Search results for: high availability of health care information
33761 Method of Synthesis of Controlled Generators Balanced a Strictly Avalanche Criteria-Functions
Authors: Ali Khwaldeh, Nimer Adwan
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In this paper, a method for constructing a controlled balanced Boolean function satisfying the criterion of a Strictly Avalanche Criteria (SAC) effect is proposed. The proposed method is based on the use of three orthogonal nonlinear components which is unlike the high-order SAC functions. So, the generator synthesized by the proposed method has separate sets of control and information inputs. The proposed method proves its simplicity and the implementation ability. The proposed method allows synthesizing a SAC function generator with fixed control and information inputs. This ensures greater efficiency of the built-in oscillator compared to high-order SAC functions that can be used as a generator. Accordingly, the method is completely formalized and implemented as a software product.Keywords: boolean function, controlled balanced boolean function, strictly avalanche criteria, orthogonal nonlinear
Procedia PDF Downloads 15733760 Acupuncture Reduces Pain Disability, Stress, and Depression in United States Military Veterans with Chronic Pain
Authors: Christine Eickhoff, Alyssa Adams, Alaine Duncan
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The Washington, DC Veterans Affairs Medical Center (DC VAMC) offers complementary and integrative health (CIH) services such as acupuncture, yoga, meditation, and nutrition education through a coordinated outpatient clinic. The primary population utilizing CIH services are veterans with chronic pain. Acupuncture is one of the most popular of the CIH services available at the DC VAMC. As interest and availability grows, it is important to measure health outcomes associated with CIH service utilization. The purpose of this study was to investigate pain and mental health outcomes for veterans with chronic pain enrolled in individual acupuncture services in the DC VAMC. Veterans at the DC VAMC with self-identified chronic pain and no prior acupuncture experience were recruited for the study (n=70). Veterans were referred for services by a medical provider and completed baseline assessments at the program orientation prior to participating in any CIH services. Veterans received four individual, full-body acupuncture appointments within four weeks of study enrollment. After the first month, participants were scheduled for six appointments that occurred every two weeks and then eight more sessions that were scheduled one month apart. Follow-up assessments were administered at 2, 4, 6, 8, and 12 months. The findings reported will include completed time points at two and four months. Measures include a demographics survey, the Measure Yourself Medical Outcome Profile-2 (MYMOP-2), The Beck Depression Inventory (BDI-II), the Defense Veterans Pain Rating Scale (DVPRS), and the Pain Disability Questionnaire (PDQ). In this sample, 67% identified a pain condition as their primary health concern. Between baseline and two-month follow-up, there were significant improvements in participants’ primary health concern (MYMOP-2 p=0.010), general wellbeing (MYMOP-2 p=0.011), and a significant decrease in the use of medication (MYMOP-2 p<0.000). Between 2 and 4-month follow-up, pain disability (PDQ p=0.035), pain rating (DVPRS p=0.027), and depression (BDI-II p=0.003) significantly improved. Preliminary findings indicate that individual acupuncture therapy can be effective at improving health outcomes, well-being, and decreasing medication use in U.S. military veterans with chronic pain. Findings also suggest that individual acupuncture therapy can improve pain ratings, pain disability, and depression in veterans with chronic pain.Keywords: acupuncture, chronic pain, depression, integrative health, medication use, military, pain, veterans, wellbeing
Procedia PDF Downloads 25933759 Patients' Out-Of-Pocket Expenses-Effectiveness Analysis of Presurgical Teledermatology
Authors: Felipa De Mello-Sampayo
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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time
Procedia PDF Downloads 14133758 An International Analysis of Career Development and Management Programs for High-Performance Athletes: A Perspective of Organizational Support
Authors: H. J. Hong
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Sporting organizations are arguably responsible for encouraging high-performance athletes to balance their life and identity during their sporting career; sporting organizations can establish the motivational climate for high-performance athletes using athlete career development and management programs. The purpose of this article to provide an overview of career development and management programs in 20 countries and to examine the following seven features of the programs: (1) Which government-funded sporting organizations provide career development and management programs? (2) Which athletes are eligible to access the programs? (3) What are the aims and objectives of the programs? (4) What are the activities and content of the programs? (5) Who is responsible for the delivery of the programs within organizations (e.g., advisors, coordinators, service providers, counsellors, etc.)? (6) Do the sporting organizations have training and development programs for support services providers? and (7) Do the sporting organizations assess the programs in terms of the programs’ impact on high-performance athletes’ career development and management skills? Web-based data collection was conducted first. The author contacted the sporting organizations to clarify information as required by requesting further information via emails, international calls, video calls on Skype, and by visiting the sporting organizations and meeting with the practitioners (Fiji, Ireland, Korea, Scotland, Singapore, and Spain). By selecting comparable career development and management programs, the present study reviews programs across the world, identifying similarities, differences, and difficulties, so that sporting organizations and practitioners may enhance the quality of their programs. Since international comparisons of career development and management programs remain scarce, the findings deepen the knowledge of high-performance athletes’ career development, management, and transitions in the areas of organizational support programs.Keywords: athletes' career development and management, athletes' psychological preparation, organizational support, sport career transition
