Search results for: public health system
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 27336

Search results for: public health system

25896 Critical Evaluation of Key Performance Indicators in Procurement Management Information System: In Case of Bangladesh

Authors: Qazi Mahdia Ghyas

Abstract:

Electronic Government Procurement (e-GP) has implemented in Bangladesh to ensure the good Governance. e-GP has transformed Bangladesh's procurement process electronically. But, to our best knowledge, there is no study to understand the key features of e-GP in Bangladesh. So, this study tries to identify the features of performance improvement after implementing an e-GP system that will help for further improvements. Data was collected from the PROMIS Overall Report (Central Procurement Technical Unit website) for the financial year from Q1 _July- Sep 2015-16 to Q4 _Apr- Jun 2021-22. This study did component factor analysis on KPIs and found nineteen KPIs that are statistically significant and represent time savings, efficiency, accountability, anti-corruption and compliance key features in procurement activities of e-GP. Based on the analysis, some practical measures have been recommended for better improvement of e-GP. This study has some limitations. Because of having multicollinearity issues, all the 42 KPIs (except 19) did not show a good fit for component factor analysis.

Keywords: public procurement, electronic government procurement, KPI, performance evaluation

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25895 Spatial Distribution and Time Series Analysis of COVID-19 Pandemic in Italy: A Geospatial Perspective

Authors: Muhammad Farhan Ul Moazzam, Tamkeen Urooj Paracha, Ghani Rahman, Byung Gul Lee, Nasir Farid, Adnan Arshad

Abstract:

The novel coronavirus pandemic disease (COVID-19) affected the whole globe, though there is a lack of clinical studies and its epidemiological features. But as per the observation, it has been seen that most of the COVID-19 infected patients show mild to moderate symptoms, and they get better without any medical assistance due to a better immune system to generate antibodies against the novel coronavirus. In this study, the active cases, serious cases, recovered cases, deaths and total confirmed cases had been analyzed using the geospatial inverse distance weightage technique (IDW) within the time span of 2nd March to 3rd June 2020. As of 3rd June, the total number of COVID-19 cases in Italy were 231,238, total deaths 33,310, serious cases 350, recovered cases 158,951, and active cases were 39,177, which has been reported by the Ministry of Health, Italy. March 2nd-June 3rd, 2020 a sum of 231,238 cases has been reported in Italy out of which 38.68% cases reported in the Lombardia region with a death rate of 18%, which is high from its national mortality rate followed by Emilia-Romagna (14.89% deaths), Piemonte (12.68% deaths), and Vento (10% deaths). As per the total cases in the region, the highest number of recoveries has been observed in Umbria (92.52%), followed by Basilicata (87%), Valle d'Aosta (86.85%), and Trento (84.54%). The COVID-19 evolution in Italy has been particularly found in the major urban area, i.e., Rome, Milan, Naples, Bologna, and Florence. Geospatial technology played a vital role in this pandemic by tracking infected patient, active cases, and recovered cases. Geospatial techniques are very important in terms of monitoring and planning to control the pandemic spread in the country.

Keywords: COVID-19, public health, geospatial analysis, IDW, Italy

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25894 Media Framing of Media Regulators in Ghana: A Content Analysis of Selected News Articles on Four Ghanaian Online Newspapers

Authors: Elizabeth Owusu Asiamah

Abstract:

The Ghanaian news media play a crucial role in shaping people's thinking patterns through the nature of the coverage they give to issues, events and personalities. Since the media do not work in a vacuum but within a broader spectrum, which is society, whatever stories they cover and the nature of frames used to narrate such stories go a long way to influence how citizens perceive issues in the country. Consequently, the National Media Commission and the National Communications Authority were instituted to monitor and direct the activities of the media to ensure professionalism that prioritizes society's interest over commercial interest. As the two media regulators go about their routine task of monitoring the operations of the media, they receive coverage from various media outlets (newspapers, radio, television and online). Some people believe that the kind of approach the regulators adopt depends on the nature of coverage the media give them in their reportage. This situation demands an investigation into how the media, regulated by these regulatory bodies, are representing the regulators in the public's eye and the issues arising from such coverage. Extant literature indicates that studies on media framing have centered on politics, environmental issues, public health issues, conflict and wars, etc. However, there appear to be no studies on media framing of media regulators, especially in the Ghanaian context. Since online newspapers have assumed more mainstream positions in the Ghanaian media and have attracted more audiences in recent times, this study investigates the nature of coverage given to media regulators by four purposively sampled online newspapers in Ghana. 96 news articles are extracted from the websites of the Daily Graphic, Ghanaian Times, Daily Guide and Chronicle newspapers within a five-year period to identify the prominence given to stories about the two media regulators and the frames used to narrate stories about them. Data collected are thematically analyzed through the lens of agenda-setting and media-framing theories. The findings of the study revealed that the two regulators were not given much coverage by way of frequency; however, much prominence was given to them in terms of enhancements such as images. The study further disclosed that most of the news articles framed the regulators as weak and incompetent, which is likely to affect how the public also views the regulators. The study concludes that since frames around the supportive nature of the regulators to issues of the media were not hammered by the online newspapers, the public will not perceive the regulators as playing their roles effectively. Thus, a need for more positive frames to be used to narrate stories about the National Media Commission and the National Communication Authority to promote a cordial relationship between the two institutions and a good image to the public.

