Search results for: health monitoring
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11256

Search results for: health monitoring

9576 Medication Errors in Neonatal Intensive Care Unit

Authors: Ramzi Shawahna

Abstract:

Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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9575 Health Trajectory Clustering Using Deep Belief Networks

Authors: Farshid Hajati, Federico Girosi, Shima Ghassempour

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We present a Deep Belief Network (DBN) method for clustering health trajectories. Deep Belief Network (DBN) is a deep architecture that consists of a stack of Restricted Boltzmann Machines (RBM). In a deep architecture, each layer learns more complex features than the past layers. The proposed method depends on DBN in clustering without using back propagation learning algorithm. The proposed DBN has a better a performance compared to the deep neural network due the initialization of the connecting weights. We use Contrastive Divergence (CD) method for training the RBMs which increases the performance of the network. The performance of the proposed method is evaluated extensively on the Health and Retirement Study (HRS) database. The University of Michigan Health and Retirement Study (HRS) is a nationally representative longitudinal study that has surveyed more than 27,000 elderly and near-elderly Americans since its inception in 1992. Participants are interviewed every two years and they collect data on physical and mental health, insurance coverage, financial status, family support systems, labor market status, and retirement planning. The dataset is publicly available and we use the RAND HRS version L, which is easy to use and cleaned up version of the data. The size of sample data set is 268 and the length of the trajectories is equal to 10. The trajectories do not stop when the patient dies and represent 10 different interviews of live patients. Compared to the state-of-the-art benchmarks, the experimental results show the effectiveness and superiority of the proposed method in clustering health trajectories.

Keywords: health trajectory, clustering, deep learning, DBN

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9574 Adaptive Process Monitoring for Time-Varying Situations Using Statistical Learning Algorithms

Authors: Seulki Lee, Seoung Bum Kim

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Statistical process control (SPC) is a practical and effective method for quality control. The most important and widely used technique in SPC is a control chart. The main goal of a control chart is to detect any assignable changes that affect the quality output. Most conventional control charts, such as Hotelling’s T2 charts, are commonly based on the assumption that the quality characteristics follow a multivariate normal distribution. However, in modern complicated manufacturing systems, appropriate control chart techniques that can efficiently handle the nonnormal processes are required. To overcome the shortcomings of conventional control charts for nonnormal processes, several methods have been proposed to combine statistical learning algorithms and multivariate control charts. Statistical learning-based control charts, such as support vector data description (SVDD)-based charts, k-nearest neighbors-based charts, have proven their improved performance in nonnormal situations compared to that of the T2 chart. Beside the nonnormal property, time-varying operations are also quite common in real manufacturing fields because of various factors such as product and set-point changes, seasonal variations, catalyst degradation, and sensor drifting. However, traditional control charts cannot accommodate future condition changes of the process because they are formulated based on the data information recorded in the early stage of the process. In the present paper, we propose a SVDD algorithm-based control chart, which is capable of adaptively monitoring time-varying and nonnormal processes. We reformulated the SVDD algorithm into a time-adaptive SVDD algorithm by adding a weighting factor that reflects time-varying situations. Moreover, we defined the updating region for the efficient model-updating structure of the control chart. The proposed control chart simultaneously allows efficient model updates and timely detection of out-of-control signals. The effectiveness and applicability of the proposed chart were demonstrated through experiments with the simulated data and the real data from the metal frame process in mobile device manufacturing.

Keywords: multivariate control chart, nonparametric method, support vector data description, time-varying process

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9573 Program of Health/Safety Integration and the Total Worker Health Concept in the Improvement of Absenteeism of the Work Accommodation Management

Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

Abstract:

Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

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9572 A Spatial Autocorrelation Analysis of Women’s Mental Health and Walkability Index in Mashhad City, Iran, and Recommendations to Improve It

