Search results for: long term care facility
9158 Spatiotemporal Neural Network for Video-Based Pose Estimation
Authors: Bin Ji, Kai Xu, Shunyu Yao, Jingjing Liu, Ye Pan
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Human pose estimation is a popular research area in computer vision for its important application in human-machine interface. In recent years, 2D human pose estimation based on convolution neural network has got great progress and development. However, in more and more practical applications, people often need to deal with tasks based on video. It’s not far-fetched for us to consider how to combine the spatial and temporal information together to achieve a balance between computing cost and accuracy. To address this issue, this study proposes a new spatiotemporal model, namely Spatiotemporal Net (STNet) to combine both temporal and spatial information more rationally. As a result, the predicted keypoints heatmap is potentially more accurate and spatially more precise. Under the condition of ensuring the recognition accuracy, the algorithm deal with spatiotemporal series in a decoupled way, which greatly reduces the computation of the model, thus reducing the resource consumption. This study demonstrate the effectiveness of our network over the Penn Action Dataset, and the results indicate superior performance of our network over the existing methods.Keywords: convolutional long short-term memory, deep learning, human pose estimation, spatiotemporal series
Procedia PDF Downloads 1549157 Measuring Sustainability Risk in the Construction Industry of Saudi Arabia
Authors: Mohammed Alquraish
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Saudi Arabia and other emerging nations have faced significant challenges in the sustainable construction industry. This paper presents a quantitative approach to assessing sustainability risk in the Saudi Arabian construction industry and offers insights into holistic sustainability design in industry operations. The implementation of sustainable construction industry practices in the manufacturing sector has been susceptible to several risk factors that need to be identified. In order to successfully execute sustainable building projects, decision makers in the fields of construction and industry can benefit greatly from the advice this study offers by promoting the elements that motivate sustainability implementation. Sustainability risk can be measured from combining failure probability with cumulative effects from sustainability factors: social, environmental, and economic; that affect the integrity of the construction industry. The cumulative effects of sustainability risk are measured by classifying the outcomes resulting from these consequences. Operators of industrial construction can strategically manage and minimize potential disruptions affecting long-term sustainability incentives by measuring sustainability risk. Thus, the suggested strategy greatly reinforces the crucial role of the construction industry.Keywords: sustainability, risk, construction industry, Saudi Arabia
Procedia PDF Downloads 489156 Level of Caregiver Burden: A Study of Caregivers of Stroke Survivors at CRP in Bangladesh
Authors: Yeasir Arafat Alve, Nazmun Nahar, Salma BeguM
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Introduction / Rationale: Caregivers of stroke survivors have experienced financial, emotional, physical and mental anxiety and have influence of family bonding and social customs, where 80% of caregivers were women and majority of the patients were cared for by immediate family members for example a spouse, son/daughter, son-in-law, daughter-in-law, siblings and they are significantly feel burden as a caregiver. In Bangladeshi context, there has a limitation of knowledge about the level of caregiver burden. This study could be suggested the health professional to focus on the care giving stress to provide a better support to them and also it will be advisable to provide equivalent services for caregivers and their families. Objectives: The study finds out the socio-demographic image of caregivers of stroke survivors in Bangladesh as well as discovers the level of burden of caregiver of stroke survivor in relation to general strain, isolation, disappointment, emotional involvement and environment. The study will find out the association between level of burden among caregivers and onset of stroke of survivors & duration of care giving. As well as to determine the association between level of burden among caregivers and caregiver’s age, gender, occupation and caregiver’s relationship with stroke survivors. Method / Approach: The study is a non experimental cross-sectional study design where 151 participants were selected through purposive comprehensive sampling. Data were selected from occupational therapy outdoor and stroke rehab unit, CRP (Savar & Mirpur) where using the Caregiver Burden Scale (a structured questionnaire) with face to face interview. Results: Most of the caregivers (78.8%) of stroke survivors faced moderate level of burden in general strain (37.7%), isolation (27.2%) but in case of disappointment (60.3%) feel higher burden and lower burden in emotional involvement (9.9%) and environment (0.7%). Caregiver burden level was significantly associated with caregivers’ age (P=0.006), sex (P=0.002), occupation (p= 0.04), relationship with stroke survivors (P=0.02), care giving duration (P=0.000), care giving hours (P=0.009), and onset of stroke (P=0.000) of stroke survivors. Conclusion: The study findings revealed that most of the caregivers faced moderate burden where no environmental burden for them, this is possibly in case of Bangladeshi culture where people hospitable. Through this study, it was also found that there is a possibility to have the higher burden. Finally, it is being also suggested that appropriate advice and support may preserve care giving which eventually enables the survivors to live a longer and more fulfilling life in the community.Keywords: caregiver, level of caregiver burden, stroke survivor, stroke rehab unit
Procedia PDF Downloads 3169155 Quality of Life Among People with Mental Illness Attending a Psychiatric Outpatient Clinic in Ethiopia: A Structural Equation Model
Authors: Wondale Getinet Alemu, Lillian Mwanri, Clemence Due, Telake Azale, Anna Ziersch
