Search results for: internet of health things
Commenced in January 2007
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Edition: International
Paper Count: 10726

Search results for: internet of health things

8476 Exploratory Study of Individual User Characteristics That Predict Attraction to Computer-Mediated Social Support Platforms and Mental Health Apps

Authors: Rachel Cherner

Abstract:

Introduction: The current study investigates several user characteristics that may predict the adoption of digital mental health supports. The extent to which individual characteristics predict preferences for functional elements of computer-mediated social support (CMSS) platforms and mental health (MH) apps is relatively unstudied. Aims: The present study seeks to illuminate the relationship between broad user characteristics and perceived attraction to CMSS platforms and MH apps. Methods: Participants (n=353) were recruited using convenience sampling methods (i.e., digital flyers, email distribution, and online survey forums). The sample was 68% male, and 32% female, with a mean age of 29. Participant racial and ethnic breakdown was 75% White, 7%, 5% Asian, and 5% Black or African American. Participants were asked to complete a 25-minute self-report questionnaire that included empirically validated measures assessing a battery of characteristics (i.e., subjective levels of anxiety/depression via PHQ-9 (Patient Health Questionnaire 9-item) and GAD-7 (Generalized Anxiety Disorder 7-item); attachment style via MAQ (Measure of Attachment Qualities); personality types via TIPI (The 10-Item Personality Inventory); growth mindset and mental health-seeking attitudes via GM (Growth Mindset Scale) and MHSAS (Mental Help Seeking Attitudes Scale)) and subsequent attitudes toward CMSS platforms and MH apps. Results: A stepwise linear regression was used to test if user characteristics significantly predicted attitudes towards key features of CMSS platforms and MH apps. The overall regression was statistically significant (R² =.20, F(1,344)=14.49, p<.000). Conclusion: This original study examines the clinical and sociocultural factors influencing decisions to use CMSS platforms and MH apps. Findings provide valuable insight for increasing adoption and engagement with digital mental health support. Fostering a growth mindset may be a method of increasing participant/patient engagement. In addition, CMSS platforms and MH apps may empower under-resourced and minority groups to gain basic access to mental health support. We do not assume this final model contains the best predictors of use; this is merely a preliminary step toward understanding the psychology and attitudes of CMSS platform/MH app users.

Keywords: computer-mediated social support platforms, digital mental health, growth mindset, health-seeking attitudes, mental health apps, user characteristics

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8475 Long-Term Exposure, Health Risk, and Loss of Quality-Adjusted Life Expectancy Assessments for Vinyl Chloride Monomer Workers

Authors: Tzu-Ting Hu, Jung-Der Wang, Ming-Yeng Lin, Jin-Luh Chen, Perng-Jy Tsai

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The vinyl chloride monomer (VCM) has been classified as group 1 (human) carcinogen by the IARC. Workers exposed to VCM are known associated with the development of the liver cancer and hence might cause economical and health losses. Particularly, for those work for the petrochemical industry have been seriously concerned in the environmental and occupational health field. Considering assessing workers’ health risks and their resultant economical and health losses requires the establishment of long-term VCM exposure data for any similar exposure group (SEG) of interest, the development of suitable technologies has become an urgent and important issue. In the present study, VCM exposures for petrochemical industry workers were determined firstly based on the database of the 'Workplace Environmental Monitoring Information Systems (WEMIS)' provided by Taiwan OSHA. Considering the existence of miss data, the reconstruction of historical exposure techniques were then used for completing the long-term exposure data for SEGs with routine operations. For SEGs with non-routine operations, exposure modeling techniques, together with their time/activity records, were adopted for determining their long-term exposure concentrations. The Bayesian decision analysis (BDA) was adopted for conducting exposure and health risk assessments for any given SEG in the petrochemical industry. The resultant excessive cancer risk was then used to determine the corresponding loss of quality-adjusted life expectancy (QALE). Results show that low average concentrations can be found for SEGs with routine operations (e.g., VCM rectification 0.0973 ppm, polymerization 0.306 ppm, reaction tank 0.33 ppm, VCM recovery 1.4 ppm, control room 0.14 ppm, VCM storage tanks 0.095 ppm and wastewater treatment 0.390 ppm), and the above values were much lower than that of the permissible exposure limit (PEL; 3 ppm) of VCM promulgated in Taiwan. For non-routine workers, though their high exposure concentrations, their low exposure time and frequencies result in low corresponding health risks. Through the consideration of exposure assessment results, health risk assessment results, and QALE results simultaneously, it is concluded that the proposed method was useful for prioritizing SEGs for conducting exposure abatement measurements. Particularly, the obtained QALE results further indicate the importance of reducing workers’ VCM exposures, though their exposures were low as in comparison with the PEL and the acceptable health risk.

Keywords: exposure assessment, health risk assessment, petrochemical industry, quality-adjusted life years, vinyl chloride monomer

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8474 Remaining Useful Life Estimation of Bearings Based on Nonlinear Dimensional Reduction Combined with Timing Signals

Authors: Zhongmin Wang, Wudong Fan, Hengshan Zhang, Yimin Zhou

Abstract:

In data-driven prognostic methods, the prediction accuracy of the estimation for remaining useful life of bearings mainly depends on the performance of health indicators, which are usually fused some statistical features extracted from vibrating signals. However, the existing health indicators have the following two drawbacks: (1) The differnet ranges of the statistical features have the different contributions to construct the health indicators, the expert knowledge is required to extract the features. (2) When convolutional neural networks are utilized to tackle time-frequency features of signals, the time-series of signals are not considered. To overcome these drawbacks, in this study, the method combining convolutional neural network with gated recurrent unit is proposed to extract the time-frequency image features. The extracted features are utilized to construct health indicator and predict remaining useful life of bearings. First, original signals are converted into time-frequency images by using continuous wavelet transform so as to form the original feature sets. Second, with convolutional and pooling layers of convolutional neural networks, the most sensitive features of time-frequency images are selected from the original feature sets. Finally, these selected features are fed into the gated recurrent unit to construct the health indicator. The results state that the proposed method shows the enhance performance than the related studies which have used the same bearing dataset provided by PRONOSTIA.

