Search results for: counseling services

Authors: Sarpong Boateng, Rohit Balasundaram, Akua Afrah Amoah

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Introduction: Racial and Gender disparities have been found to be independently associated with Salivary Gland Cancers (SGCs) survival; however, to our best knowledge, there are no previous studies on the interplay of these social determinants on the prognosis of SGCs. The objective of this study was to examine the joint effect of race and gender on the survival of SGCs. Methods: We analyzed survival outcomes of 13,547 histologically confirmed cases of SGCs using the Surveillance Epidemiology and End Results (SEER) database (2004 to 2015). Multivariable Cox regression analysis and Kaplan-Meier curves were used to estimate hazard ratios (HR) after controlling for age, tumor characteristics, treatment type and year of diagnosis. Results: 73.5% of the participants were whites, 8.5% were blacks, 10.1% were Hispanics and 58.5% were males. Overall, males had poorer survival than females (HR = 1.16, p=0.003). In the adjusted multivariable model, there were no significant differences in survival by race. However, the interaction of gender and race was statistically significant (p=0.01) in Hispanic males. Thus, compared to White females (reference), Hispanic females had significantly better survival (HR=0.53), whiles Hispanic males had worse survival outcomes (HR=1.82) for SGCs. Conclusions: Our results show significant interactions between race and gender, with racial disparities varying across the different genders for SGCs survival. This study indicates that racial and gender differences are crucial factors to be considered in the prognostic counseling and management of patients with SGCs. Biologic factors, tumor genetic characteristics, chemotherapy, lifestyle, environmental exposures, and socioeconomic and dietary factors are potential yet proven reasons that could account for racial and gender differences in the survival of SGCs.

Keywords: salivary, cancer, survival, disparity, race, gender, SEER

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Authors: Ryan Houser

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Introduction: Previous studies have found that public health systems within the United States are inadequately prepared for an act of biological terrorism. As the COVID-19 pandemic continues, few studies have evaluated bioterrorism preparedness of Emergency Medical Services, even in the accelerating environment of biothreats. Methods: This study utilized an Internet-based survey to assess the level of preparedness and willingness to respond to a bioterrorism attack and identify factors that predict preparedness and willingness among Nebraska EMS (Emergency Medical Services ) providers. The survey was available for one month in 2021, during which 190 EMS providers responded to the survey. Results: Only 56.8% of providers were able to recognize an illness or injury as potentially resulting from exposure to a CBRN agent. The provider Clinical Competency levels range from a low of 13.6% (ability to initiate patient care within his/her professional scope of practice and arrange for prompt referral appropriate to the identified condition(s)) to a high of 74% (the ability to respond to an emergency within the emergency management system of his/her practice, institution and community). Only 10% of the respondents are both willing and able to effectively function in a bioterror environment. Discussion: In order to effectively prepare for and respond to a bioterrorist attack, all levels of the healthcare system need to have the clinical skills, knowledge, and abilities necessary to treat patients exposed. Policy changes and increased focus on training and drills are needed to ensure a prepared EMS system which is crucial to a resilient state. EMS entities need to be aware of the extent of their available workforce so that the country can be prepared for the increasing threat of bioterrorism or other novel emerging infectious disease outbreaks. A resilient nation relies on a prepared set of EMS providers who are willing to respond to biological terrorism events.

Keywords: bioterrorism, prehospital, EMS, disaster, emergency, medicine, preparedness, policy

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: health management, internet of health things, remote monitoring, senior patient

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Authors: Zelalem Teshager

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The Choke Mountains have several endangered and endemic wildlife species and provide important ecosystem services. Despite their environmental importance, the Choke Mountains are found in dangerous conditions. This raised the need for an evaluation of the community's perception of deforestation and its major drivers and suggested possible solutions in the Choke Mountains of northwestern Ethiopia. For this purpose, household surveys, key informant interviews, and focus group discussions were used. A total sample of 102 informants was used for this survey. A purposive sampling technique was applied to select the participants for in-depth interviews and focus group discussions. Both qualitative and quantitative data analyses were used. Computation of descriptive statistics such as mean, percentages, frequency, tables, figures, and graphs was applied to organize, analyze, and interpret the study. This study assessed smallholder agricultural land expansion, Fuel wood collection, population growth; encroachment, free grazing, high demand of construction wood, unplanned resettlement, unemployment, border conflict, lack of a strong forest protecting system, and drought were the serious causes of forest depletion reported by local communities. Loss of land productivity, Soil erosion, soil fertility decline, increasing wind velocity, rising temperature, and frequency of drought were the most perceived impacts of deforestation. Most of the farmers have a holistic understanding of forest cover change. Strengthening forest protection, improving soil and water conservation, enrichment planting, awareness creation, payment for ecosystem services, and zero grazing campaigns were mentioned as possible solutions to the current state of deforestation. Applications of Intervention measures, such as animal fattening, beekeeping, and fruit production can contribute to decreasing the deforestation causes and improve communities’ livelihood. In addition, concerted efforts of conservation will ensure that the forests’ ecosystems contribute to increased ecosystem services. The major drivers of deforestation should be addressed with government intervention to change dependency on forest resources, income sources of the people, and institutional set-up of the forestry sector. Overall, further reduction in anthropogenic pressure is urgent and crucial for the recovery of the afro-alpine vegetation and the interrelated endangered wildlife in the Choke Mountains.