Keywords: agenda setting, media framing, media regulators, online newspapers

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25893 Public Space, Environmental Violence and Female Vulnerability in Radwa Ashour’s Specters and Betool Khadiri’s Absent

Authors: Jihan Zakarriya

Abstract:

This paper aims at examining the concepts of gender vulnerability, militarized spaces and environmental degradation in Egyptian novelist Radwa Ashour’s Specters (1999) and Iraqi novelist Betool Khadiri’s Absent (2005). Although the socio-economic, environmental and political conditions in the 1990s- Egypt and Iraq are different, this paper argues that Ashour’s Specters and Khadiri’s Absent show the two societies as sharing a concern with the politics of public participation, individual freedom and political violence. For example, while Specters exposes the planned processes of economic-political and cultural violence towards Egyptian environment and people that undermine concepts of justice, equality and democracy, Absent shows the destructive effects of the systematic, successive waves of (international) militarized interferences and socio-economic sanctions imposed on Iraq following the Gulf War that hinder efforts of social development and kindle ethnic-religious violence and polarization in the country. This paper investigates and relates issues of gender, environmental and political violence and repression in Ashour’s Specters and Khadiri’s Absent in relation to the concepts of public space and security in the two countries. The paper argues that the selected novels articulate a particular awareness of the political-international conflicts and difficulties in the 1990s-Egypt and Iraq, with the aim both to emphasize the issue of gender as a tool of oppression and power hierarchy worldwide and to figure out new notions of public participation and change.

Keywords: gender violence, public space, environment, change

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25892 The Convergence of IoT and Machine Learning: A Survey of Real-time Stress Detection System

Authors: Shreyas Gambhirrao, Aditya Vichare, Aniket Tembhurne, Shahuraj Bhosale

Abstract:

In today's rapidly evolving environment, stress has emerged as a significant health concern across different age groups. Stress that isn't controlled, whether it comes from job responsibilities, health issues, or the never-ending news cycle, can have a negative effect on our well-being. The problem is further aggravated by the ongoing connection to technology. In this high-tech age, identifying and controlling stress is vital. In order to solve this health issue, the study focuses on three key metrics for stress detection: body temperature, heart rate, and galvanic skin response (GSR). These parameters along with the Support Vector Machine classifier assist the system to categorize stress into three groups: 1) Stressed, 2) Not stressed, and 3) Moderate stress. Proposed training model, a NodeMCU combined with particular sensors collects data in real-time and rapidly categorizes individuals based on their stress levels. Real-time stress detection is made possible by this creative combination of hardware and software.

Keywords: real time stress detection, NodeMCU, sensors, heart-rate, body temperature, galvanic skin response (GSR), support vector machine

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25891 Phytoextraction of Some Heavy Metals from Artificially Polluted soil

Authors: Kareem Kalo Qassim, Hassan A. M. Mezori

Abstract:

The bioaccumulation of heavy metals in the environment has become a matter of public interest because it persists in the soil longer than other components of the biosphere. Bioremediation has emerged as the ideal alternative environmentally friendly and ecological sound technology for removing pollutants from polluted sites. Phytoremediation is an attractive remediation technology that makes use of plants to remove contaminants from the environment. A pot experiment was conducted under lath house conditions to evaluate the ability of plants (H. Annuus, S. Bicolor, and Z. Mays) to phytoextract heavy metals from artificially polluted soils by different concentrations of Cadmium, Lead, and Copper (0, 100, 200, 200 + EDTA). The Seed germination was influenced by the presence of heavy metals and inhibition increased by increasing the heavy metals concentration. A significant difference was observed in the effect of lead and copper. Generally, the length of root, shoot, and intact plant was reduced by all the concentrations used in the experiments. The root system was affected more than the shoot system of the same plants. All heavy metals concentrations caused a reduction in the dry weight and chlorophyll content of all tested plant species; the reduction was increased by increasing the concentration of all heavy metals, especially when EDTA was added. The Bioaccumulation of heavy metals concentration of all the tested plants increased by increasing the concentration. The highest accumulation of cadmium was (81.77mg kg⁻¹), and copper was ( 65.07 mg kg⁻¹) in S. bicolor, while lead-in H. annuus was (60.74 mg kg⁻¹). The order of accumulation of heavy metals in all the tested plant species in the root system and the intact plant was as follows: H. annuus ˃ S. bicolor ˃ Z. mays and shoot system was: H. annuus ˃ Z. mays ˃ S. bicolor. The highest TF of cadmium was (0.41) in H. annuus; lead was (0.72) in Z. mays and S. bicolor, and copper was (0.44) in Z. mays. The tested plant species varied in their response to the heavy metals and the inhibition was concentration depended. In general, the roots system was more affected by heavy metals toxicity than the shoots system; the roots system accumulated more heavy metals in the roots than the shoots system. The addition of EDTA to the last concentration of heavy metals facilitated the availably and absorption of heavy metals from the polluted soil by all tested plant species.

Keywords: phytoextyraction, phytoremediation, translocation, heavy metals, soil pollution

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25890 The Effects of the “War on Drugs” on Black and Latino Youth

Authors: Aniya Everette

Abstract:

In June of 1971, President Richard Nixon made his first public declaration regarding the “War on Drugs,” deeming it America’s number one public enemy. Since then, the drug war has been a divisive topic in the US. Black and brown children have been unfairly targeted and imprisoned at alarming rates as a result of this policy, which has had a negative effect on them. Black and Latino youth have faced significant obstacles that have impacted their educational opportunities, employment prospects, and general quality of life due to harsh mandatory sentences, aggressive policing tactics, and racial profiling.

Keywords: war, drugs, crime, racial profiling

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25889 Distributed Multi-Agent Based Approach on Intelligent Transportation Network

Authors: Xiao Yihong, Yu Kexin, Burra Venkata Durga Kumar

Abstract:

With the accelerating process of urbanization, the problem of urban road congestion is becoming more and more serious. Intelligent transportation system combining distributed and artificial intelligence has become a research hotspot. As the core development direction of the intelligent transportation system, Cooperative Intelligent Transportation System (C-ITS) integrates advanced information technology and communication methods and realizes the integration of humans, vehicle, roadside infrastructure, and other elements through the multi-agent distributed system. By analyzing the system architecture and technical characteristics of C-ITS, the report proposes a distributed multi-agent C-ITS. The system consists of Roadside Sub-system, Vehicle Sub-system, and Personal Sub-system. At the same time, we explore the scalability of the C-ITS and put forward incorporating local rewards in the centralized training decentralized execution paradigm, hoping to add a scalable value decomposition method. In addition, we also suggest introducing blockchain to improve the safety of the traffic information transmission process. The system is expected to improve vehicle capacity and traffic safety.

Keywords: distributed system, artificial intelligence, multi-agent, cooperative intelligent transportation system

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25888 A Study on the Ideal and Actual Coping Responses of Public and Private College School Teachers on Job-Related Stress

Authors: Zaralyn Bernardo, Dante Boac, Annabelle Del Rosario

Abstract:

Professional individuals who are in a primary role to impart learning with the new generation are alarmingly tend to have a vast decrease in their workforce due to stress at work. Thus, the study used mixed method research design to explore the ideal and actual coping patterns of college school teachers, both private and public, using Coping Response Inventory-Adult (CRI-Adult). It was suggested that in order for coping to be effective there must be a congruence or good match between coping efforts and preferred coping style. Results basically provided the same information on sources of teacher stress. However, workload and low salary were more likely heightened, for public and private school, respectively. There is also a significant difference between the ideal and actual coping style of college school teachers. Though the public school teachers leaned towards problem-focused as their ideal way of coping, both public and private teachers are somewhat inclined to use emotion-focused coping in actual situation. Results of FGD identified the factors that contribute to the incongruence or mismatch in their preferred style of coping and actual efforts to cope. Identified factors based on thematic analysis (TA) are clustered into themes such as affectivity and rehearsal of the preferred coping responses, sensitivity to pressure impairs coping efficacy, seeking for social acceptance and approval, indefinite appraisal of perceived stress, emotional dysregulation, and impulsivity, immediate desire to terminate negative emotion and adversity. Most of the factors somewhat provide partial elucidation on the engagement of the respondents on emotion-focused coping.