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Background: Mental illness is one of the most severe, chronic, and disabling public health problems that affect patients' Quality of life (QoL). Improving the QoL for people with mental illness is one of the most critical steps in stopping disease progression and avoiding complications of mental illness. Therefore, we aimed to assess the QoL and its determinants in patients with mental illness in outpatient clinics in Northwest Ethiopia in 2023. Methods: A facility-based cross-sectional study was conducted among people with mental illness in an outpatient clinic in Ethiopia. The sampling interval was decided by dividing the total number of study participants who had a follow-up appointment during the data collection period (2400) by the total sample size of 638, with the starting point selected by lottery method. The interviewer-administered WHOQOL BREF-26 tool was used to measure the QoL of people with mental illness. The domains and Health-Related Quality of Life (HRQoL) were identified. The indirect and direct effects of variables were calculated using structural equation modeling with SPSS-28 and Amos-28 software. A p-value of < 0.05 and a 95% CI were used to evaluate statistical significance. Results: A total of 636 (99.7%) participants responded and completed the WHOQOL-BREF questionnaire. The mean score of overall HRQoL of people with mental illness in the outpatient clinic was (49.6 ± 10 Sd). The highest QoL was found in the physical health domain (50.67 ±9.5 Sd), and the lowest mean QoL was found in the psychological health domain (48.41±10 Sd). Rural residents, drug nonadherence, suicidal ideation, not getting counseling, moderate or severe subjective severity, the family does not participate in patient care, and a family history of mental illness had an indirect negative effect on HRQoL. Alcohol use and psychological health domain had a direct positive effect on QoL. Furthermore, objective severity of illness, having low self-esteem, and having a history of mental illness in the family had both direct and indirect effects on QoL. Furthermore, sociodemographic factors (residence, educational status, marital status), social support-related factors (self-esteem, family not participating in patient care), substance use factors (alcohol use, tobacco use,) and clinical factors (objective and subjective severity of illness, not getting counseling, suicidal ideation, number of episodes, comorbid illness, family history of mental illness, poor drug adherence) directly and indirectly affected QoL. Conclusions: In this study, the QoL of people with mental illness was poor, with the psychological health domain being the most affected. Sociodemographic factors, social support-related factors, drug use factors, and clinical factors directly and indirectly, affect QoL through the mediator variables of physical health domains, psychological health domains, social relation health domains, and environmental health domains. In order to improve the QoL of people with mental illnesses, we recommend that emphasis be given to addressing the scourge of mental health, including the development of policy and practice drivers that address the above-identified factors.Keywords: quality of life, mental wellbeing, mental illness, mental disorder, Ethiopia
Procedia PDF Downloads 889154 Improving Engagement: Dental Veneers, a Qualitative Analysis of Posts on Instagram
Authors: Matthew Sedgwick
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Introduction: Social media continues to grow in popularity and Instagram is one of the largest platforms available. It provides an invaluable method of communication between health care professionals and patients. Both patients and dentists can benefit from seeing clinical cases posted by other members of the profession. It can prompt discussion about how the outcome was achieved and showcases what is possible with the right techniques and planning. This study aimed to identify what people were posting about the topic ‘veneers’ and inform health care professionals as to what content had the most engagement and make recommendations as to how to improve the quality of social media posts. Design: 150 consecutive posts for the search term ‘veneers’ were analyzed retrospectively between 21st October 2021 to 31st October 2021. Non-English language posts duplicated posts, and posts not about dental veneers were excluded. After exclusions were applied, 80 posts were included in the study for analysis. The content of the posts was analyzed and coded and the main themes were identified. The number of comments, likes and views were also recorded for each post. Results: The themes were: before and after treatment, cost, dental training courses, treatment process and trial smiles. Dentists were the most common posters of content (82.5%) and it was interesting to note that there were no patients who posted about treatment in this sample. The main type of media was photographs (93.75%) compared to video (6.25%). Videos had an average of 45,541 views and more comments and likes than the average for photographs. The average number of comments and likes per post were 20.88 and 761.58, respectively. Conclusion: Before and after photographs were the most common finding as this is how dentists showcase their work. The study showed that videos showing the treatment process had more engagement than photographs. Dentists should consider making video posts showing the patient journey, including before and after veneer treatment, as this can result in more potential patients and colleagues viewing the content. Video content could help dentists distinguish their posts from others as it can also be used across other platforms such as TikTok or Facebook reaching a wider audience. More informative posts about how the result has shown are achieved required, including potential costs. This will help increase transparency regarding this treatment method, including the financial and potential biological cost to teeth. As a result, this will improve patient understanding and become an invaluable adjunct in informed consent.Keywords: content analysis, dental veneers, Instagram, social media
Procedia PDF Downloads 1419153 Understanding the Perceived Barriers and Facilitators to Exercise Participation in the Workplace
Authors: Jayden R. Hunter, Brett A. Gordon, Stephen R. Bird, Amanda C. Benson
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The World Health Organisation recognises the workplace as an important setting for exercise promotion, with potential benefits including improved employee health and fitness, and reduced worker absenteeism and presenteeism. Despite these potential benefits to both employee and employer, there is a lack of evidence supporting the long-term effectiveness of workplace exercise programs. There is, therefore, a need for better-informed programs that cater to employee exercise preferences. Specifically, workplace exercise programs should address any time, motivation, internal and external barriers to participation reported by sub-groups of employees. This study sought to compare exercise participation to perceived barriers and facilitators to workplace exercise engagement of university employees. This information is needed to design and implement wider-reaching programs aiming to maximise long-term employee exercise adherence and subsequent health, fitness and productivity benefits. An online survey was advertised at an Australian university with the potential to reach 3,104 full-time employees. Along with exercise participation (International physical activity questionnaire) and behaviour (stage of behaviour change in relation to physical activity questionnaire), perceived barriers (corporate exercise barriers scale) and facilitators to workplace exercise participation