Search results for: rural health care

Authors: Marco Magasic

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This article examines how a local newspaper’s closure impacts the way everyday people in a rural Australian town are informed about and engage with political affairs. It draws on a two-month focused ethnographic study in the outback town of Lighting Ridge, New South Wales and explores people’s media-related practices following the closure of the towns’ only newspaper, The Ridge News, in 2015. While social media is considered to have partly filled the news void, there is an increasingly fragmented and less vibrant local public sphere that has led to growing complacency among individuals about political affairs. Local residents highlight a dearth of reliable, credible information and lament the loss of the newspaper and its role in community advocacy and fostering people’s engagement with political institutions, especially local government.

Keywords: public sphere, political participation, local news, democratic deficit

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Authors: Kara Gianina D. Rosas, Jade Emily L. Tong

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This study assesses the vulnerability of households to food price shocks. Using the Philippines as a case study, the researchers aim to understand how such shocks can cause food insecurity in different types of households. This paper measures the impact of actual food price changes during the food crisis of 2006-2009 on poverty in relation to their spatial location. Households are classified as rural or urban and agricultural or non-agricultural. By treating food prices and consumption patterns as heterogeneous, this study differs from conventional poverty analysis as actual prices are used. Merging the Family, Income and Expenditure Survey (FIES) with the Consumer Price Index dataset (CPI), the researchers were able to determine the effects on poverty measures, specifically, headcount index, poverty gap, and poverty severity. The study finds that, without other interventions, food inflation would lead to a significant increase in the number of households that fall below the poverty threshold, except for households whose income is derived from agricultural activities. It also finds that much of the inflation during these years was fueled by the rise in staple food prices. Essentially, this paper aims to broaden the economic perspective of policymakers with regard to the heterogeneity of impacts of inflation through analyzing the deeper microeconomic levels of different subgroups. In hopes of finding a solution to lessen the inequality gap of poverty between the rural and urban poor, this paper aims to aid policymakers in creating projects targeted towards food insecurity.

Keywords: poverty, food inflation, agricultural households, non-agricultural households, net consumption ratio, urban poor, rural poor, head count index, poverty gap, poverty severity

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Authors: Sankhanil Das, Arunava Dasgupta, Keya Mitra

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This paper investigates the relationship between natural ecological systems and modern urban morphology. Over years, ecological conditions represented by natural resources such as natural landforms, systems of water, urban geography and land covers have been a significant driving factor of how settlements have formed, expanded and functioned. These have played a pivotal role in formation of the community character and the cultural identity of the urban spaces, and have steered cultural behavior within these settings. Such cultural behaviors have been instrumental in transforming mere spaces to places with meaning and symbolism. The natural process of city formation is principally founded upon the idea of balance and harmony, mostly in a subconscious manner. Reimaging such processes of natural evolution, this paper systematically builds a development model that generates a balance between environment and development, with specific focus on the Urban-Rural fringe areas in the Temple Town of Puri, in Eastern India. Puri represents a unique cross section of ecological landscape, cultural practices and religious symbolism with a very rich history and a vibrant heritage. While the city centre gets more and more crowded by tourists and pilgrims to accommodate related businesses, the original residents of Puri relocate to move towards the urban peripheral areas for better living conditions, gradually converting agricultural lands into non agricultural uses. This rapid spread into the rural hinterland is devoid of any connection with the rich cultural identity of Puri. These past four decades of ‘development’ has been at the cost of 810 Hectares of ecological Lake systems in the region. Invaluable ecological resources at urban rural edges are often viewed as hindrances to development and conceptualized as taking away from the image of the city. This paper attempts to understand the language of development over years on existing natural resources through topo-analysis and proposes a sustainable approach of development using different planning tools, with ecological resources as the pivotal factor of development.

Keywords: livability, sustainable development, urbanization, urban-rural edge

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Authors: Sylvie Ekanga Lumumba

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Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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Authors: Abeer M. Orabi

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Midwives are being seen as a key factor in returning birth care to a normal physiologic process that is woman-centered. On the other hand, more needs to be done to increase access for every woman to professional midwifery care. Because of the nature of the midwifery specialty, the magnitude of the effect that can result from a lack of knowledge if midwives make a mistake in their care has the potential to affect a large number of the birthing population. So, the development, running, and management of midwifery educational programs should follow international standards and come after a thorough community needs assessment. At the same time, the number of accredited midwifery educational programs needs to be increased so that larger numbers of midwives will be educated and qualified, as well as access to skilled midwifery care will be increased. Indeed, the selection of promising midwives is important for the successful completion of an educational program, achievement of the program goals, and retention of graduates in the field. Further, the number of schooled midwives in midwifery education programs, their background, and their experience constitute some concerns in the higher education industry. Basically, preceptors and clinical sites are major contributors to the midwifery education process, as educational programs rely on them to provide clinical practice opportunities. In this regard, the selection of clinical training sites should be based on certain criteria to ensure their readiness for the intended training experiences. After that, communication, collaboration, and liaison between teaching faculty and field staff should be maintained. However, the shortage of clinical preceptors and the massive reduction in the number of practicing midwives, in addition to unmanageable workloads, act as significant barriers to midwifery education. Moreover, the medicalized approach inherent in the hospital setting makes it difficult to practice the midwifery model of care, such as watchful waiting, non-interference in normal processes, and judicious use of interventions. Furthermore, creating a motivating study environment is crucial for avoiding unnecessary withdrawal and retention in any educational program. It is well understood that research is an essential component of any profession for achieving its optimal goal and providing a foundation and evidence for its practices, and midwifery is no exception. Midwives have been playing an important role in generating their own research. However, the selection of novel, researchable, and sustainable topics considering community health needs is also a challenge. In conclusion, ongoing education and research are the lifeblood of the midwifery profession to offer a highly competent and qualified workforce. However, many challenges are being faced, and barriers are hindering their improvement.

