Search results for: counselling services
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4017

Search results for: counselling services

2877 Residential and Care Model for Elderly People Based on “Internet Plus”

Authors: Haoyi Sheng

Abstract:

China's aging tendency is becoming increasingly severe, which leads to the embarrassing situation of "getting old before getting wealthy". The traditional pension model does not comply with the need of today. Relying on "Internet Plus", it can efficiently integrate information and resources and meet the personalized needs of elderly care. It can reduce the operating cost of community elderly care facilities and lay a technical foundation for providing better services for the elderly. The key for providing help for the elderly in the future is to effectively integrate technology, make good use of technology, and improve the efficiency of elderly care services. The effective integration of traditional home care, community care, intelligent elderly care equipment and medical resources to create the "Internet Plus" community intelligent pension service mode has become the future development trend of aging care. The research method of this paper is to collect literature and conduct theoretical research on community pension firstly. Secondly, the combination of suitable aging design and "Internet Plus" is elaborated through research. Finally, this paper states the current level of intelligent technology in old-age care and looks into the future by understanding multiple levels of "Internet Plus". The development of community intelligent pension mode and content under "Internet Plus" has enormous development potential. In addition to the characteristics and functions of ordinary houses, residential design of endowment housing has higher requirements for comfort and personalization, and the people-oriented is the principle of design.

Keywords: ageing tendency, 'Internet Plus', community intelligent elderly care, elderly care service model, technology

Procedia PDF Downloads 137
2876 Investigating the Effect of Brand Equity on Competitive Advantage in the Banking Industry

Authors: Rohollah Asadian Kohestani, Nazanin Sedghi

Abstract:

As the number of banks and financial institutions working in Iran has been significantly increased, the attracting and retaining customers and encouraging them to continually use the modern banking services have been important and vital issues. Therefore, there would be a serious competition without a deep perception of consumers and fitness of banking services with their needs in the current economic conditions of Iran. It should be noted that concepts such as 'brand equity' is defined based on the view of consumers; however, it is also focused by shareholders, competitors and other beneficiaries of a firm in addition to bank and its consumers. This study examines the impact of brand equity on the competitive advantage in the banking industry as intensive competition between brands of different banks leads to pay more attention to the brands. This research is based on the Aaker’s model examining the impact of four dimensions of brand equity on the competitive advantage of private banks in Behshahr city. Moreover, conducting an applied research and data analysis has been carried out by a descriptive method. Data collection was done using literature review and questionnaire. A 'simple random' methodology was selected for sampling staff of banks while sampling methodology to select consumers of banks was the distribution of questionnaire between staff and consumers of five private banks including Tejarat, Mellat, Refah K., Ghavamin and, Tose’e Ta’avon banks. Results show that there is a significant relationship between brand equity and their competitive advantage. In this research, software of SPSS 16 and LISREL 8.5, as well as different methods of descriptive inferential statistics for analyzing data and test hypotheses, were employed.

Keywords: brand awareness, brand loyalty, brand equity, competitive advantage

Procedia PDF Downloads 138
2875 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame

Authors: Katie E. Jennings

Abstract:

The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

Procedia PDF Downloads 148
2874 An Intelligent Transportation System for Safety and Integrated Management of Railway Crossings

Authors: M. Magrini, D. Moroni, G. Palazzese, G. Pieri, D. Azzarelli, A. Spada, L. Fanucci, O. Salvetti

Abstract:

Railway crossings are complex entities whose optimal management cannot be addressed unless with the help of an intelligent transportation system integrating information both on train and vehicular flows. In this paper, we propose an integrated system named SIMPLE (Railway Safety and Infrastructure for Mobility applied at level crossings) that, while providing unparalleled safety in railway level crossings, collects data on rail and road traffic and provides value-added services to citizens and commuters. Such services include for example alerts, via variable message signs to drivers and suggestions for alternative routes, towards a more sustainable, eco-friendly and efficient urban mobility. To achieve these goals, SIMPLE is organized as a System of Systems (SoS), with a modular architecture whose components range from specially-designed radar sensors for obstacle detection to smart ETSI M2M-compliant camera networks for urban traffic monitoring. Computational unit for performing forecast according to adaptive models of train and vehicular traffic are also included. The proposed system has been tested and validated during an extensive trial held in the mid-sized Italian town of Montecatini, a paradigmatic case where the rail network is inextricably linked with the fabric of the city. Results of the tests are reported and discussed.

Keywords: Intelligent Transportation Systems (ITS), railway, railroad crossing, smart camera networks, radar obstacle detection, real-time traffic optimization, IoT, ETSI M2M, transport safety

Procedia PDF Downloads 497
2873 Urban Neighborhood Center Location Evaluating Method Based On UNA the GIS Spatial Analysis Tools: Kerman's Neighborhood in Tehran Case

Authors: Sepideh Jabbari Behnam, Shadabeh Gashtasbi Iraei, Elnaz Mohsenin, MohammadAli Aghajani

Abstract:

Urban neighborhoods, as important urban forming cells, play a key role in creating urban texture and integrated form. Nowadays, most of neighborhood divisions are based on urban management systems but without considering social issues and the other aspects of urban life. This can cause problems such as providing inappropriate services for city dwellers, the loss of local identity and etc. In this regard for regenerating of such neighborhoods, it is essential to locate neighborhood centers with appropriate access and services for all residents. The main objective of this article is reaching to the location of neighborhood centers in a way that, most of issues relating to the physical features (such as the form of access network and texture permeability and etc.) and other qualities such as land uses, densities and social and economic features can be done simultaneously. This paper attempts to use methods of spatial analysis in order to surveying spatial structure and space syntax of urban textures and Urban Network Analysis Systems. This can be done by one of GIS toolbars which is named UNA (Urban Network Analysis) with the use of its five functions (include: Reach, Betweenness, Gravity, Closeness, Straightness).These functions were written according to space syntax theory and offer its relating output. This paper tries to locate and evaluate the optimal location of neighborhood centers in order to create local centers. This is done through weighing of each of these functions and taking into account of spatial features.