were identified. The survey response rate was 8.1% (252 full-time employees; 95% white-collar; 60% female; 79.4% aged 30–59 years; 57% professional and 38% academic). Most employees reported meeting (43.7%) or exceeding (42.9%) exercise guidelines over the previous week (i.e. ⩾30 min of moderate-intensity exercise on most days or ⩾ 25 min of vigorous-intensity exercise on at least three days per week). Reported exercise behaviour over the previous six months showed that 64.7% of employees were in maintenance, 8.3% were in action, 10.9% were in preparation, 12.4% were in contemplation, and 3.8% were in the pre-contemplation stage of change. Perceived barriers towards workplace exercise participation were significantly higher in employees not attaining weekly exercise guidelines compared to employees meeting or exceeding guidelines, including a lack of time or reduced motivation (p < 0.001; partial eta squared = 0.24 (large effect)), exercise attitude (p < 0.05; partial eta squared = 0.04 (small effect)), internal (p < 0.01; partial eta squared = 0.10 (moderate effect)) and external (p < 0.01; partial eta squared = 0.06 (moderate effect)) barriers. The most frequently reported exercise facilitators were personal training (particularly for insufficiently active employees; 33%) and group exercise classes (20%). The most frequently cited preferred modes of exercise were walking (70%), swimming (50%), gym (48%), and cycling (45%). In conclusion, providing additional means of support such as individualised gym, swimming and cycling programs with personal supervision and guidance may be particularly useful for employees not meeting recommended moderate-vigorous volumes of exercise, to help overcome reported exercise barriers in order to improve participation, health, and fitness. While individual biopsychosocial factors should be considered when making recommendations for interventions, the specific barriers and facilitators to workplace exercise participation identified by this study can inform the development of workplace exercise programs aiming to broaden employee engagement and promote greater ongoing exercise adherence. This is especially important for the uptake of less active employees who perceive greater barriers to workplace exercise participation than their more active colleagues.Keywords: exercise barriers, exercise facilitators, physical activity, workplace health
Procedia PDF Downloads 1529152 The Image of Egypt in CNN, BBC and Al Jazeera News Channels in Terms of Democracy, Economic Status and Stability
Authors: Sarah El Mokadem
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Egypt has been the focus of international media since 2011 revolution and its repercussions. By the end of 2017, President Abdel Fattah El Sisi will have finished his first term of presidency. With an upcoming presidential election, all eyes are returning back to Egypt as there are speculations about whether the current regime will uphold or change points in the constitution determining the years of presidency term and the allowed number or reelections. In this paper, the researcher examines the reports related to Egypt in three international news channels with different ideologies. The research aims to identify the frames used to portray major issues in Egypt like the economic struggle, democracy levels and stability and safety of the country. All available reports from these three channels in 2017 on YouTube were analyzed which is the year before the presidential elections.Keywords: content analysis, Egypt, image building, news channel ideology
Procedia PDF Downloads 2209151 Approach for the Mathematical Calculation of the Damping Factor of Railway Bridges with Ballasted Track
Authors: Andreas Stollwitzer, Lara Bettinelli, Josef Fink
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The expansion of the high-speed rail network over the past decades has resulted in new challenges for engineers, including traffic-induced resonance vibrations of railway bridges. Excessive resonance-induced speed-dependent accelerations of railway bridges during high-speed traffic can lead to negative consequences such as fatigue symptoms, distortion of the track, destabilisation of the ballast bed, and potentially even derailment. A realistic prognosis of bridge vibrations during high-speed traffic must not only rely on the right choice of an adequate calculation model for both bridge and train but first and foremost on the use of dynamic model parameters which reflect reality appropriately. However, comparisons between measured and calculated bridge vibrations are often characterised by considerable discrepancies, whereas dynamic calculations overestimate the actual responses and therefore lead to uneconomical results. This gap between measurement and calculation constitutes a complex research issue and can be traced to several causes. One major cause is found in the dynamic properties of the ballasted track, more specifically in the persisting, substantial uncertainties regarding the consideration of the ballasted track (mechanical model and input parameters) in dynamic calculations. Furthermore, the discrepancy is particularly pronounced concerning the damping values of the bridge, as conservative values have to be used in the calculations due to normative specifications and lack of knowledge. By using a large-scale test facility, the analysis of the dynamic behaviour of ballasted track has been a major research topic at the Institute of Structural Engineering/Steel Construction at TU Wien in recent years. This highly specialised test facility is designed for isolated research of the ballasted track's dynamic stiffness and damping properties – independent of the bearing structure. Several mechanical models for the ballasted track consisting of one or more continuous spring-damper elements were developed based on the knowledge gained. These mechanical models can subsequently be integrated into bridge models for dynamic calculations. Furthermore, based on measurements at the test facility, model-dependent stiffness and damping parameters were determined for these mechanical models. As a result, realistic mechanical models of the railway bridge with different levels of detail and sufficiently precise characteristic values are available for bridge engineers. Besides that, this contribution also presents another practical application of such a bridge model: Based on the bridge model, determination equations for the damping factor (as Lehr's damping factor) can be derived. This approach constitutes a first-time method that makes the damping factor of a railway bridge calculable. A comparison of this mathematical approach with measured dynamic parameters of existing railway bridges illustrates, on the one hand, the apparent deviation between normatively prescribed and in-situ measured damping factors. On the other hand, it is also shown that a new approach, which makes it possible to calculate the damping factor, provides results that are close to reality and thus raises potentials for minimising the discrepancy between measurement and calculation.Keywords: ballasted track, bridge dynamics, damping, model design, railway bridges