Keywords: continuous wavelet transform, convolution neural net-work, gated recurrent unit, health indicators, remaining useful life

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8473 Knowledge, Attitude, and Practice Related to Potential Application of Artificial Intelligence in Health Supply Chain

Authors: Biniam Bahiru Tufa, Hana Delil Tesfaye, Seife Demisse Legesse, Manaye Tamire

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The healthcare industry is witnessing a digital transformation, with artificial intelligence (AI) offering potential solutions for challenges in health supply chain management (HSCM). However, the adoption of AI in this field remains limited. This research aimed to assess the knowledge, attitude, and practice of AI among students and employees in the health supply chain sector in Ethiopia. Using an explanatory case study research design with a concurrent mixed approach, quantitative and qualitative data were collected simultaneously. The study included 153 participants comprising students and employed health supply chain professionals working in various sectors. The majority had a pharmacy background, and one-third of the participants were male. Most respondents were under 35 years old, and around 68.6% had less than 10 years of experience. The findings revealed that 94.1% of participants had prior knowledge of AI, but only 35.3% were aware of its application in the supply chain. Moreover, the majority indicated that their training curriculum did not cover AI in health supply chain management. Participants generally held positive attitudes toward the necessity of AI for improving efficiency, effectiveness, and cost savings in the supply chain. However, many expressed concerns about its impact on job security and satisfaction, considering it as a burden Graduate students demonstrated higher knowledge of AI compared to employed staff, while graduate students also exhibited a more positive attitude toward AI. The study indicated low previous utilization and potential future utilization of AI in the health supply chain, suggesting untapped opportunities for improvement. Overall, while supply chain experts and graduate students lacked sufficient understanding of AI and its significance, they expressed favorable views regarding its implementation in the sector. The study recommends that the Ethiopian government and international organizations consider introducing AI in the undergraduate pharmacy curriculum and promote its integration into the health supply chain field.

Keywords: knowledge, attitude, practice, supply chain, articifial intellegence

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8472 The Role of Midwives in Promoting Childbearing in Respect to the Law of Population Youth in Iran

Authors: Parvin Abedi, Poorandokht Afshari

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Introduction: In 2022, the Youth Law of the Population was notified to all organizations, including the Iranian Ministry of Health. Some of the articles of this law are about the role of midwives in health and treatment to promote childbearing. In this regard, articles number 45, 48, 49, and 50 are related to midwifery work that will be reviewed in this article. Methods: In this review, the law of population youth was reviewed. In this regard, the statistics of midwives working in the treatment and health sector were collected and analyzed according to the population youth law. Results: Nearly 47 000 midwives are working in the public and private sectors of the country and in the healthcare sector; according to Article 49, which states that there should be one midwife for every two parturient women, about 12,000 midwives are needed in the treatment department and about 8,000 midwives are needed in the health department. In Article 50 it is mentioned to modify tariffs and efficiency in order to increase natural childbirth, and in this field, insurance organizations should have sufficient cooperation with payments. The tariff for midwifery services has been increased, but it is not enough for the stressful job of midwifery. The labor incentive for delivery by midwives is also low. Conclusion: Midwives are one of the fundamental pillars of the law of the population, and without increasing the motivation of midwives, it is not possible to increase the rate of natural childbirth and make childbirth pleasant.

Keywords: law of the population, midwife, motivation, childbearing

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8471 Understanding Jordanian Women's Values and Beliefs Related to Prevention and Early Detection of Breast Cancer

Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

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8470 Family Cohesion, Interpersonal Difficulties and Mental Health Problems in University Students

Authors: Narmeen Ali, Muhammad Arshad

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Cohesion has an exact association with family functioning and enmeshment (togetherness) on one side and disengagement (separateness) on the other. Family cohesion can apprehend as a concerned association that family members have with each other and an affirmation of association inside the family. Family cohesion, assigned as the level of congruity or sympathetic or emotional attachment that relatives have toward each other, and it was seen to be associated with relational well-being and feeling of comfort in the young generation. The cross-sectional research design was used by the researcher to answer the research questions. A stratified sampling technique was used to collect the data from the participants. The data was collected equally from the males and females of different universities and different departments of Lahore, Pakistan. A self-report questionnaire was developed of given literature and which were found to be associated with family cohesion, interpersonal difficulties and mental health problems of university students. The demographic information included age, gender, university’s name, class, family system, parent’s education, parent’s profession, number of siblings and birth order. Correlation shows the negative relation between balanced cohesion and interpersonal difficulties, while interpersonal difficulties have a highly positive relationship with mental health problems. Mental health problems also have a negative correlation with the balanced family cohesion. Gender, family system, depression and anxiety are the significant predictors of interpersonal difficulties scale in university students. And gender showed a significant difference regarding family cohesion and interpersonal difficulty scale, as women reported more interpersonal difficulties than men.

Keywords: family cohesion, interpersonal difficulties, mental health problems, university students

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8469 The Effect of Maritime Security on National Development in Nigeria

Authors: Adegboyega Adedolapo Ola

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Globally, a country’s maritime security has a significant impact on its national development because it serves as a major source of a commercial contact and food supply. However, the country has been faced with a number of problems, such as piracy, kidnapping, illegal bunkering and oil theft. As such, the study examined the contribution and the relationship between maritime security and Nigeria’s development, as well as the prospects and challenges of maritime security in Nigeria. The study utilized a questionnaire and focused group discussion/interview as instruments for data collection. The method of analysis employed in the study is descriptive. A total of Three Hundred and Ninety (390) respondents were randomly selected. The result of the study showed that maritime security contributes to national development in Nigeria by guaranteeing food security in Nigeria, creating employment opportunities as well as increasing the Gross Domestic Product (GDP) of the economy. It was also found that maritime security is yet to provide sufficient support for national development in Nigeria. It is further established that it has prospects for development through the creation of employment opportunities, increase in foreign earnings, and fostering improved living standards for citizens. The study concluded that the high level of corruption, piracy and kidnapping, lack of political will by the government and the porosity of the Nigerian borders are serious obstacles, among others. In attempting to solve the problem of piracy and kidnapping in Nigerian maritime, to contribute to National development, it is primordial to address the cancer of corruption, poverty, and youth unemployment. In view of this, the study recommends: among other things, that the maritime industry should be well secured by removing its constraints/bottlenecks so as to enhance its contributions to national development.