Keywords: evaluate optimal location, Local centers, location of neighborhood centers, Spatial analysis, Urban network

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2872 Role of Basic Health Units in Provision of Primary Health Services in District Swabi

Authors: Naila Awan, Shahrukh Inam

Abstract:

This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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2871 Bekaadendang: A Principles-Focused Evaluation

Authors: Erin Brands-Saliba

Abstract:

In this evaluation study, we explore the efficacy and implementation of the five guiding principles of Bekaadendang “Being Peaceful,” a suite of services facilitated by our Anti-Human Trafficking Team, and a pivotal component of the Holistic Prevention Services department at NCFST. The guiding principles—trauma-informed care, cultural safety, 4-quadrant medicine wheel approach, harm reduction, and after-care peer support—are the foundation of Bekaadendang's mission to support at-risk individuals and survivors of human trafficking. This evaluation is of paramount importance given the profound impact of human trafficking on these communities and aims to ensure that Bekaadendang's principles are not only understood by staff but experienced by community members in a purposeful and meaningful manner. The issues at the heart of this evaluation are deeply entrenched in the historical and contemporary challenges faced by Indigenous communities, with a particular emphasis on Indigenous women and 2SLGBTQQIA+ individuals. Well-documented reports like the National Inquiry into Missing and Murdered Indigenous Women and Girls (MMIWG) have cast a glaring light on the disproportionately high rates of violence, exploitation, and trafficking experienced by these communities. The MMIWG report underlines the pressing need for holistic, culturally informed interventions like Bekaadendang. Furthermore, the research efforts of scholars, both Indigenous and non-Indigenous, shed light on the persistent systemic issues that make Indigenous individuals more vulnerable to trafficking and exploitation. Recognizing this broader context is crucial to truly grasp the importance of evaluating the guiding principles that underpin Bekaadendang's service model.

Keywords: human trafficking, indigenous healing, MMIWG, program evaluation

Procedia PDF Downloads 50
2870 The Effect of CPU Location in Total Immersion of Microelectronics

Authors: A. Almaneea, N. Kapur, J. L. Summers, H. M. Thompson

Abstract:

Meeting the growth in demand for digital services such as social media, telecommunications, and business and cloud services requires large scale data centres, which has led to an increase in their end use energy demand. Generally, over 30% of data centre power is consumed by the necessary cooling overhead. Thus energy can be reduced by improving the cooling efficiency. Air and liquid can both be used as cooling media for the data centre. Traditional data centre cooling systems use air, however liquid is recognised as a promising method that can handle the more densely packed data centres. Liquid cooling can be classified into three methods; rack heat exchanger, on-chip heat exchanger and full immersion of the microelectronics. This study quantifies the improvements of heat transfer specifically for the case of immersed microelectronics by varying the CPU and heat sink location. Immersion of the server is achieved by filling the gap between the microelectronics and a water jacket with a dielectric liquid which convects the heat from the CPU to the water jacket on the opposite side. Heat transfer is governed by two physical mechanisms, which is natural convection for the fixed enclosure filled with dielectric liquid and forced convection for the water that is pumped through the water jacket. The model in this study is validated with published numerical and experimental work and shows good agreement with previous work. The results show that the heat transfer performance and Nusselt number (Nu) is improved by 89% by placing the CPU and heat sink on the bottom of the microelectronics enclosure.

Keywords: CPU location, data centre cooling, heat sink in enclosures, immersed microelectronics, turbulent natural convection in enclosures

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2869 Use of Psychiatric Services and Psychotropics in Children with Atopic Dermatitis

Authors: Mia Schneeweiss, Joseph Merola

Abstract:

Atopic dermatitis (AD) is a chronic inflammatory skin condition with a prevalence of 9.6 million in children under the age of 18 in the US, 3.2 million of those suffer severe AD. AD has significant effects on the quality of life and psychiatric comorbidity in affected patients. We sought to quantify the use of psychotropic medications and mental health services in children. We used longitudinal claims data form commercially insured patients in the US between 2003 and 2016 to identify children aged 18 or younger with a diagnosis of AD associated with an outpatient or inpatient encounter. A 180-day enrollment period was required before the first diagnosis of AD. Among those diagnosed, we computed the use of psychiatric services and dispensing of psychotropic medications during the following 6 months. Among 1.6 million children <18 years with a diagnosis of AD, most were infants (0-1 years: 17.6%), babies (1-2 years: 12.2%) and young children (2-4 years: 15.4). 5.1% were in age group 16-18 years. Among younger children 50% of patients were female, after the age of 14 about 60% were female. In 16-18 years olds 6.4% had at least one claim with a recorded psychopathology during the 6-month baseline period; 4.6% had depression, 3.3% anxiety, 0.3% panic disorder, 0.6% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 66% used high-potency topical corticosteroids, 3.5% used an SSRI, 0.3% used an SNRI, 1.2% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 5.2% used an anxiolytic agent. 4.4% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 14-16 years olds, 4.7% had at least one claim with a recorded psychopathology during the 6-month baseline period; 3.3% had depression, 2.5% anxiety, 0.2% panic disorder, 0.5% psychotic disorder, 0.1% anorexia. During the 6 months following the physician diagnosis of AD, 68% used high-potency topical corticosteroids, 4.6% used an SSRI, 0.6% used an SNRI, 1.5% used a tricyclic antidepressant, 1.4% used an antipsychotic medication, and 4.6% used an anxiolytic agent. 4.7% had an outpatient visit with a psychiatrist and 0.1% had been hospitalized with a psychiatric diagnosis. In 12-14 years olds, 3.3% had at least one claim with a recorded psychopathology during the 6-month baseline period; 1.9% had depression, 2.2% anxiety, 0.1% panic disorder, 0.7% psychotic disorder, 0.0% anorexia. During the 6 months following the physician diagnosis of AD, 67% used high-potency topical corticosteroids, 2.1% used an SSRI, 0.1% used an SNRI, 0.7% used a tricyclic antidepressant, 0.9 % used an antipsychotic medication, and 4.1% used an anxiolytic agent. 3.8% had an outpatient visit with a psychiatrist and 0.05% had been hospitalized with a psychiatric diagnosis. In younger children psychopathologies were decreasingly common: 10-12: 2.8%; 8-10: 2.3%; 6-8: 1.3%; 4-6: 0.6%. In conclusion, there is substantial psychiatric comorbidity among children, <18 years old, with diagnosed atopic dermatitis in a US commercially insured population. Meaningful psychiatric medication use (>3%) starts as early as 12 years old.