Procedia PDF Downloads 12733757 Design and Field Programmable Gate Array Implementation of Radio Frequency Identification for Boosting up Tag Data Processing
Authors: G. Rajeshwari, V. D. M. Jabez Daniel
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Radio Frequency Identification systems are used for automated identification in various applications such as automobiles, health care and security. It is also called as the automated data collection technology. RFID readers are placed in any area to scan large number of tags to cover a wide distance. The placement of the RFID elements may result in several types of collisions. A major challenge in RFID system is collision avoidance. In the previous works the collision was avoided by using algorithms such as ALOHA and tree algorithm. This work proposes collision reduction and increased throughput through reading enhancement method with tree algorithm. The reading enhancement is done by improving interrogation procedure and increasing the data handling capacity of RFID reader with parallel processing. The work is simulated using Xilinx ISE 14.5 verilog language. By implementing this in the RFID system, we can able to achieve high throughput and avoid collision in the reader at a same instant of time. The overall system efficiency will be increased by implementing this.Keywords: antenna, anti-collision protocols, data management system, reader, reading enhancement, tag
Procedia PDF Downloads 30633756 Iron Deficiency and Iron Deficiency Anaemia/Anaemia as a Diagnostic Indicator for Coeliac Disease: A Systematic Review With Meta-Analysis
Authors: Sahar Shams
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Coeliac disease (CD) is a widely reported disease particularly in countries with predominant Caucasian populations. It presents with many signs and symptoms including iron deficiency (ID) and iron deficiency anaemia/anaemia (IDA/A). The exact association between ID, IDA/A and CD and how accurate these signs are in diagnosing CD is not fully known. This systematic review was conducted to investigate the accuracy of both ID & IDA/A as a diagnostic indicator for CD and whether it warrants point of care testing. A systematic review was performed looking at studies published in MEDLINE, Embase, Cochrane Library, and Web of Science. QUADAS-2 tool was used to assess risk of bias in each study. ROC curve and forest plots were generated as part of the meta-analysis after data extraction. 16 studies were identified in total, 13 of which were IDA/A studies and 3 ID studies. The prevalence of CD regardless of diagnostic indicator was assumed as 1%. The QUADAS-2 tool indicated most of studies as having high risk of bias. The PPV for CD was higher in those with ID than for those with IDA/A. Meta-analysis showed the overall odds of having CD is 5 times higher in individuals with ID & IDA/A. The ROC curve showed that there is definitely an association between both diagnostic indicators and CD, the association is not a particularly strong one due to great heterogeneity between studies. Whilst an association between IDA/A & ID and coeliac disease was evident, the results were not deemed significant enough to prompt coeliac disease testing in those with IDA/A & ID.Keywords: anemia, iron deficiency anemia, coeliac disease, point of care testing
Procedia PDF Downloads 13333755 Determining Current and Future Training Needs of Ontario Workers Supporting Persons with Developmental Disabilities
Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos
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Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.Keywords: developmental disabilities, disability workers, support homes, training
Procedia PDF Downloads 18933754 Health Seeking Manners of Road Traffic Accident Victims: A Qualitative Study
Authors: Mohammad Mahbub Alam Talukder, Shahnewaz, Hasanat-E-Rabbi, Mohammed Nazrul Islam
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Road traffic accident is a global problem which is severe in the developing countries like Bangladesh. In consequence, in developing countries road trauma has now been recognized as an increasing public health hazards and economic burning issue. And after road traffic accidents the lack of management and economic costs related with health seeking behavior have a disproportionate impact on lower income groups, thus contributing to the persistence of poverty in conjunction with disability. This cross sectional study, carried out during July 2012 to June 2013, aimed to explore health seeking decision and culture of handling the road traffic accident related victims, as taken from experiences of the poor disabled people of slum dwellers of Dhaka city. The present study has been designed based on qualitative techniques such as in-depth interview and case studies. Additionally, a survey questionnaire was used to collect the demographic characteristics of the study population (n=150) and to select participants purposely for in-depth interview (n=50) and case study (n=30). Content analysis of qualitative data was done through theme coding and matrix analysis of case study was done to use relevant verbatim. Most of the time the health seeking decision totally depended on the surrounded people of the accidental place, their knowledge, awareness and remaining facility and capacity regarding proper management of the victims. However, most of the cases the victims did not get any early treatment and it took 2-12 hours to get even the first aid because of distance, shortage of money, lack of availability of getting the aid, lack of mass awareness etc. Under the reality of discriminated and unaffordable health service provision better treatment could not turn out due to economic inability of the poor victims. To avoid the severe trauma, treatment delay must be reduced by providing first aid within very short time and to do so, mass awareness campaign is necessary for handing the victims. Moreover, necessary measures should be taken to ensure cost free health service provision to treat the chronic disabled condition of the road traffic accident related poor victims.Keywords: accident, injury, disabled, qualitative, slum