Procedia PDF Downloads 1689150 Thread Lift: Classification, Technique, and How to Approach to the Patient
Authors: Panprapa Yongtrakul, Punyaphat Sirithanabadeekul, Pakjira Siriphan
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Background: The thread lift technique has become popular because it is less invasive, requires a shorter operation, less downtime, and results in fewer postoperative complications. The advantage of the technique is that the thread can be inserted under the skin without the need for long incisions. Currently, there are a lot of thread lift techniques with respect to the specific types of thread used on specific areas, such as the mid-face, lower face, or neck area. Objective: To review the thread lift technique for specific areas according to type of thread, patient selection, and how to match the most appropriate to the patient. Materials and Methods: A literature review technique was conducted by searching PubMed and MEDLINE, then compiled and summarized. Result: We have divided our protocols into two sections: Protocols for short suture, and protocols for long suture techniques. We also created 3D pictures for each technique to enhance understanding and application in a clinical setting. Conclusion: There are advantages and disadvantages to short suture and long suture techniques. The best outcome for each patient depends on appropriate patient selection and determining the most suitable technique for the defect and area of patient concern.Keywords: thread lift, thread lift method, thread lift technique, thread lift procedure, threading
Procedia PDF Downloads 2729149 The Missing Link in Holistic Health Care: Value-Based Medicine in Entrustable Professional Activities for Doctor-Patient Relationship
Authors: Ling-Lang Huang
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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care
Procedia PDF Downloads 1259148 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit
Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham
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Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine
Procedia PDF Downloads 3779147 Use of Fine Recycled Aggregates in Normal Concrete Production
Authors: Vignesh Pechiappan Ayyathurai, Mukesh Limbachiya, Hsein Kew
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There is a growing interest in using recycled, secondary use and industrial by product materials in high value commercial applications. Potential high volume applications include use of fine aggregate in flowable fill or as a component in manufactured aggregates. However, there is much scientific, as well as applied research needed in this area due to lack to availability of data on the mechanical and environmental properties of elements or products produced using fine recycled aggregates. The principle objectives of this research are to synthesize existing data on the beneficial reuse of fine recycled materials and to develop extensive testing programme for assessing and establishing engineering and long term durability properties of concrete and other construction products produced using such material for use in practical application widely. This paper is a research proposal for PhD admission. The proposed research aims to supply the necessary technical, as well as practical information on fine recycled aggregate concrete to the construction industry for promoting its wider use within the construction industry. Furthermore, to disseminate research outcomes to the local authorities for consideration of use of fine recycled aggregate concrete in various applications.Keywords: FRA, fine aggregate, recycling, concrete
Procedia PDF Downloads 3269146 Attitude and Knowledge of Primary Health Care Physicians and Local Inhabitants about Leishmaniasis and Sandfly in West Alexandria, Egypt
Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad
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Background: Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL). Objectives: The objective of this study was to assess primary health care physicians knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. Methods: This study was a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study, only 20 PHP completed the questionnaire. 60 local inhabitant were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results: 11(55%) percent of the physicians had satisfactory knowledge, they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. The second part of the questionnaire is concerned with attitude of the primary health care physicians about leishmaniasis, 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandly as a vector of the disease is poor and needs to be corrected. Most of the respondents (90%) had not heard about leishmaniasis, Only 3 (5%) of the interviewed inhabitants said they know sandfly and its role in transmission of leishmaniasis. Conclusions: knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of lesihmaniasis. Moreover, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that if the inhabitants do not perceive mosquitoes to be responsible for diseases such as malaria they do not take enough measures to protect themselves against the vector.Keywords: leishmaniasis, PHP, knowledge, attitude, local inhabitants
Procedia PDF Downloads 4539145 Trends and Perspectives of Agrotourism Development in Georgia
Authors: Tamar Lazariashvili
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The development of agrotourism in Georgia has significant potential. The trend of population growth and demand for agrotourism products makes the interest and importance of the development of this field even more relevant. The article studies the trends in the development of agrotourism in Georgia; SWOT analysis reveals the potential for the development of agrotourism and assesses the perspectives, examines the factors hindering the development of agrotourism, assesses the role of the state in the development of agrotourism. Objectives: The purpose of the study is to determine the development trends of agrotourism in Georgia and to develop recommendations for prospective directions based on the assessment of the field's potential. Methodologies: Research methods are used: analysis, synthesis, induction, deduction, comparison, statistical (selection, grouping, observation, trend) and other methods, as well as SWOT analysis. Contributions: A positive trend in the development of agrotourism has been revealed. It is also shown that the demand for agrotourism products is growing. The agro touristic potential of Georgia was assessed and prospective directions for the development of the field have been determined. Conclusions: are drawn on the problems identified in the work and recommendations are proposed on ways to effectively use the potential opportunities of agrotourism and ways of long-term development.Keywords: agrotourism, agrotourism products, agrotourism potential, development prospects.