Keywords: choke afro-alpine, deforestation, drivers, intervention measures, perceptions

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Authors: Anastasia Constantinou, Stephen Morris

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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.

Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare

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Authors: K. P. Fasalu Rahman

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The financial services industry of Islam include large number of institutions, such as investment banks and commercial banks, investment companies and mutual insurance companies. All types of these financial institutions should have to deal with many issues and risks in their field of work. Islamic banks should expect to face two types of risks: risks that are similar to those faced by conventional financial intermediaries and risks that are unique to the Islamic Banks due to their compliance with the Shariah. The use of financial services and products that comply with the Shariah principles cause special issues for supervision and risk management. Risks are uncertain future events that could influence the achievement of the bank’s objectives, including strategic, operational, financial and compliance objectives. In Islamic banks, effective risk management deserves special attention. As an operational problem, risk management is the classification and identification of methods, processes, and risks in banks to supervise, monitor and measure them. In comparison to conventional banks, Islamic banks face big difficulties in identifying and managing risks due to bigger complexities emerging from the profit loss sharing (PLS) concept and nature of particular risks of Islamic financing. As the developing of managing risks tool becomes very essential, especially in Islamic banking as most of the products are depending on PLS principle, identifying and measuring each type of risk is highly important and critical in any Islamic finance based systems. This paper highlights the special and general risks surrounding Islamic banking. And it investigates in detail the need for risk management in Islamic banks. In addition to analyzing the effectiveness of risk management strategies adopted by Islamic financial institutions at present, this research is also suggesting strategies for improving risk management process of Islamic banks in future.

Keywords: Islamic banking, management, risk, risk management

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Authors: Roya Kelishadi, Mostafa Amini-Rarani, Mostafa Qorbani

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Introduction: As a health-related behavior, physical activity (PA) has an unequal distribution relating to individual's socioeconomic status. This study aimed to assess socioeconomic inequality in PA among Iranian students and their parents at national level and according to socioeconomic status (SES) of the living regions. Method: This study was conducted as part of a national surveillance program conducted among 14400 Iranian students and their parents. Non-linear principal component analysis was used to construct the households' socioeconomic status, and the concentration index approach was applied to measure inequality in father, mother, and student’s PA. Results: The data of 13313 students and their parents were complete for the current study. At national level and SES regions, students had more PA than their parents (except in the lowest SES region), and fathers have more PA than mothers. The lowest means of mother and student's PA were find in the highest SES region. At national level, the concentration indices of father and mother’s PA were -0.050 (95 % CI: -0.067 ~ -0.030) and -0.028 (95% CI: -0.044 ~ -0.012), respectively; indicating pro-poor inequality and, the CI value of student PA was nearly equal to zero (P > 0.05). At SES regions, father and mother's PA were more concentrated in the poor, except for lower middle region. Regional concentration indices for students reveal that inequality not statistically significant at all regions. Conclusion: This study suggests that reliable evidence that comparing different aspects of inequality of PA, based on socioeconomic status and residence areas of students and their parents, could be used for better planning for health promotion programs. Moreover, given the average of mother's and student’s PA in the richer regions were low, it can be suggested that richer focused-PA planning may further increase the level of PA across higher SES and, consequently, reduce inequality in PA. These findings can be applied in the health system services.

Keywords: concentration index, health system services, physical activity, socioeconomic inequality

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Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito

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There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.

Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia

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Authors: Nur Atiqah Adam, Mor Jack Ng, Bernard Chern, Kok Hian Tan