Keywords: maritime security, national development, terrorism, piracy

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8468 Assessment of Noise Pollution in the City of Biskra, Algeria

Authors: Tallal Abdel Karim Bouzir, Nourdinne Zemmouri, Djihed Berkouk

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In this research, a quantitative assessment of the urban sound environment of the city of Biskra, Algeria, was conducted. To determine the quality of the soundscape based on in-situ measurement, using a Landtek SL5868P sound level meter in 47 points, which have been identified to represent the whole city. The result shows that the urban noise level varies from 55.3 dB to 75.8 dB during the weekdays and from 51.7 dB to 74.3 dB during the weekend. On the other hand, we can also note that 70.20% of the results of the weekday measurements and 55.30% of the results of the weekend measurements have levels of sound intensity that exceed the levels allowed by Algerian law and the recommendations of the World Health Organization. These very high urban noise levels affect the quality of life, the acoustic comfort and may even pose multiple risks to people's health.

Keywords: road traffic, noise pollution, sound intensity, public health

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8467 An Appraisal of the Relationship between Socio-Economic Status and Mental Toughness of Cricketers

Authors: Punam Shaw

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Relationship often refers to the acquaintance or association between two or more things, which are interrelated and interdependent. The socio-economic status is obviously a blending of two states, would, therefore, be a ranking of an individual by the society he or she lives in, and in terms of his/her material belonging, cultural possessions along with the degree of respect, power and influence wield. Hence, education, income and occupation of an individual play a significant role in society. Positive mental attitude leads to achieve the set goal, and improve performance particularly in team cohesiveness, which may be determined by various interrelated aspects, which can predict the future assessment in their respective field accordingly. The study intended to examine and explore the relationship between Socio-economic Status and Mental Toughness of cricketers. For the present study descriptive survey research method was used and selected 40 (male=20 female=20) U-17 years registered players under Cricket Association of Bengal (CAB), as the sample population. Modified Socio-Economic Status Scale was used to collect the data regarding players, socioeconomic Status and to assess the mental toughness; Scott Barry Kaufman questionnaire was used. The data had been analysed through applying Pearson’s Correlation Coefficient and t-test as statistical techniques. The findings of the study showed that there is a positive correlation between socioeconomic Status and Mental Toughness among cricketers, it was found that significant difference was presented between male and female SES group. It was further revealed that there is no significant difference between male and female cricketers and in their different socioeconomic class with respect to their mental toughness.

Keywords: cricketers, mental toughness, relationship, socio-economic status

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8466 Multivariate Analysis of the Relationship between Professional Burnout, Emotional Intelligence and Health Level in Teachers University of Guayaquil

Authors: Viloria Marin Hermes, Paredes Santiago Maritza, Viloria Paredes Jonathan

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The aim of this study is to assess the prevalence of Burnout syndrome in a sample of 600 professors at the University of Guayaquil (Ecuador) using the Maslach Burnout Inventory (M.B.I.). In addition, assessment was made of the effects on health from professional burnout using the General Health Questionnaire (G.H.Q.-28), and the influence of Emotional Intelligence on prevention of its symptoms using the Spanish version of the Trait Meta-Mood Scale (T.M.M.S.-24). After confirmation of the underlying factor structure, the three measurement tools showed high levels of internal consistency, and specific cut-off points were proposed for the group of Latin American academics in the M.B.I. Statistical analysis showed the syndrome is present extensively, particularly on medium levels, with notably low scores given for Professional Self-Esteem. The application of Canonical Correspondence Analysis revealed that low levels of self-esteem are related to depression, with a lack of personal resources related to anxiety and insomnia, whereas the ability to perceive and control emotions and feelings improves perceptions of professional effectiveness and performance.

Keywords: burnout, academics, emotional intelligence, general health, canonical correspondence analysis

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8465 The Higher Education System in Jordan: Philosophy and Premises Preparation

Authors: Ihsan Orsan Oglah Elrabbaei

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This research stems from the philosophy of education notion, as it is a fundamental pillar within or component of the philosophy of education. It is the general framework that society takes towards the future in order to build its integrated educational system amid the variables that surround it, in order to prepare its members in all aspects of cognitive, skill, and behavioral life, so that there is a clear concept of the system of productive values, according to the vision of philosophy that defines its future roles, which can be found in the system of productive values. With the resignation, everything changes. As a result, the philosophy of education is anticipated to evolve in response to perceived changes in society in terms of the nature of its human and material resources. The study will answer the following questions: Has the philosophy of education changed to accommodate this change? Alternatively, is the change that occurs because of natural growth without education having a role in directing this change and being aware of it in order to fit with national, regional, and global changes? Were the national educational goals and curricula and their programs viewed through the lenses of interest? On the other hand, do things happen without realizing that the philosophy of education has changed and that it proceeds according to the natural rolling of the invisible impulse? The study concluded that we must reconsider the philosophy of education and redefine who is an educated person. In addition, to recognize all the values of the roles that the individual can play in his society, according to his abilities, and with respect. Moreover, building a new philosophy of education based on what society can look at and what it wants from a flexible future takes the concept of changing life values, their contents, diversity, and the roles of each individual in them.

Keywords: higher education system, jordan, philosophy, premises preparation.

