Search results for: health services evaluation

Authors: Neeru Bhatia

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This article presents the results of a case study designed to analyze and deduce Information seekers and the Information Providers in today’s context, wherein we come across a sea of change in the provision of Information services due to the changing electronic environment. The Panjab University Library is one of the biggest libraries of India and was inaugurated in 1963 by Pt. Jawaharlal Nehru, the then Prime Minister of India. The library always thrives to assimilate new technology for the provision of Information services. As we know that the Information seekers today are a whole lot different, they are tech savvy, like to be on their electronic gadgets most of the time, and their Information seeking patterns are also different, the challenge that lies before the libraries is to be always ready for these day to day challenges. The study explores the current status of the Information Services being provided by the Panjab University Library (the Information Providers) vs. the evaluation of these Information services by the users of Library (the Information Seekers). The present study aimed at finding out whether Panjab University Library is able to achieve its mission to be an innovative and user-oriented library by exploring all the new vistas and reach up to the expectations of the information seekers by taking up all the challenges being posed by the ever changing technological scenario.

Keywords: electronic environment, information seekers, information providers, new technology

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Authors: Jenny K. Ubaque, Edward P. Guillen, Juan S. Solórzano, Leonardo J. Ramírez

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The health care must be a right for people around the world, but in order to guarantee the access to all, it is necessary to overcome geographical barriers. Telemedicine take advantage of Information Communication Technologies to deploy health care services around the world. To achieve those goals, it is necessary to use existing last mile solution to create access for home users, which is why is necessary to establish the channel characteristics for those kinds of services. This paper presents an analysis of network performance of last mile solution for the use of IPTV broadcasting with the application of streaming for telemedicine apps.

Keywords: telemedicine, IPTV, GPON, ADSL2+, coaxial, jumbogram

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

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Authors: Eda Yakit Ak, Ergül Aslan

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The study was conducted using the quasi-experimental design to determine the influence of the nursing support program prepared according to the Health Belief Model on reproductive health behaviors of orthopedically disabled women in the physical therapy and rehabilitation clinic at a university hospital between August 2019-October, 2020. The research sample included 50 women (35 in the control group and 15 in the experimental group with orthopedic disability). A 3-week nursing support program was applied to the experimental group of women. To collect the data, Introductory Information Form and Scale for Determining the Protective Attitudes of Married Women towards Reproductive Health (SDPAMW) were applied. The evaluation was made with a follow-up form for four months. In the first evaluation, the total SDPAMW scores were 119.93±20.59 for the experimental group and 122.20±16.71 for the control group. In the final evaluation, the total SDPAMW scores were 144.27±11.95 for the experimental group and 118.00±16.43 for the control group. The difference between the groups regarding the first and final evaluations for the total SDPAMW scores was statistically significant (p<0.01). In the experimental group, between the first and final evaluations regarding the sub-dimensions of SDPAMW, an increase was found in the behavior of seeing the doctor on reproductive health issues, protection from reproductive organ and breast cancer, general health behaviors to protect reproductive health, and protection from genital tract infections (p<0.05). Consequently, the nursing support program based on the Health Belief Model applied to orthopedically disabled women positively affected reproductive health behaviors.

Keywords: orthopedically disabled, woman, reproductive health, nursing support program, health belief model

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Authors: Elkington Sibusiso Mnguni

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Although South Africa has made good progress in providing basic water and sanitation services to its citizens, there is still a large section of the population that has no access to these services. This paper reviews the performance of the government’s municipal infrastructure grant programme in providing basic water and sanitation services which are part of the constitutional requirements to the citizens. The method used to gather data and information was a desk top study which sought to review the progress made in rolling out the programme. The successes and challenges were highlighted and possible solutions were identified that can accelerate the elimination of the remaining backlogs and improve the level of service to the citizens. Currently, approximately 6.5 million citizens are without access to basic water services and approximately 10 million are without access to basic sanitation services.

