Search results for: maternal health service

Authors: Oentoeng Wahjoe

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Liberalisation of air transportation practically is known as open sky policy. In the practice, the liberalisation of air transportation is divided into two group of services, i.e.: air transportation services, for passengers and goods (air service) which is categorized as hard rights and supporting services of the air transportation services (ancillary services) which is categorized as soft rights. The research in this paper focused in air transportation services for passengers and goods, consists of nine freedom of the air. The impact of the policy such as the Agreement regarding ASEAN open sky policy, is the readiness of Indonesian air transportation companies to compete with foreign air transportation companies. The goverment of Indonesia has to regulate the implementation of ASEAN Open Sky Policy to be projected in order to comply with national development, i.e. the function of air law in national development. The policy has been implemented by enact or amend the existing law as air law that regulate flight lines, the following provisions: To regulate flight line for foreign airlines to open flight lines in Indonesia region which may not or have not land and sea transportation. The regulation is intended to supprot mobility of humans, goods and services that may fulfil the needs of the people of Indonesia, which materially and spiritually and the development of the region. The regulation of flight lines of foreign air transportation for region of tourism, industrial and trade centre. The regulation is intended to support the national economic development of Indonesia.

Keywords: transport, liberalization, impact, Indonesian air service

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Authors: Krisada Sungkhamanee

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The objectives of this research are to search the management pattern of one district lodging entrepreneurs by sufficient economy ways, to know the constrains that affects this sector and design fit arrangement shape to sustain their business with Samut Songkram style. What will happen if they do not use this approach? Will they have a monetary crisis? The data and information are collected by informal discussions with 8 managers and 400 questionnaires. A mixed methods of both qualitative research and quantitative research are used and Bent Flyvbjerg’s phronesis is utilized for this analysis. Our paper will prove that sufficient economy can help small business firms to solve their problems. We think that the results of our research will be a financial pattern to solve many problems of the entrepreneurs and this way will can be a super model for other provinces of Thailand.

Keywords: Samut Songkram, service sector, sufficient economy, management pattern

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Authors: Sonia Mannan, M. Jobair Alam

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The concept of palliative care in Bangladesh largely remained limited to the sympathetic caring of patients with a life-limiting illness. Quality of Life (QoL) issues are rarely practiced in Bangladesh. Furthermore, palliative medicine, in the perspective of holistic palliative care service, does not have its proper recognition in Bangladesh. Apart from those socio-medical aspects, palliative care patients face legal issues that impact their quality of life, including access to health services and social benefits and dealing with other life-transactions of the patients and their families (such as disposing of property; planning for children). This paper is an attempt to articulate these legal dimensions of the right to palliative care in the context of Bangladesh. The major focus of this paper will be founded on the doctrinal analysis of the constitutional provisions and other relevant legislation on the right to health and their judicial interpretation, which is argued to offer a meaningful space for the right to palliative care. This paper will also investigate the gaps in the said legal framework to better secure such care. In conclusion, a few recommendations are made so that the palliative care practices in Bangladesh are better aligned with international standards, and it can respond more humanely to the patients who need palliative care.

Keywords: Bangladesh, constitution, legal regime, palliative care, quality of life

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Authors: Eniko Nagy, Csaba Csiszar

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Satisfaction of air transportation passengers is significantly affected by the perceived quality of airport information services. The development potential of ICT is considerable. The traditional and new functions of ‘smart’ airports are realized by complex services aiding seamless, comfortable and less time-consuming travel. Based on the elements of the transportation chain the information management functions, their relationships and the technical solutions have been identified. The functions have been categorized by their development level and evaluation scores have been assigned to each category. Correction factors influencing the usefulness of the technology or the service have been introduced. A method for the calculation of ‘smart’ index in order to compare the airports in objective way has been developed; thus facilitating further developments. The method has been applied for the case study of Budapest.