Keywords: pediatric atopic dermatitis, phychotropic medication use, psychiatric comorbidity, claims database

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2868 Multi-Criteria Nautical Ports Capacity and Services Planning

Authors: N. Perko, N. Kavran, M. Bukljas, I. Berbic

Abstract:

This paper is a result of implemented research on proposed introduced methodology for nautical ports capacity planning by introducing a multi-criteria approach of defined criteria and impacts at the Adriatic Sea. The purpose was analysing the determinants -characteristics of infrastructure and services of nautical ports capacity allocated, especially nowadays due to COVID-19 pandemic, as crucial for the successful operation of nautical ports. Giving the importance of the defined priorities for short-term and long-term planning is essential not only in terms of the development of nautical tourism but also in terms of developing the maritime system, but unfortunately, this is not always carried out. Evaluation of the use of resources should follow from a detailed analysis of all aspects of resources bearing in mind that nautical tourism used resources in a sustainable manner and generate effects in the tourism and maritime sectors. Consequently, the identified multiplier effect of nautical tourism, which should be defined and quantified in detail, should be one of the major competitive products on the Croatian Adriatic and the Mediterranean. Research of nautical tourism is necessary to quantify the effects and required planning system development. In the future, the greatest threat to the long-term sustainable development of nautical tourism can be its further uncontrolled or unlimited and undirected development, especially under pressure markedly higher demand than supply for new moorings in the Mediterranean. Results of this implemented research are applicable to nautical ports management and decision-makers of maritime transport system development. This paper will present implemented research and obtained result-developed methodology for nautical port capacity planning -port capacity planning multi-criteria decision-making. A proposed methodological approach of multi-criteria capacity planning includes four criteria (spatial - transport, cost - infrastructure, ecological and organizational criteria, and additional services). The importance of the criteria and sub-criteria is evaluated and carried out as the basis for sensitivity analysis of the importance of the criteria and sub-criteria. Based on the analysis of the identified and quantified importance of certain criteria and sub-criteria, as well as sensitivity analysis and analysis of changes of the quantified importance, scientific and applicable results will be presented. These obtained results have practical applicability by management of nautical ports in the planning of increasing capacity and further development and for the adaptation of existing nautical ports. Obtained research is applicable and replicable in other seas, and results are especially important and useful in this COVID-19 pandemic challenging maritime development framework.

Keywords: Adriatic Sea, capacity, infrastructures, maritime system, methodology, nautical ports, nautical tourism, service

Procedia PDF Downloads 190
2867 Assessing Acceptability and Preference of Printed Posters on COVID-19 Related Stigma: A Post-Test Study Among HIV-Focused Health Workers in Greater Accra Region of Ghana

Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

Abstract:

Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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2866 The Minimum Patch Size Scale for Seagrass Canopy Restoration

Authors: Aina Barcelona, Carolyn Oldham, Jordi Colomer, Teresa Serra

Abstract:

The loss of seagrass meadows worldwide is being tackled by formulating coastal restoration strategies. Seagrass loss results in a network of vegetated patches which are barely interconnected, and consequently, the ecological services they provide may be highly compromised. Hence, there is a need to optimize coastal management efforts in order to implement successful restoration strategies, not only through modifying the architecture of the canopies but also by gathering together information on the hydrodynamic conditions of the seabeds. To obtain information on the hydrodynamics within the patches of vegetation, this study deals with the scale analysis of the minimum lengths of patch management strategies that can be effectively used on. To this aim, a set of laboratory experiments were conducted in a laboratory flume where the plant densities, patch lengths, and hydrodynamic conditions were varied to discern the vegetated patch lengths that can provide optimal ecosystem services for canopy development. Two possible patch behaviours based on the turbulent kinetic energy (TKE) production were determined: one where plants do not interact with the flow and the other where plants interact with waves and produce TKE. Furthermore, this study determines the minimum patch lengths that can provide successful management restoration. A canopy will produce TKE, depending on its density, the length of the vegetated patch, and the wave velocities. Therefore, a vegetated patch will produce plant-wave interaction under high wave velocities when it presents large lengths and high canopy densities.

Keywords: seagrass, minimum patch size, turbulent kinetic energy, oscillatory flow

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2865 Factors Associated with Rural-Urban Migration and Its Associated Health Hazards on the Female Adolescents in Kumasi Metropolis

Authors: Freda Adomaa, Samuel Oppong Boampong, Charles Gyamfi Rahman

Abstract:

The living and working environment of migrants and their access to healthcare services induce good or poor health. This study was conducted to assess the factors associated with rural-urban migration and its associated health hazards among female adolescents. A sample size of two hundred (200) was chosen in which all responded to questionnaires comprising closed-ended questions, which were distributed to gather data from the respondents, after which it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The utilized three causes of rural-urban migration thus political, economic and socio-cultural. The study revealed that political situations such as regional inequality (65.4%) and ethnic conflicts (78.2%) whereas economic factors such as lack of amenities (82.3%), lack of employment in rural communities (77.4%), lack of education (74%), and poverty (85.3%) as well as socio-cultural factors such as divorced parents (65.6%), media influence (79.1%), family conflicts (59.4%) and appealing urban informal sector (65.2%) are major causes of migration. Respondents’ encountered challenges such as poor remuneration for services (87.2%), being maltreated by a colleague or worker (69%), sleeping in open space (73.3%), and harassment by the task force (71.4%) and teenage pregnancies (58.5%). The study concluded that the three variables play a key role in adolescent migration and when they travel they end up getting involved in serious health hazardous behaviors such as rapes as well as physical and psychological harassments’. The study, therefore, recommends that vocational training of the rural people on small scale industries (non-farm) activities that could generate an income for the rural household should be introduced.