Keywords: grant, municipal infrastructure, sanitation, services, water

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Authors: Isaac Kofi Mensah

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Public sector organizations, ministries, departments and local government agencies are adopting e-government as a means to provide efficient and quality service delivery to citizens. The purpose of this research paper is to examine the extent to which perceived usefulness (PU) of e-government services moderates between perceived ease-of-use (PEOU) of e-government services and intention to use (IU) e-government services in Ghana. A structured research questionnaire instrument was developed and administered to 700 potential respondents in Ghana, of which 693 responded, representing 99% of the questionnaires distributed. The Technology Acceptance Model (TAM) was used as the theoretical framework for the study. The Statistical Package for Social Science (SPSS) was used to capture and analyze the data. The results indicate that even though predictors such as PU and PEOU are main determiners of citizens’ intention to adopt and use e-government services in Ghana, it failed to show that PEOU and IU e-government services in Ghana is significantly moderated by the PU of e-government services. The implication of this finding on theory and practice is further discussed.

Keywords: e-government services, intention to use, moderating role, perceived ease of use, perceived usefulness, Ghana, technology acceptance model

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Rajiv Kumar, Amit Sachan, Arindam Mukherjee

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Government agencies around the world, including India, are incorporating digital technologies and processes into their day-to-day operations to become more efficient. Despite low internet penetration (around 34.8% of total population) in India, Government of India has made some public services mandatory to access online (e.g. passport, tax filing).This is insisting citizens to access mandatory public services online. However, due to digital divide, all citizens do not have equal access to internet. In light of this, it is an interesting topic to explore how citizens are able to access mandatory online public services. It is important to understand how citizens are adopting these mandatory e-government services and how the adoption behavior of these mandatory e-government services is different or similar to adoption behavior of non-mandatory e-government services. The purpose of this research is to investigate the factors that influence adoption of mandatory and non-mandatory e-government services in India. A quantitative technique is employed in this study. A conceptual model has been proposed by integrating the influencing factors to adopt e-government services from previous studies. The proposed conceptual model highlights a comprehensive set of potential factors influencing the adoption of e-government services. The proposed model has been validated by keeping in view the local context of Indian society. Online and paper based survey was administered, collected data was analyzed and results have been discussed. A total of 463 valid responses were received and further the responses were analyzed. The research reveals that the influencing factors to adopt e-government services are not same for both mandatory and non-mandatory e-government services. There are some factors that influence adoption of both mandatory and non-mandatory e-government services but there are some which are relevant for either of mandatory and non-mandatory e-government services. The research findings may help government or concerned agencies in successfully implementing e-government services.

Keywords: adoption, e-government, India, mandatory, non-mandatory

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

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

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

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: Budoor Al Abid

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Educational systems are increasingly provided as open online services, providing guidance and support for individual learners. To adapt the learning systems, a proper evaluation must be made. This paper builds the evaluation model Fuzzy C Means Adaptive System (FCMAS) based on data mining techniques to assess the difficulty of the questions. The following steps are implemented; first using a dataset from an online international learning system called (slepemapy.cz) the dataset contains over 1300000 records with 9 features for students, questions and answers information with feedback evaluation. Next, a normalization process as preprocessing step was applied. Then FCM clustering algorithms are used to adaptive the difficulty of the questions. The result is three cluster labeled data depending on the higher Wight (easy, Intermediate, difficult). The FCM algorithm gives a label to all the questions one by one. Then Random Forest (RF) Classifier model is constructed on the clustered dataset uses 70% of the dataset for training and 30% for testing; the result of the model is a 99.9% accuracy rate. This approach improves the Adaptive E-learning system because it depends on the student behavior and gives accurate results in the evaluation process more than the evaluation system that depends on feedback only.