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8464 Microfluidic Synthesis of Chlorophyll Extraction–Loaded PCL Composite Microparticles Developed as Health Food

Authors: Ching-Ju Hsiao, Mao-Chen Huang, Pei-Fan Chen, Ruo-Yun Chung, Jiun-Hua Chou, Chih-Hui Yang, Keng-Shiang Huang, Jei-Fu Shaw

Abstract:

Chlorophyll has many benefits for human body. It is known to improve the health of the circulatory, digestive, immune and detoxification systems of the body. However, Chl can’t be preserved at the environment of high temperature and light exposure for a long time due to it is chemical structure is easily degradable. This characteristic causes that human body is difficult to absorb Chl effective components. In order to solve this problem, we utilize polycaprolactone (PCL) polymer encapsulation technology to increase the stability of Chl. In particular, we also established a microfluidic platform provide the control of composite beads diameter. The new composite beads is potential to be a health food. Result show that Chl effective components via the microfludic platform can be encapsulated effectively and still preserve its effective components.

Keywords: chlorophyll, PCL, PVA, microfluidic

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8463 From an Expectations Crisis to a Mental Disorder: The Consequences of Irregular Journeys on Sub-Saharan Migrants

Authors: Siham Soulaimi

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Europe has become a difficult destination due to strict migration policies and border controls, making Morocco an immigration country. Morocco is currently at the center of the international migration debate because it not only hosts regular migrants but also must deal with the problem of irregular migrants entering its territory. Sub-Saharan irregular migration is full of challenges that might cause a delay for the migrants, announcing a death sentence for many others. The journey's hurdles are likely to cause a crisis in expectations, resulting in serious consequences on the migrants' mental health. Our research study emphasizes that sub-Saharan migrants begin irregular journeys with high hopes, only to be disappointed by how unexpectedly cruel it turns out to be. We also pointed to specific physical and, more crucially, mental health problems that they end up with after survival, resulting in somatic disorders.

Keywords: irregular migration, Sub-Saharan migrants, challenges, experiences crisis, mental health, somatoform disorder

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8462 Intelligence Failures and Infiltration: The Case of the Ethiopian Army 1977-1991

Authors: Fantahun Ibrahim

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The Ethiopian army was one of the largest and most heavily armed ground forces in Africa between 1974 and 1991. It scored a decisive victory over Somalia’s armed forces in March 1978. It, however, failed to withstand the combined onslaught of the northern insurgents from Tigray and Eritrea and finally collapsed in 1991. At the heart of the problem was the army’s huge intelligence failure. The northern insurgents, on the other hand, had a cutting edge in intelligence gathering. Among other things they infiltrated the army high command and managed to get top secrets about the army. Commanders who had fallen into the hands of the insurgents in several battles were told to send letters to their colleagues in the command structure and persuade them to work secretly for the insurgents. Some commanders did work for the insurgents and played a great role in the undoing of military operations. Insurgent commanders were able to warn their fighters about air strikes before jet fighters took off from airfields in the northern theatre. It was not uncommon for leaders of insurgents to get the full details of military operations days before their implementation. Such intelligence failures led to major military disasters like the fall of Afabet (March, 1988), Enda Sellase (February, 1989), Massawa and Debre Tabor (February, 1990), Karra Mishig, Meragna and Alem Ketema (June, 1990). This paper, therefore, seeks to investigate the army’s intelligence failures using untapped archival documents kept at the Ministry of National Defence in Addis Ababa and interviewing key former commanders of the army and ex-leaders of the insurgents.

Keywords: Ethiopian army, intelligence, infiltration, insurgents

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8461 Reintegrating Forensic Mental Health Service Users into Communities in the Western Cape, South Africa

Authors: Zolani Metu

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The death of more than 140 psychiatric patients who were unethically deinstitutionalized from the Life Esidimeni hospital Johannesburg, in 2016, shined a light on South Africa’s failing public mental healthcare system. Compounded by insufficient research evidence on African deinstitutionalization, this necessitates inquiries into deinstitutionalized mental healthcare, reintegration and community-based mental healthcare within the South African context. This study employed a quantitative research approach which utilized a cross-sectional research design, to investigate experiences with the reintegration of institutionalized forensic mental health service users into communities in the Western Cape, South Africa. A convenience sample of 100 mental health care workers from different occupational and organizational backgrounds in the Western Cape was purposively selected using the Western Cape Health Directorate as a sampling frame. A self-administered questionnaire (SAQ) was used as the data collection instrument. The results of the study indicate that criminogenic factors such as substance use, history of violent behaviour, criminal history and disruptive social behaviour complicate the reintegration of forensic mental health service users into communities. The current extent of reintegration of forensic mental health service users was found to be 'poor' (46%; n= 46); and financial difficulties, criminogenic factors and limited Community-Based Care (CBC) facilities were identified as key barriers to the reintegration process. 56% of all job applications for forensic mental health service users were unsuccessful, and 53% of all applications for their admission into CBC facilities were declined. Although social support (informal) was found to be essential for successful reintegration, institutional support (formal) through assertive community treatment (35%; n= 35) and CBC facilities (21%) and the disability grant (DG=50%) was found to be more important for family coping and reintegration. Moreover, 72% of respondents had positive perceptions about the process of reintegration; no statistically significant relationship was found between years of experience and perceptions about reintegration (P-value = 0.062); and perceptions were not found to be a barrier to reintegration. No statistically significant relationship was found between years of working experience and understanding the legislative framework of deinstitutionalization (P-Value =.0.061). However, using a Chi-square test, a significant relationship (P-value = 0.021) was found between sex and understanding the legal framework involved in the process of reintegration. The study recommends a post-2020 deinstitutionalization agenda that factors-in criminogenic realities associated with forensic mental health service users, and affirms the strengthening of PHC and community based care systems as precedents of successful deinstitutionalization and reintegration of mental health service users.