Procedia PDF Downloads 36533753 The Challenges to Information Communication Technology Integration in Mathematics Teaching and Learning
Authors: George Onomah
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Background: The integration of information communication technology (ICT) in Mathematics education faces notable challenges, which this study aimed to dissect and understand. Objectives: The primary goal was to assess the internal and external factors affecting the adoption of ICT by in-service Mathematics teachers. Internal factors examined included teachers' pedagogical beliefs, prior teaching experience, attitudes towards computers, and proficiency with technology. External factors included the availability of technological resources, the level of ICT training received, the sufficiency of allocated time for technology use, and the institutional culture within educational environments. Methods: A descriptive survey design was employed to methodically investigate these factors. Data collection was carried out using a five-point Likert scale questionnaire, administered to a carefully selected sample of 100 in-service Mathematics teachers through a combination of purposive and convenience sampling techniques. Findings: Results from multiple regression analysis revealed a significant underutilization of ICT in Mathematics teaching, highlighting a pronounced deficiency in current classroom practices. Recommendations: The findings suggest an urgent need for educational department heads to implement regular and comprehensive ICT training programs aimed at enhancing teachers' technological capabilities and promoting the integration of ICT in Mathematics teaching methodologies.Keywords: ICT, Mathematics, integration, barriers
Procedia PDF Downloads 4033752 Computer Self-Efficacy, Study Behaviour and Use of Electronic Information Resources in Selected Polytechnics in Ogun State, Nigeria
Authors: Fredrick Olatunji Ajegbomogun, Bello Modinat Morenikeji, Okorie Nancy Chituru
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Electronic information resources are highly relevant to students' academic and research needs but are grossly underutilized, despite the institutional commitment to making them available. The under-utilisation of these resources could be attributed to a low level of study behaviour coupled with a low level of computer self-efficacy. This study assessed computer self-efficacy, study behaviour, and the use of electronic information resources by students in selected polytechnics in Ogun State. A simple random sampling technique using Krejcie and Morgan's (1970) Table was used to select 370 respondents for the study. A structured questionnaire was used to collect data on respondents. Data were analysed using frequency counts, percentages, mean, standard deviation, Pearson Product Moment Correlation (PPMC) and multiple regression analysis. Results reveal that the internet (= 1.94), YouTube (= 1.74), and search engines (= 1.72) were the common information resources available to the students, while the Internet (= 4.22) is the most utilized resource. Major reasons for using electronic information resources were to source materials and information (= 3.30), for research (= 3.25), and to augment class notes (= 2.90). The majority (91.0%) of the respondents have a high level of computer self-efficacy in the use of electronic information resources through selecting from screen menus (= 3.12), using data files ( = 3.10), and efficient use of computers (= 3.06). Good preparation for tests (= 3.27), examinations (= 3.26), and organization of tutorials (= 3.11) are the common study behaviours of the respondents. Overall, 93.8% have good study behaviour. Inadequate computer facilities to access information (= 3.23), and poor internet access (= 2.87) were the major challenges confronting students’ use of electronic information resources. According to the PPMC results, study behavior (r = 0.280) and computer self-efficacy (r = 0.304) have significant (p 0.05) relationships with the use of electronic information resources. Regression results reveal that self-efficacy (=0.214) and study behavior (=0.122) positively (p 0.05) influenced students' use of electronic information resources. The study concluded that students' use of electronic information resources depends on the purpose, their computer self-efficacy, and their study behaviour. Therefore, the study recommended that the management should encourage the students to improve their study habits and computer skills, as this will enhance their continuous and more effective utilization of electronic information resources.Keywords: computer self-efficacy, study behaviour, electronic information resources, polytechnics, Nigeria
Procedia PDF Downloads 12233751 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya
Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui
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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.Keywords: multi-sectional approach, equity, people-centered, health workforce retention
Procedia PDF Downloads 11433750 Family Planning and HIV Integration: A One-stop Shop Model at Spilhaus Clinic, Harare Zimbabwe
Authors: Mercy Marimirofa, Farai Machinga, Alfred Zvoushe, Tsitsidzaishe Musvosvi