Keywords: coping responses subtypes, appraisal, teacher stress, ideal and actual coping

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25887 Effective and Innovative Health Promotion Interventions for Promoting Life-Long Opportunities through Better Health and Nutrition Beginning from Early Childhood

Authors: Nadeesha Sewwandi, Dilini Shashikala, Rajarathnam Kanapathy, Shivakumaran Viyasan, Saman Kumara, Duminda Guruge

Abstract:

Introduction: Nutrition is fundamental for good health and development during the early years of life. This study describes how rural community does interventions for improving the nutrition and health of children less than 5 year ages using health promotion approach and this study was conducted with children society and mothers groups in a rural village called Welankulama in Sri Lanka. Methodology: The details got from Public Health Midwife in this village showed there were malnourished children under 5 years age. So, we discussed this problem with the children society, mothers groups and identified the determinants with them. Then they wanted to address some of the determinants that they prioritized from their discussions. ‘Evening school’ was a new place to this village to do collective feeding for small children. ‘Mobile library’ was another new concept in this village and nutrition books, evidence collection were there to read for villagers. Mothers marked the foods given to their kids in a book called ‘Nutrition book’. And also mothers tend to mark the level of eating foods to motivate their children in a ‘Hapana calendar’. Results: In terms of results, malnourished children under 5 years age got reduced and the number of children having illnesses got reduced. Marking nutrition book and ‘Hapana calendar’ were become as trend among mothers. Apart from the above, there was good improvement of physical, social and emotional wellbeing of children. Children who received early stimulation with nutrition supplements had better outcomes than children who only received nutrition supplements, thereby amplifying the impact of nutrition. Conclusion: Health promotion interventions are helped to change nutritional behaviors of early childhood in rural community and it makes children healthier and better able to learn.

Keywords: early childhood, nutrition, determinants, health promotion process

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25886 Key Issues in Transfer Stage of BOT Project: Experience from China

Authors: Wang Liguang, Zhang Xueqing

Abstract:

The build-operate-transfer (BOT) project delivery system has provided effective routes to mobilize private sector funds, innovative technologies, management skills and operational efficiencies for public infrastructure development and have been widely used in China during the last 20 years. Many BOT projects in China will be smoothly transferred to the government soon and the transfer stage, which is considered as the last stage, must be studied carefully and handled well to achieve the overall success of BOT projects. There will be many issues faced by both the public sector and private sector in the transfer stage of BOT projects, including project post-assessment, technology and documents transfer, personal training and staff transition, etc. and sometimes additional legislation is needed for future operation and management of facilities. However, most previous studies focused on the bidding, financing, and building and operation stages instead of transfer stage. This research identifies nine key issues in the transfer stage of BOT projects through a comprehensive study on three cases in China, and the expert interview and expert discussion meetings are held to validate the key issues and give detail analysis. A proposed framework of transfer management is prepared based on the experiences derived and lessons drawn from the case studies and expert interview and discussions, which is expected to improve the transfer management of BOT projects in practice.

Keywords: BOT project, key issues, transfer management, transfer stage

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25885 The Effect of Law on Politics

Authors: Boukrida Rafiq

Abstract:

Democracy is based on the notion that all citizens have the right to participate in the managing of political affairs and that every citizens input is of equal importance. This basic assumption clearly places emphasis on public participation in maintaining a stable democracy. The level of public participation, however is highly contested with many theorists arguing that too much public participation would overwhelm and ultimately cripple democratic systems. On the other hand, others who favor high levels of participation argue that more citizen involvement leads to greater representation. Regardless of these disagreements over the utopian level of participation, there is widespread agreement amongst scholars that, at the very least, some participation is necessary to maintain democratic systems. The ways in which citizens participate vary greatly and depending on the method used, influence political decision making at varying levels. The method of political participation is a key in controlling public influence over political affairs and therefore is also an integral part of maintaining democracy, whether it be "thin" (low levels of participation) or "Robust" (high levels of participation). High levels of participation or "robust" democracy are argued by some theorists to enhance democracy through providing the opportunity for more issues to be represented during decision making. The notion of widespread participation was first advanced by classical theorists.