Keywords: barriers, challenges, midwifery education, educational programs

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Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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For infant caregivers, choosing an infant formula for their child can be a difficult task in an already stressful environment of caring for a newborn. There exist several channels that influence purchasing decision of infant formula such as, friends and family and their experiences, health care professionals, social media influencers, as well as standard media marketing. This study sought to identify the key channels by which caregivers obtain information regarding infant formula and help them make their purchasing decision. A digital survey was issued for 90 days in the US (n=121) and 30 days in Mexico (n=88) targeting respondents with children ≤4 years of age. Respondents were asked two key questions regarding the influences on their purchasing decisions: 1) “When choosing a formula brand, what do you do to help you make your decision?”, and 2) “When choosing a formula brand, what is most important to you?”. A list of potential answers was provided for each question and respondents were asked to select all that apply to them. Lastly, respondents were provided a 5-point Likert scale and asked to respond to the statement 3) “I am more likely to buy a particular formula brand if my pediatrician recommends it to me”. For question 1, in the US and Mexico, 76% and 95% of respondents respectively, selected “I ask my pediatrician” which represented the top selection. For question 2, 52% and 45% of respondents respectively, selected “On package “Pediatrician Recommended” claim…” which also represented the top selection. For statement 3, 82% and 89% of respondents respectively, stated that they either “somewhat agree” or “strongly agree” with the statement. For infant caregivers, the pediatrician is a very important channel of influence when it comes to purchasing decision of infant formula. Caregivers clearly see the pediatrician as the arbiter of their child’s nutrition and seek their recommendations for infant formula use. For infant formula manufacturers, it is important that they see the pediatrician as the gatekeeper to this market, and they put resources into medical marketing communication to this health care professional group to ensure success.

Keywords: infant formula, pediatrician, purchasing driver, caregiver

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Authors: Melvin Ouma

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Language is one of the most crucial tools in medical interaction. Its importance is as great today as it was many decades ago. Difficulty in openly discussing certain diseases and body parts is one of the challenges in language use in medical contexts. Guided by H. P. Grice’s Cooperative Principle, this paper explores the flouting of the cooperative principles in Swahili speaking medical setting. The paper examines how men flout the maxims using the Swahili language when reporting reproductive health problems to the doctor. The data used was gathered from a qualitative study carried out in a reproductive health clinic in a public facility in Nakuru County, Kenya. All the research protocols were observed by acquiring all the research permits. Respondents' ethical considerations of consent, privacy, and confidentiality were observed. The respondents recruited were men who visited the reproductive health clinic and voluntarily agreed to participate in the study without coercion or compensation. Participant observation was the key data collection tool, with the doctor and patient conversation digitally recorded. The researcher was allowed into the clinic in a socially acceptable role. Male patients flouted the maxims of quantity, quality, relation, and manner in order to describe their reproductive health problems without embarrassment using the Swahili language. The flouting was done through the discursive strategies of narration and circumlocution. Flouting of the maxims was acceptable to the doctor and patient due to the fact that sexual intercourse and private body parts are taboo topics and uncomfortable to talk about. The quality of health care received by the patient depended on the doctor’s patience when all the maxims were flouted. In the reproductive health clinic, flouting of maxims hindered communication and, at the same time, enhanced communication between the doctor and patient.

Keywords: cooperative principle, doctor, men, reproductive health

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Authors: Swanand Pathak, Kiran R. Giri, Reena R. Giri, Kamlesh Palandurkar, Sangita Totade, Rajesh Jha, S. S. Patel

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Background: Population burden, illiteracy, availability of few doctors for larger group of population leads to many unanswered questions left in a patient’s mind. Incomplete information results into noncompliance, therapeutic failure, and adverse drug reactions (ADR). It is very important to establish a system which will provide noncommercial, independent, unbiased source of medicine information. Medicines Info OPD is a concept and step towards safe and appropriate use of medicines. Objective: (1) to assess the present status of knowledge about the medicines in the patients and its correlation with education; (2) to assess the medicine information dispensing modalities, their use and sufficiency from the patients view point; (3) to assess the overall need for Medicines Information OPD in present scenario. Materials and Methods: A pre-validated questionnaire based study was conducted amongst 500 patients of tertiary health care hospital. The questionnaire consisted of specific questions regarding understanding of prescription, knowledge about adverse drug reaction, view about self-medication and opinion regarding the need of Medicines Info OPD. Results: Significantly large proportion of patients opined that doctors do not have sufficient time in current Indian healthcare to explain the prescription and they are not aware of adverse drug reactions, expiry date or use the package inserts etc. Conclusion: Clinically relevant, up to date, user specific, independent, objective and unbiased Medicines Info OPD is essential for appropriate drug use and can help in a big way to common public to address many problems faced by them.