Procedia PDF Downloads 969144 Assessment of Long-Term Changes in Surface Water Quality in the Almaty Water Body System
Authors: Aidana Vaikhanova
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The article is devoted to monitoring the state of surface water quality in four water bodies, including three rivers (Kishi Almaty, Yessentai, and Ulken Almaty) and one lake (Ulken Almaty), on nine routes. Monitoring covers the period from 2013 to 2024 and also analyzes changes in water quality depending on time and factors affecting its composition. The study analyzed 31 physical and chemical parameters, including water temperature, dissolved oxygen, hydrogen index, suspended solids, transparency, salt composition ions, biogenic and organic substances (including nitrogen, phosphorus, iron, petroleum products, phenols, BPC5 and COD), as well as heavy metals. Monitoring results allow us to identify trends in the quality of water bodies and assess their suitability for use in various fields, including recreation, irrigation, industry, and water supply.Keywords: water resources, water quality monitoring, surface waters, Kishi Rivers Almaty, Yessentai, Ulken Almaty, Ulken Lake Almaty, physical and chemical indicators, biogenic substances, heavy metals, environmental monitoring
Procedia PDF Downloads 149143 The Role of Urban Design in Creating Cohesive and People’s Public Spaces
Authors: Hazem Abuorf
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From the perspective of viewing urban design as the architecture of public spaces, the latter has many advantages; for example, in achieving attractive and vibrant public spaces, ensuring safety and amenity, supporting a strong sense of place and local character. Besides all advantages, such spaces nevertheless trigger numerous dilemmas, how to design urban spaces preserving the quality of life in the long term while equally achieving cohesion between new urban developments and the already existing urban structure without causing a split in history through the cause of functional and aesthetic degradation. Analysis of this article seeks to propose a methodology deemed essential for assessing and stimulating design criteria of the public spaces when rehabilitating urban sites. The method’s utility is shown by analyzing rehabilitation projects in Gaza Strip, whose design of the public spaces has mainly focused on the physical aspect ignoring the place’s local identity, users’ needs, and history. The proposed methodology serves as a guide for municipal authorities and technical teams to deal with interventions that would rework the role of urban design towards making sense of place.Keywords: urban design, public realm, rehabilitation projects, quality of life
Procedia PDF Downloads 1669142 Prayer Therapy in a Case of Acute Myeloid Leukemia: The Good, the Bad and the Ugly
Authors: Rubai M. Ochieng
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Cancer, which accounts for 7 percent of deaths per year in Kenya, is the third highest cause of death after infectious and cardiovascular diseases. Awareness Campaigns have tended to focus on leading cancers including breast and cervical for women as well as prostrate and Esophageal for men. Consequently, less common cancers such as Acute Myeloid Leukemia (AML) are rarely properly understood by the general population and a section of the medical fraternity. Diagnoses of AML in patients who may not have heard about it sometimes results in shock, denial and confusion not just to the diagnosed, but also to their family and friends. The diagnosed and caregivers are bound to receive a lot of contradicting information about prognosis, care and treatment of AML. This information, which often comes from diverse sources including doctors, friends, internet and social media platforms, causes further confusion and panic. The situation is handled differently by different people. Religious people sometimes resort to prayer. This paper, written from the perspective of a care giver, is based on data collected from a case of Acute Myeloid Leukemia diagnosed in a 32 year old male who lost his life within six weeks of diagnosis. The sample constitutes of 16 people who participated in prayers. Out of this total, 5 were males including the diagnosed and 11 were females. All the 16 were Christians of protestant orientation including Anglicans, Quakers and Church of God members. Data was collected by the researcher herself through participant of observation. Findings discuss how the 16 participants prayed individually at different times, together in an overnight prayer meeting and every morning through a group social media platform. They shared songs and words of encouragement from the bible. The group prayed for healing, peace and strength to the diagnosed and family, financial breakthrough and doctors’ work and decisions, among other challenges that came with the situation. The paper reveals the immense benefits of prayer to the diagnosed and his close relatives and friends. They include acceptance of the condition and a positive attitude in handling the challenges that arose from the disease and treatment processes. The challenges arising from the prayer approach of handling the situation are also discussed. The paper concludes that prayer as therapy goes a long way in cancer management.Keywords: acute myeloid leukemia, Kenya, participant observation, prayer
Procedia PDF Downloads 1669141 Comparison of Gestational Diabetes Influence on the Ultrastructure of Rectus Abdominis Muscle in Women and Rats
Authors: Giovana Vesentini, Fernanda Piculo, Gabriela Marini, Debora Damasceno, Angelica Barbosa, Selma Martheus, Marilza Rudge
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Problem statement: Skeletal muscle is highly adaptable, muscle fiber composition and size can respond to a variety of stimuli, such physiologic, as pregnancy, and metabolic abnormalities, as Diabetes mellitus. This study aimed to analyze the effects of pregnancy-associated diabetes on the rectus abdominis muscle (RA), and to compare this changes in rats and women. Methods: Female Wistar rats were maintained under controlled conditions and distributed in Pregnant (P) and Long-term mild pregnant diabetic (LTMd) (n=3 r/group). Diabetes in rats was induced by streptozotocin (100mg/Kg, sc) on the first day of life, for a hyperglycemic state between 120-300 mg/dL in adult life. Female rats were mated overnight, at day 21 of pregnancy were anesthetized, and killed for the harvesting of maternal RA. Pregnant women who attended the Diabetes Prenatal Care Clinic of Botucatu Medical School were distributed in Pregnant non-diabetic (Pnd) and Gestational Diabetic (GDM) (n=3 w/group). The diagnosis of GDM was established according to ADA’s criteria (2016). The harvesting of RA was during the cesarean