Keywords: air transportation informatics, evaluation, information service, smart airport

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Simeon Christian Chukwu, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: Health service providers are offered in-service training periodically to strengthen their ability to deliver services that are ethical, quality, timely and safe. Not all capacity-building courses have successfully resulted in intended service delivery outcomes because of poor training content, design, approach, and ambiance. The Delivering Innovations in Selfcare (DISC) project developed a Moment of Truth innovation, which is a proven training model focused on improving consumer/provider interaction that leads to an increase in the voluntary uptake of subcutaneous depot medroxyprogesterone acetate (DMPA-SC) self-injection among women who opt for injectable contraception. Methodology: Six months after training on a moment of truth (MoT) training manual, the project conducted two intensive rounds of qualitative data collection and triangulation that included provider, client, and community mobilizer interviews, facility observations, and routine program data collection. Respondents were sampled according to a convenience sampling approach, and data collected was analyzed using a codebook and Atlas-TI. Providers and clients were interviewed to understand their experience, perspective, attitude, and awareness about the DMPA-SC self-inject. Data were collected from 12 health facilities in three states – eight directly trained and four cascades trained. The research team members came together for a participatory analysis workshop to explore and interpret emergent themes. Findings: Quality-of-service delivery and performance outcomes were observed to be significantly better in facilities whose providers were trained directly trained by the DISC project than in sites that received indirect training through master trainers. Facilities that were directly trained recorded SI proportions that were twice more than in cascade-trained sites. Direct training comprised of full-day and standalone didactic and interactive sessions constructed to evoke commitment, passion and conviction as well as eliminate provider bias and misconceptions in providers by utilizing human interest stories and values clarification exercises. Sessions also created compelling arguments using evidence and national guidelines. The training also prioritized demonstration sessions, utilized job aids, particularly videos, strengthened empathetic counseling – allaying client fears and concerns about SI, trained on positioning self-inject first and side effects management. Role plays and practicum was particularly useful to enable providers to retain and internalize new knowledge. These sessions provided experiential learning and the opportunity to apply one's expertise in a supervised environment where supportive feedback is provided in real-time. Cascade Training was often a shorter and abridged form of MoT training that leveraged existing training already planned by master trainers. This training was held over a four-hour period and was less emotive, focusing more on foundational DMPA-SC knowledge such as a reorientation to DMPA-SC, comparison of DMPA-SC variants, counseling framework and skills, data reporting and commodity tracking/requisition – no facility practicums. Training on self-injection was not as robust, presumably because they were not directed at methods in the contraceptive mix that align with state/organizational sponsored objectives – in this instance, fostering LARC services. Conclusion: To achieve better performance outcomes, consideration should be given to providing training that prioritizes practice-based and emotive content. Furthermore, a firm understanding and conviction about the value training offers improve motivation and commitment to accomplish and surpass service-related performance outcomes.

Keywords: training, performance outcomes, innovation, family planning, contraception, DMPA-SC, self-care, self-injection.

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Authors: Zoltan Theisz, Gergely Mezei

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Modern industrial automation relies on service oriented concepts of Internet of Things (IoT) device modeling in order to provide a flexible and extendable environment for service meta-repository. However, state-of-the-art meta-modeling techniques prefer design-time modeling, which results in a heavy usage of class sometimes unnecessary static subtyping. Although this approach benefits from clear-cut object-oriented design principles, it also seals the model repository for further dynamic extensions. In this paper, a dynamic multi-level modeling approach is introduced that enables dynamic subtyping through a more relaxed partial instantiation mechanism. The approach is demonstrated on a simple sensor network example.

Keywords: meta-modeling, dynamic subtyping, DMLA, industrial automation, arrowhead

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Authors: W. C. Bracken

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Given that concrete masonry walls are expected to experience shrinkage combined with thermal expansion and contraction, and in some cases even carbonation, throughout their service life, cracking is to be expected. However, after concrete masonry walls have been placed into service, originally anticipated and accounted for cracking is often misdiagnosed as a structural defect. Such misdiagnoses often result in or are used to support litigation. This paper begins by discussing the causes and types of anticipated cracking within concrete masonry walls followed by a discussion on the processes and analyses that exists for properly evaluating them and their significance. From here, the paper then presents a case of misdiagnosed concrete masonry cracking and the flawed logic employed to support litigation.

Keywords: concrete masonry, masonry wall cracking, structural defect, structural damage, construction defect, forensic investigation

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Authors: Hamzeh Awad

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Disability is considered to be a worldwide complex phenomenon which rising at a phenomenal rate and caused by many different factors. Chronic diseases such as cardiovascular disease and diabetes can lead to mobility disability in particular and disability in general. The ICF is an integrative bio-psycho-social model of functioning and disability and considered by the World Health Organization (WHO) to be a reference for disability classification using its categories and core set to classify disorder’s functional limitations. Specialist programs at Sultan Bin Abdul Aziz Humanitarian City (SBAHC) are providing both inpatient and outpatient services have started to implement the ICF and use it as a problem solving tool in Rehab. Diabetes is leading contributing factor for disability and considered epidemic in several Gulf countries including the Kingdom of Saudi Arabia (KSA), where its prevalence continues to increase dramatically. Metabolic disorders, mainly diabetes are not well covered in Rehab field. The purpose of this study is present to research and clinical rehabilitation field of DREAM and ICF as a framework in clinical and research setting in Rehab service. Also, shed the light on using the ICF as problem solving tool at SBAHC. There are synergies between disability causes and wider public health priorities in relation to both chronic disease and disability prevention. Therefore, there is a need for strong advocacy and understanding of the role of ICF as a reference in Rehab settings in Middle East if we wish to seize the opportunity to reverse current trends of acquired disability in the region.