Keywords: information, prescription, unbiased, clinically relevant

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Authors: Sujit Kumar

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Historicity of inter-caste relations can be traced in the early stages of evolution of rural community in the Indian society. These have witnessed vicissitudes during long drawn interactions between caste groups. Inter-caste relations evolved in a more organized form in the guise of Jajmani system. This is a system of permanent and hereditary inter-caste relations and gives a kaleidoscopic view of socio-economic relations among various caste groupings. Universality of its prevalence in rural India for centuries is well recognized and documented. But it has been undergoing metamorphic change in some regions and changing at a slower pace in the others during post-independence period. An empirical study was conducted with the objectives to know whether Jajmani system is in vogue in the rural areas and type and intensity of socio-economic ties among different caste categories and to find out the change in inter-caste relations, if any owing to industrialization and modernization. Information was elicited from 225 respondents using interview schedule designed for this purpose. It is discernible that in majority of cases, inter-caste social relations which find better expression on the occasions like marriage, death, birth and festivals etc. among Brahmins and lower castes vis-à-vis other caste categories have grown weak. The data further unearth that economic relations as maintained on the occasions of marriage, sacred thread ceremony, mundan sacrament, birthday, death, yajna, katha, routine hair cut, manufacture and repair of various iron, earthen, wooden and leather articles between members of higher castes (general category) and lower castes (scheduled castes) are moderate but weak in case of Other Backward Classes vis-à-vis all other caste categories. Overwhelming majority of informants believe that decline in hereditary occupations, depreciation of old products and services and their availability from the market being made by industry are main reasons in descending order for change in inter caste relations. Modernization, westernization, industrialization, transportation and communications, growing materialism and consumerism together have brought change in relations among caste groups affecting about a billion population inhabiting rural India.

Keywords: inter-caste, Jajmani, sacrament, Yajna

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Authors: Niranjan Devkota , Ram Kumar Phuya, Durga Lal Shreshta

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This paper estimates cost and benefit of adoption of climate change adaptation options available to the rural rice farmers of Nepal. Adoption of adaptation strategies, intensity of use of adaptation options, identification of labor and non-labor cost and finally per unit cost and benefit analysis of climate change adaptation were made. Multi-stage sampling technique was used to source respondents for the study and used structured questionnaire techniques to collect data from 773 households from seven districts; 3 from Terai and 4 from Hilly region of Nepal. The result revealed that there are 13 major adaptation options rice farmers practice in order to protect themselves from climatic risk. Among the given adaptation options, the first three popular adaptation options practiced by rice farmers are (i) increasing use of chemical fertilizer (60.93%) (ii) use of climate smart verities (49.29%) and (iii) change in nursery date (32.08%). Adaptation cost is obvious, based on that, the first three costly adaptation options are the alternative irrigation practice which incurred average cost of US $69.95 (US$ 1 = 102.84 Nepalese Rupees) followed by a denser plantation of local seeds ($ 20.69) and using climate smart varieties ($ 18.06). 88% farmers practiced more than one adaptation strategies on the same farm with the aim of reducing the effect of extreme climatic conditions. Total cost and revenue revealed that per unit total cost ranges from $28.34 to $32.79 whereas per unit total revenue ranges $33.4 to $49.02. Surprisingly, it is observed that farmers who do not adopt any adaptation options are able to receive highest income from per unit production. As Net Present Value (NPV) is positive and Benefit Cost Ration (BCR) is greater than one for every adaptation options that indicates the available adaptation options are profitable to the rice farmers.

Keywords: climate change, adaptation options, cost benefit analysis, rural rice farmers, Nepal

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Authors: Nasiru Medugu Idris