Authors: Mohammad Rahim Rahnama, Lia Shaddel

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Today, along with the development of urbanism, its negative consequences on the health of citizens are emerging. Mental disorders are common in the big cities, while mental health enables individuals to become active citizens. Meanwhile, women have a larger share of mental problems. Depression and anxiety disorders have a higher prevalence rate among women and these disorders affect the health of future generations, too. Therefore, improving women’s mental health through the potentials offered by urban spaces are of paramount importance. The present study aims to first, evaluate the spatial autocorrelation of women’s mental health and walkable spaces and then present solutions, based on the findings, to improve the walkability index. To determine the spatial distribution of women’s mental health in Mashhad, Moran's I was used and 1000 questionnaire were handed out in various sub-districts of Mashhad. Moran's I was calculated to be 0.18 which indicates a cluster distribution pattern. The walkability index was calculated using the four variables pertaining to the length of walkable routes, mixed land use, retail floor area ratio, and household density. To determine spatial autocorrelation of mental health and the walkability index, bivariate Moran’s I was calculated. Moran's I was determined to be 0.37 which shows a direct spatial relationship between variables; 4 clusters in 9 sub-districts of Mashhad were created. In High-Low cluster, there was a negative spatial relationship and hence, to identify factors affecting walkability in urban spaces semi-structures interviews were conducted with 21 women in this cluster. The findings revealed that security is the major factor influencing women’s walking behavior in this cluster. In accordance with the findings, some suggestions are offered to improve the presence of women in this sub-district.

Keywords: Mashhad, spatial autocorrelation, women’s mental health, walkability index

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9571 The Comparison between Public's Social Distances against Syrian Refugees and Perceptions of Access to Healthcare Services: Istanbul Sample

Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

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Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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9570 Inferring the Ecological Quality of Seagrass Beds from Using Composition and Configuration Indices

Authors: Fabrice Houngnandan, Celia Fery, Thomas Bockel, Julie Deter

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Getting water cleaner and stopping global biodiversity loss requires indices to measure changes and evaluate the achievement of objectives. The endemic and protected seagrass species Posidonia oceanica is a biological indicator used to monitor the ecological quality of marine Mediterranean waters. One ecosystem index (EBQI), two biotic indices (PREI, Bipo), and several landscape indices, which measure the composition and configuration of the P. oceanica seagrass at the population scale have been developed. While the formers are measured at monitoring sites, the landscape indices can be calculated for the entire seabed covered by this ecosystem. This present work aims to search on the link between these indices and the best scale to be used in order to maximize this link. We used data collected between 2014 to 2019 along the French Mediterranean coastline to calculate EBQI, PREI, and Bipo at 100 sites. From the P. oceanica seagrass distribution map, configuration and composition indices around these different sites in 6 different grid sizes (100 m x 100 to 1000 m x 1000 m) were determined. Correlation analyses were first used to find out the grid size presenting the strongest and most significant link between the different types of indices. Finally, several models were compared basis on various metrics to identify the one that best explains the nature of the link between these indices. Our results showed a strong and significant link between biotic indices and the best correlations between biotic and landscape indices within the 600 m x 600 m grid cells. These results showed that the use of landscape indices is possible to monitor the health of seagrass beds at a large scale.

Keywords: ecological indicators, decline, conservation, submerged aquatic vegetation

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9569 Is Swaziland on Track with the 2015 Millennium Development Goals?

Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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9568 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru

Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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9567 Developing a Sustainable System to Deliver Early Intervention for Emotional Health through Australian Schools

Authors: Rebecca-Lee Kuhnert, Ron Rapee

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Up to 15% of Australian youth will experience an emotional disorder, yet relatively few get the help they need. Schools provide an ideal environment through which we can identify young people who are struggling and provide them with appropriate help. Universal mental health screening is a method by which all young people in school can be quickly assessed for emotional disorders, after which identified youth can be linked to appropriate health services. Despite the obvious logic of this process, universal mental health screening has received little scientific evaluation and even less application in Australian schools. This study will develop methods for Australian education systems to help identify young people (aged 9-17 years old) who are struggling with existing and emerging emotional disorders. Prior to testing, a series of focus groups will be run to get feedback and input from young people, parents, teachers, and mental health professionals. They will be asked about their thoughts on school-based screening methods and and how to best help students at risk of emotional distress. Schools (n=91) across New South Wales, Australia will be randomised to do either immediate screening (in May 2021) or delayed screening (in February 2022). Students in immediate screening schools will complete a long online mental health screener consisting of standard emotional health questionnaires. Ultimately, this large set of items will be reduced to a small number of items to form the final brief screener. Students who score in the “at-risk” range on any measure of emotional health problems will be identified to schools and offered pathways to relevant help according to the most accepted and approved processes identified by the focus groups. Nine months later, the same process will occur among delayed screening schools. At this same time, students in the immediate screening schools will complete screening for a second time. This will allow a direct comparison of the emotional health and help-seeking between youth whose schools had engaged in the screening and pathways to care process (immediate) and those whose schools had not engaged in the process (delayed). It is hypothesised that there will be a significant increase in students who receive help from mental health support services after screening, compared with baseline. It is also predicted that all students will show significantly less emotional distress after screening and access to pathways of care. This study will be an important contribution to Australian youth mental health prevention and early intervention by determining whether school screening leads to a greater number of young people with emotional disorders getting the help that they need and improving their mental health outcomes.