Keywords: forensic mental health, deinstitutionalization, reintegration, mental health service users

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8460 Assessment of Knowledge, Attitude, and Practice of Health Care Professionals and Factors Associated with Adverse Drug Reaction Reporting in Public and Private Hospitals of Islamabad

Authors: Zaka Nisa, Farooq Sher

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Adverse drug reactions (ADRs) underreporting is a great challenge to Pharmacovigilance. Health care professionals have to consider ADR reporting as their professional obligation, an effective system of ADR reporting is important to improve patient health care and safety. The present study is designed to assess the knowledge, attitude, practice and factors associated with ADR reporting by health care professionals (physicians and pharmacists) in public and private hospitals of Pakistan. A pretested questionnaire was administered to 384 physicians and pharmacists in public and private hospitals. Respondents were evaluated for their knowledge, attitude, and practice related to ADR reporting. The data was analyzed using the SPSS statistical software, the factors which encourage and discourage respondents in reporting ADRs were determined. Most of the respondents have shown a positive attitude towards ADR reporting. The response rate was 95.32%. Of the 367 questionnaires, including 333 (86.5%) physicians and 34 (8.8%) pharmacists with the mean age 28.34 (SD= 6.69), most of the respondents showed poor ADR reporting knowledge (83.1%). The majority of respondents (78.2%) showed positive attitude towards ADR reporting and only (12.3%) hospitals have good ADR reporting practice. Knowledge of respondents in public hospitals (8.6%) was less as compare to those in the private hospitals (29.7%) (P < 0.001). Attitude of respondents in private hospitals was more positive (92.4%) than those in public hospitals (68.8%) (P < 0.001). No significant difference was observed in practicing of ADR reporting in public (11.8%) and private hospitals (13.1%) (P value 0.89). Seriousness of ADR, unusualness of reaction, new drug involvement and confidence in diagnosis of ADR were the factors which encourage respondents to report ADR, however, lack of knowledge regarding where and how to report ADR, lack of access to ADR reporting form, managing patients was more important than reporting ADR, legal liability issues were the factors which discourage respondents to report ADR. The study reveals poor knowledge and practice regarding ADR reporting. However positive attitude was seen regarding ADR reporting. There is a need of educational training for health care professionals as well as genuine and continuous efforts are required by Government and health authorities to ensure the proper implementation of ADR reporting system in all of the hospitals.

Keywords: adverse drugs reactions (ADR), pharmacovigilance, spontaneous ADR reporting, knowledge of ADR, attitude of health care profesionals, practice of ADR reporting

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8459 Knowledge, Attitudes and Its Associated Factors on the Provision of Psychological First Aid during Response to Disasters among Public Health Midwives in Colombo

Authors: S. P. Hewagama

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Different kinds of distressing events happen in the world causing a wide range of reactions and feelings. Psychological first aid (PFA) is humane supportive response for suffering. All health workers especially PHMs who play a major role as first responders in a disaster should be able to provide basic PFA effectively. Aim of this study was to assess the knowledge, attitudes and associated factors on the provision of PFA among PHMs during disasters. A descriptive cross-sectional study was carried out among 307 Public Health Midwives in Colombo RDHS area. In the study population, 86.6% (n=266) of the respondents were aware of the term “Psychological first aid” while 13.4% (n=41) were not aware. The total knowledge score was good in majority 85.4%(n=262) of the respondents while only 14.3%(n=45) had a poor knowledge on PFA. There was the statistically significant difference in relation to the level of education with the total knowledge score. Comprehensive desirable attitudes towards PFA was low (30.61%, n=94). According to the study, only a less than a quarter (21.82%, (n = 67)) of the study population had received training on PFA. More than half (56%, n=172) of the respondents had experience in responding to disasters. Conclusions and Recommendations: The overall knowledge and attitudes were found to be satisfactory. However, it is important to improve the knowledge level of the PHMs by providing training and workshops on PFA.

Keywords: disaster, humane supportive assistance, psychological first aid, public health midwives

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8458 A Mechanism of Reusable, Portable, and Reliable Script Generator on Android

Authors: Kuei-Chun Liu, Yu-Yu Lai, Ching-Hong Wu

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A good automated testing tool could reduce as much as possible the manual work done by testers. Traditional record-replay testing tool provides an automated testing solution by recording mouse coordinates as test scripts, but it will be easily broken if any change of resolutions. Therefore, more and more testers design multiple test scripts to automate the testing process for different devices. In order to improve the traditional record-replay approach and reduce the effort that the testers spending on writing test scripts, we propose an approach for generating the Android application test scripts based on accessibility service without connecting to a computer. This approach simulates user input actions and replays them correctly even at the different conditions such as the internet connection is unstable when the device under test, the different resolutions on Android devices. In this paper, we describe how to generate test scripts automatically and make a comparison with existing tools for Android such as Robotium, Appium, UIAutomator, and MonkeyTalk.

Keywords: accessibility service, Appium, automated testing, MonkeyTalk, Robotium, testing, UIAutomator

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8457 Fulfillment of Models of Prenatal Care in Adolescents from Mexico and Chile