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Introduction: Gestational diabetes (GDM) is a common pregnancy complication with short and long-term health consequences for both mother and fetus. Factors such as family history of diabetes mellitus, maternal obesity, maternal age, ethnicity and parity have been reported to influence the risk of GDM. In a multi-racial country like Singapore, it is worthwhile to study the GDM prevalences of different ethnicities. We aim to investigate the influence of ethnicity on the racial prevalences of GDM in Singapore. This is important as it may help us to improve guidelines on GDM healthcare services according to significant risk factors unique to Singapore. Materials and Methods: Obstetric cohort data of 926 singleton deliveries in KK Women’s and Children’s Hospital (KKH) from 2011 to 2013 was obtained. Only patients aged 18 and above and without complicated pregnancies or chronic illnesses were targeted. Factors such as ethnicity, maternal age, parity and maternal body mass index (BMI) at booking visit were studied. A multivariable logistic regression model, adjusted for confounders, was used to determine which of these factors are significantly associated with an increased risk of GDM. Results: The overall GDM prevalence rate based on WHO 1999 criteria & at risk screening (race alone not a risk factor) was 8.86%. GDM rates were higher among women above 35 years old (15.96%), obese (15.15%) and multiparous women (10.12%). Indians had a higher GDM rate (13.0 %) compared to the Chinese (9.57%) and Malays (5.20%). However, using multiple logistic regression model, variables that are significantly related to GDM rates were maternal age (p < 0.001) and maternal BMI at booking visit (p = 0.006). Conclusion: Maternal age (p < 0.001) and maternal booking BMI (p = 0.006) are the strongest risk factors for GDM. Ethnicity per se does not seem to have a significant influence on the prevalence of GDM in Singapore (p = 0.064). Hence we should tailor guidelines on GDM healthcare services according to maternal age and booking BMI rather than ethnicity.

Keywords: ethnicity, gestational diabetes, healthcare, pregnancy

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Authors: Bahareh Golchin, Nooshin Riahi

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One of the most significant issues as attended a lot in recent years is that of recognizing the sentiments and emotions in social media texts. The analysis of sentiments and emotions is intended to recognize the conceptual information such as the opinions, feelings, attitudes and emotions of people towards the products, services, organizations, people, topics, events and features in the written text. These indicate the greatness of the problem space. In the real world, businesses and organizations are always looking for tools to gather ideas, emotions, and directions of people about their products, services, or events related to their own. This article uses the Twitter social network, one of the most popular social networks with about 420 million active users, to extract data. Using this social network, users can share their information and opinions about personal issues, policies, products, events, etc. It can be used with appropriate classification of emotional states due to the availability of its data. In this study, supervised learning and deep neural network algorithms are used to classify the emotional states of Twitter users. The use of deep learning methods to increase the learning capacity of the model is an advantage due to the large amount of available data. Tweets collected on various topics are classified into four classes using a combination of two Bidirectional Long Short Term Memory network and a Convolutional network. The results obtained from this study with an average accuracy of 93%, show good results extracted from the proposed framework and improved accuracy compared to previous work.

Keywords: emotion classification, sentiment analysis, social networks, deep neural networks

Procedia PDF Downloads 133

Authors: Benoit Atge, Alice Dhersin, Oscar Da Silva Cacao, Beatrice Martinez, Dominique Ducint, Catherine Verdun-Esquer, Isabelle Baldi, Mathieu Molimard, Antoine Villa, Mireille Canal-Raffin

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Introduction: Healthcare workers' exposure to antineoplastic drugs (AD) is a burning issue for occupational medicine practitioners. Biological monitoring of occupational exposure (BMOE) is an essential tool for assessing AD contamination of healthcare workers. In addition to BMOE, surface sampling is a useful tool in order to understand how workers get contaminated, to identify sources of environmental contamination, to verify the effectiveness of surface decontamination way and to ensure monitoring of these surfaces. The objective of this work was to develop a complete tool including a kit for surface sampling and a quantification analytical method for AD traces detection. The development was realized with the three following criteria: the kit capacity to sample in every professional environment (healthcare services, veterinaries, etc.), the detection of very low AD traces with a validated analytical method and the easiness of the sampling kit use regardless of the person in charge of sampling. Material and method: AD mostly used in term of quantity and frequency have been identified by an analysis of the literature and consumptions of different hospitals, veterinary services, and home care settings. The kind of adsorbent device, surface moistening solution and mix of solvents for the extraction of AD from the adsorbent device have been tested for a maximal yield. The AD quantification was achieved by an ultra high-performance liquid chromatography method coupled with tandem mass spectrometry (UHPLC-MS/MS). Results: With their high frequencies of use and their good reflect of the diverse activities through healthcare, 15 AD (cyclophosphamide, ifosfamide, doxorubicin, daunorubicin, epirubicin, 5-FU, dacarbazin, etoposide, pemetrexed, vincristine, cytarabine, methothrexate, paclitaxel, gemcitabine, mitomycin C) were selected. The analytical method was optimized and adapted to obtain high sensitivity with very low limits of quantification (25 to 5000ng/mL), equivalent or lowest that those previously published (for 13/15 AD). The sampling kit is easy to use, provided with a didactic support (online video and protocol paper). It showed its effectiveness without inter-individual variation (n=5/person; n= 5 persons; p=0,85; ANOVA) regardless of the person in charge of sampling. Conclusion: This validated tool (sampling kit + analytical method) is very sensitive, easy to use and very didactic in order to control the chemical risk brought by AD. Moreover, BMOE permits a focal prevention. Used in routine, this tool is available for every intervention of occupational health.

