Search results for: Greek public hospital sector
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10189

Search results for: Greek public hospital sector

7999 Basic Aspects and Ecology of a Group of Capuchin Monkeys (Cebus spp.) (Primates: Cebidae) and Frequency of Contact with Visitor of the State Park Alberto Lofgren, Sao Paulo, Brazil

Authors: Luma Vaz, Marcio Port-Carvalho

Abstract:

The main objective of this research was to study the basics aspects of the ecology of a group of capuchin monkeys (Cebus spp.), evaluating the risks that habit and food that is given by the visitors may cause to the people's health and animals welfare, also how to make proposals for mitigation and management guidelines. In order to do that, some aspects of the animal's ecology (such as diet, habitat range and habitat use) and activity patterns were studied. It was also measured the frequency of contact with visitors at the park using protocols for data collection. The behavioral categories of displacement and resting represent more than 80% of total activities, followed by feeding (13%) and others (6%). When compared to the studies in natural environment, the Cebus group studied has a small living area (1.7ha) occupying mostly the PEAL public area. The diversity of items offered by the visitors and the high frequency of contact closer than one meter suggests that using information and education campaigns must be a priority in the public program in PEAL in order to avoid future accidents and diseases transmissions.

Keywords: capuchin monkeys, Cebus, environmental education, public health, wildlife management

Procedia PDF Downloads 133
7998 We Cannot Cross Our Limits: Sexuality and Desire in Urban Pakistani Youth's Gendered Performance

Authors: Shirin Zubair

Abstract:

Keeping in view the segregation of space(s) experienced by young women and men at puberty in Pakistan and the socially constructed and performative aspect of gender identity by Western theorists of gender and self, this paper will explore Pakistani youth’s differential, gendered performances. Specifically focused on Pakistani youth’s perceptions and experiences of sexuality, extramarital and same-sex relationships in constructing and performing gendered identities as manifested through their talk, the research will also draw upon recent theories of space in cultural studies and postcolonial discourses. The data cited has been culled from two different studies conducted at universities in the city of Multan. Informal, unstructured group discussions of women and men aged between twenty and twenty nine years of age were recorded separately among groups of friends and cohorts studying at two different universities. The findings clearly show both young women and men doing the boundary work in identity construction in private and public spaces: talking of sexuality, sexual desire and sexual relationships, women tend to safely couch their articulations in euphemisms: distance themselves from the Western concepts of sexual liberation ; while young men’s exhibitionism in boasting of their sexual prowess and sexual encounters as well as the use of sexually explicit and tabooed words frequently in their intimate conversations shows a clear departure from and a contestation of the normative public discourses. Further the findings illustrate that young men conform to the patriarchal ideologies by constructing heterosexual identities whereas young women initiate discourse on same-sex relationships. The data also reveals that the private identities of these young Pakistanis are different from their public identities, as it is in their intimate conversations and private (or safe) spaces that they talk about their pre-marital sexual activities and love affairs. These intimate and safe spaces thus emerge as subversion and contestation of their public identity, as sex and sexuality are tabooed subjects in public discourses.

Keywords: sexuality, gender, identity, performance

Procedia PDF Downloads 329
7997 Role of mHealth in Effective Response to Disaster

Authors: Mohammad H. Yarmohamadian, Reza Safdari, Nahid Tavakoli

Abstract:

In recent years, many countries have suffered various natural disasters. Disaster response continues to face the challenges in health care sector in all countries. Information and communication management is a significant challenge in disaster scene. During the last decades, rapid advances in information technology have led to manage information effectively and improve communication in health care setting. Information technology is a vital solution for effective response to disasters and emergencies so that if an efficient ICT-based health information system is available, it will be highly valuable in such situation. Of that, mobile technology represents a nearly computing technology infrastructure that is accessible, convenient, inexpensive and easy to use. Most projects have not yet reached the deployment stage, but evaluation exercises show that mHealth should allow faster processing and transport of patients, improved accuracy of triage and better monitoring of unattended patients at a disaster scene. Since there is a high prevalence of cell phones among world population, it is expected the health care providers and managers to take measures for applying this technology for improvement patient safety and public health in disasters. At present there are challenges in the utilization of mhealth in disasters such as lack of structural and financial issues in our country. In this paper we will discuss about benefits and challenges of mhealth technology in disaster setting considering connectivity, usability, intelligibility, communication and teaching for implementing this technology for disaster response.

Keywords: information technology, mhealth, disaster, effective response

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7996 Maternal Risk Factors Associated with Low Birth Weight Neonates in Pokhara, Nepal: A Hospital Based Case Control Study

Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

Abstract:

Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

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7995 Increasing Participation of KUD (Rural Unit Cooperative) Through 'Kemal Propuri' System to Independence Farmers

Authors: Ikrima Zaleda Zia, Devi Fitri Kumalasari, Rosita Khusna, Farah Hidayati, Ilham Fajrul Haq, Amin Yusuf Efendi

Abstract:

Fertilizer is one of the production factors that are important to agriculture. Fertilizers contribution to the agricultural sector improvement is quite high. Fertilizers scarcity on the society are giving effect to agricultural sector, that is decreasing farmers production. Through a system called Kemal Propuri, society will be taught how to be independent, especially in terms of supplying the fertilizer and how to earn extra income besides of relying on the agriculture production. This research aims to determine implementation measures of Kemal Propuri in realizing farmers independence. This research was designed to use descriptive research with a qualitative approach. In this case, writers are trying to make an illustration of the increasing role of KUD (rural unit cooperative) through Kemal Propuri system (Independence System Through Individual Fertilizer Production) towards farmer independence. It can be concluded that Kemal Propuri system can contribute in order to achieve farmers independence. Independence fertilizer production will overcome farmers dependence of the subsidized fertilizer from the government.