section. Transversal cross-sections of the RA of both women and rats were analyzed by transmission electron microscopy. All procedures were approved by the Ethics Committee on Animal Experiments of the Botucatu Medical School (Protocol Number 1003/2013) and by the Botucatu Medical School Ethical Committee for Human Research in Medical Sciences (CAAE: 41570815.0.0000.5411). Results: The photomicrographs of the RA of rats revealed disorganized Z lines, thinning sarcomeres, and a usual quantity of intermyofibrillar mitochondria in the P group. The LTMd group showed swollen sarcoplasmic reticulum, dilated T tubes and areas with sarcomere disruption. The ultrastructural analysis of Pnd non-diabetic women in the RA showed well-organized myofibrils forming intact sarcomeres, organized Z lines and a normal distribution of intermyofibrillar mitochondria. The GDM group revealed increase in intermyofibrillar mitochondria, areas with sarcomere disruption and increased lipid droplets. Conclusion: Pregnancy and diabetes induce adaptations in the ultrastructure of the rectus abdominis muscle for both women and rats, changing the architectural design of these tissues. However, in rats these changes are more severe maybe because, besides the high blood glucose levels, the quadrupedal animal may suffer an excessive mechanical tension during pregnancy by gravity. Probably, these findings may suggest that these alterations are a risk factor that contributes to the development of muscle dysfunction in women with GDM and may motivate treatment strategies in these patients.Keywords: gestational diabetes, muscle dysfunction, pregnancy, rectus abdominis
Procedia PDF Downloads 2959140 Cultural Competence and Healthcare Challenges of Migrants in South Wales United Kingdom
Authors: Qirat Naz, Abasiokpon Udoakah
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In developed countries, global migration is diversifying. The minority ethnic population, including refugees and asylum seekers who, fled their home countries due to war, terrorism, oppression, or natural disasters, and returning home is dangerous for them. They need sanctuary and peaceful environment in host countries. They begin the process of acculturation, in which a person adopts the social mores and behavioral patterns of the dominant culture, yet they still have unique multicultural needs that the dominant society fails to address. The aim of this research is to provide a holistic understanding of the living experiences of a minority population, particularly migrants, including asylum seekers and refugees, in the health and social care system of South Wales. The purpose of this study is to investigate three research objectives: the multicultural health care needs of minorities, as well as the barriers to seeking health and social care facilities. There are Welsh policies for promoting cultural competence in the health and social care sectors; this research will explore the implications and impact of these policies on the target population. This research study will be conducted using qualitative research methods, tools, and techniques. This research is an inductive approach to coming up with a grounded theory. The sample will be divided into two groups: migrants and professionals providing any kind of services to migrants; each group will contain 30 participants. Interpretive phenomenological analysis would be utilized during the process of coding and developing the main themes of this research. The positionality of the researcher would be minimized by unloaded and open-ended questions, researcher’s work experience in research, continuous evaluation of her positionality, daily base reflection of fieldwork and seeking the help of male and female gatekeepers. The research findings would be based on emic perspective, and by documenting the emic perspective of minorities, this research will contribute to the knowledge of appropriate channels, including organizations, academics, and policymakers, to discover possible solutions and coping mechanisms to deal with the challenges and meet the multicultural demands of minorities. This research will provide a more in-depth understanding of minorities and will help to promote the diversity of health and social care in South Wales.Keywords: migration, migrants, cultural competence, cultural barriers, healthcare challenges
Procedia PDF Downloads 659139 Environment Saving and Efficiency of Diesel Heat-Insulated Combustion Chamber Using Semitransparent Ceramic Coatings
Authors: Victoria Yu. Garnova, Vladimir G. Merzlikin, Sergey V. Khudyakov, Valeriy A. Tovstonog, Svyatoslav V. Cheranev
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Long-term scientific forecasts confirm that diesel engines still will be the basis of the transport and stationary power in the near future. This is explained by their high efficiency and profitability compared to other types of heat engines. In the automotive industry carried basic researches are aimed at creating a new generation of diesel engines with reduced exhaust emissions (with stable performance) determining the minimum impact on the environment. The application of thermal barrier coatings (TBCs) and especially their modifications based on semitransparent ceramic materials allows solving this problem. For such researches, the preliminary stage of testing of physical characteristics materials and coatings especially with semitransparent properties the authors proposed experimental operating innovative radiative-and-convective cycling simulator. This setup contains original radiation sources (imitator) with tunable spectrum for modeling integral flux up to several MW/m2.Keywords: environment saving, radiative and convective cycling simulator, semitransparent ceramic coatings, imitator radiant energy
Procedia PDF Downloads 2709138 The Effect of Combustion Chamber Deposits (CCD) on Homogeneous Change Compression Ignition (HCCI)
Authors: Abdulmagid A. Khattabi, Ahmed A. Hablus, Osama Ab. M. Shafah
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The goal of this work is to understand how the thermal influence of combustion chamber deposits can be utilized to expand the operating range of HCCI combustion. In order to do this, two main objectives must first be met; tracking deposit formation trends in an HCCI engine and determining the sensitivity of HCCI combustion to CCD. This requires testing that demonstrates the differences in combustion between a clean engine and one with deposits coating the chamber. This will involve a long-term test that tracks the effects of CCD on combustion. The test will start with a clean engine. One baseline HCCI operating point is maintained for the duration of the test during which gradual combustion chamber deposit formation will occur. Combustion parameters, including heat release rates and emissions will be tracked for the duration and compared to the case of a clean engine. This work will begin by detailing the specifics of the test procedure and measurements taken throughout the test. Then a review of the effects of the gradual formation of deposits in the engine will be given.Keywords: fuels, fuel atomization, pattern factor, alternate fuels combustion, efficiency gas turbine combustion, lean blow out, exhaust and liner wall temperature