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This research is aimed at assessing the vulnerability of climate change to rural communities (farmers, herdsmen and fishermen) in Nigeria with the view to study the underlying causes and degree of vulnerability to climate change and examine the conflict between farmers and herdsmen as a result of climate change. This research employed the use of quantitative and qualitative means of data gathering techniques as well as physical observations. Six states (Kebbi, Adamawa, Nasarawa, Osun, Ebonyi, and Akwa Ibom) have been selected on the ground that they are key food production areas in the country and are therefore essential to continual food security in the country. So also, they also double as fishing communities in order to aid the comprehensive study of all the effects on climate on farmers and fishermen alike. Community focus group discussions were carried out in the various states for an interactive session and also to have firsthand information on their level of awareness on climate change. Climate data from the Nigerian Meteorological Agency over the past decade were collected for the purpose of analyzing trends in climate. The study observed that the level of vulnerability of rural dwellers most especially farmers, herdsmen and fishermen to climate change is very high due to their socioeconomic, ethnic and historical perspective of their trend. The study, therefore, recommends that urgent step needs to be put in place to help control natural hazards and man-made disasters and serious measures are also needed in order to minimize severe societal, economic and political crises; some of which may either escalate to violent conflicts or could be avoided by efforts of conflict resolution and prevention by the initiation of a process of de-escalation. So this study has recommended the best-fit adaptive and mitigation measures to climate change vulnerability in rural communities of Nigeria.

Keywords: adaptation, farmers, fishermen, herdsmen

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Introduction: Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. Methods: A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Results: Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Discussion and conclusions: Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: central venous access, critically ill patients, hospital-acquired complications, prevention

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Authors: Joserra Díez, Ainhoa Meñika, Iñaki Sanz-Azkue, Arritokieta Ortuzar

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Biodiversity provides humans with a great range of ecosystemic services; it is therefore an indispensable resource and a legacy to coming generations. However, in the last decades, the increasing exploitation of the Planet has caused a great loss of biodiversity and its acquaintance has decreased remarkably; especially in urbanized areas, due to the decreasing attachment of humans to nature. Yet, the Primary Education curriculum primes the identification of flora and fauna to guarantee the knowledge of children on their surroundings, so that they care for the environment as well as for themselves. In order to produce effective didactic material that meets the needs of both teachers and pupils, it is fundamental to diagnose the current situation. In the present work, the knowledge on biodiversity of 3^rd cycle Primary Education students in Biscay (n=98) and its relation to the size of the town/city of their school is discussed. Two tests have been used with such aim: one for tree identification and the other one so that the students enumerated the species of trees and animals they knew. Results reveal that knowledge of students on tree identification is scarce regardless the size of the city/town and of their school. On the other hand, animal species are better known than tree species.

Keywords: biodiversity, population, tree identification, animal identification

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Authors: Emmanuel Mkambankhani, Tiwonge Manda

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Software platform architecture includes system components, their relationships, and design, as well as evolution principles. Software architecture and documentation affect a platform's customizability and openness to external innovators, thus affecting developer productivity. Malawi Point of Care (POC) Electronic Medical Records System (EMRS) follows some architectural design standards, but it lacks third-party innovators and is difficult to customize as compared to CommCare and District Health Information System 2 (DHIS2). Improving software architecture and documentation for the Malawi POC will increase productivity and third-party contributions. A conceptual framework based on Generativity and Boundary Resource Model (BRM) was used to compare the three platforms. Interviews, observations, and document analysis were used to collect primary and secondary data. Themes were found by analyzing qualitative and quantitative data, which led to the following results. Configurable, flexible, and cross-platform software platforms and the availability of interfaces (Boundary Resources) that let internal and external developers interact with the platform's core functionality, hence boosting developer productivity. Furthermore, documentation increases developer productivity, while its absence inhibits the use of resources. The study suggests that the architecture and openness of the Malawi POC EMR software platform will be improved by standardizing web application program interfaces (APIs) and making interfaces that can be changed by the user. In addition, increasing the availability of documentation and training will improve the use of boundary resources, thus improving internal and third-party development productivity.

Keywords: health systems, configurable platforms, software architecture, software documentation, software development productivity

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Authors: Sonia Nemakallu, Pota Kalima

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Introduction: Vancomycin is a glycopeptide antibiotic, commonly used to treat gram-positive bacteraemia. It has been increasingly used in the critical care setting due to an increased awareness of resistant gram positive organisms. In Edinburgh both tertiary hospitals, The Western General Hospital and The Royal Infirmary Of Edinburgh, commonly use Vancomycin for a variety of infections. Administration of Vancomyicn in these hospitals is by continuous infusion as it is thought to maintain serum concentrations easier and is a simpler monitoring system. Purpose: The aim of the study was to evaluate the efficacy and reliability in which Vancomycin is used. Material and Methods: A retrospective study, over a 6-month period from January 2014 to June 2014. 91 admissions were included, all received Vancomycin by continuous infusion during their critical care stay. Results: The number one use for Vancomycin in critical care settings was in the treatment of ventilator or hospital-acquired pneumonia. Only 3% of population had MRSA. 49% of admissions were not therapeutic on day 1 post loading dose. Of those that were therapeutic on day 1 post loading dose, 39% of admissions showed no organisms in any cultures taken, 42% had organisms sensitive to Vancomycin and 19% had only organisms resistant to Vancomycin. Those that were not therapeutic on day 1 showed similar organism sensitivities. 15% of admissions had Vancomycin levels above 25 (levels should be maintained between 15-25). An increase in creatinine was proportionally seen with an increase in Vancomycin levels. Conclusion: Within Edinburgh Vancomycin is being overused in the critical care setting with only 3% of the population having highly resistant organisms. Continuous infusion have not ruled out the complexity of maintaining therapeutic levels, with a large proportion of patients not being therapeutic on day 1. Further research is also required into the nephrotoxic effects of using higher doses of Vancomycin.