Keywords: Kemal Propuri, KUD (Rural Unit Cooperative), independence farmers, fertilizer production

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7994 Transformation Strategies of the Nigerian Textile and Clothing Industries: The Integration of China Clothing Sector Model

Authors: Adetoun Adedotun Amubode

Abstract:

Nigeria's Textile Industry was the second largest in Africa after Egypt, with above 250 vibrant factories and over 50 percent capacity utilization contributing to foreign exchange earnings and employment generation. Currently, multifaceted challenges such as epileptic power supply, inconsistent government policies, growing digitalization, smuggling of foreign textiles, insecurity and the inability of the local industries to compete with foreign products, especially Chinese textile, has created a hostile environment for the sector. This led to the closure of most of the textile industries. China's textile industry has experienced institutional change and industrial restructuring, having 30% of the world's market share. This paper examined the strategies adopted by China in transforming her textile and clothing industries and designed a model for the integration of these strategies to improve the competitive strength and growth of the Nigerian textile and clothing industries in a dynamic and changing market. The paper concludes that institutional support, regional production, export-oriented policy, value-added and branding cultivation, technological upgrading and enterprise resource planning be integrated into the Nigerian clothing and textile industries.

Keywords: clothing, industry, integration, Nigerian, textile, transformation.

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7993 Ecosystem Services Assessment for Urban Nature-Based Solutions Implemented in the Public Space: Case Study of Alhambra Square in Bogotá, Colombia

Authors: Diego Sánchez, Sandra M. Aguilar, José F. Gómez, Gustavo Montaño, Laura P. Otero, Carlos V. Rey, José A. Martínez, Juliana Robles, Jorge E. Burgos, Juan S. López

Abstract:

Bogota is making efforts towards urban resilience through Nature-based Solutions (NbS) incorporation in public projects as a climate change resilience strategy. The urban renovation project on the Alhambra square includes Green Infrastructure (GI), like Sustainable Urban Drainage Systems (SUDS) and Urban Trees (UT), as ecosystem services (ES) boosters. This study analyzes 3 scenarios: (1) the initial situation without NbS, (2) the expected situation including NbS in the design and (3) the projection of the second one after 30 years, calculating the ecosystem services, the stormwater management benefits provided by SUDS and the cultural services. The obtained results contribute to the understanding of the urban NbS benefits in public spaces, providing valuable information to foster investment in sustainable projects and encouraging policy makers to integrate NbS in urban planning.

Keywords: ecosystem services, nature-based solutions, stormwater management, sustainable urban drainage systems

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7992 The Effect of Evil Eye in the Individuals' Journey for Personhood within a Christian Orthodox Society

Authors: Nikolaos Souvlakis

Abstract:

The present paper negotiates the effect of 'the evil eye' on individuals' mental health while at the same time poses the problem of how the evil eye fits into the anthropological arena as a key question that forges a fundamental link between religion, anthropology and mental health professions. It is the argument of the paper that the evil eye is an essential and fundamental human phenomenon and therefore any scholarly field involved in its study must consider the insight it provides into the development of personhood. The study was an anthropological study in the geographical area of Corfu, a Greek Orthodox society uninfluenced by the Ottoman Islamic Culture. The paper aims to deepen our understanding of the evil eye as it analyses the interaction between the evil eye and gaze and how they affect the development of personhood; based on the empirical data collected from the fieldwork. Therefore, the paper adopts a psychoanalytic anthropology approach to facilitate a better understanding of the evil eye through the accounts of individuals’ journeys in the process of their development of personhood. Finally, the paper aims to offer a detailed analysis of the particular element of eye (‘I’) and, more specifically, of ‘the others’, as they relate to the phenomenon of the evil eye.

Keywords: gaze, evil eye, mental health, personhood

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7991 Pregnancy Outcomes in Patients With Inflammatory Bowel Disease: Retrospective Data From a Greek National Registry

Authors: Evgenia Papathanasiou, Georgios Kokkotis, Georgios Axiaris, Theodoros Argyropoulos, Nikos Viazis, Olga Giouleme, Konstantinos Gkoumas, Αnthia Gatopoulou, Αggelos Theodoulou, Georgios Theocharis, Αngeliki Theodoropoulou, Μaria Κalogirou, Pantelis Karatzas, Κonstantinos Κatsanos, Theodora Kafetzi, Κonstantinos Κarmiris, Αnastasia Κourikou, Ιoannis E Κoutroubakis, Christos Liatsos, Gerassimos J. Mantzaris, Νicoletta Μathou, Georgia Bellou, George Michalopoulos Αikaterini Μantaka, Penelope Nikolaou, Μichael Oikonomou, Dimitrios Polymeros, George Papatheodoridis, Εvdoxia Stergiou, Κonstantinos Soufleris, Εpameinondas Skouloudis, Μaria Tzouvala, Georgia Tsiolakidou, Εftychia Tsironi, Styliani Tsafaraki, Kalliopi Foteinogiannopoulou, Konstantina Chalakatevaki, Αngeliki Christidou, Dimitrios K. Christodoulou, Giorgos Bamias, Spyridon Michopoulos, Εvanthia Zampeli

Abstract:

Background: Inflammatory bowel disease (IBD) commonly affects female patients of reproductive age, making the interaction between fertility, pregnancy and IBD an important issue in disease management. The effect of disease activity on the outcome of pregnancy and its impact on neonatal growth is a field of intense research. Close follow-up of pregnant IBD patients by a multidisciplinary team improves maternal and neonatal outcomes. Aim – Methods: Α national retrospective study of pregnancies in women with IBD between 2010-2020 was carried out in 22 IBD reference centers in Greece. Patient characteristics such as disease profile, type of treatment, and disease activity during gestation were analyzed in correlation to the method of delivery, pregnancy outcomes, as well as breastfeeding and offspring health. Results: Two-hundred and twenty-three pregnancies in 175 IBD patients were registered in the study. 122 with Crohn’s disease (CD). Median age during diagnosis was 25.6 years (12-44), with median disease duration of 7.4 years (0-23). One-hundred and twenty-nine patients (58%) were recorded during their first pregnancy. Early pregnancy termination was reported by 48 patients (22%). Pregnancy as a result of in vitro fertilization (IVF) occurred in 15 cases (6.7%). At the beginning of gestation, 165 patients (74%) were under treatment: 48 with anti-TNF agents (29%), 43 with azathioprine (26%), 101 with 5-aminosalicylic acid formulations (61%) and 12 with steroids (7%). We recorded 49 cases of IBD flares (22%) during pregnancy. Two-thirds of them (n=30) were in remission at the onset of the pregnancy. Almost half of them (n=22) required corticosteroid treatment. Patients with ulcerative colitis (UC) were in greater risk of disease flare during pregnancy (p<0.001). All but 3 pregnancies (99.1%) resulted in uncomplicated delivery. In 147 cases (67.1%), cesarean delivery was performed. Two late fetal deaths (0.9%) were reported, both in patients with continuously active disease since the beginning of pregnancy. After delivery, 75 patients (34%) presented with a disease flare, which was associated with active disease at the beginning of pregnancy (p <0.001). Conclusion: The majority of female, Greek IBD patients, had a favorable pregnancy outcome. Active inflammation during gestation and UC diagnosis were associated with a negative impact on pregnancy outcomes. The results of this study are in favor of the continuation of IBD treatment during pregnancy.

Keywords: pregnancy, ulcerative colitis, Crohn disease, flare

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7990 The Influence of Transformational Leadership on Knowledge Sharing in Iraq’s Public and Private Higher Education: A Comparison Study

Authors: Sawsan J. Al-Husseini

Abstract:

Transformational leadership (TL) has been found to have an important influence on knowledge and knowledge management (KM). It can contribute to organizational learning, employees’ creativity, encourage followers to participate in educational programs and develop the skills needed to achieve exceptional performance. This research sought to examine the impact of TL on knowledge donating and collecting and the differences between these impacts in public and private higher education institutes (HEIs) in Iraq. A mixed method approach was taken and 580 valid responses were collected to test the causal relationships between the factors, then 12 interviews were conducted with the leaders of HEIs to give more insight of the findings from quantitative stage. Employing structural equation modelling with AMOS v.24, the research found that TL would be ideal in an educational context, promoting knowledge sharing activities in both sectors. The interviews revealed differences between public and private HEIs in terms of the effects relationships. Guidelines are developed for academics as well as leaders and provided evidence to support the use of TL to encourage knowledge sharing activities within higher education in developing countries particularly Iraq.

Keywords: transformational leadership, knowledge sharing, higher education, multi-group

Procedia PDF Downloads 152
7989 Potency of Minapolitan Area Development to Enhance Gross Domestic Product and Prosperty in Indonesia

Authors: Shobrina Silmi Qori Tarlita, Fariz Kukuh Harwinda

Abstract:

Indonesia has 81.000 kilometers coastal line and 70% water surface which is known as the country who has a huge potential in fisheries sector and also which is able to support more than 50 % of Gross Domestic Product. But according to Department of Marine and Fisheries data, fisheries sector supported only 20% of Total GDP in 1998. Not only that, the highest decline in fisheries sector income occured in 2009. Those conditions occur, because of some factors contributed to the lack of integrated working platform for the fisheries and marine management in some areas which have a high productivity to increase the economical profit every year for the country, especially Indonesia, besides the labor requirement for every company, whether a big company or smaller one, depends on the natural condition that makes a lot of people become unemployed if the weather condition or any other conditions dealing with the natural condition is bad for creating fisheries and marine management, especially in aquaculture and fish – captured operation. Not only those, a lot of fishermen, especially in Indonesia, mostly make their job profession as an additional job or side job to fulfill their own needs, although they are averagely poor. Another major problem are the lack of the sustainable developmental program to stabilize the productivity of fisheries and marine natural source, like protecting the environment for fish nursery ground and migration channel, that makes the low productivity of fisheries and marine natural resource, even though the growth of the society in Indonesia has increased for years and needs more food resource to comply the high demand nutrition for living. The development of Minapolitan Area is one of the alternative solution to build a better place for aqua-culturist as well as the fishermen which focusing on systemic and business effort for fisheries and marine management. Minapolitan is kind of integration area which gathers and integrates the ones who is focusing their effort and business in fisheries sector, so that Minapolitan is capable of triggering the fishery activity on the area which using Minapolitan management intensively. From those things, finally, Minapolitan is expected to reinforce the sustainable development through increasing the productivity of fish – capturing operation as well as aquaculture, and it is also expected that Minapolitan will be able to increase GDP, the earning for a lot of people and also will be able to bring prosperity around the world. From those backgrounds, this paper will explain more about the Minapolitan Area and the design of reinforcing the Minapolitan Area by zonation in the Fishery and Marine exploitation area with high productivity as well as low productivity. Hopefully, this solution will be able to answer the economical and social issue for declining food resource, especially fishery and marine resource.