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The Government of Zimbabwe embarked on integrating family planning with Sexually Transmitted Infection (STI) and Human Immunodeficiency Virus (HIV) services in May 2020 with support from the World Health Organization (WHO). There was high HIV prevalence, incidence rates and STI infections among women attending FP clinics. Spilhaus is a specialized center of excellence clinic which offers a range of sexual reproductive health services. HIV services were limited to testing only, and clients were referred to other facilities for further management. Integration of services requires that all the services be available at one point so that clients will access them during their visit to the facility. Objectives: The study was conducted to assess the impact the one-stop-shop model has made in accessing integrated Family Planning services and sexual reproductive health services compared to the supermarket approach. It also assessed the relationship family planning services have with other sexual reproductive health services. Methods: A secondary data analysis was conducted at Spilhaus clinic in Harare using family planning registers and HIV services registers comparing years 2019 and 2021. A 2 sample t-test was used to determine the difference in clients accessing the services under the two models. A Spearman’s rank correlation was used to determine if accessing family planning services has a relationship with other sexual reproductive health services. Results: In 2019, 7,548 clients visited the Spilhaus clinic compared to 8,265 during the period January to December 2021. The median age for all clients accessing services was 32 years. An increase of 69% in the number of services accessed was recorded from 2019 to 2021. More services were accessed in 2021. There was no difference in the number of clients accessing family planning services cervical cancer, and HIV services. A difference was found in the number of clients who were offered STI screening services. There was also a relationship between accessing family planning services and STI screening services (ρ = 0.729, p-value=0.006). Conclusion: Programming towards SRH services was a great achievement, the use of an integrated approach proved to be cost-effective as it minimised the required resources for separate programs. Clients accessed important health needs at once. The integration of these services provided an opportunity to offer comprehensive information which addressed an individual’s sexual reproductive health needs.Keywords: intergration, one stop shop, family planning, reproductive health
Procedia PDF Downloads 6933749 The Relation between Coping Strategies with Stress and Mental Health Situation in Flying Addicted Family of Self Introducer and Private
Authors: Farnoush Haghanipour
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Recent research studies relation between coping strategies with stress and mental health situation in flying addicted family of self-introducer and private, Units of Guilan province. For this purpose 251 family (parent, spouse), that referred to private and self-introducer centers to break out of drug are selected in random sampling form. Research method was cross sectional-descriptive and purpose of research was fixing of between kinds of coping strategies with stress and mental health condition with attention to demographic variables. Therefore to collection of information, coping strategies questionnaire (CSQ) and mental health questionnaire (GHQ) was used and finally data analyzed by descriptive statistical methods (average, standard deviation) and inferential statistical correlation coefficient and regression. Study of correlation coefficient between mental healths with problem focused emotional focused and detachment strategies in level more than %99 is confirmed. Also mental health with avoidant focused hasn't correlation in other words relation is between mental health with problem focused strategies (r= 0/34) and emotional focused with mental health (r=0.52) and detachment with mental health (r= 0.18) in meaningful level 0.05. And also relation is between emotional focused strategies and mental health (r= 0.034) that is meaningless in Alpha 0.05. Also relation between problem processed coping strategies and mental health situation with attention to demographic variable is meaningful and relation level verified in confidence level more than 0.99. And result of anticipation equation regression statistical test has most a have in problem focused coping strategy, mental health, but relation of the avoidant emotional, detachment strategy with mental health was meaningless with attention to demographic variables.Keywords: stress, coping strategy with stress, mental health, self introducer and private
Procedia PDF Downloads 31133748 Comparison between High Resolution Ultrasonography and Magnetic Resonance Imaging in Assessment of Musculoskeletal Disorders Causing Ankle Pain
Authors: Engy S. El-Kayal, Mohamed M. S. Arafa
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There are various causes of ankle pain including traumatic and non-traumatic causes. Various imaging techniques are available for assessment of AP. MRI is considered to be the imaging modality of choice for ankle joint evaluation with an advantage of its high spatial resolution, multiplanar capability, hence its ability to visualize small complex anatomical structures around the ankle. However, the high costs and the relatively limited availability of MRI systems, as well as the relatively long duration of the examination all are considered disadvantages of MRI examination. Therefore there is a need for a more rapid and less expensive examination modality with good diagnostic accuracy to fulfill this gap. HRU has become increasingly important in the assessment of ankle disorders, with advantages of being fast, reliable, of low cost and readily available. US can visualize detailed anatomical structures and assess tendinous and ligamentous integrity. The aim of this study was to compare the diagnostic accuracy of HRU with MRI in the assessment of patients with AP. We included forty patients complaining of AP. All patients were subjected to real-time HRU and MRI of the affected ankle. Results of both techniques were compared to surgical and arthroscopic findings. All patients were examined according to a defined protocol that includes imaging the tendon tears or tendinitis, muscle tears, masses, or fluid collection, ligament sprain or tears, inflammation or fluid effusion within the joint or bursa, bone and cartilage lesions, erosions and osteophytes. Analysis of the results showed that the mean age of patients was 38 years. The study comprised of 24 women (60%) and 16 men (40%). The accuracy of HRU in detecting causes of AP was 85%, while the accuracy of MRI in the detection of causes of AP was 87.5%. In conclusions: HRU and MRI are two complementary tools of investigation with the former will be used as a primary tool of investigation and the latter will be used to confirm the diagnosis and the extent of the lesion especially when surgical interference is planned.Keywords: ankle pain (AP), high-resolution ultrasound (HRU), magnetic resonance imaging (MRI) ultrasonography (US)