Keywords: machine learning, adaptive, fuzzy logic, data mining

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Authors: Carmen Cantuarias-Villessuzanne, Jeffrey Blain, Radmila Pineau

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Our research project aims at analyzing the sensitiveness of French households to urban biodiversity and urban ecosystem services (UES). Opinion surveys show that the French population is sensitive to biodiversity and ecosystem services loss, but the value given to these issues within urban fabric and real estate market lacks evidence. Using GIS data and economic evaluation, by hedonic price methods, weassess the isolated contribution of the explanatory variables of biodiversityand UES on the price of residential real estate. We analyze the variation of the valuefor three urban ecosystem services - flood control, proximity to green spaces, and refreshment - on the price of real estate whena property changes ownership. Our modeling and mapping focus on the price at theIRIS scale (statistical information unit) from 2014 to 2019. The main variables are internal characteristics of housing (area, kind of housing, heating), external characteristics(accessibility and infrastructure, economic, social, and physical environmentsuch as air pollution, noise), and biodiversity indicators and urban ecosystemservices for the Ile-de-France region. Moreover, we compare environmental values on the enhancement of greenspaces and their impact on residential choices. These studies are very useful for real estate developers because they enable them to promote green spaces, and municipalities to become more attractive.

Keywords: urban ecosystem services, sustainable real estate, urban biodiversity perception, hedonic price, environmental values

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Authors: Andrew Rylance, Anna Spenceley

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An evaluation was undertaken to understand opportunities for stimulating local enterprise development within the tourism supply chain, linked to a private game reserve in South Africa, the Sabi Sand Game Reserve, which neighbors the Kruger National Park. The study focused on understanding the market demand for local products and services from commercial lodges, and the current local supply from enterprises and entrepreneurs in local communities. This article quantifies the value of current procurement spend by lodges on local products and services and estimates their potential future expenditure. The study matches these responses with the availability of products and services in the neighboring communities. It also provides insights into relationships between private lodges, game reserves and local communities in South Africa. It concurs with previous research on tourism supply chains in rural South Africa, and also makes recommendations for the development of local businesses with higher technical capacity development.

Keywords: tourism, communities, business development, South Africa, Sabi Sand Game Reserve, market study, supply study

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Authors: M. Moiz

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Family planning has been known and accepted as a key tool to decrease fertility, provides birth spacing and plays a vital role to attain better outcomes for maternal and child health. Pakistan initiated various family planning programs to preserve maternal and child health for six decades. However, less contraceptive use leading to high fertility and low birth spacing is ultimately a risk for increasing morbidity and mortality. As an outcome of 2012 London Summit on Family Planning where 20 countries including Pakistan made its commitment to increase contraceptive prevalence rate by 55% and provide a universal access to reproductive health to protect human rights of women and ensure safe, choice informed and affordable contraceptives throughout the country. This paper will assess some of the factors of service delivery, coverage and the role of Ministry of Health and Population Welfare Department in providing Family Planning services and how it can be improved in Pakistan. In view of Pakistan Demographic Health Survey 2017-18, there are total nine million potential users of contraceptives and one third among them never used with unmet need while every fifth pregnancy ends into abortion indicates need for Family Planning services. In order to explain this concern, a comprehensive analysis has been done on role of governance in implementing family planning policy and its limitations are discussed. Moreover, this paper highlights policy options and recommendations for improving service provision through public and private sector in creating demand for Family Planning services in Pakistan.

Keywords: contraceptive prevalence rate, family planning, maternal and child health, policy options

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Authors: Mohamed Elhadi M. Sharif, Mona Masood

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The usage of e-health facilities is seen to be the first priority by the Libyan government. As such, this paper focuses on how the key factors or elements of working size in terms of technological availability, structural environment, and other competence-related matters may affect nurses’ sharing of knowledge in e-health. Hence, this paper investigates learning readiness assessment to raise e-health for Libyan regional hospitals by using e-health services in nursing education.