Keywords: Minapolitan, fisheries, economy, Indonesia

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7988 Building Information Modelling Based Value for Money Assessment in Public-Private Partnership

Authors: Guoqian Ren, Haijiang Li, Jisong Zhang

Abstract:

Over the past 40 years, urban development has undergone large-scale, high-speed expansion, beyond what was previously considered normal and in a manner not proportionally related to population growth or physical considerations. With more scientific and refined decision-making in the urban construction process, new urbanization approaches, aligned with public-private partnerships (PPPs) which evolved in the early 1990s, have become acceptable and, in some situations, even better solutions to outstanding urban municipal construction projects, especially in developing countries. However, as the main driving force to deal with urban public services, PPPs are still problematic regarding value for money (VFM) process in most large-scale construction projects. This paper therefore reviews recent PPP articles in popular project management journals and relevant toolkits, published in the last 10 years, to identify the indicators that influence VFM within PPPs across regions. With increasing concerns about profitability and environmental and social impacts, the current PPP structure requires a more integrated platform to manage multi-performance project life cycles. Building information modelling (BIM), a popular approach to the procurement process in AEC sectors, provides the potential to ensure VFM while also working in tandem with the semantic approach to holistically measure life cycle costs (LCC) and achieve better sustainability. This paper suggests that BIM applied to the entire PPP life cycle could support holistic decision-making regarding VFM processes and thus meet service targets.

Keywords: public-private partnership, value for money, building information modelling, semantic approach

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7987 Hidden Populations and Women: New Political, Methodological and Ethical Challenges

Authors: Renée Fregosi

Abstract:

The contribution presently proposed will report on the beginnings of a Franco-Chilean study to be launched in 2015 by a multidisciplinary team of Renée Fregosi Political Science University Paris 3 / CECIEC, Norma Muñoz Public Policies University of Santiago of Chile, Jean-Daniel Lelievre, Medicine Paris 11 University, Marcelo WOLFF Medicine University of Chile, Cecilia Blatrix Political Science University Paris-Tech, Ernesto OTTONE, Political Science University of Chile, Paul DENY Medicine Paris 13 University, Rafael Bugueno Medicine Hospital Urgencia Pública of Santiago, Eduardo CARRASCO Political Science Paris 3 University. The problem of hidden populations challenges some criteria and concepts to re-examine: in particular the concept of target population, sampling methods to "snowball" and the cost-effectiveness criterion that shows the connection of political and scientific fields. Furthermore, if the pattern of homosexual transmission still makes up the highest percentage of the modes of infection with HIV, there is a continuous increase in the number of people infected through heterosexual sex, including women and persons aged 50 years and older. This group can be described as " unknown risk people." Access to these populations is a major challenge and raises methodological, ethical and political issues of prevention, particularly on the issue of screening. This paper proposes an inventory of these types of problems and their articulation, to define a new phase in the prevention against HIV refocused on women.

Keywords: HIV testing, hidden populations, difficult to reach PLWHA, women, unknown risk people

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7986 Effect of Building Construction Sizes on Project Delivery Methods in Nigeria

Authors: Nuruddeen Usman, Mohammad Sani

Abstract:

The performance of project delivery methods has been an issue of concern to various stakeholders in the construction industry. The contracting system of project delivery is the traditional system used in the delivery of most public projects in Nigeria. The direct labor system is used most times as an alternative to the traditional system. There were so many complain about the performance of contracting system and the suitability of direct labor as an alternative to the delivery of public projects. Therefore, this paper is aimed at investigating the effect of project size on the project delivery methods in the completed public buildings. Questionnaires were self-administered to managerial staff in the study area and analyzed using descriptive statistics. The findings reveals that contracting system was choosing for large size building construction project delivery with higher frequency (F) of 40 (76.9%) against direct labor with 12 (23.1%). While the small size project, the result revealed a frequency (F) of 26 (50%) for contracting system and direct labor system respectively. Base on the research findings, the contracting system, was recommended for all sizes of building construction project delivery while direct labor system can only use as an alternative for small size building construction projects delivery.

Keywords: construction size, contracting system, direct labour, effect

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7985 Green Public Procurement in Open Access and Traditional Journals: A Comparative Bibliometric Analysis

Authors: Alonso-Cañadas J., Galán-Valdivieso F., Saraite-Sariene L., García-Tabuyo M., Alonso-Morales N.

Abstract:

Green Public Procurement (GPP) has recently gained attention in the academic and policy arenas since climate change has shown the need to be addressed by both private companies and public entities. Such growing interest motivates this article, aiming to explore the most influential journals, publishers, categories, and topics, as well as the recent trends and future research lines in GPP. Based on the Web of Science database, 578 articles from 2004 to February 2022 devoted to GPP are analyzed using Bibliometrix, an R-tool to perform bibliometric analysis, and Google’s Big Query and Data Studio. This article introduces a variety of findings. First, the most influential journals by far are “Journal of Cleaner Production” and “Sustainability,” differing in that the latter is open access while the former publishes via traditional subscription. This result also occurs regarding the main publishers (Elsevier and MDPI). These features lead us to split the sample into open-access journals and traditional journals to deepen into the similarities and differences between them, confirming that traditional journals exhibit a higher degree of influence in the literature than their open-access counterparts in terms of the number of documents, number of citations and impact (according to the H index). Second, this research also highlights the recent emergence of green-related terms (sustainable, environment) and, parallelly, the increase in categorizing GPP papers in “green” WoS categories, particularly since 2019. Finally, a number of related topics are emerging and will lead the research, such as food security, infrastructures, and implementation barriers of GPP.