Keywords: rural, urban, migration, female health hazards

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2864 The Need for a Tool to Support Users of E-Science Infrastructures in a Virtual Laboratory Environment

Authors: Hashim Chunpir

Abstract:

Support processes play an important role to facilitate researchers (users) to accomplish their research activities with the help of cyber-infrastructure(s). However, the current user-support process in cyber-infrastructure needs a feasible tool to support users. This tool must enable the users of a cyber-infrastructure to communicate efficiently with the staffs of a cyber-infrastructure in order to get technical and scientific assistance, whilst saving resources at the same time. This research paper narrates the real story of employing various forms of tools to support the user and staff communication. In addition, this paper projects the lessons learned from an exploration of the help-desk tools in the current state of user support process in Earth System Grid Federation (ESGF) from support staffs’ perspective. ESGF is a climate cyber-infrastructure that facilitates Earth System Modeling (ESM) and is taken as a case study in this paper. Finally, this study proposes a need for a tool, a framework or a platform that not only improves the user support process to address support servicing needs of end-users of e-Science infrastructures but also eases the life of staffs in providing assistance to the users. With the help of such a tool; the collaboration between users and the staffs of cyber-infrastructures is made easier. Consequently, the research activities of the users of e-Science infrastructure will thrive as the scientific and technical support will be available to users. Finally, this results into painless and productive e-Research.

Keywords: e-Science User Services, e-Research in Earth Sciences, Information Technology Services Management (ITSM), user support process, service desk, management of support activities, help desk tools, application of social media

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2863 Consultation Liasion Psychiatry in a Tertiary Care Hospital

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

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

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

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2862 Perceptions of Cognitive Behavioural Therapy in Physiotherapy Management for Chronic Low Back Pain: A Qualitative Exploration of Stakeholder Views

Authors: Latifa Alenezi, Liz Croot, Janet Harris

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Chronic Low Back Pain (CLBP) is one of the most common and recurrent musculoskeletal problems that causes patients to access health care services frequently. The Bio-psychosocial Model emphasises that psychological, behavioural and social factors contribute to the development and persistence of CLBP. Cognitive behavioural therapy (CBT) is a psychological pain management strategy that can be used by physiotherapists treating chronic low back pain. However, evidence of the effectiveness of CBT for CLBP varies between different studies. The proposed study was preceded by a mixed methods systematic review that found that CBT has a beneficial effect for CLBP patients when compared to waiting list or other treatments; however, there is variation in effectiveness across different settings. Little is known about how CBT is applied by physiotherapists in physiotherapy settings. The interest of this study is directed towards generating an explanation and understanding of why, when, and how some physiotherapists make decisions and choose to apply CBT for CLBP patients, whereas others do not. Also, how and for what type of CLBP patients does CBT work, and for whom might CBT not work? Therefore, the study will take a qualitative approach to explore CLBP patients’, physiotherapists’ and managers’ perceptions of CBT and how it is used in physiotherapy to enable a deeper understanding and richer explanation of CBT effectiveness and help to inform research and practice. The study will use grounded theory approach to generate an explanatory theory of the clinical application of CBT for CLBP in physiotherapy settings. Physiotherapists, patients and managers of physiotherapy services will be interviewed. Grounded theory techniques will be used to analyse the data. The presentation will describe findings from the interviews and the emerging theory. This research will help to further inform RCTs about the effectiveness of CBT for CLBP in physiotherapy.

Keywords: CBT, CLBP, perception, physiotherapy, theory

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2861 Development of a Web-Based Application for Intelligent Fertilizer Management in Rice Cultivation

Authors: Hao-Wei Fu, Chung-Feng Kao

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In the era of rapid technological advancement, information technology (IT) has become integral to modern life, exerting significant influence across diverse sectors and serving as a catalyst for development in various industries. Within agriculture, the integration of IT offers substantial benefits, notably enhancing operational efficiency. Real-time monitoring systems, for instance, have been widely embraced in agriculture, effectively improving crop management practices. This study specifically addresses the management of rice panicle fertilizer, presenting the development of a web application tailored to handle data associated with rice panicle fertilizer management. Leveraging the normalized difference red edge index, this application optimizes the quantity of rice panicle fertilizer used, providing recommendations to agricultural stakeholders and service providers in the agricultural information sector. The overarching objective is to minimize costs while maximizing yields. Furthermore, a robust database system has been established to store and manage relevant data for future reference in rice cultivation management. Additionally, the study utilizes the Representational State Transfer software architectural style to construct an application programming interface (API), facilitating data creation, retrieval, updating, and deletion for users via the HyperText Transfer Protocol methods. Future plans involve integrating this API with third-party services to incorporate it into larger frameworks, thus catering to the diverse requirements of various third-party services.

Keywords: application programming interface, HyperText Transfer Protocol, nitrogen fertilizer intelligent management, web-based application

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2860 The Cloud Systems Used in Education: Properties and Overview

Authors: Agah Tuğrul Korucu, Handan Atun

Abstract:

Diversity and usefulness of information that used in education are have increased due to development of technology. Web technologies have made enormous contributions to the distance learning system especially. Mobile systems, one of the most widely used technology in distance education, made much easier to access web technologies. Not bounding by space and time, individuals have had the opportunity to access the information on web. In addition to this, the storage of educational information and resources and accessing these information and resources is crucial for both students and teachers. Because of this importance, development and dissemination of web technologies supply ease of access to information and resources are provided by web technologies. Dynamic web technologies introduced as new technologies that enable sharing and reuse of information, resource or applications via the Internet and bring websites into expandable platforms are commonly known as Web 2.0 technologies. Cloud systems are one of the dynamic web technologies that defined as a model provides approaching the demanded information independent from time and space in appropriate circumstances and developed by NIST. One of the most important advantages of cloud systems is meeting the requirements of users directly on the web regardless of hardware, software, and dealing with install. Hence, this study aims at using cloud services in education and investigating the services provided by the cloud computing. Survey method has been used as research method. In the findings of this research the fact that cloud systems are used such studies as resource sharing, collaborative work, assignment submission and feedback, developing project in the field of education, and also, it is revealed that cloud systems have plenty of significant advantages in terms of facilitating teaching activities and the interaction between teacher, student and environment.