Keywords: Libyan nurses, e-learning readiness, e-health, nursing education

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Authors: Mokhtar Azizi

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Due to heavy traffic and congested roads, it is crucial that the most popular main public transport services in Kuala Lumpur i.e. Putra LRT, Star LRT, KTM Commuter, KL Monorail and Rapid Bus must be continuously monitored and improved to fulfill the rider’s requirement and kept updated by the transit agencies. Evaluation on the current status of the services has been determined out by calculating the transit supportive area (TSA) and level of service (LOS) for each transit station. This research study has carried out the TSA and LOS mapping based on GIS techniques. The detailed census data of the region along the line of services has been collected from the Department of Statistics Malaysia for this purpose. The service coverage has been decided by 400 meters buffer zone for bus stations and 800 meters for rails station and railways in measurement the Quality of Service along the line of services. All the required information has been calculated by using the customized GIS software called Kuala Lumpur Transit Information System (KLTIS). The transit supportive area was calculated with the employment density at least 10 job/hectare or household density at 7.5 unit/hectare and total area covered by transit supportive area is 22516 hectare and the total area that is not supported by transit is 1718 hectare in Kuala Lumpur. The level of service is calculated with the percentage of transit supportive area served by transit for each station. In overall the percentage transit supportive areas served by transit for all the stations were less than 50% which falls in a very low level of service category. This research has proven its benefit by providing the current transit services operators with vital information for improvement of existing public transport services.

Keywords: service coverage, transit supportive area, level of service, transit system

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Authors: Doctor Akanle Florence Foluso

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Access to health care and people’s ability to having a responsible, satisfying and safe sexual life is clearly a defined human right of people with hearing impairment and others with disabilities this paper looks at disability and sexuality: a human right approach to sexual and reproductive health of the hearing impaired adolescents in developing countries. This paper investigates the extent to which the hearing impaired has a satisfying, safe sexual life and whether their human right in regards to information education is violated. The study population consists of all hearing impaired adolescents and young adults aged 10-24 years who are currently enrolled in the primary and secondary schools in Nigeria. A sample of 389 hearing impaired adolescents was selected, an adapted version of the illustrative questionnaire for interview – survey by Johncleland was used to collect the data. A correlation of 0.80 was obtained at p<0.05 level of significance. Teachers in the schools of the deaf who used sign language were used in the administration of the questionnaire. The data generated were analyzed using Frequency Counts, Percentages, Means and Standard Deviation to give a Summary on responses on access to information, education, voluntary testing and counselling and other reproductive services. This is to investigate if the sexual and reproductive right violated or protected. Findings show that a gap exists in the level of knowledge of SRH services, voluntary counselling because more than half the respondents are not aware of these services in their community. Access to information, education and health services are rights denied the hearing impaired. So their SRH rights are violated.

Keywords: sexual right diability, family planning, pregnancy, diability

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Authors: Samaneh Abedini, Diana Urajnik, Nicole Naccarato