Keywords: international classification of functioning, disability and health (ICF), prototype, rehabilitation and diabetes

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Authors: William C. Dean

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In the pedagogical sequence of the four- and five-year architectural programs at Alfred State, the fourth-year Urban Design Studio constitutes the first course where students directly explore design issues in the urban context. It is the first large-scale, community-based service learning project for most of the participating students. The students learn key lessons that include the benefits of working both individually and in groups of different sizes toward a common goal, accepting - and responding creatively too - criticism from stakeholders at different points in the project, and recognizing the role that local politics and activism can play in planning for community development. Above all, students are exposed to the importance of good planning in relation to preservation and community revitalization. The purpose of this paper is to discuss the use of community-based service-learning projects in undergraduate architectural education to promote student civic engagement as a means of helping communities visualize potential solutions for revitalizing their neighborhoods and business districts. A series of case studies will be presented in terms of challenges that were encountered, opportunities for student engagement and leadership, and the feasibility of sustainable community development resulting from those projects. The reader will be encouraged to consider how they can recognize needs within their own communities that could benefit from the assistance of architecture students and faculty.

Keywords: urban design, service-learning, civic engagement, community revitalization

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Authors: Akpokiere Ugbede Roseline

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Chemistry is an activity oriented subject in which many students achievement over the years are not encouraging. Among the reasons found to be responsible for student’s poor performance in chemistry are ineffective teaching strategies. This study, therefore, sought to determine the effect of guided inquiry, guided inquiry with demonstration, and demonstration with conventional approach on pre-service teachers’ cognitive attainment and practical skills acquisition on stoichiometry and chemical reactions in practical chemistry, Two research questions and hypotheses were each answered and tested respectively. The study was a quasi-experimental research involving 50 students in each of the experimental groups and 50 students in the control group. Out of the five instruments used for the study, three were on stimulus and two on response (Test of Cognitive Attainment and Test of Practical Skills in Chemistry) instruments administered, and dataobtained were analyzed with t-test and Analysis of Variance. Findings revealed, among others, that there was a significant effect of treatments on students' cognitive attainment and on practical skills acquisition. Students exposed to guided inquiry (with/without demonstration) strategies achieved better than those exposed to demonstration with conventional strategy. It is therefore recommended, among others, that Lecturers in Colleges of Education should utilize the guided inquiry strategy for teaching concepts in chemistry.

Keywords: instructional strategy, practical chemistry, learning outcomes, pre-service teachers

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Authors: Syed Kashif Ali, Usman Javaid, Abdullah Chohan

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In large enterprises multiple departments use different sort of information systems and databases according to their needs. These systems are independent and heterogeneous in nature and sharing information/data between these systems is not an easy task. The usage of middleware technologies have made data sharing between systems very easy. However, monitoring the exchange of data/information for verification purposes between target and source systems is often complex or impossible for maintenance department due to security/access privileges on target and source systems. In this paper, we are intended to present our experience of an end to end data monitoring approach at middle ware level implemented in Oracle BPEL for data verification without any help of monitoring tool.

Keywords: service level agreement, SOA, BPEL, oracle fusion middleware, web service monitoring

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Authors: Dezhi Li, Peng Cui, Bo Zhang, Tengyuan Chang

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In order to solve the housing problem for the low-income families, the construction of affordable housing is booming in China. However, due to various reasons, the service facilities and systems in the indemnificatory residential community meet many problems. This article established a Satisfaction Evaluation System of the Fundamental Public Services for Large-scale Indemnificatory Residential Community based on the national standards and local criteria and developed evaluation methods and processes. At last, in the case of Huagang project in Nanjing, the satisfaction of basic public service is calculated according to a survey of local residents.