Keywords: assumption clearly places emphasis, ultimately cripple, influence political decision making at varying, classical theorists

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25884 Planning the Journey of Unifying Medical Record Numbers in Five Facilities and the Expected Challenges: Case Study in Saudi Arabia

Authors: N. Al Khashan, H. Al Shammari, W. Al Bahli

Abstract:

Patients who are eligible to receive treatment at the National Guard Health Affairs (NGHA), Saudi Arabia will typically have four medical record numbers (MRN), one in each of the geographical areas. More hospitals and primary healthcare facilities in other geographical areas will launch soon which means more MRNs. When patients own four MRNs, this will cause major drawbacks in patients’ quality of care such as creating new medical files in different regions for relocated patients and using referral system among regions. Consequently, the access to a patient’s medical record from other regions and the interoperability of health information between the four hospitals’ information system would be challenging. Thus, there is a need to unify medical records among these five facilities. As part of the effort to increase the quality of care, a new Hospital Information Systems (HIS) was implemented in all NGHA facilities by the end of 2016. NGHA’s plan is put to be aligned with the Saudi Arabian national transformation program 2020; whereby 70% citizens and residents of Saudi Arabia would have a unified medical record number that enables transactions between multiple Electronic Medical Records (EMRs) vendors. The aim of the study is to explore the plan, the challenges and barriers of unifying the 4 MRNs into one Enterprise Patient Identifier (EPI) in NGHA hospitals by December 2018. A descriptive study methodology was used. A journey map and a project plan are created to be followed by the project team to ensure a smooth implementation of the EPI. It includes the following: 1) Approved project charter, 2) Project management plan, 3) Change management plan, 4) Project milestone dates. Currently, the HIS is using the regional MRN. Therefore, the HIS and all integrated health care systems in all regions will need modification to move from MRN to EPI without interfering with patient care. For now, the NGHA have successfully implemented an EPI connected with the 4 MRNs that work in the back end in the systems’ database.

Keywords: consumer health, health informatics, hospital information system, universal medical record number

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25883 Health Hazards of Performance Enhancing Drugs

Authors: Austin Oduor Otieno

Abstract:

There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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25882 Internet of Health Things as a Win-Win Solution for Mitigating the Paradigm Shift inside Senior Patient-Physician Shared Health Management

Authors: Marilena Ianculescu, Adriana Alexandru

Abstract:

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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25881 The Metaproteomic Analysis of HIV Uninfected Exposed Infants’ Gut Microbiome to Help Understand Their Poor Health Statuses in An African Cohort

Authors: Tara Miller, Tariq Ganief, Jonathan Blackburn

Abstract:

Millions of babies are still born to HIV-infected mothers each year despite the ramped-up HAART use. However, these infants are HIV uninfected but exposed, which is now a growing population that has weakened immune systems and poorer outcomes. Due to HIV exposure and possible ARV exposure during pregnancy and breastfeeding, these infants are believed to have altered immune responses and microbiomes when compared to their healthy counterparts. The gut microbiome roles an important role in infant development, specifically in the immune system. Research has shown these HIV-exposed, uninfected infants have weaker immune responses to their neonate vaccines, and in developing countries, this leaves them vulnerable to opportunistic disease. By gaining a deeper understanding of the gut microbiome and the products of the microbes via metaproteomic analysis, we can hopefully understand and improve the immune system and health of these infants. To investigate the metaproteome of the infants’ guts, mass spectrometry will be used, followed by data analysis using DIA-NN. The hypothesized results are that the HIV-exposed, uninfected infants have an altered microbiome compared to their healthy counterparts. Additionally, the differences found are hypothesized to be involved with inflammation which would contribute to the poor health of the infants.

Keywords: HIV, mass spectrometry, metaproteomics, microbiome

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25880 Artificial Intelligence in Bioscience: The Next Frontier

Authors: Parthiban Srinivasan

Abstract:

With recent advances in computational power and access to enough data in biosciences, artificial intelligence methods are increasingly being used in drug discovery research. These methods are essentially a series of advanced statistics based exercises that review the past to indicate the likely future. Our goal is to develop a model that accurately predicts biological activity and toxicity parameters for novel compounds. We have compiled a robust library of over 150,000 chemical compounds with different pharmacological properties from literature and public domain databases. The compounds are stored in simplified molecular-input line-entry system (SMILES), a commonly used text encoding for organic molecules. We utilize an automated process to generate an array of numerical descriptors (features) for each molecule. Redundant and irrelevant descriptors are eliminated iteratively. Our prediction engine is based on a portfolio of machine learning algorithms. We found Random Forest algorithm to be a better choice for this analysis. We captured non-linear relationship in the data and formed a prediction model with reasonable accuracy by averaging across a large number of randomized decision trees. Our next step is to apply deep neural network (DNN) algorithm to predict the biological activity and toxicity properties. We expect the DNN algorithm to give better results and improve the accuracy of the prediction. This presentation will review all these prominent machine learning and deep learning methods, our implementation protocols and discuss these techniques for their usefulness in biomedical and health informatics.