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A high prevalence of mental health problems was observed in marginalized youth living in underserved regions of Ontario during the COVID-19 pandemic. To address this issue, a growing number of community-based traditional mental health services are offering digital mental health resources due to their accessibility, affordability, and scalability. The feasibility of providing these resources in underserved regions has been examined by researchers rather than by representatives of effective services within a mental health system. Indeed, digitalized mental health contents are not routinely embedded within local mental health organizations' services in Northern Ontario, where they can make a substantial impact. To date, many technology-based mental health initiatives have not been effectively implemented in this region. The obstacles associated with implementing digitalized mental health resources in Northern Ontario may be unique to that region. Thus, specific context-based considerations might need to be applied for developing and implementing digital resources by regional mental health organizations in Northern Ontario. The target population was child-serving organizations situated in northeastern Ontario, specifically within Greater Sudbury and the Sudbury District. A sample of six organizations were selected with representation from the mental health, social, and healthcare sectors. The project supervisor was in a unique position to access the organizations by virtue of existing relationships with the practice and lay communities at large. Thus, recruitment was conducted through professional outreach in partnership with the Center for Rural and Northern Health Research (CRaNHR). Semi-structured interviews were conducted with 1-2 key personnel (e.g., administrator, clinician) from participating organizations. Audio recordings from the semi-structured interviews were transcribed verbatim and thematically analyzed supported by NVivo. Thematic analysis of the data resulted in a total of 13 excerpts which were categorized into two major themes including 1) digital mental health services as a valuable resource for organizations both during and after the pandemic, and 2) barriers and facilitators to a successful implementation of digital mental health resources in northern Ontario. Four secondary themes were identified: 1) perceived barriers to implementation of digital mental health resources to the offered services by mental health agencies; 2) acceptability and feasibility of digital health sources for people living in northern Ontario; 3) data security, safety, and risk; and 4) connecting with clients. The employees of mental health organizations in northern Ontario considered digital mental health resources as generally acceptable to youth. However, they raised several concerns that may affect their implementation into routine practice and service delivery. The implementation of digital systems should be simple and straightforward and should enhance rather than hinder clinical workflows for staff. A clear plan for implementing technological services is also required for the successful adoption of digital systems. For successful adoption and implementation of digital systems, staff views must be considered.

Keywords: COVID-19 pandemic, digital mental health resources, Ontario, underserved

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Authors: Jiaqi Zhang, Zhi Dong, Pan Xing

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With the continuous development of urban agglomerations, higher demands are placed on intercity public transport travel services. To improve these services, it is necessary to comprehensively understand the views and evaluations of travelers. Taking the Guanzhong Plain urban agglomeration in China as the object, this study explores subjective attitude indicators from self-administrated survey data and examines the relationship among perceived accessibility, preference, and satisfaction for intercity public transport using a structural equation model. The results show that perceived service quality has a direct positive impact on perceived accessibility and satisfaction. Perceived accessibility and preference significantly affect satisfaction. In addition, perceived accessibility mediates the effect of service quality on satisfaction. This study provides valuable insights from a policy perspective to improve the subjective evaluation of intercity public transport travelers while emphasizing the importance of subjective variables in transport system evaluation and advocates for their subdivision to more comprehensively improve the travel experience.

Keywords: intercity public transport, perceived accessibility, satisfaction, structural equation model

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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Authors: Nasim Hashemi, Abbas Sheikhtaheri

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Telemedicine is the use of telecommunication and information technologies to provide health care services that would often not be consistently available in distant rural communities to people at these remote areas. Teleophthalmology is a branch of telemedicine that delivers eye care through digital medical equipment and telecommunications technology. Thus, teleophthalmology can overcome geographical barriers and improve quality, access, and affordability of eye health care services. Since teleophthalmology has been widespread applied in recent years, the aim of this study was to determine the different applications of teleophthalmology in the world. To this end, three bibliographic databases (Medline, ScienceDirect, Scopus) were comprehensively searched with these keywords: eye care, eye health care, primary eye care, diagnosis, detection, and screening of different eye diseases in conjunction with telemedicine, telehealth, teleophthalmology, e-services, and information technology. All types of papers were included in the study with no time restriction. We conducted the search strategies until 2015. Finally 70 articles were surveyed. We classified the results based on the’type of eye problems covered’ and ‘the type of telemedicine services’. Based on the review, from the ‘perspective of health care levels’, there are three level for eye health care as primary, secondary and tertiary eye care. From the ‘perspective of eye care services’, the main application of teleophthalmology in primary eye care was related to the diagnosis of different eye diseases such as diabetic retinopathy, macular edema, strabismus and aged related macular degeneration. The main application of teleophthalmology in secondary and tertiary eye care was related to the screening of eye problems i.e. diabetic retinopathy, astigmatism, glaucoma screening. Teleconsultation between health care providers and ophthalmologists and also education and training sessions for patients were other types of teleophthalmology in world. Real time, store–forward and hybrid methods were the main forms of the communication from the perspective of ‘teleophthalmology mode’ which is used based on IT infrastructure between sending and receiving centers. In aspect of specialists, early detection of serious aged-related ophthalmic disease in population, screening of eye disease processes, consultation in an emergency cases and comprehensive eye examination were the most important benefits of teleophthalmology. Cost-effectiveness of teleophthalmology projects resulted from reducing transportation and accommodation cost, access to affordable eye care services and receiving specialist opinions were also the main advantages of teleophthalmology for patients. Teleophthalmology brings valuable secondary and tertiary care to remote areas. So, applying teleophthalmology for detection, treatment and screening purposes and expanding its use in new applications such as eye surgery will be a key tool to promote public health and integrating eye care to primary health care.