Keywords: children and young people, early intervention, mental health, mental health screening, prevention, school-based mental health

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9566 Reframing the Teaching-Learning Framework in Health Sciences Education: Opportunities, Challenges and Prospects

Authors: Raul G. Angeles, Rowena R. De Guzman

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The future workforce for health in a globalized context highlights better health human resource planning. Health sciences students are challenged to develop skills needed for global migration. Advancing health sciences education is crucial in preparing them to overcome border challenges. The purpose of this mixed-method, two-part study was to determine the extent by which the current instructional planning and implementation (IPI) framework is reframed with teaching approaches that foster students' 21st-century skills development and to examine participants’ over-all insights on learner-centered teaching and learning (LCTL) particularly in health sciences classrooms. Participants were groups of teachers and students drawn from a national sample through the Philippine higher education institutions (HEIs). To the participants, the use of technology, practices driven by students’ interests and enriching learning experiences through project-based learning are the approaches that must be incorporated with great extent in IPI to encourage student engagement, active learning and collaboration. Participants were asked to detail their insights of learner-centered teaching and learning and using thematic content analysis parallel insights between the groups of participants lead to three emerging themes: opportunities, challenges and prospects. More contemporary understanding of LTCL in today’s health sciences classrooms were demonstrated by the participants. Armed with true understanding, educational leaders can provide interventions appropriate to the students’ level of need, teachers’ preparation and school’s readiness in terms of resources. Health sciences classrooms are innovated to meet the needs of the current and future students.

Keywords: globalization, health workforce, role of education, student-centered teaching and learning, technology in education

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9565 Improving Collective Health and Social Care through a Better Consideration of Sex and Gender: Analytical Report by the French National Authority for Health

Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

Abstract:

Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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9564 Value Creation of My Health Bank of National Health Insurance: Service Dominant Logic Perspective

Authors: Yu Hua Yan

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Background: This research attempts to extend and apply the concept of service dominant logic on My Health Bank platform, analyzed to find out are there any significant difference in wills to participate (potential factors for value) on the results of value co-creation? Methods: The questionnaires were delivered from August 2017 to October 2017 in hospitals. 167 valid ones were received, with an effective response rate of 98.2%. Results: This research employed the questionnaire method in collecting research data, with patients that have used My Health Bank as objects, to whom questionnaires were sent. Regarding the factors influencing therapeutic effects, in the statistics of capability and interaction, it reached a significant level (p <0.1). Regarding the factors influencing satisfaction on medical service, in the statistics of capability and interaction, it reached a significant level (p <0.001). Conclusion: Regarding the contributions of this research, it is possible to clarify its contents with the studies on value co-creation to enrich the literature of the studies of service dominant logic and value co-creation in Taiwan. Regarding its contribution in practice, the results of this research allows the value advocator – the government, to have a broader view in the consideration of making the policies on value co-creation.

Keywords: My Health Bank, interactive, participation, value creation

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9563 Dynamics of Parent to Adolescent Communication on Sexual and Reproductive Health in Sub-Saharan Africa: A Focus on Barriers and Policy Implications

Authors: Douglas Nyathi, Mxolisi Sibanda, Joram Ndlovuu, Thulani Dube, Innocent T. Mahiya

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Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast mediato come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.