Keywords: cloud systems, cloud systems in education, online learning environment, integration of information technologies, e-learning, distance learning

Procedia PDF Downloads 349
2859 Automatic Aggregation and Embedding of Microservices for Optimized Deployments

Authors: Pablo Chico De Guzman, Cesar Sanchez

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Microservices are a software development methodology in which applications are built by composing a set of independently deploy-able, small, modular services. Each service runs a unique process and it gets instantiated and deployed in one or more machines (we assume that different microservices are deployed into different machines). Microservices are becoming the de facto standard for developing distributed cloud applications due to their reduced release cycles. In principle, the responsibility of a microservice can be as simple as implementing a single function, which can lead to the following issues: - Resource fragmentation due to the virtual machine boundary. - Poor communication performance between microservices. Two composition techniques can be used to optimize resource fragmentation and communication performance: aggregation and embedding of microservices. Aggregation allows the deployment of a set of microservices on the same machine using a proxy server. Aggregation helps to reduce resource fragmentation, and is particularly useful when the aggregated services have a similar scalability behavior. Embedding deals with communication performance by deploying on the same virtual machine those microservices that require a communication channel (localhost bandwidth is reported to be about 40 times faster than cloud vendor local networks and it offers better reliability). Embedding can also reduce dependencies on load balancer services since the communication takes place on a single virtual machine. For example, assume that microservice A has two instances, a1 and a2, and it communicates with microservice B, which also has two instances, b1 and b2. One embedding can deploy a1 and b1 on machine m1, and a2 and b2 are deployed on a different machine m2. This deployment configuration allows each pair (a1-b1), (a2-b2) to communicate using the localhost interface without the need of a load balancer between microservices A and B. Aggregation and embedding techniques are complex since different microservices might have incompatible runtime dependencies which forbid them from being installed on the same machine. There is also a security concern since the attack surface between microservices can be larger. Luckily, container technology allows to run several processes on the same machine in an isolated manner, solving the incompatibility of running dependencies and the previous security concern, thus greatly simplifying aggregation/embedding implementations by just deploying a microservice container on the same machine as the aggregated/embedded microservice container. Therefore, a wide variety of deployment configurations can be described by combining aggregation and embedding to create an efficient and robust microservice architecture. This paper presents a formal method that receives a declarative definition of a microservice architecture and proposes different optimized deployment configurations by aggregating/embedding microservices. The first prototype is based on i2kit, a deployment tool also submitted to ICWS 2018. The proposed prototype optimizes the following parameters: network/system performance, resource usage, resource costs and failure tolerance.

Keywords: aggregation, deployment, embedding, resource allocation

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2858 Thermal Simulation for Urban Planning in Early Design Phases

Authors: Diego A. Romero Espinosa

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Thermal simulations are used to evaluate comfort and energy consumption of buildings. However, the performance of different urban forms cannot be assessed precisely if an environmental control system and user schedules are considered. The outcome of such analysis would lead to conclusions that combine the building use, operation, services, envelope, orientation and density of the urban fabric. The influence of these factors varies during the life cycle of a building. The orientation, as well as the surroundings, can be considered a constant during the lifetime of a building. The structure impacts the thermal inertia and has the largest lifespan of all the building components. On the other hand, the building envelope is the most frequent renovated component of a building since it has a great impact on energy performance and comfort. Building services have a shorter lifespan and are replaced regularly. With the purpose of addressing the performance, an urban form, a specific orientation, and density, a thermal simulation method were developed. The solar irradiation is taken into consideration depending on the outdoor temperature. Incoming irradiation at low temperatures has a positive impact increasing the indoor temperature. Consequently, overheating would be the combination of high outdoor temperature and high irradiation at the façade. On this basis, the indoor temperature is simulated for a specific orientation of the evaluated urban form. Thermal inertia and building envelope performance are considered additionally as the materiality of the building. The results of different thermal zones are summarized using the 'Degree day method' for cooling and heating. During the early phase of a design process for a project, such as Masterplan, conclusions regarding urban form, density and materiality can be drawn by means of this analysis.

Keywords: building envelope, density, masterplanning, urban form

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2857 Nurse Practitioner Led Pediatric Primary Care Clinic in a Tertiary Care Setting: Improving Access and Health Outcomes

Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

Abstract:

Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

Procedia PDF Downloads 494
2856 Delivering User Context-Sensitive Service in M-Commerce: An Empirical Assessment of the Impact of Urgency on Mobile Service Design for Transactional Apps

Authors: Daniela Stephanie Kuenstle

Abstract:

Complex industries such as banking or insurance experience slow growth in mobile sales. While today’s mobile applications are sophisticated and enable location based and personalized services, consumers prefer online or even face-to-face services to complete complex transactions. A possible reason for this reluctance is that the provided service within transactional mobile applications (apps) does not adequately correspond to users’ needs. Therefore, this paper examines the impact of the user context on mobile service (m-service) in m-commerce. Motivated by the potential which context-sensitive m-services hold for the future, the impact of temporal variations as a dimension of user context, on m-service design is examined. In particular, the research question asks: Does consumer urgency function as a determinant of m-service composition in transactional apps by moderating the relation between m-service type and m-service success? Thus, the aim is to explore the moderating influence of urgency on m-service types, which includes Technology Mediated Service and Technology Generated Service. While mobile applications generally comprise features of both service types, this thesis discusses whether unexpected urgency changes customer preferences for m-service types and how this consequently impacts the overall m-service success, represented by purchase intention, loyalty intention and service quality. An online experiment with a random sample of N=1311 participants was conducted. Participants were divided into four treatment groups varying in m-service types and urgency level. They were exposed to two different urgency scenarios (high/ low) and two different app versions conveying either technology mediated or technology generated service. Subsequently, participants completed a questionnaire to measure the effectiveness of the manipulation as well as the dependent variables. The research model was tested for direct and moderating effects of m-service type and urgency on m-service success. Three two-way analyses of variance confirmed the significance of main effects, but demonstrated no significant moderation of urgency on m-service types. The analysis of the gathered data did not confirm a moderating effect of urgency between m-service type and service success. Yet, the findings propose an additive effects model with the highest purchase and loyalty intention for Technology Generated Service and high urgency, while Technology Mediated Service and low urgency demonstrate the strongest effect for service quality. The results also indicate an antagonistic relation between service quality and purchase intention depending on the level of urgency. Although a confirmation of the significance of this finding is required, it suggests that only service convenience, as one dimension of mobile service quality, delivers conditional value under high urgency. This suggests a curvilinear pattern of service quality in e-commerce. Overall, the paper illustrates the complex interplay of technology, user variables, and service design. With this, it contributes to a finer-grained understanding of the relation between m-service design and situation dependency. Moreover, the importance of delivering situational value with apps depending on user context is emphasized. Finally, the present study raises the demand to continue researching the impact of situational variables on m-service design in order to develop more sophisticated m-services.