Keywords: Vancomycin, continuous infusion, multi resistant organisms, sepsis, renal toxicity

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Authors: Anwaar Ahmed, Muhammad Bilal Khurshid, Samuel Labi

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The effect of trucks on the level of service is determined by considering passenger car equivalents (PCE) of trucks. The current version of Highway Capacity Manual (HCM) uses a single PCE value for all tucks combined. However, the composition of truck traffic varies from location to location; therefore a single PCE-value for all trucks may not correctly represent the impact of truck traffic at specific locations. Consequently, present study developed separate PCE values for single-unit and combination trucks to replace the single value provided in the HCM on different freeways. Site specific PCE values, were developed using concept of spatial lagging headways (the distance from the rear bumper of a leading vehicle to the rear bumper of the following vehicle) measured from field traffic data. The study used data from four locations on a single urban freeway and three different rural freeways in Indiana. Three-stage-least-squares (3SLS) regression techniques were used to generate models that predicted lagging headways for passenger cars, single unit trucks (SUT), and combination trucks (CT). The estimated PCE values for single-unit and combination truck for basic urban freeways (level terrain) were: 1.35 and 1.60, respectively. For rural freeways the estimated PCE values for single-unit and combination truck were: 1.30 and 1.45, respectively. As expected, traffic variables such as vehicle flow rates and speed have significant impacts on vehicle headways. Study results revealed that the use of separate PCE values for different truck classes can have significant influence on the LOS estimation.

Keywords: level of service, capacity analysis, lagging headway, trucks

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Authors: Anyi Katherine Garzon Robles, Luis Carlos Gomez Florez

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Since the advent of the Internet, the use of Information Technologies (IT) has increased exponentially. The field of informatics and telecommunications has put on the table countless possibilities for the development of different socio-economic activities, promoting a change of social paradigm and the emergence of the so-called information and knowledge society. For more than a decade, the Colombian government has been working on the incorporation of IT into the public sector through an e-government strategy. However, to date, many technological gaps has not yet been identified in the country to our knowledge, especially in rural areas and far from large cities, where factors such as low investment and the expansion of the armed conflict have led to economic and technological stagnation. This paper presents the research results obtained from the execution of a research project, which was approach from a qualitative approach and a methodological design of a participatory action research type. This design consists of nine fundamental stages divided into four work cycles. For which different strategies for data collection and analysis were established. From which, a methodology was obtained for the identification of technological gaps and the measurement of the level of technological acceptance in the rural sector, based on the TAM (Technology Acceptance Model) model, as a previous activity to the development of IT solutions framed in the e-government strategy in Colombia. The result of this research work represents a contribution from academia for the improvement of the country's technological development and a guide for the proper planning of IT solutions aimed at promoting a close relationship between government and citizens.

Keywords: E-government, knowledge society, level of technological acceptance, technological gaps, technology acceptance model

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Authors: Novawiguna Kemalasari, Ahmad Badawi Saluy

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This research is a planned activity to find an objective answer to PT XYZ problem through scientific procedure. In this study, It was used quantitative research methods by using samples taken from a department selected by researchers. This study aims to analyze the influence of organizational culture, work discipline and work motivation on employee performance of Personal Care & Cosmetic Department (PCC) Flammable PT XYZ. This research was conducted at PT XYZ Personal Care & Cosmetic Department (PCC) Flammable involving 82 employees as respondents, the data were obtained by using questionnaires filled in self-rating by respondents. The data were analyzed by multiple linear regression model processed by using SPSS version 22. The result of research showed that organizational culture variable, work discipline and work motivation had significant effect to employee performance.

Keywords: organizational culture, work discipline, employee motivation, employees performance

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Authors: Louise Penzenstadler, Tiphaine Robet, Radu Iuga, Daniele Zullino