Authors: Alejandra Sierra, Gloria Valadez, Adriana Dávalos, Mirliana Ramírez

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For years, the Pan American Health Organization/World Health Organization and other organizations have made efforts to the improve access and the quality of prenatal care as part of comprehensive programs for maternal and neonatal health, the standards of care have been renewed in order to migrate from a medical perspective to a holistic perspective. However, despite the efforts currently antenatal care models have not been verified by a scientific evaluation in order to determine their effectiveness. The teenage pregnancy is considered as a very important phenomenon since it has been strongly associated with inequalities, poverty and the lack of gender quality; therefore it is important to analyze the antenatal care that’s been given, including not only the clinical intervention but also the activities surrounding the advertising and the health education. In this study, the objective was to describe if the previously established activities (on the prenatal care models) are being performed in the care of pregnant teenagers attending prenatal care in health institutions in two cities in México and Chile during 2013. Methods: Observational and descriptive study, of a transversal cohort. 170 pregnant women (13-19 years) were included in prenatal care in two health institutions (100 women from León-Mexico and 70 from Chile-Coquimbo). Data collection: direct survey, perinatal clinical record card which was used as checklists: WHO antenatal care model WHO-2003, Official Mexican Standard NOM-007-SSA2-1993 and Personalized Service Manual on Reproductive Process- Chile Crece Contigo; for data analysis descriptive statistics were used. The project was approved by the relevant ethics committees. Results: Regarding the fulfillment of interventions focused on physical, gynecological exam, immunizations, monitoring signs and biochemical parameters in both groups was met by more than 84%; the activities of guidance and counseling pregnant teenagers in Leon compliance rates were below 50%, on the other hand, although pregnant women in Coquimbo had a higher percentage of compliance, no one reached 100%. The topics that less was oriented were: family planning, signs and symptoms of complications and labor. Conclusions: Although the coverage of the interventions indicated in the prenatal care models was high, there were still shortcomings in the fulfillment of activities to orientation, education and health promotion. Deficiencies in adherence to prenatal care guidelines could be due to different circumstances such as lack of registration or incomplete filling of medical records, lack of medical supplies or health personnel, absences of people at prenatal check-up appointments, among many others. Therefore, studies are required to evaluate the quality of prenatal care and the effectiveness of existing models, considering the role of the different actors (pregnant women, professionals and health institutions) involved in the functionality and quality of prenatal care models, in order to create strategies to design or improve the application of a complete process of promotion and prevention of maternal and child health as well as sexual and reproductive health in general.

Keywords: adolescent health, health systems, maternal health, primary health care

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8456 The Impact of Heat Waves on Human Health: State of Art in Italy

Authors: Vito Telesca, Giuseppina A. Giorgio

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The earth system is subject to a wide range of human activities that have changed the ecosystem more rapidly and extensively in the last five decades. These global changes have a large impact on human health. The relationship between extreme weather events and mortality are widely documented in different studies. In particular, a number of studies have investigated the relationship between climatological variations and the cardiovascular and respiratory system. The researchers have become interested in the evaluation of the effect of environmental variations on the occurrence of different diseases (such as infarction, ischemic heart disease, asthma, respiratory problems, etc.) and mortality. Among changes in weather conditions, the heat waves have been used for investigating the association between weather conditions and cardiovascular events and cerebrovascular, using thermal indices, which combine air temperature, relative humidity, and wind speed. The effects of heat waves on human health are mainly found in the urban areas and they are aggravated by the presence of atmospheric pollution. The consequences of these changes for human health are of growing concern. In particular, meteorological conditions are one of the environmental aspects because cardiovascular diseases are more common among the elderly population, and such people are more sensitive to weather changes. In addition, heat waves, or extreme heat events, are predicted to increase in frequency, intensity, and duration with climate change. In this context, are very important public health and climate change connections increasingly being recognized by the medical research, because these might help in informing the public at large. Policy experts claim that a growing awareness of the relationships of public health and climate change could be a key in breaking through political logjams impeding action on mitigation and adaptation. The aims of this study are to investigate about the importance of interactions between weather variables and your effects on human health, focusing on Italy. Also highlighting the need to define strategies and practical actions of monitoring, adaptation and mitigation of the phenomenon.

Keywords: climate change, illness, Italy, temperature, weather

Procedia PDF Downloads 242
8455 Using AI Based Software as an Assessment Aid for University Engineering Assignments

Authors: Waleed Al-Nuaimy, Luke Anastassiou, Manjinder Kainth

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As the process of teaching has evolved with the advent of new technologies over the ages, so has the process of learning. Educators have perpetually found themselves on the lookout for new technology-enhanced methods of teaching in order to increase learning efficiency and decrease ever expanding workloads. Shortly after the invention of the internet, web-based learning started to pick up in the late 1990s and educators quickly found that the process of providing learning material and marking assignments could change thanks to the connectivity offered by the internet. With the creation of early web-based virtual learning environments (VLEs) such as SPIDER and Blackboard, it soon became apparent that VLEs resulted in higher reported computer self-efficacy among students, but at the cost of students being less satisfied with the learning process . It may be argued that the impersonal nature of VLEs, and their limited functionality may have been the leading factors contributing to this reported dissatisfaction. To this day, often faced with the prospects of assigning colossal engineering cohorts their homework and assessments, educators may frequently choose optimally curated assessment formats, such as multiple-choice quizzes and numerical answer input boxes, so that automated grading software embedded in the VLEs can save time and mark student submissions instantaneously. A crucial skill that is meant to be learnt during most science and engineering undergraduate degrees is gaining the confidence in using, solving and deriving mathematical equations. Equations underpin a significant portion of the topics taught in many STEM subjects, and it is in homework assignments and assessments that this understanding is tested. It is not hard to see that this can become challenging if the majority of assignment formats students are engaging with are multiple-choice questions, and educators end up with a reduced perspective of their students’ ability to manipulate equations. Artificial intelligence (AI) has in recent times been shown to be an important consideration for many technologies. In our paper, we explore the use of new AI based software designed to work in conjunction with current VLEs. Using our experience with the software, we discuss its potential to solve a selection of problems ranging from impersonality to the reduction of educator workloads by speeding up the marking process. We examine the software’s potential to increase learning efficiency through its features which claim to allow more customized and higher-quality feedback. We investigate the usability of features allowing students to input equation derivations in a range of different forms, and discuss relevant observations associated with these input methods. Furthermore, we make ethical considerations and discuss potential drawbacks to the software, including the extent to which optical character recognition (OCR) could play a part in the perpetuation of errors and create disagreements between student intent and their submitted assignment answers. It is the intention of the authors that this study will be useful as an example of the implementation of AI in a practical assessment scenario insofar as serving as a springboard for further considerations and studies that utilise AI in the setting and marking of science and engineering assignments.