Procedia PDF Downloads 5349137 Ripple Effect Analysis of Government Investment for Research and Development by the Artificial Neural Networks
Authors: Hwayeon Song
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The long-term purpose of research and development (R&D) programs is to strengthen national competitiveness by developing new knowledge and technologies. Thus, it is important to determine a proper budget for government programs to maintain the vigor of R&D when the total funding is tight due to the national deficit. In this regard, a ripple effect analysis for the budgetary changes in R&D programs is necessary as well as an investigation of the current status. This study proposes a new approach using Artificial Neural Networks (ANN) for both tasks. It particularly focuses on R&D programs related to Construction and Transportation (C&T) technology in Korea. First, key factors in C&T technology are explored to draw impact indicators in three areas: economy, society, and science and technology (S&T). Simultaneously, ANN is employed to evaluate the relationship between data variables. From this process, four major components in R&D including research personnel, expenses, management, and equipment are assessed. Then the ripple effect analysis is performed to see the changes in the hypothetical future by modifying current data. Any research findings can offer an alternative strategy about R&D programs as well as a new analysis tool.Keywords: Artificial Neural Networks, construction and transportation technology, Government Research and Development, Ripple Effect
Procedia PDF Downloads 2519136 Multi-Criteria Decision Making Network Optimization for Green Supply Chains
Authors: Bandar A. Alkhayyal
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Modern supply chains are typically linear, transforming virgin raw materials into products for end consumers, who then discard them after use to landfills or incinerators. Nowadays, there are major efforts underway to create a circular economy to reduce non-renewable resource use and waste. One important aspect of these efforts is the development of Green Supply Chain (GSC) systems which enables a reverse flow of used products from consumers back to manufacturers, where they can be refurbished or remanufactured, to both economic and environmental benefit. This paper develops novel multi-objective optimization models to inform GSC system design at multiple levels: (1) strategic planning of facility location and transportation logistics; (2) tactical planning of optimal pricing; and (3) policy planning to account for potential valuation of GSC emissions. First, physical linear programming was applied to evaluate GSC facility placement by determining the quantities of end-of-life products for transport from candidate collection centers to remanufacturing facilities while satisfying cost and capacity criteria. Second, disassembly and remanufacturing processes have received little attention in industrial engineering and process cost modeling literature. The increasing scale of remanufacturing operations, worth nearly $50 billion annually in the United States alone, have made GSC pricing an important subject of research. A non-linear physical programming model for optimization of pricing policy for remanufactured products that maximizes total profit and minimizes product recovery costs were examined and solved. Finally, a deterministic equilibrium model was used to determine the effects of internalizing a cost of GSC greenhouse gas (GHG) emissions into optimization models. Changes in optimal facility use, transportation logistics, and pricing/profit margins were all investigated against a variable cost of carbon, using case study system created based on actual data from sites in the Boston area. As carbon costs increase, the optimal GSC system undergoes several distinct shifts in topology as it seeks new cost-minimal configurations. A comprehensive study of quantitative evaluation and performance of the model has been done using orthogonal arrays. Results were compared to top-down estimates from economic input-output life cycle assessment (EIO-LCA) models, to contrast remanufacturing GHG emission quantities with those from original equipment manufacturing operations. Introducing a carbon cost of $40/t CO2e increases modeled remanufacturing costs by 2.7% but also increases original equipment costs by 2.3%. The assembled work advances the theoretical modeling of optimal GSC systems and presents a rare case study of remanufactured appliances.Keywords: circular economy, extended producer responsibility, greenhouse gas emissions, industrial ecology, low carbon logistics, green supply chains
Procedia PDF Downloads 1629135 Analysis of Citation Rate and Data Reuse for Openly Accessible Biodiversity Datasets on Global Biodiversity Information Facility
Authors: Nushrat Khan, Mike Thelwall, Kayvan Kousha
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Making research data openly accessible has been mandated by most funders over the last 5 years as it promotes reproducibility in science and reduces duplication of effort to collect the same data. There are evidence that articles that publicly share research data have higher citation rates in biological and social sciences. However, how and whether shared data is being reused is not always intuitive as such information is not easily accessible from the majority of research data repositories. This study aims to understand the practice of data citation and how data is being reused over the years focusing on biodiversity since research data is frequently reused in this field. Metadata of 38,878 datasets including citation counts were collected through the Global Biodiversity Information Facility (GBIF) API for this purpose. GBIF was used as a data source since it provides citation count for datasets, not a commonly available feature for most repositories. Analysis of dataset types, citation counts, creation and update time of datasets suggests that citation rate varies for different types of datasets, where occurrence datasets that have more granular information have higher citation rates than checklist and metadata-only datasets. Another finding is that biodiversity datasets on GBIF are frequently updated, which is unique to this field. Majority of the datasets from the earliest year of 2007 were updated after 11 years, with no dataset that was not updated since creation. For each year between 2007 and 2017, we compared the correlations between update time and citation rate of four different types of datasets. While recent datasets do not show any correlations, 3 to 4 years old datasets show weak correlation where datasets that were updated more recently received high citations. The results are suggestive that it takes several years to cumulate citations for research datasets. However, this investigation found that when searched on Google Scholar or Scopus databases for the same datasets, the number of citations is often not the same as GBIF. Hence future aim is to further explore the citation count system adopted by GBIF to evaluate its reliability and whether it can be applicable to other fields of studies as well.Keywords: data citation, data reuse, research data sharing, webometrics