Procedia PDF Downloads 19333747 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models
Authors: Haya Salah, Srinivas Sharan
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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time
Procedia PDF Downloads 12233746 Crop Losses, Produce Storage and Food Security, the Nexus: Attaining Sustainable Maize Production in Nigeria
Authors: Charles Iledun Oyewole, Harira Shuaib
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While fulfilling the food security of an increasing population like Nigeria remains a major global concern, more than one-third of crop harvested is lost or wasted during harvesting or in postharvest operations. Reducing the harvest and postharvest losses, especially in developing countries, could be a sustainable solution to increase food availability, eliminate hunger and improve farmers’ livelihoods. Nigeria is one of the countries in sub-Saharan Africa with insufficient food production and high food import bill, which has had debilitating effects on the country’s economy. One of the goals of Nigeria’s agricultural development policy is to ensure that, the nation produces enough food and be less dependent on importation so as to ensure adequate and affordable food for all. Maize could fill the food gap in Nigeria’s effort to beat hunger and food insecurity. Maize is the most important cereal after rice and its production contributes immensely to food availability on the tables of many Nigerians. Maize grains constitute primary source of food for large percentage of the Nigerian populace, thus a considerable waste of this valuable food pre and post-harvest constitutes such a major agricultural bottleneck; that the reduction of pre and post-harvest losses is now a common food security strategy. In surveys conducted, as much as 60% maize outputs can be lost on the field and during the storage stage due to technical inefficiency. Field losses due to rodent damage alone can account for between 10% - 60% grain losses depending on the location. While the use of scientific storage methods can reduce losses below 2% in storage, timely harvesting of crop can check losses on the fields resulting from rodent damage or pest infestation. A push for increased crop production must be complemented by available and affordable post-harvest technologies that will reduce losses on farmers’ fields as well as in storage.Keywords: government policy, maize, population increase, storage, sustainable food production, yield, yield losses
Procedia PDF Downloads 14133745 The Investigation of Work Stress and Burnout in Nurse Anesthetists: A Cross-Sectional Study
Authors: Yen Ling Liu, Shu-Fen Wu, Chen-Fuh Lam, I-Ling Tsai, Chia-Yu Chen
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Purpose: Nurse anesthetists are confronting extraordinarily high job stress in their daily practice, deriving from the fast-track anesthesia care, risk of perioperative complications, routine rotating shifts, teaching programs and interactions with the surgical team in the operating room. This study investigated the influence of work stress on the burnout and turnover intention of nurse anesthetists in a regional general hospital in Southern Taiwan. Methods: This was a descriptive correlational study carried out in 66 full-time nurse anesthetists. Data was collected from March 2017 to June 2017 by in-person interview, and a self-administered structured questionnaire was completed by the interviewee. Outcome measurements included the Practice Environment Scale of the Nursing Work Index (PES-NWI), Maslach Burnout Inventory (MBI) and nursing staff turnover intention. Numerical data were analyzed by descriptive statistics, independent t test, or one-way ANOVA. Categorical data were compared using the chi-square test (x²). Datasets were computed with Pearson product-moment correlation and linear regression. Data were analyzed by using SPSS 20.0 software. Results: The average score for job burnout was 68.7916.67 (out of 100). The three major components of burnout, including emotional depletion (mean score of 26.32), depersonalization (mean score of 13.65), and personal(mean score of 24.48). These average scores suggested that these nurse anesthetists were at high risk of burnout and inversely correlated with turnover intention (t = -4.048, P < 0.05). Using linear regression model, emotional exhaustion and depersonalization were the two independent factors that predicted turnover intention in the nurse anesthetists (19.1% in total variance). Conclusion/Implications for Practice: The study identifies that the high risk of job burnout in the nurse anesthetists is not simply derived from physical overload, but most likely resulted from the additional emotional and psychological stress. The occurrence of job burnout may affect the quality of nursing work, and also influence family harmony, in turn, may increase the turnover rate. Multimodal approach is warranted to reduce work stress and job burnout in nurse anesthetists to enhance their willingness to contribute in anesthesia care.Keywords: anesthesia nurses, burnout, job, turnover intention
Procedia PDF Downloads 29833744 Evaluating and Improving Healthcare Staff Knowledge of the [NG179] NICE Guidelines on Elective Surgical Care during the COVID-19 Pandemic: A Quality Improvement Project
Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain
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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement
Procedia PDF Downloads 19533743 International Financial Reporting Standards and the Quality of Banks Financial Statement Information: Evidence from an Emerging Market-Nigeria
Authors: Ugbede Onalo, Mohd Lizam, Ahmad Kaseri, Otache Innocent