Keywords: applications, telehealth, telemedicine, teleophthalmology

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Authors: Akram Atef Rawshdeh

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This research aims to prove the role of Islamic pilgrimage caravans in formulating the concept of the tourism industry and the concept of Grand Tours before that which was found in Europe in the medieval and modern Ages, through its duration and the number of tourists who participated in it and its role in providing tourism services from the establishment of castles and inns that were built To accommodate pilgrims during their travels from different regions of the Islamic world to the holy places in Saudi Arabia, as well as food and beverage services, transportation and support services like tourist security and tourist guide services. This research will depend on the historical method

Keywords: grand tour, hajj caravan routes, tourism services, transportation

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Authors: Anan Alssbaiheen, Steve Love

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Given the lack of research into potential opportunities and challenges which are likely to be associated with the implementation of mobile services in developing countries including Saudi Arabia, the research reported here investigated the challenges and opportunities which are associated with the implementation of mobile government services in Saudi Arabia. By collecting data through surveys from 103 Saudi citizens and 46 employees working at the Ministry of Communication and Information Technology Saudi Arabia, this study indicates that the high level of mobile penetration in the country offers an opportunity for Saudi Arabian government to offer mobile government services in the country. The results also suggest that though a large percentage of populations do not have access to mobile technologies, there is still a strong desire among users for the provision of mobile government services. Moreover, the results suggest that effective implementation of mobile government services would help to increase the technological development of Saudi Arabia. However, there are certain challenges which may prevent the effective implementation of such services. First, there does not appear to be a sufficient level of understanding among the Saudi Arabian population about the benefits which are associated with mobile government services. Secondly, the results suggest that the implementation of the services needs to be closely tailored and personalised to the individual needs of target users. Finally, the lack of access to mobile technologies would be a challenge to the successful introduction of these services.

Keywords: challenges, e-government, mobile government, opportunities

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Authors: Festus Adedoyin, Nana Mbeah Otoo, Sofia Meacham

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Hypertension is one of the main health issues in Ghana, where prevalence is higher in rural than in urban areas. This is due to the challenges rural areas have in accessing technology and healthcare services for hypertension control. This study's goal is to create a digital healthcare solution to alleviate this inequality. Through an analysis of current technology and problems, using the ring onion methodology, the study determined the needs for the intervention and evaluated healthcare disparities. An online application with teleconsultation capabilities, reminder mechanisms, and clinical decision support is part of the suggested solution. In outlying areas, mobile clinics in containers with the required equipment will be established. Heuristic evaluation and think-aloud sessions were used to assess the prototype's usability and navigational problems. This study highlights the need to develop digital health interventions to help manage hypertension in rural locations and decrease healthcare disparities. To develop and improve digital healthcare solutions for rural areas worldwide and in Ghana, this study might be used as a tool for future research.