Keywords: bibliometric analysis, green public procurement, open access, traditional journals

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7984 Common Misconceptions around Human Immunodeficiency Virus in Rural Uganda: Establishing the Role for Patient Education Leaflets Using Patient and Staff Surveys

Authors: Sara Qandil, Harriet Bothwell, Lowri Evans, Kevin Jones, Simon Collin

Abstract:

Background: Uganda suffers from high rates of HIV. Misconceptions around HIV are known to be prevalent in Sub-Saharan Africa (SSA). Two of the most common misconceptions in Uganda are that HIV can be transmitted by mosquito bites or from sharing food. The aim of this project was to establish the local misconceptions around HIV in a Central Ugandan population, and identify if there is a role for patient education leaflets. This project was undertaken as a student selected component (SSC) offered by Swindon Academy, based at the Great Western Hospital, to medical students in their fourth year of the undergraduate programme. Methods: The study was conducted at Villa Maria Hospital; a private, rural hospital in Kalungu District, Central Uganda. 36 patients, 23 from the hospital clinic and 13 from the community were interviewed regarding their understanding of HIV and by what channels they had obtained this understanding. Interviews were conducted using local student nurses as translators. Verbal responses were translated and then transcribed by the researcher. The same 36 patients then undertook a 'misconception' test consisting of 35 questions. Quantitative data was analysed using descriptive statistics and results were scored based on three components of 'transmission knowledge', 'prevention knowledge' and 'misconception rejection'. Each correct response to a question was scored one point, otherwise zero e.g. correctly rejecting a misconception scored one point, but answering ‘yes’ or ‘don’t know’ scored zero. Scores ≤ 27 (the average score) were classified as having ‘poor understanding’. Mean scores were compared between participants seen at the HIV clinic and in the community, and p-values (including Fisher’s exact test) were calculated using Stata 2015. Level of significance was set at 0.05. Interviews with 7 members of staff working in the HIV clinic were undertaken to establish what methods of communication are used to educate patients. Interviews were transcribed and thematic analysis undertaken. Results: The commonest misconceptions which failed to be rejected included transmission of HIV by kissing (78%), mosquitoes (69%) and touching (36%). 33% believed HIV may be prevented by praying. The overall mean scores for transmission knowledge (87.5%) and prevention knowledge (81.1%) were better than misconception rejection scores (69.3%). HIV clinic respondents did tend to have higher scores, i.e. fewer misconceptions, although there was statistical evidence of a significant difference only for prevention knowledge (p=0.03). Analysis of the qualitative data is ongoing but several patients expressed concerns about not being able to read and therefore leaflets not having a helpful role. Conclusions: Results from this paper identified that a high proportion of the population studied held misconceptions about HIV. Qualitative data suggests that there may be a role for patient education leaflets, if pictorial-based and suitable for those with low literacy skill.

Keywords: HIV, human immunodeficiency virus, misconceptions, patient education, Sub-Saharan Africa, Uganda

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7983 An Experiment of Three-Dimensional Point Clouds Using GoPro

Authors: Jong-Hwa Kim, Mu-Wook Pyeon, Yang-dam Eo, Ill-Woong Jang

Abstract:

Construction of geo-spatial information recently tends to develop as multi-dimensional geo-spatial information. People constructing spatial information is also expanding its area to the general public from some experts. As well as, studies are in progress using a variety of devices, with the aim of near real-time update. In this paper, getting the stereo images using GoPro device used widely also to the general public as well as experts. And correcting the distortion of the images, then by using SIFT, DLT, is acquired the point clouds. It presented a possibility that on the basis of this experiment, using a video device that is readily available in real life, to create a real-time digital map.

Keywords: GoPro, SIFT, DLT, point clouds

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7982 On the Right an Effective Administrative Justice in the Republic of Macedonia: Challenges and Problems

Authors: Arlinda Memetaj

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A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of effective public administration, has been since 1990s among the most 'important and urgent' final strategic objectives of the Republic of Macedonia. To this aim the country has so far adopted a huge series of legislative and strategic documents related to any aspects of the administrative justice system. The latter is designed to strengthen the legal position of citizens, businesses, civic organizations, and other societal subjects. 'Changes and reforms' in this field have been thus the most frequent terms being used in the country for the last more than 20 years. Several years ago the County established Administrative Courts, while permanently amending the Law on the General Administrative procedure (LGAP). The new LGAP was adopted in 2015 and it introduced considerable innovations concerned. The most recent inputs in this regard includes the National Public Administration Reform Strategy 2017 – 2022, one of the key expected result of which includes both providing effective protection of the citizens` rights. In doing the aforesaid however there is still a series of interrelated shortcomings in this regard, such as (just to mention few) the complex appeal procedure, delays in enforcing court rulings, etc. Against the above background, the paper firstly describes the Macedonian institutional and legislative framework in the above field, and then illustrates the shortcomings therein. It finally claims that the current status quo situation may be overcome only if there is a proper implementation of the administrative courts decisions and far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main method used in this paper is the descriptive, analytical and comparative one due to the very character of the paper itself.

Keywords: administrative justice, administrative procedure, administrative courts/disputes, European Human Rights Court, human rights, monitoring, reform, benefit.