Keywords: surface contamination, sampling kit, analytical method, sensitivity

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Authors: Rahmadanih, Sitti Bulkis, A. Amrullah, R. M. Rukka, N. M. Viantika

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Food security is still a global issue, including in Indonesia. In South Sulawesi, this issue also occurs in members of farmer groups/women farmer groups. This study aims to (1) describe the implementation of strengthening institutional model of Women Farmer Groups (WFG) and (2) analyzing the capacity building of WFG members in order to develop food security after the implementations on institutional model. The research was conducted in Bulukumba and Luwu Utara District, South Sulawesi, Indonesia. The research was designed with qualitative and quantitative (mixed) method. Qualitative data were collected through in-depth interview and Focus Group Discussion (FGD); while quantitative data collected through a household survey of WGF members. Two WGF were selected they are WFG in Bulukumba and WGF in Luwu Utara District. Both WGF has been selected as the case unit, which consisting of 60 households. Institutional strengthening model that been implemented is a combination model of (1) institutional support and (2) capacity development of WGF members. The model of institutional support aim is to develop food security could be achieved through facilitation on produce banana chips (initiate a business group formation) and preparation of institution rule (AD/ART). (2) The developing Model of WFG members capacity building are (a) technical training of banana chips producing process, also food and nutrition counseling as well as the utilization of the yard, (b) processing of food products from their yards. Food and nutrition knowledge of WFG members was increased about 30% - 60% and accompanied by the development of households’ food security by 6.7% - 10.0%.; when compared to last year percentage.

Keywords: food security, institutional strengthening, model implementation, women farmer group

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Piero Favino, Luca Preis

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A settlement strategy is to anticipate and respond the needs of existing and future communities through the provision of primary health care facilities in marginalized areas. Access to a health care network is important to improving healthcare coverage, often lacking, in developing countries. The study explores that a good sanitary system strategy of rural contexts brings advantages to an existing settlement: improving transport, communication, water and social facilities. The objective of this paper is to define a possible methodology to implement primary health care facilities in disadvantaged areas of emerging countries. In this research, we analyze the case study of Lauro de Freitas, a municipality in the Brazilian state of Bahia, part of the Metropolitan Region of Salvador, with an area of 57,662 km² and 194.641 inhabitants. The health localization system in Lauro de Freitas is an integrated process that involves not only geographical aspects, but also a set of factors: population density, epidemiological data, allocation of services, road networks, and more. Data were collected also using semi-structured interviews and questionnaires to the local population. Synthesized data suggest that moving away from the coast where there is the greatest concentration of population and services, a network of primary health care facilities is able to improve the living conditions of small-dispersed communities. Based on the health service needs of populations, we have developed a methodological approach that is particularly useful in rural and remote contexts in emerging countries.

Keywords: healthcare, settlement strategy, urban health, rural

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Authors: Dasat G. S., Christopher F. Tim, J. Dun C.

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Salt marshes are known to sequester carbon dioxide from the atmosphere into the soil, but natural and anthropogenic activities could trigger the release of large quantities of centuries of buried carbon dioxide, methane and nitrous oxide (CO2, CH4 and N2O) which are the major greenhouse gases (GHGs) implicated with climate change. Therefore, this study investigated the biogeochemical activities by collecting soil samples from low, mid and high zones of the Cefni salt marsh, within the Maltreat estuary, on the island of Anglesey, north Wales, United Kingdom for a consortium of laboratory based experiments using standard operating protocols (POS) to quantify the soil organic matter contents and the rate of microbial decomposition and carbon storage at the Carbon Capture Laboratory of Bangor University Wales. Results of investigations reveals that the mid zone had 56.23% and 9.98% of soil water and soil organic matter (SOM) contents respectively higher than the low and high zones. Phenol oxidase activity (1193.53µmol dicq g-1 h-1) was highest at the low zone in comparison to the high and mid zones (867.60 and 608.74 µmol dicq g-1 h-1) respectively. Soil phenolic concentration was found to be highest in the mid zone (53.25 µg-1 g-1) when compared with those from the high (15.66 µg-1 g-1) and low (4.18 µg-1 g-1) zones respectively. Activities of hydrolase enzymes showed similar trend for the high and low zones and much lower activities in the mid zone. CO2 flux from the mid zone (6.79 ug g-1 h-1) was significantly greater than those from high (-2.29 ug g-1 h-1) and low (1.30 µg g-1 h-1) zones. Since salt marshes provide essential ecosystem services, their degradation or alteration in whatever form could compromise such ecosystem services and could convert them from net sinks into net sources with consequential effects to the global environment.