Keywords: engineering education, assessment, artificial intelligence, optical character recognition (OCR)

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8454 Exploring Help Seeking Attitude among Muslim Students in a School with a Dual Education System in Brunei Darussalam

Authors: Aziz Zulazmi Samsudin, Siti Norhedayah Abdul Latif

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The lack of normalization of mental health as a conversational topic is becoming increasingly evident in certain cultures. The fact that students underutilize mental health services in schools can be attributed to the presence of various barriers that impede their willingness to seek for help. Stigma surrounding mental health services continue to be the most prevalent barrier for help seeking behavior. Alternative barriers have emerged that are both personal and public in nature that can have a substantial impact on students’ preference to seek for help in schools. A sequential explanatory study was carried out among 256 Muslim students in a school with dual education system in exploring both their Self-Stigma of Seeking Help (SSOSH) and Mental Health Help-Seeking Attitude (MHSA). In addition, 12 students were interviewed in a focus group setting to explore further the phenomena of help seeking approach by students to understand the initial quantitative analysis. Preliminary findings indicated that the students’ level of self-stigma was only moderate, but they had a favorable attitude towards counselling help. There was no significant difference on gender for both variables; however, the lower the self-stigma, the higher the mental help-seeking attitude for this current study, which is a common trend of relationship between the two variables. The interview revealed that, apart from public stigma, the absence of a qualified counsellor, a lack of ethical principles of counselling, a confidentiality issue, and the emotional openness of the students were identified as other barriers to their help-seeking attitudes. This paper also discussed the recommendation made by students in addressing barriers to counselling and facilitating their counselling needs for the improvement of students' mental and academic well-being. Additionally, this research offers the most recent data about mental health in the context of schools with a dual education system in Brunei Darussalam. It is hoped to serve as a guide for policy makers to consider the provision of mental health services that is more appealing to the students’ mental and academic well-being.

Keywords: mental health help-seeking attitude (MHSA), public stigma, school counselling, self-stigma, self-stigma of seeking help (SSOSH), well-being.

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8453 Impact of Financial and Nutrition Support on Blood Health, Dietary Intake, and Well-Being among Female Student-Athletes

Authors: Kaila A. Vento

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Within the field of sports science, financial situations have been reported as a key barrier in purchasing high-quality foods. A lack of proper nutrition leads to insecurities of health, impairs training, and diminishes optimal performances. Consequently, insufficient nutrient intake, disordered eating patterns, and eating disorders may arise, leading to poor health and well-being. Athletic scholarships, nutrition resources, and meal programs are available, yet are disproportionally allocated, favoring male sports, Caucasian athletes, and higher sport levels. Direct athlete finances towards nutrition at various sport levels and the role race influences aid received has yet to be examined. Additionally, a diverse female athlete population is missing in the sports science literature, specifically in nutrition. To address this gap, the current project assesses how financial and nutrition support and nutrition knowledge impacts physical health, dietary intake, and overall quality of life of a diverse sample of female athletes at the National Collegiate Athletic Association (NCAA), National Junior Collegiate Athletic Association (NJCAA), and cub sport levels. The project will identify differences in financial support in relation to race, as well. Approximately (N = 120) female athletes will participate in a single 30-minute lab visit. At this visit, body composition (i.e., height, weight, body mass index, and fat percent), blood health indicators (fasted blood glucose and lipids), and resting blood pressure are measured. In addition, three validated questionnaires pertaining to nutrition knowledge (Sports Nutrition Knowledge Questionnaire; SNKQ), dietary intake (Rapid Eating Assessment for Participants; REAP), and quality of life (World Health Organization Quality of Life Brief; WHOQL-B) are gathered. Body composition and blood health indicators will be compared with the results of self-reported sports nutrition knowledge, dietary intake, and quality of life questionnaires. It is hypothesized that 1) financial and nutrition support and nutrition knowledge will differ between the sport levels and 2) financial and nutrition support and nutrition knowledge will have a positive association with quality of dietary intake and blood health indicators, 3) financial and nutrition support will differ significantly among racial background across the various competition levels, and 4) dietary intake will influence blood health indicators and quality of life. The findings from this study could have positive implications on athletic associations' policies on equity of financial and nutrition support to improve the health and safety of all female athletes across several sport levels.

Keywords: athlete, equity, finances, health, resources

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8452 A Study of Fecal Sludge Management in Auroville and Its Surrounding Villages in Tamilnadu, India

Authors: Preethi Grace Theva Neethi Dhas

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A healthy human gut microbiome has commensal and symbiotic functions in digestion and is a decisive factor for human health. The soil microbiome is a crucial component in the ecosystem of soils and their health and resilience. Changes in soil microbiome are linked to human health. Ever since the industrial era, the human and the soil microbiome have been going through drastic changes. The soil microbiome has changed due to industrialization and extensive agricultural practices, whereas humans have less contact with soil and increased intake of highly processed foods, leading to changes in the human gut microbiome. Regenerating the soil becomes crucial in maintaining a healthy ecosystem. The nutrients, once obtained from the soil, need to be given back to the soil. Soil degradation needs to be addressed in effective ways, like adding organic nutrients back to the soil. Manure from animals and humans needs to be returned to the soil, which can complete the nutrient cycle in the soil. On the other hand, fecal sludge management (FSM) is a growing concern in many parts of the developing world. Hence, it becomes crucial to treat and reuse fecal sludge in a safe manner, i.e., low in risk to human health. Co-composting fecal sludge with organic wastes is a practice that allows the safe management of fecal sludge and the safe application of nutrients to the soil. This paper will discuss the possible impact of co-composting fecal sludge with coconut choir waste on the soil, water, and ecosystem at large. Impact parameters like nitrogen, phosphorus, and fecal coliforms will be analyzed. The overall impact of fecal sludge application on the soil will be researched and presented in this study.