Keywords: digital health, health inequalities, hypertension management, rural areas

Procedia PDF Downloads 108

Authors: T. Frawley, G. O'Kelly

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The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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Authors: Purevdolgor Luvsantseren, Ajnai Luvsan-Ish, Oyuntsetseg Sandag, Javzmaa Tsend, Akhit Tileubai, Baasandorj Chilhaasuren, Jargalbat Puntsagdash, Galbadrakh Chuluunbaatar

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One of the indicators of the quality of university services is student satisfaction. Aim: We aimed to study the level of satisfaction of students in the first year of premedical courses in the course of Medical Physics using the cluster method. Materials and Methods: In the framework of this goal, a questionnaire was collected from a total of 324 students who studied the medical physics course of the 1st course of the premedical course at the Mongolian National University of Medical Sciences. When determining the level of satisfaction, the answers were obtained on five levels of satisfaction: "excellent", "good", "medium", "bad" and "very bad". A total of 39 questionnaires were collected from students: 8 for course evaluation, 19 for teacher evaluation, and 12 for student evaluation. From the research, a database with 39 fields and 324 records was created. Results: In this database, cluster analysis was performed in MATLAB and R programs using the k-means method of data mining. Calculated the Hopkins statistic in the created database, the values are 0.88, 0.87, and 0.97. This shows that cluster analysis methods can be used. The course evaluation sub-fund is divided into three clusters. Among them, cluster I has 150 objects with a "good" rating of 46.2%, cluster II has 119 objects with a "medium" rating of 36.7%, and Cluster III has 54 objects with a "good" rating of 16.6%. The teacher evaluation sub-base into three clusters, there are 179 objects with a "good" rating of 55.2% in cluster II, 108 objects with an "average" rating of 33.3% in cluster III, and 36 objects with an "excellent" rating in cluster I of 11.1%. The sub-base of student evaluations is divided into two clusters: cluster II has 215 objects with an "excellent" rating of 66.3%, and cluster I has 108 objects with an "excellent" rating of 33.3%. Evaluating the resulting clusters with the Silhouette coefficient, 0.32 for the course evaluation cluster, 0.31 for the teacher evaluation cluster, and 0.30 for student evaluation show statistical significance. Conclusion: Finally, to conclude, cluster analysis in the model of the medical physics lesson “good” - 46.2%, “middle” - 36.7%, “bad” - 16.6%; 55.2% - “good”, 33.3% - “middle”, 11.1% - “bad” in the teacher evaluation model; 66.3% - “good” and 33.3% of “bad” in the student evaluation model.

Keywords: questionnaire, data mining, k-means method, silhouette coefficient

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Authors: Hasnizan Aksah, Adi Irfan Che Ani

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Refurbished historic government buildings should perform as intended to support the organization’s goals that enhance occupant satisfaction. However, these buildings may have issues associated with functional performance evaluation. The aim of this study is to develop a Post Occupancy Evaluation (POE) sustainability assessment tool for functional performance evaluation of refurbished historic government buildings. Developing an assessment tool requires a strategic methodology for a logical and cohesive tool that incorporating relevant theories and practical experiences. In this study, mixed method approaches use to collect all necessary data to achieve the objectives of this study. The design of sampling involves are interviews and survey questionnaires to relevant professionals in order to evaluate the criteria and problem encircled in functional performance evaluation. Then, the involvement of expert panels is required in establishing the assessment tool. During the process of investigation on the functional performance criteria, it was discovered that is seen to be critical in aspects of comfort, safety, and services. The proposed assessment tool has a significant role in providing opportunities for the improvement of building performance especially on functional performance for the future historic government building refurbishment project. It is hoped that the tool developed from this study will give benefits to related professionals, public agencies, local municipality, and relevant interested parties in historic building management.