Keywords: parent, adolecsent, communication, sexual and reproductive health

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9562 Children Beliefs about Illness, Treatments and Vaccines after the Experience of Covid 19 Pandemic

Authors: Margarida Maria Cabugueira Csutódio dos Santos, Joana Filipa Pintéus Pereira

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The way children understand the concept of health and illness influences their reaction in contexts where these concepts are present (e.g.,illness; vaccination). The recognition of the importance of children's beliefs/representations about health and disease has led to the development of models that seek to explain the development process of these concepts. In the construction of their representations, children are influenced not only by their cognitive competence but also by their life experiences. In the last 3 years, children have experienced a pandemic health crisis that has exposed them to anomalous and stressful situations. Objective: the aim of this study was (1) to identify children’s representations about disease (including symptoms, causes, control/treatment) and prevention (including health procedures and vaccines) and (2) whether COVID19 is mentioned and influences their representations. Methodology: a qualitative study in which 67 children with 7 to 10 years old (mean 8,8) participated. A semi-structured interview was used following the Bibace and Walsh model, focusing on the representation of the disease and its prevention. Results show a marked influence of the lived experience with regard to causes of the disease, disease control and treatment, and adherence to vaccination. Age-dependent differences were found with older children being able to talk about illness and contamination process and younger displaying more basic, concrete and rigid representations. Conclusions: The results of this study bring clues to the adequacy of communication with the child in the context of health and illness and discriminately in a future health pandemic crisis.

Keywords: childen, health beliefs, pediatrics, covid19, vaccines

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9561 Analysis of Patient No-Shows According to Health Conditions

Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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9560 Classification of Health Information Needs of Hypertensive Patients in the Online Health Community Based on Content Analysis

Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

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Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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9559 Work Ability Index (WAI) and Its Health-Related Detriments among Iranian Farmers Working in the Small Farm Enterprises

Authors: Akbar Rostamabadi, Adel Mazloumi, Abbas Rahimi Foroushani

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This study aimed to determine the Work Ability Index (WAI) and examine the influence of health dimensions and demographic variables on the work ability of Iranian farmers working in small farm enterprises. A cross-sectional study was conducted among 294 male farmers. The WAI and SF-36 questionnaires were used to determine work ability and health status. The effect of demographics variables on the work ability index was investigated with the independent samples t-test and one-way ANOVA. Also, multiple linear regression analysis was used to test the association between the mean WAI score and the SF-36 scales. The mean WAI score was 35.1 (SD=10.6). One-way ANOVA revealed a significant relationship between the mean WAI and age. Multiple linear regression analysis showed that work ability was more influenced by physical scales of the health dimensions, such as physical function, role-physical, and general health, whereas a lower association was found for mental scales such as mental health. The average WAI was at a moderate work ability level for the sample population of farmers in this study. Based on the WAI guidelines, improvement of work ability and identification of factors affecting it should be considered a priority in interventional programs. Given the influence of health dimensions on WAI, any intervention program for preservation and promotion work ability among the studied farmers should be based on balancing and optimizing the physical and psychosocial work environments, with a special focus on reducing physical work load.

Keywords: farmers, SF-36, Work Ability Index (WAI), Iran

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9558 Fast Robust Switching Control Scheme for PWR-Type Nuclear Power Plants

Authors: Piyush V. Surjagade, Jiamei Deng, Paul Doney, S. R. Shimjith, A. John Arul

Abstract:

In sophisticated and complex systems such as nuclear power plants, maintaining the system's stability in the presence of uncertainties and disturbances and obtaining a fast dynamic response are the most challenging problems. Thus, to ensure the satisfactory and safe operation of nuclear power plants, this work proposes a new fast, robust optimal switching control strategy for pressurized water reactor-type nuclear power plants. The proposed control strategy guarantees a substantial degree of robustness, fast dynamic response over the entire operational envelope, and optimal performance during the nominal operation of the plant. To improve the robustness, obtain a fast dynamic response, and make the system optimal, a bank of controllers is designed. Various controllers, like a baseline proportional-integral-derivative controller, an optimal linear quadratic Gaussian controller, and a robust adaptive L1 controller, are designed to perform distinct tasks in a specific situation. At any instant of time, the most suitable controller from the bank of controllers is selected using the switching logic unit that designates the controller by monitoring the health of the nuclear power plant or transients. The proposed switching control strategy optimizes the overall performance and increases operational safety and efficiency. Simulation studies have been performed considering various uncertainties and disturbances that demonstrate the applicability and effectiveness of the proposed switching control strategy over some conventional control techniques.