Keywords: indemnificatory residential community, public services, satisfaction evaluation, structural equation modeling

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Authors: Juliana da Silva Cardoso, Cláudia Correia, Rita Gomes, Carolina Fraga, Inês Cascais, Sara Monteiro, Beatriz Teixeira, Sandra Ribeiro, Carolina Andrade, Cláudia Oliveira, Diana Gonzaga, Catarina Prior, Inês Vaz Matos

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The average daily screen time (ST) has been increasing in children, even at young ages. This seems to be associated with a higher incidence of neurodevelopmental disorders, and as the time of exposure increases, the greater is the functional impact. This study aims to compare the daily ST of toddlers and preschoolers previously and during the COVID-19 pandemic. A questionnaire was applied by telephone to parents/caregivers of children between 1 and 5 years old, followed up at 4 primary care units belonging to the Group of Primary Health Care Centers of Western Porto, Portugal. 520 children were included: 52.9% male, mean age 39.4 ± 13.9 months. The mean age of first exposure to screens was 13.9 ± 8.0 months, and most of the children were exposed to more than one screen daily. Considering the WHO recommendations, before the COVID-19 pandemic, 385 (74.0%) and 408 (78.5%) children had excessive ST during the week and the weekend, respectively; during the lockdown, these values increased to 495 (95.2%) and 482 (92.7%). Maternal education and both the child's median age and the median age of first exposure to screens had a statistically significant association with excessive ST, with OR 0.2 (p = 0.03, CI 95% 0.07-0.86), OR 1.1 (p = 0.01, 95% CI 1.05-1.14) and OR 0.9 (p = 0.05, 95% CI 0. 87-0.98), respectively. Most children in this sample had a higher than recommended ST, which increased with the onset of the COVID-19 pandemic. These results are worrisome and point to the need for urgent intervention.

Keywords: COVID-19 pandemic, preschoolers, screen time, toddlers

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Authors: Odaleia de O. Farias, Suzelene C. Marinho, Ecleidson B. Fragoso, Daniel S. Lima, Francisco R. S. Lira, Lara S. Araújo, Gabriel dos S. D. Soares

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In populous cities, prehospital care services that use vehicles alternative to ambulances are needed in order to reduce costs and improve response time to occurrences in areas with large concentration of people, such as leisure and tourism spaces. In this context, it was implanted a program called BIKE VIDA, that is innovative quick access and assistance program. The aim of this study is to describe the implantation and initial profile of occurrences performed by an urgency/emergency pre-hospital care service through paramedics on bicycles. It is a cross-sectional, descriptive study carried out in the city of Fortaleza, Ceara, Brazil. The data included service records from July to August 2017. Ethical aspects were respected. The service covers a perimeter of 4.5 km, divided into three areas with perimeter of 1.5 km for each paramedic, attending from 5 am to 9 pm. Materials transported by bicycles include External Automated Defibrillator - DEA, portable oxygen, oximeter, cervical collar, stethoscope, sphygmomanometer, dressing and immobilization materials and personal protective equipment. Occurrences are requested directly by calling the emergency number 192 or through direct approach to the professional. In the first month of the program, there were 93 emergencies/urgencies, mainly in the daytime period (71,0%), in males (59,7%), in the age range of 26 to 45 years (46,2%). The main nature was traumatic incidents (53.3%). Most of the cases (88,2%) did not require ambulance transport to the hospital, and there were two deaths. Pre-hospital service through bicycles is an innovative strategy in Brazil and has shown to be promising in terms of reducing costs and improving the quality of the services offered.

Keywords: emergency, response time, prehospital care, urgency

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Authors: Lina Abou Haibeh, Nadir Hakem, Ousama Abu Safia

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In this paper, the performance and quality of Voice over IP (VoIP) calls carried over a Mobile Ad Hoc Network (MANET) which has a number of SIP nodes registered on a SIP Proxy are analyzed. The testing campaigns are carried out in an indoor corridor structure having a well-defined channel’s characteristics and model for the different voice codecs, G.711, G.727 and G.723.1. These voice codecs are commonly used in VoIP technology. The calls’ quality are evaluated using four Quality of Service (QoS) metrics, namely, mean opinion score (MOS), jitter, delay, and packet loss. The relationship between the wireless channel’s parameters and the optimum codec is well-established. According to the experimental results, the voice codec G.711 has the best performance for the proposed MANET topology

Keywords: wireless channel modelling, Voip, MANET, session initiation protocol (SIP), QoS

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Authors: Juan Pedro Aznar Alarcon, Josep Maria Sayeras Maspera