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7981 Recovery of the Demolition and Construction Waste, Casablanca (Morocco)

Authors: Morsli Mourad, Tahiri Mohamed, Samdi Azzeddine

Abstract:

Casablanca is the biggest city in Morocco. It concentrates more than 60% of the economic and industrial activity of the kingdom. Its building and public works (BTP) sector is the leading source of inert waste scattered in open areas. This inert waste is a major challenge for the city of Casablanca, as it is not properly managed, thus causing a significant nuisance for the environment and the health of the population. Hence the vision of our project is to recycle and valorize concrete waste. In this work, we present concrete results in the exploitation of this abundant and permanent deposit. Typical wastes are concrete, clay and concrete bricks, ceramic tiles, marble panels, gypsum, scrap metal, wood . The work performed included: geolocation with a combination of artificial intelligence and Google Earth, estimation of the amount of waste per site, sorting, crushing, grinding, and physicochemical characterization of the samples. Then, we proceeded to the exploitation of the types of substrates to be developed: light cement, coating, and glue for ceramics... The said products were tested and characterized by X-ray fluorescence, specific surface, resistance to bending and crushing, etc. We will present in detail the main results of our research work and also describe the specific properties of each material developed.

Keywords: déchets de démolition et des chantiers de construction, logiciels de combinaison SIG, valorisation de déchets inertes, enduits, ciment leger, casablanca

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7980 The Effectiveness of the Counselling Module in Counseling Interventions for Low Performance Employees

Authors: Hazaila Hassan

Abstract:

This research aims and discusses about the effectiveness of the Psynnova i-Behaviour Modification Technique (iBMT) module towards the change in behaviour of low-performing employees. The purpose of the study is to examine the effectiveness of the Psynnova Module on changing behaviour through five factors among low-performing employees in the public sector. The five main factors/constructs were cognitive enhancement and rationality, emotional stability, attitude alignment and adjustment, social skills development and psycho-spirituality enhancement. In this research, 5 main constructs will be using to indicate behaviour changing performance of the employees after attending The Psynnova Program that using this Psynnova IBMT Module. The respondents are among those who have low scores in terms of annual performance through annual performance value reports and have gone through various stages before being required to attend Psynnova Program. Besides that, the research plan was also to critically examine and understand the change in behaviour among the low-performing employees through the five dimensions in the Psynnova Module. A total of 50 respondent will purposively sampled to be the respondents of this research. This study will use the Experimental Method to One Group Purposively Pre and Post Test using the Time Series Design. Experimental SPSS software version 22.0 will be used to analyse this data. Hopefully this research can see the changing of their behaviour in five factors as an indicator to the respondent after attending the Psynnova Programme. Findings from this study are also used to propose to assisting psychologist to see the changes that occurred to the respondents with the best framework of behaviour changing for them.

Keywords: five dimension of behaviour changing, among adult, low performance, modul effectiveness

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7979 Sports Fans and Non-Interested Public Recognition of the Problems of Sports in Egypt through Caricature

Authors: Alaaeldin Hamdy Ahmed Mohammed

Abstract:

Introduction: This study examines sports’ fans and non-interested public perception and recognition of the problems that have negative impacts upon the Egyptian sports, particularly football, through caricatures. Eight caricature paintings were designed to express eight problems affecting the Egyptian sports and its development. These paintings were distributed on two groups of the fans and the non-interested public. Methods: The study was limited to eight caricatures representing the eight issues which are: the impact of stopping the sports activity on athletes, the effect of clubs’ disagreement, fanaticism between the members of the ultras of different clubs, the negative impact of the mingling of politics into sports, the negative role of the clubs affects the professionalism of the promising players, the conflict between the national organization responsible for sports, the breaking in of the fans to the playgrounds, the impact of the lack of planning on the national team. The Results: The results showed that both sports fans and those who are not interested in sports recognized the problems that the caricatures refer to and criticizes exaggeration although the rate was higher for the fans. These caricatures contributed also in their recognition of the danger of the negative impact of these problems on the Egyptian sports, particularly football which is the most common at the Egyptian sports fans. Discussion: This finding echoes the conclusion that caricatures are distinctive in the adults’ facial stimuli that are either systematically exaggerated recognition of them.

Keywords: caricature, fans, football, sports

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7978 Common Sense Leadership in the Example of Turkish Political Leader Devlet Bahçeli

Authors: B. Gültekin, T. Gültekin

Abstract:

Peace diplomacy is the most important international tool to maintain peace all over the World. This study consists of three parts. In the first part, the leadership of Devlet Bahçeli, leader of the Nationalist Movement Party, will be introduced as a tool of peace communication and peace management. Also, in this part, peace communication will be explained by the peace leadership traits of Devlet Bahçeli, who is one of the efficient political leaders representing the concepts of compromise and agreement on different sides of politics. In the second part of study, it is aimed to analyze Devlet Bahçeli’s leadership within the frame of peace communication and the final part of this study is about creating an original public communication model for public diplomacy based on Devlet Bahçeli as an example. As a result, the main purpose of this study is to develop an original peace communication model including peace modules, peace management projects, original dialogue procedures and protocols exhibited in the policies of Devlet Bahçeli. The political leadership represented by Devlet Bahçeli inspires political leaders to provide peace communication. In this study, principles and policies of peace leadership of Devlet Bahçeli will be explained as an original model on a peace communication platform.