Keywords: saltmarsh, decomposition, carbon cycling, enzymes

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Authors: Ellen Bautista, Rebecca M. Flueckiger, Easter Dasmarinas, Rajeev Colaco, Fulbert Alec R. Gillego, Alma M. Lozada, Cristina Bisson

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Lactational Amenorrhea Method (LAM) for family planning is at least 98% effective at preventing pregnancy when all criteria are met; (1) the mother is exclusively or nearly exclusively breastfeeding, (2) the mother is amenorrheic (not menstruating), and (3) the baby is six months old or younger. LAM is particularly suited for women interested in family planning accepted by religious authorities. As a majority catholic nation, LAM is a common and accepted form of family planning in the Philippines. The USAID funded, LuzonHealth project conducted a prospective evaluation in Legazpi City to inform the enhancement of guidelines aimed at increasing LAM compliance and encouraging a second form of contraceptive once LAM protection expires. LAM compliance, reasons for non-compliance, family planning referral and uptake of secondary modern family planning methods were tracked over a nine-month period among 521 postpartum women. The evaluation found that at three months postpartum, 97% of women either met LAM criteria or had shifted to a non-LAM modern family planning method. In month six 87% of women no longer met LAM criteria and of these only 35% had shifted to an alternative modern family planning method. This means that at six-months postpartum 65% of the women in this evaluation were not protected against pregnancy through modern family planning methods. By postpartum month nine, 70% of the women had been referred to family planning counseling, yet of those referred only 34% reported using modern family planning methods. This evaluation clearly indicates scale-up of non-LAM modern family planning does not sufficiently complement the scale-down of LAM compliance. There is a need to increase client knowledge and understanding of LAM as a temporary family planning method with a strong focus on preparing to shift to another form of modern family planning once LAM protection expires. Additionally, there is great need to restructure the referral mechanism to ensure efficacy and quality of care.

Keywords: Philippines, family planning, lactational amenorrhea method, contraceptives

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Joyce Fernandez

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This study examined the effects of critical incident stress debriefing and other related interventions on the psychological recovery of earthquake survivors. It is a mixed experimental and qualitative study using post-test only control group design and focus group discussion. After the conduct of critical incident stress debriefing activities and other related interventions in the form of counseling and psychiatric treatment to the survivors of a 6.9 magnitude earthquake, a post-test measuring the level of psychological recovery was given to randomized participants categorized as intervention and control groups. Using the traumatic assessment and belief scale as instrument for the quantitative aspect in order to gauge recovery in the psychological need areas of safety, trust, esteem, intimacy and control, the findings are the following: Intervention group participants have relatively better adjustment along the five psychological need areas compared to the control group participants; there is no significant difference in the psychological recovery among female and male participants of the invention and control groups and; there are significant differences between intervention and control groups in the psychological need areas of self-safety, self-trust, other-trust, self-esteem, and self-intimacy. Using a guided interview for the qualitative data, the themes derived are the following. Safety: The world is an unsafe place to live because of the calamities. Trust: Trust and dependence are anchored on the family. Esteem: Participants are having confused self-worth. Intimacy: Participants are thriving on attachment with their family. Control: Participants have unaltered desire to help but feeling restricted because of personal and logistical concerns.As an outcome of the study a Psychosocial Care Program for Individuals, Families and Communities Affected by Disaster and Trauma was proposed.

Keywords: critical incident stress debriefing, earthquake survivors, psychological recovery, related interventions

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Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

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Authors: Mammar Khames, Mustapha Oumouna

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Brucellosis is one of the most common zoonoses in the world. It represents a serious threat to human health; the existence of brucellosis in Algeria dates back to the beginning of the 19th century. Its transmission to humans is through coccobacilli of the genus Brucella following direct contact with contaminated animals or indirectly through the consumption of their unpasteurized dairy products. The present investigation covers a retrospective study on human brucellosis in the district of Medea over a period from 2011 to 2021 at the level of two public health establishments. In the first place, it is at the level of the Directorate of Public Health and in the infectious department level at Medea Hospital, and at the level of the directorate of agricultural services in the third place. The results showed that during these eleven years of study, 795 cases were collected from the department of health and population, and 141 cases were collected from the infectious department of the district of Medea. A total of 56 cases of bovine brucellosis were obtained from the directorate of agricultural services of the district of Medea. Human brucellosis affects all age groups with different percentages, but the rate has been higher in the 20-44 age group, with a predominance of men. However, the geographic distribution map of the cases shows that the western part of the district was the most affected. A cohort of 141 cases was hospitalized at the infectious service level of Medea Hospital. They were 89 men and 52 women. The most common age reached is [20-44] years. The majority were of rural origin. Two serological reactions were performed for diagnosis: the buffered antigen test and Wright's serodiagnosis. Bovine brucellosis affects all age groups with different percentages, but the rate was higher in the 2-to-4-year age group, with a predominance of females. From these data, we conclude that brucellosis has a strong spread in the region studied.