Keywords: mobile consumer behavior, mobile service design, mobile service success, self-service technology, situation dependency, user-context sensitivity

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2855 A Study on Employer Branding and Its Impact on Employee

Authors: Kvnkc Sharma

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Globalization, coupled with increase in competition is compelling organizations to adopt innovative strategies and identify core competencies in order to distinguish themselves from the competition. The capability of an organization is no longer determined by their products or services alone. The intellectual assets and quality of the human resource are fast emerging as key differentiators. Corporations are now positioning themselves as ‘brands’ not solely to market their products and services, but also to lure and to retain the best talent in the business. This paper identifies leadership as the ‘key element’ in developing an organization’s brand, which has a significant influence on the employee’s eventual perception of this external brand as portrayed by the organization. External branding incorporates innovation, consumer concern, trust, quality and sustainability. The paper contends that employees are indeed an organization’s ‘brand ambassadors. Internal branding involves taking care of these ambassadors of corporate brand i.e. human resource. If employees of an organization are not exposed to the organization’s branding (an ongoing process that functionally aligns, motivates and empower employees at all levels to consistently provide a satisfying customer experience), the external brand could be jeopardized. Internal branding, on the other hand, refers to employee’s perception of the organization’s brand. The current business environment can at best, be termed as volatile. Employees with the right technical and behavioral skills remain a scarce resource and the employers need to be ready to capture the attention, interest and commitment of the best and brightest candidates. This paper attempts to review and understand the relationship between employer branding and employee retention. The paper also seeks to identify potential impact of employer branding across all the factors affecting employees.

Keywords: external branding, human resource, internal branding, leadership

Procedia PDF Downloads 247
2854 Academic Major, Gender, and Perceived Helpfulness Predict Help-Seeking Stigma

Authors: Tran Tran

Abstract:

Mental health issues are prevalent among Vietnamese undergraduate students, and they are greatly exacerbated during the COVID-19 pandemic for this population. While there is empirical evidence supporting the effectiveness and efficiency of therapy on mental health issues among college students, the rates of Vietnamese college students seeking professional mental health services were alarmingly low. Multiple factors can prevent those in need from finding support. The Internalized Stigma Model posits that public stigma directly affects intentions to seek psychological help via self-stigma and attitudes toward seeking help. However, little research has focused on what factors can predict public stigma toward seeking professional psychological support, especially among this population. A potential predictor is academic majors since academic majors can influence undergraduate students' perceptions, attitudes, and intentions. A study suggested that students who have completed two or more psychology courses have a more positive attitude toward seeking care for mental health issues and reduced stigma, which might be attributed to increased mental health literacy. In addition, research has shown that women are more likely to utilize mental health services and have lower stigma than men. Finally, studies have also suggested that experience of mental health services can increase endorsement of perceived need and lower stigma. Thus, it is expected that perceived helpfulness from past service uses can reduce stigma. This study aims to address this gap in the literature and investigate which factors can predict public stigma, specifically academic major, gender, and perceived helpfulness, potentially suggesting an avenue of prevention and ultimately improving the well-being of Vietnamese college students. The sample includes 408 undergraduate students (Mage = 20.44; 80.88% female) Hanoi city, Vietnam. Participants completed a pen-and-paper questionnaire. Students completed the Stigma Scale for Receiving Psychological Help, which yielded a mean public stigma score. Participants also completed a measurement assessing their perceived helpfulness of their university’s counseling center, which included eight subscales: future self-development, learning issues, career counseling, medical and health issues, mental health issues, conflicts between teachers and students, conflicts between parents and students, and interpersonal relationships. Items were summed to create a composite perceived helpfulness score. Finally, participants provided demographic information. This included gender, which was dichotomized between female and other. Additionally, it included academic major, which was also similarly dichotomized between psychology and other (e.g., natural science, social science, and pedagogy & social work). Linear relationships between public stigma and gender, academic major, and perceived helpfulness were analyzed individually with a regression model. Findings suggested that academic major, gender, and perceived counseling center's helpfulness predicted stigma against seeking professional psychological help. Specifically, being a psychology major predicted lower levels of public stigma (β = -.25, p < .001). Additionally, gender female predicted lower levels of public stigma (β = -.11, p < .05). Lastly, higher levels of perceived helpfulness of the counseling center also predicted lower levels of public stigma (β = -.16, p < .01). The study’s results offer potential intervention avenues to help reduce stigma and increase well-being for Vietnamese college students.

