relationship with mother PCS-YSR and CRPBI by barber, and intimacy, rejection, sacrifice, punishment, demands, control and internal control by Opacic and Kos. Differentiation of self (DOS) is measured by emotional self scale (Opacic), self-efficacy (SE) by general incompetence scale by Bezinovic, and depression by BDI (Back), CES-D (Radloff) and D6R (Momirovic). Two-path structural equation modeling based on most commonly reported fit indices, showed that the mediation model had unfavorable fit to our data for total sample [(χ2 (1, N = 324) = 13.73); RMSEA= .20 (90% CI= [.12, .30]); CFI= .98; NFI= .97; AIC=31.73]. Path model provided an adequate fit to the data only for AIG - and not to the data from ACG and GCG. SE and DOS mediated the relationship between PFF and depressiveness. Test of the indirect effects revealed that 23.85% of PFF influences on depressiveness is mediated by these two mediators (the quotient of mediated effect = .24). Test of specific indirect effects showed that SE mediates 22.17%, while DOS mediates 1.67% of PFF influence on depressiveness. Lack of expected mediation effect could be explained by missing other potential mediators (i.e., relationship with that father, social skills, self-esteem) and lower variability of both predictor and criterion variable due to their low levels on the whole sample and on control subsamples. Results suggested that inaccessibility and/or successfulness of other adaptive and defensive mechanisms for overcoming social disadvantages has a strong impact on the mediation effect of self/efficacy and differentiation of self from poor family functioning to depressive symptoms. Further researches could include other potential mediators and a sample of clinically depressed people.

Keywords: antisocial behavior, mediating effect, moderating effect, natural setting, incarceration

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1812 Why and When to Teach Definitions: Necessary and Unnecessary Discontinuities Resulting from the Definition of Mathematical Concepts

Authors: Josephine Shamash, Stuart Smith

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We examine reasons for introducing definitions in teaching mathematics in a number of different cases. We try to determine if, where, and when to provide a definition, and which definition to choose. We characterize different types of definitions and the different purposes we may have for formulating them, and detail examples of each type. Giving a definition at a certain stage can sometimes be detrimental to the development of the concept image. In such a case, it is advisable to delay the precise definition to a later stage. We describe two models, the 'successive approximation model', and the 'model of the extending definition' that fit such situations. Detailed examples that fit the different models are given based on material taken from a number of textbooks, and analysis of the way the concept is introduced, and where and how its definition is given. Our conclusions, based on this analysis, is that some of the definitions given may cause discontinuities in the learning sequence and constitute obstacles and unnecessary cognitive conflicts in the formation of the concept definition. However, in other cases, the discontinuity in passing from definition to definition actually serves a didactic purpose, is unavoidable for the mathematical evolution of the concept image, and is essential for students to deepen their understanding.

Keywords: concept image, mathematical definitions, mathematics education, mathematics teaching

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1811 Governance and Local Planning for Sustainability: Need for Change - Implications of Legislation on Local Planning

Authors: Rahaf Suleiman Altallaa

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City planning involves making plans, organizing and dealing with the cities urban areas. It attempts to organize socio-spatial relationships at exceptional ranges of governance Urban planning offers the social, monetary and environmental effects of defining spatial obstacles and the influence on the spatial distribution of resources. The dreams and methods of reaching such dissemination vary extensively traditionally and geographically and are often challenged through traditional strategies that expose the political nature of application interventions and the bounds of technical know-how claims. Space, network, argument, and postcolonial debates address how present-day socio-spatial organization is formed, what needs to or should not trade, and the way it underscores whether or not a good plan will contribute to a given situation. Inside the absence of an agreed-upon technical justification for the planning exercise, the planning idea has a tendency to focus on normative processes, positioning making plans as an area for participatory democracy.

Keywords: environmental governance, environmental planning, environmental management, sustainable competitiveness, sustainability

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1810 Requirements for a Shared Management of State-Owned Building in the Archaeological Park of Pompeii

Authors: Maria Giovanna Pacifico

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Maintenance, in Italy, is not yet a consolidated practice despite the benefits that could come from. Among the main reasons, there are the lack of financial resources and personnel in the public administration and a general lack of knowledge about how to activate and to manage a prevented and programmed maintenance. The experimentation suggests that users and tourists could be involved in the maintenance process from the knowledge phase to the monitoring ones by using mobile devices. The goal is to increase the quality of Facility Management for cultural heritage, prioritizing usage needs, and limiting interference between the key stakeholders. The method simplifies the consolidated procedures for the Information Systems, avoiding a loss in terms of quality and amount of information by focusing on the users' requirements: management economy, user safety, accessibility, and by receiving feedback information to define a framework that will lead to predictive maintenance. This proposal was designed to be tested in the Archaeological Park of Pompeii on the state property asset.

Keywords: asset maintenance, key stakeholders, Pompeii, user requirement

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