Keywords: human brucellosis, serology, Medea, Algeria

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Authors: Nada Azhar

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The aim of the paper is to investigate the effect of corporate social responsibility (CSR) CSR on the National Commercial Bank (NCB) in Saudi Arabia. In order to achieve this, a case study was made of the CSR activities of this bank from the perspective of its branch managers. The NCB was chosen as it was one of the first Saudi banks to engage in CSR and currently has a wide range of CSR initiatives. A qualitative research method was used. Open-ended questionnaires were administered to eighty branch managers of the NCB, with fifty-five usable questionnaires returned and twenty managers were interviewed as part of the primary research. Data from both questionnaires and interviews were analysed using qualitative content analysis. Six themes emerged from the questionnaire findings were used to develop the interview questions. These themes are the following: Awareness of employees about CSR in the NCB; CSR activities as a type of investment; Government and media support; Increased employee loyalty in the NCB; Prestige and profit to the NCB; and View of CSR in Islam. This paper makes a theoretical contribution in that it investigates and increases understanding of the effect of CSR on the NCB in Saudi Arabia. In addition, it makes a practical contribution by making recommendations which can support the development of CSR in the NCB. A limitation of the paper is that it is a case study of only one bank. It is therefore recommended that future research could be conducted with other banks in Saudi Arabia, or indeed, with a range of other types of firm within the financial services area in Saudi Arabia. In this way, the same issues could be explored but with a greater potential generalisability of findings of CSR within the Saudi Arabian financial services industry. In addition, this paper takes a qualitative approach and it is suggested that future research be carried out using mixed methods, which could provide a greater depth of analysis.

Keywords: branch managers, corporate social responsibility, national commercial bank, Saudi Arabia

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Authors: Hilmi Rafet Yüncü

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Today Internet has very important role to promote products and services all over the world. Companies and destinations in tourism industry use Internet to sell and to promote their core products to directly potential tourists. Internet technologies have redefined the relationships between tourists, tourism companies, and travel agents. The new relationship allows for accessing and tapping tourism information and services. Internet technologies ensure new opportunities to available for the tourism industry, including travel accommodation, and tourist destination organizations. Websites are important devices to the marketing of a destination. Most people make a research about the destination before arriving via internet. Governments have a considerable role in the process of marketing tourism destinations. Governments make policies and regulations; furthermore, they help to market destinations to potential tourists. Governments have a comprehensive overview of the sector to see changes in tourism market and design better policies, programs and marketing plans. At the same time, governments support developing of alternative tourism in the country with regulations and marketing tools. The aim of this study is to analyse of an Internet website of governmental tourism portal in Turkey to determine effectiveness about gastronomy tourism. The Turkish government has established a culture portal for foreign and local tourists. The Portal provides local and general information about tourism attractions of cities and Turkey. There are 81 official cities in Turkey and all these cities are conducted to analyse to determine how effective marketing is done by Turkish Government in the manner of gastronomy tourism. A content analysis will be conducted to Internet website of the portal with food content, recipes and gastronomic feature of cities.

Keywords: culture portal, gastronomy tourism, government, Turkey

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Authors: Maria Krambia-Kapardis, Elisavet Charalambous

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Corruption has given rise to extensive discussion due to its notorious consequences. It undermines democracy, brings in inequalities and imbalances and weakens governance. With the recent financial turmoil pinpointing that corruption has played a vital part, lessons have to be learned and actions have to be taken. Regulation can be the means for doing so as it advances transparency and accountability, leaving no space for corruption to flourish. Much depends though on the culture of a state and how determined it is to mark the end of corruption.

Keywords: banking regulation, corruption, culture, European Union

Procedia PDF Downloads 510

Authors: E. Tuğba Topçu, Ebru E. Kazan, Erhan Büken

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Emergency nurses are the first health care professional to generally observe the patients, communicate patients’ family or relatives, touch the properties of patients and contact to laboratory sample of patients. Also, they are the encounter incidents related crime, people who engage in violence or suspicious injuries frequently. So, documentation of patients’ condition came to the hospital and conservation of evidence are important in the inquiry of forensic medicine. The aim of the study was to determine the knowledge level of healthcare professional working at the emergency services regarding their approaches to common forensic cases. The study was comprised of 404 healthcare professional working (nurse, emergency medicine technician, health officer) at the emergency services of 6 state hospitals, 6 training and 6 research hospitals and 3 university hospitals in Ankara. Data was collected using questionnaire form which was developed by researches in the direction of literature. Questionnaire form is comprised of two sections. The first section includes 17 questions related demographic information about health care professional and 4 questions related Turkish laws. The second section includes 43 questions to the determination of knowledge level of health care professional’s working in the emergency department, about approaches to frequently encountered forensic cases. For the data evaluation of the study; Mann Whitney U test, Bonferroni correction Kruskal Wallis H test and Chi Square tests have been used. According to study, it’s said that there is no forensic medicine expert in the foundation by 73.4% of health care professionals. Two third (66%) of participants’ in emergency department reported daily average 7 or above forensic cases applied to the emergency department and 52.1% of participants did not evaluate incidents came to the emergency department as a forensic case. Most of the participants informed 'duty of preservation of evidence' is health care professionals duty related forensic cases. In result, we determinated that knowledge level of health care professional working in the emergency department, about approaches to frequently encountered forensic cases, is not the expected level. Because we found that most of them haven't received education about forensic nursing.Postgraduates participants, educated health professional about forensic nursing, staff who applied to sources about forensic nursing and staff who evaluated emergency department cases as forensic cases have significantly higher level of knowledge. Moreover, it’s found that forensic cases diagnosis score is the highest in health officer and university graduated. Health care professional’s deficiency in knowledge about forensic cases can cause defects in operation of the forensic process because of mistakes in collecting and conserving of evidence. It is obvious that training about the approach to forensic nursing should be arranged.