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Giving the paucity of studies on IFRS adoption and quality of banks accounting quality, particularly in emerging economies, this study is motivated to investigate whether the Nigeria decision to adopt IFRS beginning from 1 January 2012 is associated with high quality accounting measures. Consistent with prior literatures, this study measure quality of financial statement information using earnings measurement, timeliness of loss recognition and value relevance. A total of twenty Nigeria banks covering a period of six years (2008-2013) divided equally into three years each (2008, 2009, 2010) pre adoption period and (2011, 2012, 2013) post adoption period were investigated. Following prior studies eight models were in all employed to investigate earnings management, timeliness of loss recognition and value relevance of Nigeria bank accounting quality for the different reporting regimes. Results suggest that IFRS adoption is associated with minimal earnings management, timely recognition of losses and high value relevance of accounting information. Summarily, IFRS adoption engenders higher quality of banks financial statement information compared to local GAAP. Hence, this study recommends the global adoption of IFRS and that Nigeria banks should embrace good corporate governance practices.Keywords: IFRS, SAS, quality of accounting information, earnings measurement, discretionary accruals, non-discretionary accruals, total accruals, Jones model, timeliness of loss recognition, value relevance
Procedia PDF Downloads 46633742 Needs-Gap Analysis on Culturally and Linguistically Diverse Grandparent Carers ‘Hidden Issues’: An Insight for Community Nurses
Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft
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In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.Keywords: CALD grandparents, carer needs, community nurses, grandparent carers
Procedia PDF Downloads 31333741 Experimental Investigation of Hybrid Rocket Motor: Ignition, Throttling and Re-Ignition Phenomena
Authors: A. El-S. Makled, M. K. Al-Tamimi
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Ignition phenomena are of great interest area over the past many years, and it has a direct impact on many propulsion and combustion applications. The direct goal of the paper is to realize and evaluate a functioning ignition method, shut-off, throttling and re-start operations for the hybrid rocket motor. A small-scale hybrid rocket motor (SSHRM) is designed, manufactured, demonstrated at various operating conditions and finally equipped for laboratory firing tests with high level of safety. Various solid fuel grains as Polymethyle-methacrylate (PMMA) and Polyethylene (PE) are selected, and it is decided to use the commercial gaseous oxygen (GO2) for its availability and low cost. Examine different types of ignition methods, pyrotechnic charge, fuse wire, heat wire and finally hot oxidizer method by using the heat exchanger, which are proposed as very safe ignition methods. Finally; recognize phenomena of throttling and re-start operations. Ignition by hot GO2 impingement is proved to be a very attractive ignition method for laboratory SSHRM, for its high safety, reliability and acceptable delay time. Finally; the throttling and re-start operations are demonstrated several times and can be carried out more easily with hot air ignition method.Keywords: hybrid rocket motor, ignition system, re-start phenomena, throttling
Procedia PDF Downloads 30133740 Criminal Laws Associated with Cyber-Medicine and Telemedicine in Current Law Systems in the World
Authors: Shahryar Eslamitabar
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Currently, the internet plays an important role in the various scientific, commercial and service practices. Thanks to information and communication technology, the healthcare industry via the internet, generally known as cyber-medicine, can offer professional medical service in a wider geographical area. Having some appealing benefits such as convenience in offering healthcare services, improved accessibility to the services, enhanced information exchange, cost-effectiveness, time-saving, etc. Tele-health has increasingly developed innovative models of healthcare delivery. However, it presents many potential hazards to cyber-patients, inherent in the use of the system. First, there are legal issues associated with the communication and transfer of information on the internet. These include licensure, malpractice, liabilities and jurisdictions as well as privacy, confidentiality and security of personal data as the most important challenge brought about by this system. Additional items of concern are technological and ethical. Although, there are some rules to deal with pitfalls associated with cyber-medicine practices in the USA and some European countries, yet for all developments, it is being practiced in a legal vacuum in many countries. In addition to the domestic legislations to deal with potential problems arisen from the system, it is also imperative that some international or regional agreement should be developed to achieve the harmonization of laws among countries and states. This article discusses some implications posed by the practice of cyber-medicine in the healthcare system according to the experience of some developed countries using a comparative study of laws. It will also review the status of tele-health laws in Iran. Finally, it is intended to pave the way to outline a plan for countries like Iran, with newly-established judicial system for health laws, to develop appropriate regulations through providing some recommendations.Keywords: tele-health, cyber-medicine, telemedicine, criminal laws, legislations, time-saving
Procedia PDF Downloads 66233739 Socio-Ecological Factors Characterising Migrants and Refugee Youth’s Sexual and Reproductive Health and Rights
Authors: Michaels Aibangbee, Sowbhagya Micheal, Pranee Liamputtong, Elias Mpofu, Tinashe Dune