Keywords: switching control, robust control, optimal control, nuclear power control

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9557 A Sociological Study of Rural Women Attitudes toward Education, Health and Work outside Home in Beheira Governorate, Egypt

Authors: A. A. Betah

Abstract:

This research was performed to evaluate the attitudes of rural women towards education, health and work outside the home. The study was based on a random sample of 147 rural women, Kafr-Rahmaniyah village was chosen for the study because its life expectancy at birth for females, education and percentage of females in the labor force, were the highest in the district. The study data were collected from rural female respondents, using a face-to-face questionnaire. In addition, the study estimated several factors like age, main occupation, family size, monthly household income, geographic cosmopolites, and degree of social participation for rural women respondents. Using Statistical Package for the Social Sciences (SPSS), data were analyzed by non-parametric statistical methods. The main finding in this study was a significant relationship between each of the previous variables and each of rural women’s attitudes toward education, health, and work outside home. The study concluded with some recommendations. The most important element is ensuring attention to rural women’s needs, requirements and rights via raising their health awareness, education and their contributions in their society.

Keywords: attitudes, education, health, rural women, work outside home

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9556 A Bayesian Approach for Health Workforce Planning in Portugal

Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

Abstract:

Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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9555 The Application of Local Wisdom in Health Care of Early Childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Supalak Fakkhum, Wannita Pochanakul

Abstract:

This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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9554 Gammarus: Asellus Ratio as an Index of Organic Pollution: A Case Study in Markeaton, Kedleston Hall, and Allestree Park Lakes Derby, UK

Authors: Usman Bawa

Abstract:

Macro-invertebrates have been used to monitor organic pollution in rivers and streams. Several biotic indices based on macro-invertebrates have been developed over the years including the Biological Monitoring Working Party (BMWP). A new biotic index, the Gammarus:Asellus ratio has been recently proposed as an index of organic pollution. This study tested the validity of the Gammarus:Asellus ratio as an index of organic pollution, by examining the relationship between the Gammarus:Asellus ratio and physical-chemical parameters, and other biotic indices such as BMWP and, Average Score Per Taxon (ASPT) from lakes and streams at Markeaton Park, Allestree Park, and Kedleston Hall, Derbyshire. Macro invertebrates were sampled using the standard five-minute kick sampling techniques physical and chemical environmental variables were obtained based on standard sampling techniques. Eighteen sites were sampled, six sites from Markeaton Park (three sites across the stream and three sites across the lake). Six sites each were also sampled from Allestree Park and Kedleston Hall lakes. The Gammarus:Asellus ratio showed an opposite significant positive correlations with parameters indicative of organic pollution such as the level of nitrates, phosphates, and calcium and also revealed a negatively significant correlations with other biotic indices (BMWP/ASPT). The BMWP score correlated positively significantly with some water quality parameters such as dissolved oxygen and flow rate, but revealed no correlations with other chemical environmental variables. The BMWP score was significantly higher in the stream than the lake in Markeaton Park, also The ASPT scores appear to be significantly higher in the upper Lakes than the middle and lower lakes. This study has further strengthened the use of BMWP/ASPT score as an index of organic pollution. But, additional application is required to validate the use of Gammarus:Asellus as a rapid bio monitoring tool.

Keywords: Asellus, biotic index, Gammarus, macro invertebrates, organic pollution

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9553 Evaluation of Static Modulus of Elasticity Depending on Concrete Compressive Strength

Authors: Klara Krizova, Rudolf Hela

Abstract:

The paper is focused on monitoring of dependencies of different composition concretes on elastic modulus values. To obtain a summary of elastic modulus development independence of concrete composition design variability was the objective of the experiment. Essential part of this work was initiated as a reaction to building practice when questions of elastic moduli arose at the same time and which mostly did not obtain the required and expected values from concrete constructions. With growing interest in this theme the elastic modulus questions have been developing further.

Keywords: concrete, compressive strength, modulus of elasticity, EuroCode 2

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9552 Primary Health Care Vital Signs Profile in Malaysia: Challenges and Opportunities

Authors: Rachel Koshy, Nazrila Hairizan Bt. Nasir, Samsiah Bt. Awang, Kamaliah Bt. Mohamad Noh

Abstract:

Malaysia collaborated as a ‘trailblazer’ country with PHCPI (Primary Health Care Performance Initiative) to populate the Primary Health Care (PHC) Vital Signs Profile (VSP) for the country. The PHC VSP provides an innovative snapshot of the primary health care system's performance. Four domains were assessed: system financing, system capacity, system performance, and system equity, and completed in 2019. There were two phases using a mixed method study design. The first phase involved a quantitative study, utilising existing secondary data from national and international sources. In the case of unavailability of data for any indicators, comparable alternative indicators were used. The second phase was a mixed quantitative-qualitative approach to measure the functional capacity based on governance and leadership, population health needs, inputs, population health management, and facility organisation and management. PHC spending constituted 35% of overall health spending in Malaysia, with a per capita PHC spending of $152. The capacity domain was strong in the three subdomains of governance and leadership, information system, and funds management. The two subdomains of drugs & supplies and facility organisation & management had low scores, but the lowest score was in empanelment of the population under the population health management. The PHC system performed with an access index of 98%, quality index of 84%, and service coverage of 62%. In the equity domain, there was little fluctuation in the coverage of reproductive, maternal, newborn, and child health services by mother’s level of education and under-five child mortality between urban and rural areas. The public sector was stronger in the capacity domain as compared to the private sector. This is due to the different financing, organisational structures, and service delivery mechanism. The VSP has identified areas for improvement in the effort to provide high-quality PHC for the population. The gaps in PHC can be addressed through the system approach and the positioning of public and private primary health care delivery systems.

Keywords: primary health care, health system, system domains, vital signs profile

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9551 African Swine Fewer Situation and Diagnostic Methods in Lithuania

Authors: Simona Pileviciene

Abstract:

On 24th January 2014, Lithuania notified two primary cases of African swine fever (ASF) in wild boars. The animals were tested positive for ASF virus (ASFV) genome by real-time PCR at the National Reference Laboratory for ASF in Lithuania (NRL), results were confirmed by the European Union Reference Laboratory for African swine fever (CISA-INIA). Intensive wild and domestic animal monitoring program was started. During the period of 2014-2017 ASF was confirmed in two large commercial pig holding with the highest biosecurity. Pigs were killed and destroyed. Since 2014 ASF outbreak territory from east and south has expanded to the middle of Lithuania. Diagnosis by PCR is one of the highly recommended diagnostic methods by World Organization for Animal Health (OIE) for diagnosis of ASF. The aim of the present study was to compare singleplex real-time PCR assays to a duplex assay allowing the identification of ASF and internal control in a single PCR tube and to compare primers, that target the p72 gene (ASF 250 bp and ASF 75 bp) effectivity. Multiplex real-time PCR assays prove to be less time consuming and cost-efficient and therefore have a high potential to be applied in the routine analysis. It is important to have effective and fast method that allows virus detection at the beginning of disease for wild boar population and in outbreaks for domestic pigs. For experiments, we used reference samples (INIA, Spain), and positive samples from infected animals in Lithuania. Results show 100% sensitivity and specificity.

Keywords: African swine fewer, real-time PCR, wild boar, domestic pig

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9550 Linking Remittances and Household Level Development in India: An Analysis of NSSO 64th Round Data

Authors: Rakesh Mishra, Mukunda Upadhyay, Rajni Singh

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This paper attempts to link remittances sent by internal as well as international out-migrants and its domestic preferences of usage in three different dimension of Household level development in India and its states. Investment of remittances in these sectors reveals for mixed choices of preferential among the states from where people have out-migrated. The multivariate analysis implies that among all three indicators of human development, health (Investment in Food and Health) is the one that attracts the major investment followed by capital formation and least on Education. Usage of the remittances has been found to be varying across all the states in India as far as usage in health, capital formation and education are concerned. Orissa, Nagaland, Madhya Pradesh, Jharkhand, Gujarat, D & H Haweli are some of the states and union territory that contributes highest of its international remittances on health, while most of the usage of the internal remittances has second or third preferences of investment on the health except for Uttar Pradesh, D & H Haweli, Arunachal Pradesh and A & N Is. This paper tries to access usage of international remittances as well as internal remittances on the flow of remittances at the micro level and its implications across three basic determinants of Human Development that is Health, Capital formation and Education coupled with the preferences of usage in presence of Several Socio economic and Demographic variable.