Keywords: refurbished historic government buildings, functional performance, Post Occupancy Evaluation, sustainability

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Authors: Mikiyas Yonas Fufa

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- Maternal and child health service was a critical service which may have many risks and many maternal and newborn mortality is there if not managed properly. In middle and low countries like Ethiopia accessibility and quality of MCH service is low. During this COVID-19 Pandemics even the pervious access of MCH will be decreased. So many pregnant mothers are not attending their ANC, Delivery and other services in the hospital because they think they are more vulnerable to COVID-19. This condition may make an increase of maternal and neonatal morbidity and mortality. The innovation is an idea (which is development of a mobile app prepared by Maternity Foundation organization that focuses on midwifery care. The app has detailed videos on danger signs in pregnancy and procedures during labor and delivery). By telling this to clients it is planned to explore the perception, attitude towards this innovation and barriers to accepting it. What is planned to study is to explore the perceptions and barriers towards using of new idea which is innovation of mHealth on the MCH services. It is planned to interview the pregnant mothers who come for ANC at health facility and mothers who are absent from their appointment of services. In this way it is planned to explore how the mothers accept this idea and what barriers make them from accepting this idea. This is a phenomenological qualitative study and application of diffusion of innovation theory on the MCH services. The participant will be selected by using quota sampling methods for the mother who are interviewed at hospitals and snowball/quota sampling methods for the mother who are absent from their appointment/visits. Sample size of the participant depends on the saturation of data/idea. Each participant will be interviewed based the open-ended questionnaires, and the interview will be recorded then transcribed then finally analyzed by the open code 4.03. Beneficiaries: The federal ministry of health prepares them to develop the apk of mhealth. Health professionals in the MCH will have a low overload and accessibility and the quality of care will be increased during COVID-19 Different collaborations will be participated and promote the mother to enjoy the new idea.

Keywords: COVID-19, m health, MCH, diffusion of innovation

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Authors: Erickson Bernardo, Caridad Pineda

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The project Adolescent Reproductive Health Information and Services (ARHIS) is a nine-month pilot project which intends to bridge the existing gap between reproductive health information and services, particularly with regard to family planning and HIV, among adolescent boys and girls aged 10-19 years in the 2nd Congressional District of Quezon City, in the Philippines. It aims to increase adolescents' and young people's awareness about their reproductive health concerns and at the same time make a wide range of reproductive health (RH) services accessible and available to them. A number of methodologies were utilized in the implementation of the project. At the onset, a baseline survey was conducted by community mobilizers to gather a situational analysis of adolescents' and young people's issues and concerns. The results of this survey were then presented in a multi-stakeholders' meeting to gather community support and foster their involvement. Further, interactive learning sessions (ILS) on a variety of reproductive health topics, among young people, parents and community leaders based on the results of the baseline survey was conducted. With regard to reproductive health service provision, both facility-based delivery and conduct of outreach activities were employed. In the span of nine months, the project was able to yield the following results: • A total of 521 adolescents and youth (AY) were reached by ILS on puberty, responsible relationships, teenage pregnancy, family planning, as well as HIV & AIDS. • A total of 218 parents and community leaders were informed of AY RH-related issues and concerns. • More than 350 AYs availed of a wide range of FP services including pills – both combined oral and progestin-only, and progestin-only injectables and implants. • More than 380 AYs availed of condoms as means of STI and HIV prevention. A noble initiative of the project is the utilization of a "condom distributor", a youth leader who has been educated about STI and HIV prevention as well as correct condom use, as the focal point for condom access in the community. • A total of 25 young people, parents, and community leaders were identified as ARHIS champions who have been instrumental in the achievement of project deliverables through their dedication and commitment to support the project. The concept of adolescent sexual and reproductive health (ASRH) remains to be a major challenge in the Philippine context. This is due to the fact that majority of Filipinos are still not keen on discussing issues and concerns related to ASRH, albeit the alarming number of teenage pregnancies and the rapid increase of HIV cases among 15- 24 year olds. In addition, Republic Act 10354 or the Responsible Parenthood and Reproductive Health Act of 2012, requires minor adolescents to present a written parental consent prior to accessing RH services. However, with the involvement and support of parents and key community stakeholders, these barriers may be addressed. The project has demonstrated how adolescents and young people yearn for reproductive health information and services.

Keywords: adolescent sexual reproductive health, barriers to access, reproductive health information and services, teenage pregnancies

Procedia PDF Downloads 177