Keywords: deep learning, drug discovery, health informatics, machine learning, toxicity prediction

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25879 Towards A New Maturity Model for Information System

Authors: Ossama Matrane

Abstract:

Information System has become a strategic lever for enterprises. It contributes effectively to align business processes on strategies of enterprises. It is regarded as an increase in productivity and effectiveness. So, many organizations are currently involved in implementing sustainable Information System. And, a large number of studies have been conducted the last decade in order to define the success factors of information system. Thus, many studies on maturity model have been carried out. Some of this study is referred to the maturity model of Information System. In this article, we report on development of maturity models specifically designed for information system. This model is built based on three components derived from Maturity Model for Information Security Management, OPM3 for Project Management Maturity Model and processes of COBIT for IT governance. Thus, our proposed model defines three maturity stages for corporate a strong Information System to support objectives of organizations. It provides a very practical structure with which to assess and improve Information System Implementation.

Keywords: information system, maturity models, information security management, OPM3, IT governance

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25878 Patient Understanding of Health Information: Implications for Organizational Health Literacy in Germany

Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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25877 Collaborative Governance in Dutch Flood Risk Management: An Historical Analysis

Authors: Emma Avoyan

Abstract:

The safety standards for flood protection in the Netherlands have been revised recently. It is expected that all major flood-protection structures will have to be reinforced to meet the new standards. The Dutch Flood Protection Programme aims at accomplishing this task through innovative integrated projects such as construction of multi-functional flood defenses. In these projects, flood safety purposes will be combined with spatial planning, nature development, emergency management or other sectoral objectives. Therefore, implementation of dike reinforcement projects requires early involvement and collaboration between public and private sectors, different governmental actors and agencies. The development and implementation of such integrated projects has been an issue in Dutch flood risk management since long. Therefore, this article analyses how cross-sector collaboration within flood risk governance in the Netherlands has evolved over time, and how this development can be explained. The integrative framework for collaborative governance is applied as an analytical tool to map external factors framing possibilities as well as constraints for cross-sector collaboration in Dutch flood risk domain. Supported by an extensive document and literature analysis, the paper offers insights on how the system context and different drivers changing over time either promoted or hindered cross-sector collaboration between flood protection sector, urban development, nature conservation or any other sector involved in flood risk governance. The system context refers to the multi-layered and interrelated suite of conditions that influence the formation and performance of complex governance systems, such as collaborative governance regimes, whereas the drivers initiate and enable the overall process of collaboration. In addition, by applying a method of process tracing we identify a causal and chronological chain of events shaping cross-sectoral interaction in Dutch flood risk management. Our results indicate that in order to evaluate the performance of complex governance systems, it is important to firstly study the system context that shapes it. Clear understanding of the system conditions and drivers for collaboration gives insight into the possibilities of and constraints for effective performance of complex governance systems. The performance of the governance system is affected by the system conditions, while at the same time the governance system can also change the system conditions. Our results show that the sequence of changes within the system conditions and drivers over time affect how cross-sector interaction in Dutch flood risk governance system happens now. Moreover, we have traced the potential of this governance system to shape and change the system context.

Keywords: collaborative governance, cross-sector interaction, flood risk management, the Netherlands

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25876 Elementary Education Outcome Efficiency in Indian States

Authors: Jyotsna Rosario, K. R. Shanmugam

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Since elementary education is a merit good, considerable public resources are allocated to universalise it. However, elementary education outcomes vary across the Indian States. Evidences indicate that while some states are lagging in elementary education outcome primarily due to lack of resources and poor schooling infrastructure, others are lagging despite resource abundance and well-developed schooling infrastructure. Addressing the issue of efficiency, the study employs Stochastic Frontier Analysis for panel data of 27 Indian states from 2012-13 to 2017-18 to estimate the technical efficiency of State governments in generating enrolment. The mean efficiency of states was estimated to be 58%. Punjab, Meghalaya, and West Bengal were found to be the most efficient states. Whereas Jammu and Kashmir, Nagaland, Madhya Pradesh, and Odisha are one of the most inefficient states. This study emphasizes the efficient utilisation of public resources and helps in the identification of best practices.