Keywords: fecal sludge management, nutrient cycle, soil health, composting

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8451 A Hybrid Digital Watermarking Scheme

Authors: Nazish Saleem Abbas, Muhammad Haris Jamil, Hamid Sharif

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Digital watermarking is a technique that allows an individual to add and hide secret information, copyright notice, or other verification message inside a digital audio, video, or image. Today, with the advancement of technology, modern healthcare systems manage patients’ diagnostic information in a digital way in many countries. When transmitted between hospitals through the internet, the medical data becomes vulnerable to attacks and requires security and confidentiality. Digital watermarking techniques are used in order to ensure the authenticity, security and management of medical images and related information. This paper proposes a watermarking technique that embeds a watermark in medical images imperceptibly and securely. In this work, digital watermarking on medical images is carried out using the Least Significant Bit (LSB) with the Discrete Cosine Transform (DCT). The proposed methods of embedding and extraction of a watermark in a watermarked image are performed in the frequency domain using LSB by XOR operation. The quality of the watermarked medical image is measured by the Peak signal-to-noise ratio (PSNR). It was observed that the watermarked medical image obtained performing XOR operation between DCT and LSB survived compression attack having a PSNR up to 38.98.

Keywords: watermarking, image processing, DCT, LSB, PSNR

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8450 Extracellular Enzymes as Promising Soil Health Indicators: Assessing Response to Different Land Uses Using Long-Term Experiments

Authors: Munisath Khandoker, Stephan Haefele, Andy Gregory

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Extracellular enzymes play a key role in soil organic carbon (SOC) decomposition and nutrient cycling and are known indicators for soil health; however, it is not understood how these enzymes respond to different land uses and their relationships to other soil properties have not been extensively reviewed. The relationships among the activities of three soil enzymes: β-glucosaminidase (NAG), phosphomonoesterase (PHO) and β-glucosidase (GLU), were examined. The impact of soil organic amendments, soil types and land management on soil enzyme activities were reviewed, and it was hypothesized that soils with increased SOC have increased enzyme activity. Long-term experiments at Rothamsted Research Woburn and Harpenden sites in the UK were used to evaluate how different management practices affect enzyme activity involved in carbon (C) and nitrogen (N) cycling in the soil. Samples were collected from soils with different organic treatments such as straw, farmyard manure (FYM), compost additions, cover crops and permanent grass cover to assess whether SOC can be linked with increased levels of enzymatic activity and what influence, if any, enzymatic activity has on total C and N in the soil. Investigating the interactions of important enzymes with soil characteristics and SOC can help to better understand the health of soils. Studies on long-term experiments with known histories and large datasets can better help with this. SOC tends to decrease during land use changes from natural ecosystems to agricultural systems; therefore, it is imperative that agricultural lands find ways to increase and/or maintain SOC in the soil.

Keywords: biological soil health indicators, extracellular enzymes, soil health, soil, microbiology

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8449 Levels of Selected Heavy Metals in Varieties of Vegetable oils Consumed in Kingdom of Saudi Arabia and Health Risk Assessment of Local Population

Authors: Muhammad Waqar Ashraf

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Selected heavy metals, namely Cu, Zn, Fe, Mn, Cd, Pb, and As, in seven popular varieties of edible vegetable oils collected from Saudi Arabia, were determined by graphite furnace atomic absorption spectrometry (GF-AAS) using microwave digestion. The accuracy of procedure was confirmed by certified reference materials (NIST 1577b). The concentrations for copper, zinc, iron, manganese, lead and arsenic were observed in the range of 0.035 - 0.286, 0.955 - 3.10, 17.3 - 57.8, 0.178 - 0.586, 0.011 - 0.017 and 0.011 - 0.018 µg/g, respectively. Cadmium was found to be in the range of 2.36 - 6.34 ng/g. The results are compared internationally and with standards laid down by world health agencies. A risk assessment study has been carried out to assess exposure to these metals via consumption of vegetable oils. A comparison has been made with safety intake levels for these heavy metals recommended by Institute of Medicine of the National Academies (IOM), US Environmental Protection Agency (US EPA) and Joint FAO/WHO Expert Committee on Food Additives (JECFA). The results indicated that the dietary intakes of the selected heavy metals from daily consumption of 25 g of edible vegetable oils for a 70 kg individual should pose no significant health risk to local population.

Keywords: vegetable oils, heavy metals, contamination, health risk assessment

Procedia PDF Downloads 445
8448 Diabetes Prevalence and Quality of Life of Female Nursing Students in Riyadh

Authors: Alyaa Farouk AbdelFattah Ibrahim, Agnes Monica, Dolores I. Cabansag

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The prevalence of diabetes mellitus is reaching epidemic proportions in many parts of the world causing an increasing public health concern. Cases of Type 2 diabetes are rapidly increasing in the Middle East region. Deprived of lifestyle deviations, a section of the Middle East’s inhabitants will be pretentious by 2035. As all sociocultural factors have created unhealthy lifestyles, which have become part of the social norms within Saudi society, thereby increased the prevalence of sedentary lifestyle and obesity in women living in Saudi Arabia. So, this study aimed to assess the impact of diabetes mellitus on quality of life of female nursing students in King Saud bin Abdulaziz University for Health Sciences, Riyadh. In a crossectional study design, 151 nursing students at King Saud bin Abdulaziz University for health sciences in Riyadh were included in the study. Biosociodemographic questionnaire and Short-Form 36 (SF-36) Health Related Quality of life Survey Arabic version were used for data collection, and all included students were screened for random blood glucose level. Results depicted that among 151 subjects included in the study 17 (11.3%) had diagnosed medical problems, and 29.4% of those participants with medical problems were diabetics. Univariate regression model for the relation between diabetes mellitus and overall percent score of SF-36 health survey domains showed no statistically significant difference between diabetic and non-diabetic subjects 0.990(0.931-1.053). In conclusion, although the diabetes prevalence was high among the study subjects it did not affect their quality of life may be due to age of the study population.

Keywords: diabetes mellitus, diabetes prevalence, quality of life, university students' health

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8447 Management Support, Role Ambiguity and Role Ambiguity among Professional Nurses at National Health Insurance Pilot Sites in South Africa: An Interpretive Phenomenology

Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

Procedia PDF Downloads 139