Keywords: stigma, vietnamese college students, counseling services, help-seeking

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2853 The Role of Temples Redevelopment for Informal Sector Business Development in India

Authors: Prashant Gupta

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Throughout India, temples have served as cultural centers, commerce hubs, art galleries, educational institutions, and social centers in addition to being places of worship since centuries. Across the country, there are over two million temples, which are crucial economic hubs, attracting devotees and tourists worldwide. In India, we have 53 temples per each 100,000 Indians. As per NSSO survey, the temple economy is worth about $40 billion and 2.32 per cent of GDP based on major temple’s survey, which only includes formal sector. It could be much larger as an actual estimation has not been done yet. In India, 43.1% of total economy represents informal sector. Over 10 billion domestic tourists visit to new destinations every year within India. Even 20 per cent of the 90 million foreign tourists visited Madurai and Mahabalipuram temples which became the most visited tourist spot in 2022. Recently the current central government in power have started revitalizing the ancient Indian civilization by reconstructing and beautifying the major temples of India i.e., Kashi Vishwanath Corridor, Mahakaleshwara Temple, Kedarnath, Ayodhya etc. The reason researcher chose Kashi as a case study because it is known as a Spiritual Capital of India, which is also the abode for the spread of Hinduism, Buddhism, Jainism and Sikkism, which are core Sanatan Dharmic practices. 17,800 Million INR Amount was spend to redevelop Kashi Vishwanath Corridor since 2019. RESEARCH OBJECTIVES 1. To assess historical contribution of temples in socio economic development and revival of Indic Civilization. 2. To examine the role of temples redevelopment for informal sector businesses. 3. To identify the sub-sectors of informal sector businesses 4. To identify products and services of informal businesses for investigation of marketing strategies and business development. PROPOSED METHODS AND PROCEDURES This study will follow a mixed approach, employing both qualitative and quantitative methods of research. To conduct the study, data will be collected from 500 informal business owners through structured questionnaire and interview instruments. The informal business owners will be selected using a systematic random sampling technique. In addition, documents from government offices of the last 10 years of tax collection will be reviewed to substantiate the study. To analyze the study, descriptive and econometric analysis techniques will be employed. EXPECTED CONTRIBUTION OF THE PROPOSED STUDY By studying the contribution of temple re-development on informal business creation and growth, the study will be beneficial to the informal business owners and the government. For the government, scientific and empirical evidence on the contribution of temple re-development for informal business creation and growth to give evidence the study will give based infrastructural development and boosting tax collection. For informal businesses, the study will give them a detailed insight on the nature of their business and the possible future growth potential of their business, and the alternative products and services supplying to their customers in the future. Studying informal businesses will help to identify the key products and services which are majorly profitable and possess potential to multiply and grow through correct product marketing strategies and business development.

Keywords: business development, informal sector businesses, services and products marketing, temple economics

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2852 Analyzing the Shearing-Layer Concept Applied to Urban Green System

Authors: S. Pushkar, O. Verbitsky

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Currently, green rating systems are mainly utilized for correctly sizing mechanical and electrical systems, which have short lifetime expectancies. In these systems, passive solar and bio-climatic architecture, which have long lifetime expectancies, are neglected. Urban rating systems consider buildings and services in addition to neighborhoods and public transportation as integral parts of the built environment. The main goal of this study was to develop a more consistent point allocation system for urban building standards by using six different lifetime shearing layers: Site, Structure, Skin, Services, Space, and Stuff, each reflecting distinct environmental damages. This shearing-layer concept was applied to internationally well-known rating systems: Leadership in Energy and Environmental Design (LEED) for Neighborhood Development, BRE Environmental Assessment Method (BREEAM) for Communities, and Comprehensive Assessment System for Building Environmental Efficiency (CASBEE) for Urban Development. The results showed that LEED for Neighborhood Development and BREEAM for Communities focused on long-lifetime-expectancy building designs, whereas CASBEE for Urban Development gave equal importance to the Building and Service Layers. Moreover, although this rating system was applied using a building-scale assessment, “Urban Area + Buildings” focuses on a short-lifetime-expectancy system design, neglecting to improve the architectural design by considering bio-climatic and passive solar aspects.

Keywords: green rating system, urban community, sustainable design, standardization, shearing-layer concept, passive solar architecture

Procedia PDF Downloads 579
2851 The Challenges of Cloud Computing Adoption in Nigeria

Authors: Chapman Eze Nnadozie

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Cloud computing, a technology that is made possible through virtualization within networks represents a shift from the traditional ownership of infrastructure and other resources by distinct organization to a more scalable pattern in which computer resources are rented online to organizations on either as a pay-as-you-use basis or by subscription. In other words, cloud computing entails the renting of computing resources (such as storage space, memory, servers, applications, networks, etc.) by a third party to its clients on a pay-as-go basis. It is a new innovative technology that is globally embraced because of its renowned benefits, profound of which is its cost effectiveness on the part of organizations engaged with its services. In Nigeria, the services are provided either directly to companies mostly by the key IT players such as Microsoft, IBM, and Google; or in partnership with some other players such as Infoware, Descasio, and Sunnet. This action enables organizations to rent IT resources on a pay-as-you-go basis thereby salvaging them from wastages accruable on acquisition and maintenance of IT resources such as ownership of a separate data centre. This paper intends to appraise the challenges of cloud computing adoption in Nigeria, bearing in mind the country’s peculiarities’ in terms of infrastructural development. The methodologies used in this paper include the use of research questionnaires, formulated hypothesis, and the testing of the formulated hypothesis. The major findings of this paper include the fact that there are some addressable challenges to the adoption of cloud computing in Nigeria. Furthermore, the country will gain significantly if the challenges especially in the area of infrastructural development are well addressed. This is because the research established the fact that there are significant gains derivable by the adoption of cloud computing by organizations in Nigeria. However, these challenges can be overturned by concerted efforts in the part of government and other stakeholders.