Keywords: technical efficiency, public expenditure, elementary education outcome, stochastic frontier analysis

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25875 The Silent Tuberculosis: A Case Study to Highlight Awareness of a Global Health Disease and Difficulties in Diagnosis

Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

Abstract:

Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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25874 The Practice of Integrating Sustainable Elements into the Housing Industry in Malaysia

Authors: Wong Kean Hin, Kumarason A. L. V. Rasiah

Abstract:

A building provides shelter and protection for an individual to live, work, sleep, procreate or engage in leisurely activities comfortably. Currently, a very popular term related to building was often stated by many parties, which is sustainability. A sustainable building is environmental friendly, healthy to the occupants, as well as efficient in electricity and water. This particular research is important to any parties that are involved in the construction industry. This research will provide the awareness and acceptability of Malaysian public towards sustainable residential building. It will also provide the developers about which sustainable features that the people usually want so that the developers can build a sustainable housing that suits the needs of people. Then, propose solutions to solve the difficulties of implementing sustainability in Malaysian housing industry. Qualitative and quantitative research methods were used throughout the process of data collection. The quantitative research method was distribution of questionnaires to 100 Malaysian public and 50 individuals that worked in developer companies. Then, the qualitative method was an interview session with experienced personnel in Malaysian construction industry. From the data collected, there is increasingly Malaysian public and developers are aware about the existence of sustainability. Moreover, the public is willing to invest on sustainable residential building with minimum additional cost. However, there is a mismatch in between sustainable elements provided by developers and the public needs. Some recommendations to improve the progression of sustainability had been proposed in this study, which include laws enforcement, cooperation between the both government sector with private sector, and private sector with private sector, and learn from modern countries. These information will be helpful and useful for the future of sustainability development in Malaysia.

Keywords: acceptability, awareness, Malaysian housing industry, sustainable elements, green building index

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25873 Gendered Economic, Social, and Health Effects of the Mobile Health and Nutritional Services of the International Medical Corps (IMC) in Vulnerable Areas of Ethiopia

Authors: Abdela Zeinu Yasin

Abstract:

The current research aimed to assess the status of IMC in providing treatment for malnourished children and programs in water, sanitation, and hygiene (WASH), food and livelihood security, and comprehensive healthcare through Mobile health and nutrition programs during the last 5 years period. We have conducted 60 in-depth interviews with women during the period from conception to a child’s birthday, health facility staff, and female community health volunteers (FCHVs), as well as 12 focus group discussions with health facility staff and other household decision-makers. We employed thematic analysis using framework matrices and analytical memorandums. The study revealed that 78% of the respondents, of whom 97% were women, have benefited from the selected vulnerable areas. The use of the clear water and sanitization program has reached the 81% of selected households. The use of a modern baby delivery system among the respondent has been 68% of the women and health facilities among the decision-makers/focal person. More than 8 in 10 participants (84%) could read and understand the health facility instructions, and the majority (82%) of women, health facility staff, and male decision-makers can also read and write bulletins and instructions. We found that decision-maker women preferred participative education, whereas health facilities and the IMC desired educational and motivational bulletins. A Mobile Health and Nutrition program intervention by the IMC is acceptable in the conditions of the Ethiopian community and has the potential to improve community health and nutrition service utilization, particularly by providing clean water and sanitization; women’s birth control, and health improvement in the vulnerable regions of the country. The current research findings shall contribute to text IMC Mobile Health and Nutritional intervention design in under-resourced settings.

Keywords: clean water, health and nutrition services, hygiene, IMC, mobile health, sanitation

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25872 Empowering the Sustainability of Community Health: An Application of the Theory of Maqasid Al-Shariah

Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

Abstract:

Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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25871 The Influence of E-Health Education on Professional Practice: A Qualitative Study

Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

Abstract:

Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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25870 Use of Triclosan-Coated Sutures Led to Cost Saving in Public and Private Setting in India across Five Surgical Categories: An Economical Model Assessment

Authors: Anish Desai, Reshmi Pillai, Nilesh Mahajan, Hitesh Chopra, Vishal Mahajan, Ajay Grover, Ashish Kohli

Abstract:

Surgical Site Infection (SSI) is hospital acquired infection of growing concern. This study presents the efficacy and cost-effectiveness of triclosan-coated suture, in reducing the burden of SSI in India. Methodology: A systematic literature search was conducted for economic burden (1998-2018) of SSI and efficacy of triclosan-coated sutures (TCS) vs. non-coated sutures (NCS) (2000-2018). PubMed Medline and EMBASE indexed articles were searched using Mesh terms or Emtree. Decision tree analysis was used to calculate, the cost difference between TCS and NCS at private and public hospitals, respectively for 7 surgical procedures. Results: The SSI range from low to high for Caesarean section (C-section), Laparoscopic hysterectomy (L-hysterectomy), Open Hernia (O-Hernia), Laparoscopic Cholecystectomy (L-Cholecystectomy), Coronary artery bypass graft (CABG), Total knee replacement (TKR), and Mastectomy were (3.77 to 24.2%), (2.28 to 11.7%), (1.75 to 60%), (1.71 to 25.58%), (1.6 to 18.86%), (1.74 to 12.5%), and (5.56 to 25%), respectively. The incremental cost (%) of TCS ranged 0.1%-0.01% in private and from 0.9%-0.09% at public hospitals across all surgical procedures. Cost savings at median efficacy & SSI risk was 6.52%, 5.07 %, 11.39%, 9.63%, 3.62%, 2.71%, 9.41% for C-section, L-hysterectomy, O-Hernia, L-Cholecystectomy, CABG, TKR, and Mastectomy in private and 8.79%, 4.99%, 12.67%, 10.58%, 3.32%, 2.35%, 11.83% in public hospital, respectively. Efficacy of TCS and SSI incidence in a particular surgical procedure were important determinants of cost savings using one-way sensitivity analysis. Conclusion: TCS suture led to cost savings across all 7 surgeries in both private and public hospitals in India.

Keywords: cost Savings, non-coated sutures, surgical site infection, triclosan-coated sutures

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25869 Spanish University Governance Reporting

Authors: Agustin Baidez, Yolanda Ramirez

Abstract:

There is currently a growing interest in the improvement of university governance and the disclosure of information on governance processes as an essential part of the transparency and accountability of universities. This paper aims to examine the extent and quality of voluntary corporate governance disclosure by public Spanish universities on their websites in relation to information need of stakeholders. The results of this study show that Spanish university stakeholders attach great importance to the disclosure of specific information on aspects of corporate governance. However, the quality of disclosed information on university governance in public Spanish universities websites is in the middle level. In order to satisfy the information needs of university stakeholders, Spanish universities can be recommended to focus on reporting higher quality information on university autonomy in financing, autonomy in management, autonomy regarding student selection and assessment, degree of consanguinity of executive directors, report on assigned public funding based on results, and management reports.

Keywords: university, governance, transparency, stakeholders

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25868 Composite Kernels for Public Emotion Recognition from Twitter

Authors: Chien-Hung Chen, Yan-Chun Hsing, Yung-Chun Chang

Abstract:

The Internet has grown into a powerful medium for information dispersion and social interaction that leads to a rapid growth of social media which allows users to easily post their emotions and perspectives regarding certain topics online. Our research aims at using natural language processing and text mining techniques to explore the public emotions expressed on Twitter by analyzing the sentiment behind tweets. In this paper, we propose a composite kernel method that integrates tree kernel with the linear kernel to simultaneously exploit both the tree representation and the distributed emotion keyword representation to analyze the syntactic and content information in tweets. The experiment results demonstrate that our method can effectively detect public emotion of tweets while outperforming the other compared methods.

Keywords: emotion recognition, natural language processing, composite kernel, sentiment analysis, text mining

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25867 A Wireless Feedback Control System as a Base of Bio-Inspired Structure System to Mitigate Vibration in Structures

Authors: Gwanghee Heo, Geonhyeok Bang, Chunggil Kim, Chinok Lee

Abstract:

This paper attempts to develop a wireless feedback control system as a primary step eventually toward a bio-inspired structure system where inanimate structure behaves like a life form autonomously. It is a standalone wireless control system which is supposed to measure externally caused structural responses, analyze structural state from acquired data, and take its own action on the basis of the analysis with an embedded logic. For an experimental examination of its effectiveness, we applied it on a model of two-span bridge and performed a wireless control test. Experimental tests have been conducted for comparison on both the wireless and the wired system under the conditions of Un-control, Passive-off, Passive-on, and Lyapunov control algorithm. By proving the congruence of the test result of the wireless feedback control system with the wired control system, its control performance was proven to be effective. Besides, it was found to be economical in energy consumption and also autonomous by means of a command algorithm embedded into it, which proves its basic capacity as a bio-inspired system.

Keywords: structural vibration control, wireless system, MR damper, feedback control, embedded system

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