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Context: The outpatient clinic of the psychiatric addiction service of Geneva University Hospital has been providing support to individuals affected by various narcotics for 30 years. However, the increasing consumption of crack cocaine in Geneva has presented a new challenge for the healthcare system. Research Aim: The aim of this research is to evaluate the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder. Methodology: The research utilizes a combination of quantitative and qualitative retrospective data analysis to evaluate the effectiveness of the outreach intervention. Findings: The data collected from October 2023 to December 2023 show that the outreach program successfully made 1,071 contacts with drug users and led to 15 new requests for care and enrollment in treatment. Patients expressed high satisfaction with the intervention, citing easy and rapid access to treatment and social support. Theoretical Importance: This research contributes to the understanding of the challenges and specific needs of a complex group of drug users who face severe health problems. It highlights the importance of outreach interventions in establishing trust, connecting users with care, and facilitating medication-assisted treatment for opioid addiction. Data Collection: Data was collected through the outreach program's interactions with drug users, including street outreach interventions and presence at locations frequented by users. Patient satisfaction surveys were also utilized. Analysis Procedures: The collected data was analyzed using both quantitative and qualitative methods. The quantitative analysis involved examining the number of contacts made, new requests for care, and treatment enrollment. The qualitative analysis focused on patient satisfaction and their perceptions of the intervention. Questions Addressed: The research addresses the following questions: What is the impact of an outreach intervention on crack cocaine addiction in users with co-occurring opioid use disorder? How effective is the outreach program in connecting drug users with care and initiating medication-assisted treatment? Conclusion: The outreach program has proven to be an effective intervention in establishing trust with crack users, connecting them with care, and initiating medication-assisted treatment for opioid addiction. It has also highlighted the importance of addressing the specific challenges faced by this group of drug users.

Keywords: crack addiction, outreach treatment, peer intervention, polydrug use

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Authors: Racheal Ayanga, Nancy Katumba Muwangala, Jane Babirye, Harriet Kivumbi

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Background: Deaf adolescents are vulnerable. Deafness limits their access to resources that are accessed by their hearing peers. There is minimal attention placed on the SRH needs of persons with disabilities, especially in developing countries. We sought to assess barriers to access of SRH education and services for deaf adolescents in Uganda. Methods: We performed a cross sectional study using a questionnaire on knowledge of and access to SRH education and services from a selected sample of deaf adolescents aged 13-19 years at Wakiso Secondary school for the deaf. A consecutive sample of eligible participants was asked to join the study after obtaining informed consent until the target sample size was reached. Results: From 01 Jul 2022 to 30 Jan 2023, 70 quantitative interviews were conducted. Participants’ mean age was 17 years, and 66% were female. 89% had heard about several components of SRH. 99% reported a need for education and services but had challenges with access 85% of the time. 54% reported receipt of education and services from government or private facilities, and the rest from friends, parents, siblings, teachers and the internet. Conclusion: Government needs to look into availing tailored, sustainable SRH education/services to deaf adolescents at health facilities and teach health workers sign language. SRH education to parents, teachers and communities of deaf adolescents improves access in hard-to-reach areas. Integration of services into routine health care is key in creating and improving models of access to wider communities of persons with disabilities to improve their mental health.

Keywords: sexual and reproductive health, deaf, adolescents, education, services, disabilities, mental health, hard-to-reach areas

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Authors: Sanjay Sinha, Mohd Umair Khan

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The level of income inequality in India has been worrisome as the World Inequality Report termed it as a “poor and unequal country, with an affluent elite”. As important as income is to understand inequality and deprivation, it is just one dimension. But the historical roots and current realities of inequality and deprivation in India lies in many of the non-income dimensions such as housing, nutrition, education, agency, sense of inclusion etc. which are often ignored, especially in solution-oriented research. The level of inequality and deprivation among the tribal is one such case. There is a corpus of literature establishing that the tribal communities in India are disadvantageous on various grounds. Given their rural geography, issues of access and quality of basic facilities such as education and healthcare are often unaddressed. COVID-19 has further exacerbated this challenge and climate change will make it even more worrying. With this background, a succinct measurement tool at the village level is necessary to design short to medium-term actions with reference to risk mitigation for tribal communities. This research paper examines the level of inequality and deprivation among the tribal communities in the rural areas of Andhra Pradesh state of India using a Multidimensional Inequality and Deprivation Index based on the Alkire-Foster methodology. The methodology is theoretically grounded in the capability approach propounded by Amartya Sen, emphasizing on achieving the “beings and doings” (functionings) an individual reason to value. In the index, the authors have five domains, including Livelihood, Food Security, Education, Health and Housing and these domains are divided into sixteen indicators. This assessment is followed by domain-wise short-term and long-term solutions.

Keywords: Andhra Pradesh, Alkire-Foster methodology, deprivation, inequality, multidimensionality, poverty, tribal

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Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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Authors: Walter Rafael Ramos Villanueva

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The overwhelming majority of scholarship on David Chariandy’s novel Soucouyant focuses on how Adele’s dementia represents the preservation of “cultural memory” and the perniciousness of “historical trauma.” However, by metaphorizing Adele’s mental condition, these critics risk treating her dementia as mostly figurative, and they thus elide a more detailed discussion of the literal ramifications of her dementia diagnosis. To move beyond these readings, then, my paper will approach Adele’s disorder as a literal medical condition and explore how her caregiving needs affect not only her but also those around her. Soucouyant subverts traditional caregiving narratives by depicting the difficult and typically invisible labour of informal caregiving that is undertaken by the families and friends of those who are ill or otherwise disabled. Because Adele’s family is unable to access proper public healthcare resources within the community, the burden of care falls upon the protagonist and his brother, who become “parentified children.” Parentified children, according to Nancy D. Chase, are “parents to their parents, and fulfill this role at the expense of their own developmentally appropriate needs and pursuits.” The novel provides a depiction of informal caregiving that is multi-faceted and asks us to question why is it exactly that we place the burden of care on those who are not equipped to handle such pressures instead of putting the onus on the government and the public healthcare system to take care of its most vulnerable members. Ageing Studies scholar Larry Polvika notes that although policymakers often offer “pious expressions of appreciation” and acknowledge that informal caregiving is “the backbone of our long-term care system,” governmental support for these caregivers remains inadequate. It is my belief that, by showcasing the struggles of informal caregivers, Chariandy’s text combats this dangerous and empty political rhetoric.