Keywords: cloud computing, data centre, infrastructure, it resources, virtualization

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2850 Rural-To-Urban Migrants' Experiences with Primary Care in Four Types of Medical Institutions in Guangzhou, China

Authors: Jiazhi Zeng, Leiyu Shi, Xia Zou, Wen Chen, Li Ling

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Background: China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Due to the household registration system, migrants are in a vulnerable state when they attempt to access to primary care services. A strong primary care system can reduce health inequities and mitigate socioeconomic disparities in healthcare utilization. Literature indicated that migrants were more reliant on the primary care system than local residents. Although the Chinese government has attached great importance to creating an efficient health system, primary care services are still underutilized. The referral system between primary care institutions and hospitals has not yet been completely established in China. The general populations often go directly to hospitals instead of primary care institutions for their primary care. Primary care institutions generally consist of community health centers (CHCs) and community health stations (CHSs) in urban areas, and township health centers (THCs) and rural health stations (THSs) in rural areas. In addition, primary care services are also provided by the outpatient department of municipal hospitals and tertiary hospitals. A better understanding of migrants’ experiences with primary care in the above-mentioned medical institutions is critical for improving the performance of primary care institutions and providing indications of the attributes that require further attention. The purpose of this pioneering study is to explore rural-to-urban migrants’ experiences in primary care, compare their primary care experiences in four types of medical institutions in Guangzhou, China, and suggest implications for targeted interventions to improve primary care for the migrants. Methods: This was a cross-sectional study conducted with 736 rural-to-urban migrants in Guangzhou, China, in 2014. A multistage sampling method was employed. A validated Chinese version of Primary Care Assessment Tool - Adult Short Version (PCAT-AS) was used to collect information on migrants’ primary care experiences. The PCAT-AS consists of 10 domains. Analysis of covariance was conducted for comparison on PCAT domain scores and total scores among migrants accessing four types of medical institutions. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results: After controlling for socio-demographic characteristics, migrant characteristics, health status and health insurance status, migrants accessing primary care in tertiary hospitals had the highest PCAT total scores when compared with those accessing primary care THCs/ RHSs (25.49 vs. 24.18, P=0.007) and CHCs/ CHSs(25.49 vs. 24.24, P=0.006). There was no statistical significant difference for PCAT total scores between migrants accessing primary care in CHCs/CHSs and those in municipal hospitals (24.24 vs. 25.02, P=0.436). Factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P < 0.001). Conclusions: This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Migrants receiving primary care from THCs, RHSs, CHSs and CHSs reported worse primary care experiences than those receiving primary care from tertiary hospitals. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. Further research exploring the specific reasons for poorer PCAT scores of primary care institutions users will be needed.

Keywords: China, PCAT, primary care, rural-to-urban migrants

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2849 A Study on the Effects of Urban Density, Sociodemographic Vulnerability, and Medical Service on the Impact of COVID-19

Authors: Jang-hyun Oh, Kyoung-ho Choi, Jea-sun Lee

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The outbreak of the COVID-19 pandemic brought reconsiderations and doubts about urban density as compact cities became epidemic hot spots. Density, though, provides an upside in that medical services required to protect citizens against the spread of disease are concentrated within compact cities, which helps reduce the mortality rate. Sociodemographic characteristics are also a crucial factor in determining the vulnerability of the population, and the purpose of this study is to empirically discover how these three urban factors affect the severity of the epidemic impacts. The study aimed to investigate the influential relationships between urban factors and epidemic impacts and provide answers to whether superb medical service in compact cities can scale down the impacts of COVID-19. SEM (Structural Equation Modeling) was applied as a suitable research method for verifying interrelationships between factors based on theoretical grounds. The study accounted for 144 municipalities in South Korea during periods from the first emergence of COVID-19 to December 31st, 2022. The study collected data related to infection and mortality cases from each municipality, and it holds significance as primary research that enlightens the aspects of epidemic impact concerning urban settings and investigates for the first time the mediated effects of medical service. The result of the evaluation shows that compact cities are most likely to have lower sociodemographic vulnerability and better quality of medical service, while cities with low density contain a higher portion of vulnerable populations and poorer medical services. However, the quality of medical service had no significant influence in reducing neither the infection rate nor the mortality rate. Instead, density acted as the major influencing factor in the infection rate, while sociodemographic vulnerability was the major determinant of the mortality rate. Thus, the findings strongly paraphrase that compact cities, although with high infection rates, tend to have lower mortality rates due to less vulnerability in sociodemographics, Whereas death was more frequent in less dense cities due to higher portions of vulnerable populations such as the elderly and low-income classes. Findings suggest an important lesson for post-pandemic urban planning-intrinsic characteristics of urban settings, such as density and population, must be taken into account to effectively counteract future epidemics and minimize the severity of their impacts. Moreover, the study is expected to contribute as a primary reference material for follow-up studies that further investigate related subjects, including urban medical services during the pandemic.

Keywords: urban planning, sociodemographic vulnerability, medical service, COVID-19, pandemic

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2848 Academic Identities in Transition

Authors: Caroline Selai, Sushrut Jadhav

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Background: University College London (UCL), the first secular university in England to admit students regardless of their religion and gender, has nearly 29,000 students of which approximately 30% are international students. The UCL Cultural Consultation Service (CCS) for staff and students is a unique service that provides assistance to staff and students experiencing challenges in their teaching, enabling, support work or studies which they believe may have a cultural component. The service provides one-to-one and group consultations, lectures, seminars, ‘grand rounds’, interactive workshops and bespoke interventions. Data: This paper presents a content analysis of CCS referrals over the last 36 months. We focus on the experience of international students, many of whom experience not only a challenge to their academic identity but also a profound challenge to their personal cultural identity. We also present 3 vignettes to illustrate how students interpret, accept, contest and resist changes in their cultural and academic identity. Discussion: This paper highlights (i) how students from collectivist cultures attempt to assimilate within an individualistic, highly competitive western university that is bound by its own institutional norms; (ii) problems in negotiating challenges at the interface of culture and gender (iii) the impact of culturally different hierarchies of power, discrimination and authority and (iv) the significance of earlier traumatic and kinship conflicts. Many international students’ social identities are shaped by their cultural and family scripts. A large number have been taught that their teachers are to be revered and their teachings unchallenged. This is at odds with quintessential goal of the western university to encourage healthy scepticism and hone students’ critical thinking skills. Conclusions: Pupil-teacher ‘cultural transference’ and shifts in cultural academic identities of students underscore critical aspects of developmental and learning challenges for students. Staff-student cultural conflict requires a broader, systemic analysis of students, staff and the wider organisation. Our findings challenge Eurocentric psychodynamic concepts such as the nature of parent-child relationship in Western Europe. We argue for a broader, more inclusive approach to develop both effective pedagogic skills in euro-american academic institutions and culturally- appropriate psychodynamic theory to underpin counselling international students.

Keywords: academic identity, cultural transference, cultural consultation in higher education, cultural formulation, cultural identity.

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