Keywords: emergency nurses, forensic case, forensic nursing, level of knowledge

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Authors: Alan Silva, Carla Cipolla

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The increase of life expectancy in the world is a current challenge for governments, demanding solutions towards elderly people. In this context, service design and age-friendly design appear as an approach to create solutions which favor active aging by social inclusion and better life quality. In essence, the age-friendly design aims to include elderly people in the democratic process of creation in order to strengthen the participation and empowerment of them through intellectual, social, civic, recreational, cultural and spiritual activities. All of these activities aim to provide resilience to this segment by granting access to the reserves needed for adaptation and growth in the face of life's challenges. On that approach, the following research brings an overview of the actions related to the integration and social qualification of the elderly people, considering a suburban area of Rio de Janeiro. Based on Design Thinking presented by Brown (2009), this research has a qualitative-exploratory approach demanding certain necessities and actions, which are collected through observation and interviews about the daily life of the elderly community individuals searching for information about personal capacitation and social integration of the studied population. Subsequently, a critical analysis is done on this overview, pointing out the potentialities and limitations of these actions. At the end of the research, a well-being map of solutions classified as physical, mental and social is created, also indicating which current services are relevant and which activities can be transformed into services to that community. In conclusion, the contribution of this research is the construction of a map of solutions that provides resilience to the studied public and favors the concept of active aging in society. From this map of solutions, it is possible to discriminate what are the resources necessary for the solutions to be operationalized and their journeys with the users of the elderly segment.

Keywords: resilience, age-friendly design, service design, active aging

Procedia PDF Downloads 91

Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

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Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

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Authors: Karen V. Lee

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The background and significance of this study involves autoethnographic research about a music teacher learning how education and curriculum planning can help her overcome harmful and lasting career consequences from sexual violence. Curriculum surrounding intervention resources from education helps her cope with consequences influencing her career as music teacher. Basic methodology involves the qualitative method of research as theoretical framework where the author is drawn into a deep storied reflection about political issues surrounding teachers who need to overcome social, psychological, and health risk behaviors from violence. Sub-themes involve counseling, curriculum, adult education to ensure teachers receive social, emotional, physical, spiritual, and intervention resources that evoke visceral, emotional responses from the audience. Major findings share how stories provide helpful resources to teachers who have been victims of violence. It is hoped the research dramatizes an episodic yet incomplete story that highlights the circumstances surrounding the protagonist’s life as teacher with previous sexual violence. In conclusion, the research has a reflexive storied framework with video and music from curriculum planning that embraces harmful and lasting consequences from sexual violence. The reflexive story of the sensory experience critically seeks verisimilitude by evoking lifelike and believable feelings from others. Thus, the scholarly importance of using education and curriculum as intervention resources to accompany storied research can provide transformative aspects that can contribute to social change. Overall, the circumstance surrounding the story about sexual violence is not uncommon in society. Thus, continued education and curriculum that supports the moral mission to help teachers overcome sexual violence that socially impacts their professional lives as victims.

Keywords: education, curriculum, sexual violence, storied autoethnography

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Authors: Setareh Yousife

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Introduction: Studies suggest that Extramarital Infidelity (EMI) variants, such as sexual and emotional infidelities are increasing in marriage relationships. To our knowledge, less is known about what therapies and mental-hygiene factors can prevent more effective this behavior and address it. Spiritual and cognitive-behavioural health have proven to reduce marital conflict, Increase marital satisfaction and commitment. Objective: This study aims to discuss the effectiveness of spiritual counseling combined with Cognitive-behavioural techniques in addressing Extramarital Infidelity. Method: Descriptive, analytical, and intervention articles indexed in SID, Noormags, Scopus, Iranmedex, Web of Science and PubMed databases, and Google Scholar were searched. We focused on Studies in which Women with extramarital relationships, including heterosexual married couples-only studies and spirituality/religion and CBT as coping techniques used as EMI therapy. Finally, the full text of all eligible articles was prepared and discussed in this review. Results: 25 publications were identified, and their textual analysis facilitated through four thematic approaches: The nature of EMI in Women, the meaning of spirituality in the context of mental health and human behavior as well as psychotherapy; Spirituality integrated into Cognitive-Behavioral approach, The role of Spirituality as a deterrent to EMI. Conclusions: The integration of the findings discussed herein suggests that the application of cognitive and behavioral skills in addressing these kinds of destructive family-based relationships is inevitable. As treatments based on religion/spirituality or cognition/behavior do not seem adequately effective in dealing with EMI, the combination of these approaches may lead to higher efficacy in fewer sessions and a shorter time.