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Airbnb and other similar platforms are offering a near substitute to the traditional accommodation service supplied by the hotel sector. In this context, hotels can try to compete by offering higher quality and additional services, which imply the need for new investments or try to compete by reducing prices. The theoretical model presented in this paper analyzes the best response using a sequential game theory model. The main conclusion is that due to the financial constraints that small and medium hotels have these hotels have reduced prices whereas hotels that belong to international groups or have an easy access to financial resources have increased their investment to increase the quality of the service provided. To check the validity of the theoretical model financial data from Barcelona, London and Paris hotels have been used analyzing profitability, quality of the service provided, the investment propensity and the evolution of the gross profit. The model and the empirical data provide the base for some industrial policy in the hospitality industry. To address the extra cost that small hotels in Europe have to face compared by bigger firms would help to improve the level of quality provided and to some extent have positive externalities in terms of job creation and an increasing added value for the industry.

Keywords: Airbnb, profitability, hospitality industry, game theory

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Authors: Michael Dreyfuss, Yahel Giat

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Limited battery range and long recharging times are the greatest obstacles to the successful adoption of electric cars. One of the suggestions to overcome these problems is that carmakers retain ownership of batteries and provide battery swapping service so that customers exchange their depleted batteries for recharged batteries. Motivated by this example, we consider the problem of optimal spares allocation in an exchangeable-item, multi-location repair system. We generalize the standard service measures of fill rate and average waiting time to reflect the fact that customers penalize the service provider only if they have to wait more than a ‘tolerable’ time window. These measures are denoted as the window fill rate and the truncated waiting time, respectively. We find that the truncated waiting time is convex and therefore a greedy algorithm solves the spares allocation problem efficiently. We show that the window fill rate is generally S-shaped and describe an efficient algorithm to find a near-optimal solution and detail a priori and a posteriori upper bounds to the distance from optimum. The theory is complemented with a large scale numerical example demonstrating the spare battery allocation in battery swapping stations.

Keywords: convex-concave optimization, exchangeable item, M/G/infinity, multiple location, repair system, spares allocation, window fill rate

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Authors: Ada Rocha, Beatriz Almeida, Cláudia Viegas

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Considering the growing trend of food consumption outside the home, Food Service units (FSU) achieved importance and responsibility in feeding the population. FSU have a strong environmental impact since the large-scale production of meals implies a high use of resources and produce high amounts of waste with economic and environmental consequences. At the end of 2019, with the emergence of the Covid-19 pandemic, this effort towards sustainability was affected by the contingency measures imposed to stop the spread of the virus. Preventive measures in FSU, include the provision of cutlery and paper napkins in individual bags, the use of disposable paper towels, the supply of individual portions of bread and spices, as well as bottled water. These measures are, in many cases, a setback and an obstacle to the implementation of more sustainable practices and imply greater consumption of natural resources and materials. The present study aimed to assess the impact of the implementation of the contingency measures for the Covid-19 pandemic on the environmental practices of FSU in Portugal. A questionnaire was developed to characterize the FSU and the impact of the implementation of contingency measures for the Covid-19 pandemic. A great impact of the implementation of the contingency measures in the sustainability of FSU was observed, highlighting concerns about the need to keep these measures, some of them adopted due to fear of the unknown and its consequences on an ongoing successful process. Policymakers should keep only the ones that may prove to be efficient and positive and abandon or relieve the unnecessary ones.

Keywords: COVID-19, environment, food service, sustainability, SGD

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Authors: Rachna Jain, Sushila Madan, Bindu Garg

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Cloud computing is the key powerhouse in numerous organizations due to shifting of their data to the cloud environment. In recent years it has been observed that cloud-based-services are being used on large scale for content storage, distribution and processing. Various issues have been observed in cloud computing environment that need to be addressed. Security and privacy are found topmost concern area. In this paper, a novel security model is proposed to secure data by utilizing CDN services like image to icon conversion. CDN Service is a content delivery service which converts an image to icon, word to pdf & Latex to pdf etc. Presented model is used to convert an image into icon by keeping image secret. Here security of image is imparted so that image should be encrypted and decrypted by data owners only. It is also discussed in the paper that how server performs multiplication and selection on encrypted data without decryption. The data can be image file, word file, audio or video file. Moreover, the proposed model is capable enough to multiply images, encrypt them and send to a server application for conversion. Eventually, the prime objective is to encrypt an image and convert the encrypted image to image Icon by utilizing homomorphic encryption.