Keywords: caregiving, dementia, literature, parentified children

Procedia PDF Downloads 178

Authors: Anne Gesare Timu, Megan Sheahan, Andrew Gache Mude, Rupsha Banerjee

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Women headed households are among the most vulnerable to negative climatic shocks and are often left poorer as a result. Credit provision has been recognized as one way of alleviating rural poverty and developing poor rural households’ resilience to shocks. Much has been documented about credit demand in small-holder agriculture settings in Kenya. However, little is known about demand for credit among pastoral women. This paper analyzes the determinants of demand for credit in the pastoral regions of Marsabit District of Northern Kenya. Using a five wave balanced panel data set of 820 households, a double hurdle model is employed to analyze if shocks, financial literacy and risk aversion affect credit demand among female and male headed households differently. The results show that borrowing goods on credit and monetary credit from informal market segments are the most common sources of credit in the study area. The impact of livestock loss and financial literacy on the decision to borrow and how much to borrow vary with gender. While the paper suggests that provision of credit is particularly valuable in the aftermath of a negative shock and more so for female-headed households, it also explores alternatives to the provision of credit where credit access is a constraint. It recommends further understanding of systems and institutions which could enhance access to credit, and particularly during times of stress, to enable households in the study area in particular and Northern Kenya in general to invest, engage in meaningful development and growth, and be resilient to persistent shocks.

Keywords: female headed households, pastoralism, rural financing, double hurdle model

Procedia PDF Downloads 269

Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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Authors: Rian Diana, Naufal Muharam Nurdin, Faisal Anwar, Hadi Riyadi, Ali Khomsan

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The use of traditional medicine (herbs and medicinal plants) are common among Indonesian people especially the elderly. Few study explore the use of medicinal plants in middle aged people. This study aims to collect information on the use of medicinal plants in middle aged people in rural areas. This cross sectional study included 224 subjects aged 45-59 years old and conducted in Cianjur District, West Java in 2014. Semi-structured questionnaires were used to collect information about preference in treatment of illness, the use of medicinal plants, and their purposes. Information also recorded plant names, parts used, mode of preparation, and dosage. Buying drugs in stall (83.9%) is the first preference in treatment of illness, followed by modern treatment 19.2% (doctors) and traditional treatment 17.0% (herbs/medicinal plants). 87 subjects (38.8%) were using herbs and medicinal plants for curative (66.7%), preventive (31.2%), and rehabilitative (2.1%) purposes. In this study, 48 species are used by the subjects. Physalis minima L. 'cecenet', Orthosiphon aristatus Mic. 'kumis kucing', and Annona muricata 'sirsak' are commonly used for the treatment of hypertension and stiffness. Leaves (64.6%) are the most common part used. Medicinal plants were washed and boiled in a hot water. Subject drinks the herbs with a different dosage. One in three middle aged people used herbal and medicinal plants for curative and preventive treatment particularly hypertension and stiffness. Increasing knowledge about herbal or medicinal plants dosage and their interaction with medical drugs are important to do.Doses vary between 1-3 glasses/day for treatment and 1-2 glasses/months for prevention of diseases.

Keywords: herbs, hypertension, medicinal plants, middle age, rural

Procedia PDF Downloads 244

Authors: Kedir Teji Roba, Thomas P. O’Connor, Tefera Belachew, Nora M. O’Brien

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Micronutrient deficiencies of ferritin, zinc and haemoglobin are prevalent among the mothers and their infants in developing countries. But little attention has been given to these vulnerable groups. No study has been done on co-existence of the deficiencies among lactating mothers and their breast feeding infants in two different agro-ecological zones of rural Ethiopia. Methods: Data were collected from 162 lactating mothers and their breast feeding infants (aged 6-23 months) who were living in two different agro-ecological zones. The data were collected via a structured interview, anthropometric measurements, and blood test for Zinc, ferritin and anaemia. Correlation and Chi square test were used to determine the association among nutritional status and agro ecological zones. Results: Iron deficiency was found in 44.4% of the infants and 19.8% of the mothers. Zinc deficiency was found in 72.2% of the infants and 67.3% of the mothers. Of the study subject 52.5% of the infants and 19.1% of the mothers were anaemic, and 29.6% of the infants and 10.5% of the mothers had iron deficiency anaemia. Among the mothers with iron deficiency, 81.2% and 56.2% of their children were deficient in zinc and iron respectively. Similarly, among the zinc deficient mothers, 75.2% and 45.3% of their children were deficient in zinc and iron. There was a strong correlation between the micronutrient status of the mothers and the infants on status of ferritin, zinc and anaemia (P < 0.001). There is also statistically significant association between micronutrient deficiency and agro-ecological zones among the mothers (p < 0.001) but not with their infants. Deficiency in one, two, or three, micronutrients was observed in 48.1%, 16.7% and 9.9% of the mothers and 35.8%, 29.0%, and 23.5%, of their infants respectively. Conclusion: This study shows that iron and zinc deficiencies are the prevalent micronutrient deficiencies among the lactating mothers and their infants, with variation of the magnitude across the agro-ecological zones. This finding calls for a need to design effective preventive public health nutrition programs to address both the mothers’ and their infants’ needs.