Keywords: spirituality, religion, cognitive behavioral therapy, extramarital relation, infidelity

Procedia PDF Downloads 247

Authors: Kristin Drexler

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Climate change has exacerbated food and livelihood insecurity for Mayan milpa farmers in Central America. For centuries, milpa farming has been sustainable for subsistence; however, in the last 50 years, milpas have become less reliable due to accelerating climate change, resource degradation, declining markets, poverty, and other factors. Using interviews with extension leaders and milpa farmers in Belize, this qualitative study examines the capacity for increasing climate-smart agriculture (CSA) aspects of existing traditional milpa practices, specifically no-burn mulching, soil enrichment, and the use of cover plants. Applying community capitals and socio-ecological systems frameworks, this study finds four key capitals were perceived by farmers and agriculture extension leaders as barriers for increasing CSA practices: (1) human-capacity, (2) financial, (3) infrastructure, and (4) governance-justice capitals. The key barriers include a lack of CSA technology and pest management knowledge-sharing (human-capacity), unreliable roads and utility services (infrastructure), the closure of small markets and crop-buying programs in Belize (financial), and constraints on extension services and exacerbating a sense of marginalization in Maya communities (governance-justice). Recommendations are presented for government action to reduce barriers and facilitate an increase in milpa crop productivity, promote food and livelihood security, and enable climate resilience of Mayan milpa communities in Belize.

Keywords: socio-ecological systems, community capitals, climate-smart agriculture, food security, milpa, Belize

Procedia PDF Downloads 88

Authors: Karim Abouelmehdi, Loubna Dali, Elmoutaoukkil Abdelmajid, Hoda Elsayed, Eladnani Fatiha, Benihssane Abderahim

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The security of cloud services is the concern of cloud service providers. In this paper, we will mention different classifications of cloud attacks referred by specialized organizations. Each agency has its classification of well-defined properties. The purpose is to present a high-level classification of current research in cloud computing security. This classification is organized around attack strategies and corresponding defenses.

Keywords: cloud computing, classification, risk, security

Procedia PDF Downloads 538

Authors: Sunil Sangwan, Narayan Chandra Nayak

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Over the last few decades, Indian banking system has achieved remarkable growth in its credit volume. However, one of the most disturbing facts about this growth is the uneven distribution of financial services across regions. Having witnessed limited success from all the earlier efforts towards financial inclusion targeting the rural poor and the underprivileged, provision of microfinance, of late, has emerged as a supplementary mechanism. There are two prominent modes of microfinance distribution in India namely Bank-SHG linkage (SBLP) and private Microfinance Institutions (MFIs). Ironically, such efforts also seem to have failed to achieve the desired targets as the microfinance services have witnessed skewed distribution across the states of the country. This study attempts to make a comparative analysis of the geographical skew of the SBLP and MFI in India and examine the factors influencing their regional distribution. The results indicate that microfinance services are largely concentrated in the southern region, accounting for about 50% of all microfinance clients and 49% of all microfinance loan portfolios. This is distantly followed by an eastern region where client outreach is close to 25% only. The north-eastern, northern, central, and western regions lag far behind in microfinance sectors, accounting for only 4%, 4%, 10%, and 7 % client outreach respectively. The penetration of SHGs is equally skewed, with the southern region accounting for 46% of client outreach and 70% of loan portfolios followed by an eastern region with 21% of client outreach and 13% of the loan portfolio. Contrarily, north-eastern, northern, central, western and eastern regions account for 5%, 5%, 10%, and 13% of client outreach and 3%, 3%, 7%, and 4% of loan portfolios respectively. The study examines the impact of literacy rate, rural poverty, population density, primary sector share, non-farm activities, loan default behavior and bank penetration on the microfinance penetration. The study is limited to 17 major states of the country over the period 2008-2014. The results of the GMM estimation indicate the significant positive impact of literacy rate, non-farm activities and population density on microfinance penetration across the states, while the rise in loan default seems to deter it. Rural poverty shows the significant negative impact on the spread of SBLP, while it has a positive impact on MFI penetration, hence indicating the policy of exclusion being adhered to by the formal financial system especially towards the poor. However, MFIs seem to be working as substitute mechanisms to banks to fill the gap. The findings of the study are a pointer towards enhancing financial literacy, non-farm activities, rural bank penetration and containing loan default for achieving greater microfinance prevalence.

Keywords: bank penetration, literacy rate, microfinance, primary sector share, rural non-farm activities, rural poverty

Procedia PDF Downloads 226