Keywords: cloud computing, user data security, homomorphic encryption, image multiplication, CDN service

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Authors: Mejía M. Paula, Ramírez L. Leonardo, Puerta A. Gabriel

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In telemedicine, the image repository service is important to increase the accuracy of diagnostic support of medical personnel. This study makes comparison between two routing algorithms regarding the quality of service (QoS), to be able to analyze the optimal performance at the time of loading and/or downloading of medical images. This study focused on comparing the performance of Tabu Search with other heuristic and metaheuristic algorithms that improve QoS in telemedicine services in Colombia. For this, Tabu Search and Simulated Annealing heuristic algorithms are chosen for their high usability in this type of applications; the QoS is measured taking into account the following metrics: Delay, Throughput, Jitter and Latency. In addition, routing tests were carried out on ten images in digital image and communication in medicine (DICOM) format of 40 MB. These tests were carried out for ten minutes with different traffic conditions, reaching a total of 25 tests, from a server of Universidad Militar Nueva Granada (UMNG) in Bogotá-Colombia to a remote user in Universidad de Santiago de Chile (USACH) - Chile. The results show that Tabu search presents a better QoS performance compared to Simulated Annealing, managing to optimize the routing of medical images, a basic requirement to offer diagnostic images services in telemedicine.

Keywords: medical image, QoS, simulated annealing, Tabu search, telemedicine

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Authors: Yasser Y. Lenis, Amy Jo Montgomery, Diego F. Carrillo-Gonzalez

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Introduction: The use of didactic instruments in different learning environments plays a pivotal role in enhancing the level of knowledge in veterinary science students. The direct instruction of basic animal reproduction concepts in students enrolled in veterinary medicine programs allows them to elucidate the biological and molecular mechanisms that perpetuate the animal species in an ecosystem. Therefore, universities must implement didactic strategies that facilitate the teaching and learning processes for students and, in turn, enrich learning environments. Objective: to evaluate the effect of the use of a didactic textbook on the level of theoretical knowledge in embryo-maternal recognition for veterinary medicine students. Methods: the participants (n=24) were divided into two experimental groups: control (Ctrl) and treatment (Treat). Both groups received 4 hours of theoretical training regarding the basic concepts in bovine embryo-maternal recognition. However, the Treat group was also exposed to a guided lecture and the activity play-to-learn from a cow reproduction didactic textbook. A pre-test and a post-test were applied to assess the prior and subsequent knowledge in the participants. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, a repeated measures model was applied where the effect of the intervention was considered. Results: no significant difference (p>0,05) was observed in the number of right answers for groups Ctrl (54,2%±12,7) and Treat (40,8%±16,8) in the pre-test. There was no difference (p>0,05) compering the number of right answers in Ctrl pre-test (54,2%±12,7) and post-test (60,8±18,8). However, the Treat group showed a significant (p>0,05) difference in the number of right answers when comparing pre-test (40,8%±16,8) and post-test (71,7%±14,7). Finally, after the theoretical training and the didactic activity in the Treat group, an increase of 10.9% (p<0,05) in the number of right answers was found when compared with the Ctrl group. Conclusion: the use of didactic tools that include guided lectures and activities like play-to-learn from a didactic textbook enhances the level of knowledge in an animal reproduction course for veterinary medicine students.

Keywords: animal reproduction, pedagogic, level of knowledge, learning environment

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Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum

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Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.

Keywords: health policy, health professional, remote areas, RV Car Clinic

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Authors: Valentine Seymour

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Environmental volunteering organisations use questionnaires to explore the relationship between environmental volunteers and their health. To the author’s best knowledge, no one has explored volunteers’ health perception, which could be considered when designing a health impact measurement tool used to increase effective communication. This paper examines environmental volunteers' perceptions of health, knowledge which can be used to design a health impact measurement tool. This study uses focus group interviews, content analysis, and a general inductive approach to explore the health perceptions of volunteers who engage in environmental volunteering activities from the perspective of UK charity The Conservation Volunteers. Findings showed that volunteer groups presented were relatively similar in how they defined the term health, with their overall conceptual model closely resembling that of the World Health Organization 1948 definition. This suggests that future health impact measurement tools in the environmental volunteering sector could base their design around the World Health Organization’s definition.