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Background: The challenges migrants and refugee youth (MRY) experience in maintaining their sexual and reproductive health and rights (SRHR) continues to be a global public health issue. Consequently, MRY is more likely to encounter adverse SRH experiences due to limited access to and knowledge of SRH services. Using a socio-ecological framework, this study examined the MRY’s SRHR micro-level experiences to macro-levels analyses of SRH-related social systems and constructions. Methods: Eighteen focus groups were conducted using participatory action research (PAR) methodology to understand the phenomena. The focus groups included MRY participants (ages 16-26) living in Greater Western Sydney and facilitated by youth project liaisons (YPL). The data was afterward synthesised and analysed using the thematic-synthesis method. Results: In total, 86 MRY (male n= 25, female n= 61) MRY (across 20 different cultural backgrounds) participated in the focus groups. The findings identified socio-ecological factors characterising MRY SRHR, highlighting facilitators such as social media and significant barriers such as lack of access to services and socio-cultural dissonance, and the under-implementation of SRHR support and services by MRY. Key themes from the data included traditional and institutional stigma, lack of SRH education, high reliance on social media for SRH information, anonymity, and privacy concerns. Conclusion: The data shows a limited extent to which MRY SRHR is considered and the intergenerational understanding and stigma affecting the rights of MRY. Therefore, these findings suggest a need for policies and practices to empower MRY’s agency through a collaborative SRHR strategy and policy design to maintain relevance in multicultural contexts.Keywords: migrant and refugee youth, sexual health, reproductive health, sexual and reproductive health and rights, culture, agency
Procedia PDF Downloads 7233738 Establishment of a Classifier Model for Early Prediction of Acute Delirium in Adult Intensive Care Unit Using Machine Learning
Authors: Pei Yi Lin
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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model
Procedia PDF Downloads 7933737 Integrated Free Space Optical Communication and Optical Sensor Network System with Artificial Intelligence Techniques
Authors: Yibeltal Chanie Manie, Zebider Asire Munyelet
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5G and 6G technology offers enhanced quality of service with high data transmission rates, which necessitates the implementation of the Internet of Things (IoT) in 5G/6G architecture. In this paper, we proposed the integration of free space optical communication (FSO) with fiber sensor networks for IoT applications. Recently, free-space optical communications (FSO) are gaining popularity as an effective alternative technology to the limited availability of radio frequency (RF) spectrum. FSO is gaining popularity due to flexibility, high achievable optical bandwidth, and low power consumption in several applications of communications, such as disaster recovery, last-mile connectivity, drones, surveillance, backhaul, and satellite communications. Hence, high-speed FSO is an optimal choice for wireless networks to satisfy the full potential of 5G/6G technology, offering 100 Gbit/s or more speed in IoT applications. Moreover, machine learning must be integrated into the design, planning, and optimization of future optical wireless communication networks in order to actualize this vision of intelligent processing and operation. In addition, fiber sensors are important to achieve real-time, accurate, and smart monitoring in IoT applications. Moreover, we proposed deep learning techniques to estimate the strain changes and peak wavelength of multiple Fiber Bragg grating (FBG) sensors using only the spectrum of FBGs obtained from the real experiment.Keywords: optical sensor, artificial Intelligence, Internet of Things, free-space optics
Procedia PDF Downloads 6433736 Scaling up Small and Sick Newborn Care Through the Establishment of the First Human Milk Bank in Nepal
Authors: Prajwal Paudel, Shreeprasad Adhikari, Shailendra Bir Karmacharya, Kalpana Upadhyaya
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Background: Human milk banks have been recommended by the World Health Organization (WHO) for newborn and child nourishment in the provision of optimum nutrition as an alternative to breastfeeding in circumstances when direct breastfeeding is inaccessible. The vulnerable group of babies, mainly preterm, low birth weight, and sick newborns, are at a greater risk of mortality and possibly benefit from the safe use of donated human milk through milk banks. In this study, we aimed to shed light on the process involved during the setting up of the nation’s first milk bank and its vitality in small and sick newborn nutrition and care. Methods: The study was conducted in Paropakar Maternity and Women’s Hospital, where the first human milk (HMB) was established. The establishment involved a stepwise process of need assessment meeting, formation of the HMB committee, learning visit to HMB in India, studying the strengths and weaknesses of promoting breastfeeding and HMB system integration, procurement, installation, and setting up the infrastructure, and developing technical competency, launching of the HMB. After the initiation of HMB services, information regarding the recruited donor mothers and the volume of milk pasteurized and consumed by the needy recipient babies were recorded. Descriptive statistics with frequencies and percentages were used to describe the utilization of HMB services. Results: During the study period, a total of 506113 ml of milk was collected, while 49930 ml of milk was pasteurized. Of the pasteurized milk, 381248 ml of milk was dispensed. The total volume of milk received was from a total of 883 after proper routine screening tests. Similarly, the total number of babies who received the donated human milk (DHM) was 912 with different neonatal conditions. Among the babies who received DHM, 527(57.7%) were born via CS, and 385 (42.21%) were delivered normally. In the birth weight category,9 (1%) of the babies were less than 1000 grams, 75 (8.2%) were less than 1500 grams, 405 (44.4%) were between 1500 to less than 2500 grams whereas, 423 (46.4%) of the babies who received DHM were normal weight babies. Among the sick newborns, perinatal asphyxia accounted for 166 (18.2%), preterm with other complications 372 (40.7%), preterm 23 (2.02%), respiratory distress 140 (15.35%), neonatal jaundice 150 (16.44%), sepsis 94 (10.30%), meconium aspiration syndrome 9(1%), seizure disorder 28 (3.07%), congenital anomalies 13 (1.42%) and others 33(3. 61%). The neonatal mortality rate dropped to 6.2/1000 live births from 7.5/1000 live births in the first year of establishment as compared to the previous year. Conclusion: The establishment of the first HMB in Nepal involved a comprehensive approach to integrate a new system with the existing newborn care in the provision of safe DHM. Premature babies with complication, babies born via CS, perinatal asphyxia and babies with sepsis consumed the greater proportion of DHM. Rigorous research is warranted to assess the impact of DHM in small and sick newborn who otherwise would be fed formula milk.Keywords: human milk bank, sick-newborn, mortality, neonatal nutrition