Keywords: multivariate analysis, household development, remittances, internal and international migration

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9549 Sustainable Community Participation in Australia

Authors: Virginia Dickson-Swift, Amanda Kenny, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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In this presentation, we will focus on the methods of Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. Using oral health as the focus, we will discuss the ways that RSF can be used to achieve sustainable engagement with stakeholders from various parts of the community. We will describe our findings of using RSF methods to engage with rural communities, including the steps involved and what happened when we asked people about the oral health services that they thought were needed in their community. We found that most community members started by thinking that a public dental clinic was required in every community, which is not a sustainable health service delivery option. Through a series of facilitated workshops, communities were able to discuss and prioritise their needs and develop a costed plan for their community which will ensure sustainable service delivery into the future. Our study highlights the complexities of decision making in rural communities. It is important to ensure that when communities participate in health care planning that the outcomes are practical, feasible and sustainable.

Keywords: community participation, sustainable health planning, Remote Services Futures, rural communities

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9548 Analysis on the Feasibility of Landsat 8 Imagery for Water Quality Parameters Assessment in an Oligotrophic Mediterranean Lake

Authors: V. Markogianni, D. Kalivas, G. Petropoulos, E. Dimitriou

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Lake water quality monitoring in combination with the use of earth observation products constitutes a major component in many water quality monitoring programs. Landsat 8 images of Trichonis Lake (Greece) acquired on 30/10/2013 and 30/08/2014 were used in order to explore the possibility of Landsat 8 to estimate water quality parameters and particularly CDOM absorption at specific wavelengths, chlorophyll-a and nutrient concentrations in this oligotrophic freshwater body, characterized by inexistent quantitative, temporal and spatial variability. Water samples have been collected at 22 different stations, on late August of 2014 and the satellite image of the same date was used to statistically correlate the in-situ measurements with various combinations of Landsat 8 bands in order to develop algorithms that best describe those relationships and calculate accurately the aforementioned water quality components. Optimal models were applied to the image of late October of 2013 and the validation of the results was conducted through their comparison with the respective available in-situ data of 2013. Initial results indicated the limited ability of the Landsat 8 sensor to accurately estimate water quality components in an oligotrophic waterbody. As resulted by the validation process, ammonium concentrations were proved to be the most accurately estimated component (R = 0.7), followed by chl-a concentration (R = 0.5) and the CDOM absorption at 420 nm (R = 0.3). In-situ nitrate, nitrite, phosphate and total nitrogen concentrations of 2014 were measured as lower than the detection limit of the instrument used, hence no statistical elaboration was conducted. On the other hand, multiple linear regression among reflectance measures and total phosphorus concentrations resulted in low and statistical insignificant correlations. Our results were concurrent with other studies in international literature, indicating that estimations for eutrophic and mesotrophic lakes are more accurate than oligotrophic, owing to the lack of suspended particles that are detectable by satellite sensors. Nevertheless, although those predictive models, developed and applied to Trichonis oligotrophic lake are less accurate, may still be useful indicators of its water quality deterioration.

Keywords: landsat 8, oligotrophic lake, remote sensing, water quality

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9547 Exploring Women's Needs Referring to Health Care Centers for Doing Pap Smear Test

Authors: Arezoo Fallahi, Fateme Aslibigi, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background and Aims: Cancer of the cervix, one of cancer-related death, is the second most common cancer in women worldwide. It develops over time but it is one of the most preventable types of cancer and there is the available proper screening program for its preventing. Since Pap smear test is vital to prevent and control of disease but women do not accomplish it regularly. Therefore, this study was aimed to explore women's needs referring to health care centers for doing Pap smear test. Material and methods: In this study, an inductive qualitative method with content analysis approach was used. This survey was done in varamin city (is located capital of Iran) in year 2014. Through the purposive sampling 15 women's view of point referring to health care centers of for doing Pap smear test was surveyed. Inclusion criteria were: 20-50 years old married women, having experience Pap smear test and attendance to participate in the Study. Recorded semi- structured interviews were typed and analyzed through of content analysis method. To obtain trustworthiness and rigor of the data, the criteria of credibility, dependability, confirmability and transferability was used. Results: During the data analysis, four main categories of “role of health care team”, “role of organizations”, “social support” and “policies and administration system” were developed. The participants emphasized on making motivational rules and coordination among organizations to do behaviors related to women health. Conclusion: The findings of study showed that doing Pap smear test are attributed to appropriate and intimate interactions with health professionals, family support, encouraging legislation and policies and coordination and notification of organizations. Therefore, designers and stockholders of policies and health system should more consider to growth and involve other organizations toward women's health.

Keywords: qualitative approach, pap smear test, women, health care centers

Procedia PDF Downloads 492