Keywords: health perception, impact measurement, mental models, tool development

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Authors: Kailas Bhandarkar, Talib Dar, Laura Karia, Manasvi Upadhyaya

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Introduction: Frenotomy for tongue tie is commonly performed in breastfed infants who experience difficulty in latching after failed conservative management for tongue tie. However, there is no consensus for the routine use of massage following frenotomy. Our aim was to assess the efficacy of massage in preventing recurrence following frenotomy. Methods: The tongue tie service in our tertiary referral hospital consists of 5 consultants and a breastfeeding (BF) midwife. 3 consultants routinely advice massage post procedure. Babies are assessed by the midwife after the procedure and a follow-up consultation after a week. After due ethical approval, data were collected by two staff members who were independent of TT service on a standardized questionnaire to avoid bias. Fischer exact test was employed (p < 0.05 considered significant). Results: Six hundred and thirty-two babies attended the clinic from January 2018 to December 2018. Thirty-three of these were excluded as the procedure was not needed. Parents were contacted at a median of six months post-procedure (range 2-10 months). 282/599 were advised massage. 92/282 could be contacted. 40/ 92 adhered to massage regimen. None of these had a recurrence. 52/92 (54%), although advised, did not perform massage. Reasons cited for lack of adherence to massage included difficulty in performing massaging and conflicting advice given by other health care professionals involved in patient care like paediatricians and group practice and lack of information on the internet). Overall, 4/599 (0.66%) had recurrences, and this difference was not statistically significant. Conclusion: In our experience, the rate of recurrence after frenotomy is low enough for us to conclude that there is no significant benefit of massage after frenotomy for tongue tie. We could also conclude that among parents who were advised massage more than half failed to adhere to the advice.

Keywords: tongue tie, frenotomy, massage, recurrence

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Authors: Chia-Ching Sun, Li-Yin Chien, Chun-Ting Hsiao

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Background: Appropriate gestation weight gain benefits pregnant women and their children; however, excessive weight gain could raise the risk of adverse health outcomes and chronicle diseases. Nevertheless, there is currently limited evidence on the effect of physical activities on pregnant women’s gestational weight gain. Purpose: This study aimed to explore the correlation between the level of physical activity and gestation weight gain during the second and third trimester of pregnancy. Methods: This longitudinal study enrolled 800 healthy pregnant women aged over 20 from six hospitals in northern Taiwan. Structured questionnaires were used to collect data twice for each participant during 14-27 and 28-40 weeks of gestation. Variables included demographic data, maternal health history, and lifestyle. The International Physical Activity Questionnaire-short form was used to measure the level of physical activity from walking and of moderate-intensity and vigorous-intensity before and during pregnancy. Weight recorded at prenatal checkups were used to calculate average weight gain in each trimester of pregnancy. T-tests, ANOVA, chi-squared tests, and multivariable logistic regression models were applied to determine the predicting factors for weight gain during the second and third trimester. Result: Participants who had achieved recommended physical activity level (150 minutes of moderate physical activity or 75 minutes of vigorous physical activity a week) before pregnancy (aOR=1.85, 95% CI=1.27-2.67) or who achieved recommended walking level (150 minutes a week) during the second trimester of pregnancy (aOR=1.43, 95% CI= 1.00-2.04) gained significantly more weight during the second trimester. Compared with those who did not reach recommended level of moderate-intensity physical activity (150 minutes a week), women who had reached that during the second trimester were more likely to be in the less than recommended weight gain group than in the recommended weight gain group (aOR=2.06, CI=1.06-4.00). However, there was no significant correlation between physical activity level and weight gain in the third trimester. Other predicting factors of excessive weight gain included education level which showed a negative correlation (aOR=0.38, CI=0.17-0.88), whereas overweight and obesity before pregnancy showed a positive correlation (OR=3.97, CI=1.23-12.78). Conclusions/implications for practice: Participants who had achieved recommended physical activity level before pregnancy significantly reduced exercise during pregnancy and gained excessive weight during the second trimester. However, women who engaged in the practice of physical activity as recommended could effectively control weight gain in the third trimester. Healthcare professionals could suggest that pregnant women who exercise maintain their pre-pregnancy level of physical activity, given activities requiring physical contact or causing falls are avoided. For those who do not exercise, health professionals should encourage them to gradually increase the level of physical activity. Health promotion strategies related to weight control and physical activity level achievement should be given to women before pregnancy.