Keywords: public diplomacy, dialogue management, peace leadership, peace diplomacy

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7977 Polarization of Lithuanian Society on Issues Related to Language Politics

Authors: Eglė Žurauskaitė, Eglė Gudavičienė

Abstract:

The goal of this paper is to reveal how polarization is constructed through the use of impoliteness strategies. In general, media helps to spread various ideas very fast, and it means that processes of polarization are best revealed in computer-mediated communication (CMC) contexts. For this reason, data for the research was collected from online texts about a current, very diverse topic in Lithuania - Lithuanian language policy and regulations, because this topic is causing a lot of tension in Lithuanian society. Computer-mediated communication allows users to edit their message before they send it. It means that addressees carefully select verbal expressions to convey their message. In other words, each impoliteness strategy and its verbal expression were created intentionally. Impoliteness strategies in this research are understood as various ways to reach a communicative goal: belittle the other. To reach the goal, the public opinions of various Lithuanian public figures (e. g., cultural people, politicians, officials) were collected from new portals in 2019–2023 and analyzed using both quantitative and qualitative approaches. First, problematic aspects of the language policy, for which public figures complain, were identified. Then instances when public figures take a defensive position were analyzed: how they express this position and what it reveals about Lithuanian culture. Findings of this research demonstrate how concepts of impoliteness theory can be applied in analyzing the process of polarization in Lithuanian society on issues related to the State language policy. Also, to reveal how polarization is constructed, these tasks were set: a) determine which impoliteness strategies are used throughout the process of creating polarization, b) analyze how they were expressed verbally (e. g., as an advice, offer, etc.).

Keywords: impoliteness, Lithuanian language policy, polarization, impoliteness strategies

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7976 The Relationship between Vitamin D and Vitamin B12 Concentrations in Cataract Patients (Senile vs Diabetic)

Authors: Ali Showail Ali Alasmari

Abstract:

Introduction: Cataract is the loss of transparency of the lens inside the eye. It is the most common cause of visual loss and blindness worldwide. This study provides a systemic review of the recent findings on the association of vitamin D, and vitamin B12, and their possible role in preventing cataracts in senile (S) and diabetic mellitus (DM) patient groups. Objective: This study was intended to establish and investigate if there is any role between vitamin D and vitamin B12? Secondly, the connection between serum level of vitamin D and vitamin B12 in cataract incidence senile (s) vs. diabetic mellitus (DM) cataract patient groups. Furthermore, to evaluate and analyze cataract occurrence regarding vitamin D and vitamin B12 levels with other risk factors. Finally, to evaluate lens opacities pre and post treatment with vitamin D and vitaminB12 linked to age and visual acuity loss in both senile(S) and diabetic mellitus (DM) cataract patients’ groups. Methods: This study conducted at the ophthalmology clinic at Muhyail General Hospital. Select a prospective case-control to study the effect of vitamin D and Vit B12 on senile(S) cataracts that caused by age and diabetic mellitus (DM)cataract patients; then we compare these two groups. This study prospectively enrolled a total of 50 samples, 25 with senile cataract and 25 with diabetic cataract, from ophthalmology clinic at Muhyail General Hospital. Measuring 25-hydroxy vitamin D and vitamin B12 level concentrations in the assigned samples. Analyses were performed using SAS (statistical analysis software) program. Results: The most important finding in this study was that the senile(s) cataract patients’ group greatly benefited by the combination therapy of vitamin D, and Vitamin B12 reached (28.5±1.50 and 521.1±21.10) respectively; on the contrary, the diabetic cataract patient group hardly shows any significant improvement (21.5 ± 1.00 and 197.2 ± 7.20) respectively. This is because of the Metformin, the first line drug for treating diabetes, has been reported to potentially decrease vitamin B-12 status. This epigenetic modification was correlated with the diabetic mellitus (DM) cataract patients’ group not responding. Vitamin B12 deficiency also leads to an impairment of the conversion of methylmalonyl-CoA to succinyl-CoA, which has been associated with insulin resistance. There was no significant difference between the age, body mass index (BMI), the mean of Vit-D pre-treatments, and the mean values of Hemoglobin A1C of both senile (S) and diabetic mellitus (DM) cataract patient groups. On other hand, there was a highly significant difference between the mean values of glucose levels in both senile (S) and diabetic mellitus (DM) cataract patient groups. Conclusion: Here we conclude that diabetic mellitus (DM) cataract patient group hardly benefited from this combination therapy vitamin D and vitamin B12; on the other hand senile patient group (s) benefited a lot from the therapy.

Keywords: cataract patients, senile, diabetes mellitus, vitamin B12, vitamin D, Muhyail General Hospital, Saudi Arabia

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7975 Adherence of Trauma and Orthopaedics Surgery Operative Notes to the RCS Good Surgical Practice Guidelines in Ashford and St. Peter's Hospital

Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak

Abstract:

Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.

Keywords: surgery, notes, RCS, guidelines

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7974 Digital Health During a Pandemic: Critical Analysis of the COVID-19 Contact Tracing Apps

Authors: Mohanad Elemary, Imose Itua, Rajeswari B. Matam

Abstract:

Virologists and public health experts have been predicting potential pandemics from coronaviruses for decades. The viruses which caused the SARS and MERS pandemics and the Nipah virus led to many lost lives, but still, the COVID-19 pandemic caused by the SARS-CoV2 virus surprised many scientific communities, experts, and governments with its ease of transmission and its pathogenicity. Governments of various countries reacted by locking down entire populations to their homes to combat the devastation caused by the virus, which led to a loss of livelihood and economic hardship to many individuals and organizations. To revive national economies and support their citizens in resuming their lives, governments focused on the development and use of contact tracing apps as a digital way to track and trace exposure. Google and Apple introduced the Exposure Notification Systems (ENS) framework. Independent organizations and countries also developed different frameworks for contact tracing apps. The efficiency, popularity, and adoption rate of these various apps have been different across countries. In this paper, we present a critical analysis of the different contact tracing apps with respect to their efficiency, adoption rate and general perception, and the governmental strategies and policies, which led to the development of the applications. When it comes to the European countries, each of them followed an individualistic approach to the same problem resulting in different realizations of a similarly functioning application with differing results of use and acceptance. The study conducted an extensive review of existing literature, policies, and reports across multiple disciplines, from which a framework was developed and then validated through interviews with six key stakeholders in the field, including founders and executives in digital health startups and corporates as well as experts from international organizations like The World Health Organization. A framework of best practices and tactics is the result of this research. The framework looks at three main questions regarding the contact tracing apps; how to develop them, how to deploy them, and how to regulate them. The findings are based on the best practices applied by governments across multiple countries, the mistakes they made, and the best practices applied in similar situations in the business world. The findings include multiple strategies when it comes to the development milestone regarding establishing frameworks for cooperation with the private sector and how to design the features and user experience of the app for a transparent, effective, and rapidly adaptable app. For the deployment section, several tactics were discussed regarding communication messages, marketing campaigns, persuasive psychology, and the initial deployment scale strategies. The paper also discusses the data privacy dilemma and how to build for a more sustainable system of health-related data processing and utilization. This is done through principles-based regulations specific for health data to allow for its avail for the public good. This framework offers insights into strategies and tactics that could be implemented as protocols for future public health crises and emergencies whether global or regional.

Keywords: contact tracing apps, COVID-19, digital health applications, exposure notification system

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7973 Text Analysis to Support Structuring and Modelling a Public Policy Problem-Outline of an Algorithm to Extract Inferences from Textual Data

Authors: Claudia Ehrentraut, Osama Ibrahim, Hercules Dalianis

Abstract:

Policy making situations are real-world problems that exhibit complexity in that they are composed of many interrelated problems and issues. To be effective, policies must holistically address the complexity of the situation rather than propose solutions to single problems. Formulating and understanding the situation and its complex dynamics, therefore, is a key to finding holistic solutions. Analysis of text based information on the policy problem, using Natural Language Processing (NLP) and Text analysis techniques, can support modelling of public policy problem situations in a more objective way based on domain experts knowledge and scientific evidence. The objective behind this study is to support modelling of public policy problem situations, using text analysis of verbal descriptions of the problem. We propose a formal methodology for analysis of qualitative data from multiple information sources on a policy problem to construct a causal diagram of the problem. The analysis process aims at identifying key variables, linking them by cause-effect relationships and mapping that structure into a graphical representation that is adequate for designing action alternatives, i.e., policy options. This study describes the outline of an algorithm used to automate the initial step of a larger methodological approach, which is so far done manually. In this initial step, inferences about key variables and their interrelationships are extracted from textual data to support a better problem structuring. A small prototype for this step is also presented.

Keywords: public policy, problem structuring, qualitative analysis, natural language processing, algorithm, inference extraction

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7972 Exploring the Impact of Corruption on Human Rights in Cameroon: The Quest for Sustainable Solutions

Authors: Eugene Muambeh Muntoh

Abstract:

Corruption has a destructive effect on State institutions and on the capacity of States to respect, protect and fulfil human rights, particularly of those persons and groups in situation of vulnerability and marginalization. In Cameroon, corruption pose a major challenge as it divert public revenues and cripple public budgets that should provide healthcare, housing, education, and other essential services. Corruption has undermined the States’ ability to meet the minimum core obligations and pre-existing legal obligations to maximize all available resources to respect, protect and fulfil Economic, Social and Cultural Rights. This study therefore makes use of the qualitative research design, ranging from interviews, observations and content analysis of vital documents to provide evidence and associations between corruption and human rights concerns in Cameroon. The study made use of research material from both primary and secondary sources. Findings from the study reveals that the impact of corruption in Cameroon is especially pronounced regarding economic, social and cultural rights. In most cases, the right to be treated equally is violated, for example, when someone is requested to pay a bribe to obtain a public service. There is an urgent need for sustainable measures to counter corruption in order to protect and promote human rights.

Keywords: corruption, governance, human rights, law

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7971 Statistical and Land Planning Study of Tourist Arrivals in Greece during 2005-2016

Authors: Dimitra Alexiou

Abstract:

During the last 10 years, in spite of the economic crisis, the number of tourists arriving in Greece has increased, particularly during the tourist season from April to October. In this paper, the number of annual tourist arrivals is studied to explore their preferences with regard to the month of travel, the selected destinations, as well the amount of money spent. The collected data are processed with statistical methods, yielding numerical and graphical results. From the computation of statistical parameters and the forecasting with exponential smoothing, useful conclusions are arrived at that can be used by the Greek tourism authorities, as well as by tourist organizations, for planning purposes for the coming years. The results of this paper and the computed forecast can also be used for decision making by private tourist enterprises that are investing in Greece. With regard to the statistical methods, the method of Simple Exponential Smoothing of time series of data is employed. The search for a best forecast for 2017 and 2018 provides the value of the smoothing coefficient. For all statistical computations and graphics Microsoft Excel is used.

Keywords: tourism, statistical methods, exponential smoothing, land spatial planning, economy

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7970 Repeated Suicidal Attempts in Foster Teenagers: Breaking the Cycle Using a Stepped Care Approach

Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

Abstract:

In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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