Procedia PDF Downloads 1533735 Distribution and Comparative Diversity of Nematocera within Four Livestock Types in the Plain of Mitidja Algeria
Authors: Nebri Rachid, Berrouane Fatima, Doumandji Salah Eddine
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During six months, from November 2013 to May 2014, census of Nematocera insects was conducted on four livestock: cattle, sheep, equine and cameline. The census, that took place in a station located in Mitidja plain, Algeria, revealed thirteen Nematocera species that had been observed and identified: Scatopse notata, Chironomus Sp., Sciara bicolor, Psychoda phalaenoïdes, Culex pipiens, Orthocladius Sp., Psycoda alternata, Trichocera regelationis, Culicoïdes Sp., Contarinia Sp., Ectaetia Sp., Tipula Sp., and Culicoïdes coprosus. A factorial correspondence analysis has been performed to study the distribution of the different species captured in colored traps that were placed in the four farms. The results showed the presence of three collections of Nematocera relating to the breeding type where the highest availability is in favor of the equine and the cattle. The analysis of the comparative diversity of Nematocera specimens revealed an indifferent taxonomic structure compared with the hosts. However, in terms of individuals, the supremacy is to the equine’s advantage. On the ecological arrival scale, Psycoda alternata, is undeniably the most predominant on the equines as well as on the cattle.Keywords: Algeria, availability, biodiversity, census, livestock, nematocera
Procedia PDF Downloads 45833734 Problem Gambling in the Conceptualization of Health Professionals: A Qualitative Analysis of the Discourses Produced by Psychologists, Psychiatrists and General Practitioners
Authors: T. Marinaci, C. Venuleo
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Different conceptualizations of disease affect patient care. This study aims to address this gap. It explores how health professionals conceptualize gambling problem, addiction and the goals of recovery process. In-depth, semi-structured, open-ended interviews were conducted with Italian psychologists, psychiatrists, general practitioners, and support staff (N= 114), working within health centres for the treatment of addiction (public health services or therapeutic communities) or medical offices. A Lexical Correspondence Analysis (LCA) was applied to the verbatim transcripts. LCA allowed to identify two main factorial dimensions, which organize similarity and dissimilarity in the discourses of the interviewed. The first dimension labelled 'Models of relationship with the problem', concerns two different models of relationship with the health problem: one related to the request for help and the process of taking charge and the other related to the identification of the psychopathology underlying the disorder. The second dimension, labelled 'Organisers of the intervention' reflects the dialectic between two ways to address the problem. On the one hand, they are the gambling dynamics and its immediate life-consequences to organize the intervention (whatever the request of the user is); on the other hand, they are the procedures and the tools which characterize the health service to organize the way the professionals deal with the user’ s problem (whatever it is and despite the specify of the user’s request). The results highlight how, despite the differences, the respondents share a central assumption: understanding gambling problem implies the reference to the gambler’s identity, more than, for instance, to the relational, social, cultural or political context where the gambler lives. A passive stance is attributed to the user, who does not play any role in the definition of the goal of the intervention. The results will be discussed to highlight the relationship between professional models and users’ ways to understand and deal with the problems related to gambling.Keywords: cultural models, health professionals, intervention models, problem gambling
Procedia PDF Downloads 15633733 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh
Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen
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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers
Procedia PDF Downloads 19433732 Impact of Health Indicators on Economic Growth: Application of Ardl Model on Pakistan’s Data Set
Authors: Sheraz Ahmad Choudhary
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Health plays a vital role in the growth. The study examined the effect of health indicator on the growth of Pakistan. ARDL model is used to check the growth rate which is affected by the health by using the time series date of Pakistan from 1990 to 2017. Health indicator, fertility rate, life expectancy, foreign direct investment, and infant mortality rate are variables Where the unit root is applied to check the stationarity of the model. consequences find a significant relationship between GDP, foreign direct investment, fertility rate, and life expectancy in the short run, whereas mortality rate effected negatively to economic growth but have significant values. In the long run, foreign direct investment (FDI) and fertility rate(FR) have significantly influenced the GDP. The results show thateconomic growth is positively stimulated by most of the health indicators. The study accomplishes that nations can achieve a high level of economic growth by increasing wellbeing human capital.Keywords: economic growth, health expenditures, fertility rate, human capital, life expectancy, foreign direct investment, and infant mortality rate
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