Keywords: pregnant woman, physical activity, gestation weight gain, obesity, overweight

Procedia PDF Downloads 157

Authors: Devyani Shete, Sudeep Rai

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Background: The COVID-19 pandemic has caused one of the highest disruptions to the NHS (National Health Service), especially to the fundamental cervical cancer screening service. To prioritize screening response effectively, it is vital to understand the underlying disease risks amongst groups of women who are less likely to resume their screening/follow up at General Practices. The current government target is to have>=80% of women have an adequate test within the previous 3.5 years (ages 25-49) or 5.5 years (ages 50-64). Aims/Objectives: To increase the number of eligible people aged 25-49 attending cervical screening by 5% at Lakeside Healthcare (a General Practice in Corby). Methods: An online survey was posted on the Lakeside Healthcare website to find out what the barriers towards cervical screening were. It was apparent that patients needed more information catered to their responses. 6 informational videos and a “Cervical Screening Guide” were created for Lakeside patients about cervical screening, which were posted on the Healthcare website. Lakeside also started sending reminder texts to those eligible, with a link to a booking form. Results: On 18th January 2022, 69.7% of patients aged 25-49 years (7207) had an adequate cervical screening test in the last 3.5 years. There were 80 total responders to the online survey. In response to “which of the following are reasons why you have not attended screening”, 30% ticked “I kept putting it off/did not get around to it,” and 13% ticked “I was worried it would be painful or daunting.” In response to “which of the following would make you more likely to book an appointment”, 23% ticked “More detailed explanations of what the risks are if I don’t have screening,” and 20% ticked “I would like more information about the test and what the smear entails.” 10% of responders had previous trauma, whilst 28% of responders said the pandemic had impacted them getting a smear. Survey results were used to carry out interventions to increase smear uptake. On 23rdMarch 2022 (after a 2-month period), 75%of patients aged 25-49 (7119) attended the screening, which was a 5.3% increase from January. Discussion/Conclusion: The survey was vital in carrying out the exact interventions that were required for patients to increase screening uptake, as it is important to know what the populations’ needs are in order to create personalized invitations. This helps to optimise response during a pandemic. A HPV self-sample kit at home could be a popular method of dealing with further outbreaks.

Keywords: gynaecology, cervical screening, public health, COVID-19

Procedia PDF Downloads 150

Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

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Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

Procedia PDF Downloads 111

Authors: Raghava Satya SaiKrishna Dittakavi

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Cloud computing has revolutionized how businesses and individuals store, access, and process data, increasing efficiency and reducing infrastructure costs. However, the need for more transparency in cloud service billing often raises concerns about overcharging and hidden fees, hindering the realization of the full potential of cloud computing. This research paper explores how blockchain technology can be leveraged to introduce cost transparency and accountability in cloud computing services. We present a comprehensive analysis of blockchain-enabled solutions that enhance cost visibility, facilitate auditability, and promote trust in cloud service providers. Through this study, we aim to provide insights into the potential benefits and challenges of implementing blockchain in the cloud computing domain, leading to improved cost management and customer satisfaction.

Keywords: blockchain, cloud computing, cost transparency, blockchain technology

Procedia PDF Downloads 85

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

Abstract:

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

Procedia PDF Downloads 62

Authors: Sheillah Hlamalani Mboweni, Lufuno Makhado

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Background: The increasing number of people who tested HIV positive and who demand antiretroviral therapy (ART) prompted the National Department of Health to adopt WHO recommendations of task shifting where Professional Nurses(PNs) initiate ART rather than doctors in the hospital. This resulted in the decentralization of services to primary health care(PHC), generating a need to capacitate PNs on NIMART. After years of training, the impact of NIMART was assessed where it was established that even though there was an increased number who accessed ART, the quality of care is of serious concern. The study aims to answer the following question: What are the challenges influencing NIMART implementation in primary health care. Objectives: This study explores challenges influencing NIMART training and implementation and makes recommendations to improve patient and HIV program outcomes. Methods: A qualitative explorative program evaluation research design. The study was conducted in the rural districts of North West province. Purposive sampling was used to sample PNs trained on NIMART. FGDs were used to collect data with 6-9 participants and data was analysed using ATLAS ti. Results: Five FGDs, n=28 PNs and three program managers were interviewed. The study results revealed two themes: inadequacy in NIMART training and the health care system challenges. Conclusion: The deficiency in NIMART training and health care system challenges is a public health concern as it compromises the quality of HIV management resulting in poor patients’ outcomes and retard the goal of ending the HIV epidemic. These should be dealt with decisively by all stakeholders. Recommendations: The national department of health should improve NIMART training and HIV management: standardization of NIMART training curriculum through the involvement of all relevant stakeholders skilled facilitators, the introduction of pre-service NIMART training in institutions of higher learning, support of PNs by district and program managers, plan on how to deal with the shortage of staff, negative attitude to ensure compliance to guidelines. There is a need to develop a conceptual framework that provides guidance and strengthens NIMART implementation in PHC facilities.

Keywords: antiretroviral therapy, nurse initiated management of retroviral therapy, primary health care, professional nurses

Procedia PDF Downloads 159