Keywords: ferritin/iron, zinc, anaemia, agroecology, malnutrition

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Authors: Seyed Mohammad Mousavi Shalheh, Elham Rostami, Seyed Majid Mousavi, Somayeh Shirin Jani

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The aim of this research was to evaluate the potential of Rogbeh village located in Khanafereh, Shadegan city functions in Khuzestan also is the feasibility to build infrastructure and appropriate spaces to attract tourists as well as creating jobs and transforming the village institute of ecotourism in the region. It seems that the village has the potential for developing rural tourism with careful planning, and with regard to job creation and economic recovery programs, social-cultural and environmental-ecological accompanied will be welcomed by the people. Therefore, we can provide a strategy for developing tourism and achieving sustainable advancement of rural tourism. Based on researches carried out and according to regional climate differences and the position of the Rogbeh Village toward the lagoon, this research can be used by other researchers to develop and manage tourism.

Keywords: Shadegan Lagoon, Iranian villages, tourism industry, local architecture, Rogbeh village, landscape design, ecology

Procedia PDF Downloads 175

Authors: G. Yoga Sairam Teja, K. Harsha Vardhan, A. Vinay Kumar, K. Nithish Kumar, Ch. Shanthi Priyag

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The emergence of the Internet of Things (IoT) has facilitated better device control and monitoring in the modern world. The constant monitoring of a patient would be drastically altered by the usage of IoT in healthcare. As we've seen in the case of the COVID-19 pandemic, it's important to keep oneself untouched while continuously checking on the patient's heart rate and temperature. Additionally, patients with paralysis should be closely watched, especially if they are elderly and in need of special care. Our "IoT BASED PATIENT HEALTH MONITORING SYSTEM" project uses IoT to track patient health conditions in an effort to address these issues. In this project, the main board is an 8051 microcontroller that connects a number of sensors, including a heart rate sensor, a temperature sensor (LM-35), and a saline water measuring circuit. These sensors are connected via an ESP832 (WiFi) module, which enables the sending of recorded data directly to the cloud so that the patient's health status can be regularly monitored. An LCD is used to monitor the data in offline mode, and a buzzer will sound if any variation from the regular readings occurs. The data in the cloud may be viewed as a graph, making it simple for a user to spot any unusual conditions.

Keywords: IoT, ESP8266, 8051 microcontrollers, sensors

Procedia PDF Downloads 88

Authors: Abram Zoltan

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Over the past hundred years, human activities, particularly the burning of fossil fuels, have released enough carbon dioxide and other greenhouse gases to dissipate additional heat into the lower atmosphere and affect the global climate. Climate change affects many social and environmental determinants of health: clean air, safe drinking water, and adequate food. Our aim is to draw attention to the effects of climate change on the health and health care system. Improving climate awareness and the knowledge related to climate change's health impacts are essential among medical students and practicing medical doctors. Therefore, in their everyday practice, they also need some assistance and up-to-date knowledge of how climate change can endanger human health and deal with these novel health problems. Our activity, based on the cooperation of more universities, aims to develop new curriculum outlines and learning materials on climate change's health impacts for medical schools. Special attention is intended to pay to the possible preventative measures against these impacts. For all of this, the project plans to create new curriculum outlines and learning materials for medical students, elaborate methodological guidelines and create training materials for medical doctors' postgraduate learning programs. The target groups of the project are medical students, educational staff of medical schools and universities, practicing medical doctors with special attention to the general practitioners and family doctors. We had searched various surveys, domestic and international studies about the effects of climate change and statistical estimation of the possible consequences. The health effects of climate change can be measured only approximately by considering only a fraction of the potential health effects and assuming continued economic growth and health progress. We can estimate that climate change is expected to cause about 250,000 more deaths. We conclude that climate change is one of the most serious problems of the 21st century, affecting all populations. In the short- to medium-term, the health effects of climate change will be determined mainly by human vulnerability. In the longer term, the effects depend increasingly on the extent to which transformational action is taken now to reduce emissions. We can contribute to reducing environmental pollution by raising awareness and by educating the population.

Keywords: climate change, health impacts, medical students, education

Procedia PDF Downloads 127