Procedia PDF Downloads 1869134 The Reflexive Interaction in Group Formal Practices: The Question of Criteria and Instruments for the Character-Skills Evaluation
Authors: Sara Nosari
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In the research field on adult education, the learning development project followed different itineraries: recently it has promoted adult transformation by practices focused on the reflexive oriented interaction. This perspective, that connects life stories and life-based methods, characterizes a transformative space between formal and informal education. Within this framework, in the Nursing Degree Courses of Turin University, it has been discussed and realized a formal reflexive path on the care work professional identity through group practices. This path compared the future care professionals with possible experiences staged by texts used with the function of a pre-tests: these texts, setting up real or believable professional situations, had the task to start a reflection on the different 'elements' of care work professional life (relationship, educational character of relationship, relationship between different care roles; or even human identity, aims and ultimate aim of care, …). The learning transformative aspect of this kind of experience-test is that it is impossible to anticipate the process or the conclusion of reflexion because they depend on two main conditions: the personal sensitivity and the specific situation. The narrated experience is not a device, it does not include any tricks to understand the answering advance; the text is not aimed at deepening the knowledge, but at being an active and creative force which takes the group to compare with problematic figures. In fact, the experience-text does not have the purpose to explain but to problematize: it creates a space of suspension to live for questioning, for discussing, for researching, for deciding. It creates a space 'open' and 'in connection' where each one, in comparing with others, has the possibility to build his/her position. In this space, everyone has to possibility to expose his/her own argumentations and to be aware of the others emerged points of view, aiming to research and find the own personal position. However, to define his/her position, it is necessary to learn to exercise character skills (conscientiousness, motivation, creativity, critical thinking, …): if these not-cognitive skills have an undisputed evidence, less evident is how to value them. The paper will reflect on the epistemological limits and possibility to 'measure' character skills, suggesting some evaluation criteria.Keywords: transformative learning, educational role, formal/informal education, character-skills
Procedia PDF Downloads 1979133 A Functional Thermochemical Energy Storage System for Mobile Applications: Design and Performance Analysis
Authors: Jure Galović, Peter Hofmann
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Thermochemical energy storage (TCES), as a long-term and lossless energy storage principle, provides a contribution for the reduction of greenhouse emissions of mobile applications, such as passenger vehicles with an internal combustion engine. A prototype of a TCES system, based on reversible sorption reactions of LiBr composite and methanol has been designed at Vienna University of Technology. In this paper, the selection of reactive and inert carrier materials as well as the design of heat exchangers (reactor vessel and evapo-condenser) was reviewed and the cycle stability under real operating conditions was investigated. The performance of the developed system strongly depends on the environmental temperatures, to which the reactor vessel and evapo-condenser are exposed during the phases of thermal conversion. For an integration of the system into mobile applications, the functionality of the designed prototype was proved in numerous conducted cycles whereby no adverse reactions were observed.Keywords: dynamic applications, LiBr composite, methanol, performance of TCES system, sorption process, thermochemical energy storage
Procedia PDF Downloads 1709132 Role of Long Noncoding RNA HULC on Colorectal Carcinoma Progression through Epigenetically Repressing NKD2 Expression
Authors: Shu-Jun Li, Cheng-Cao Sun, De-Jia Li
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Recently, long noncoding RNAs (lncRNAs) have been emerged as crucial regulators of human diseases and prognostic markers in numerous of cancers, including colorectal carcinoma (CRC). Here, we identified an oncogenetic lncRNA HULC, which may promote colorectal tumorigenesis. HULC has been found to be up-regulated and acts as oncogene in gastric cancer and hepatocellular carcinoma, but its expression pattern, biological function and underlying mechanism in CRC is still undetermined. Here, we reported that HULC expression is also over-expressed in CRC, and its increased level is associated with poor prognosis and shorter survival. Knockdown of HULC impaired CRC cells proliferation, migration and invasion, facilitated cell apoptosis in vitro, and inhibited tumorigenicity of CRC cells in vivo. Mechanistically, RNA immunoprecipitation (RIP) and RNA pull-down experiment demonstrated that HULC could simultaneously interact with EZH2 to repress underlying targets NKD2 transcription. In addition, rescue experiments determined that HULC oncogenic function is partly dependent on repressing NKD2. Taken together, our findings expound how HULC over-expression endows an oncogenic function in CRC.Keywords: long noncoding RNA, HULC, NKD2, colorectal carcinoma, proliferation, apoptosis
Procedia PDF Downloads 2269131 Impact of the Hayne Royal Commission on the Operating Model of Australian Financial Advice Firms
Authors: Mohammad Abu-Taleb
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The final report of the Royal Commission into Australian financial services misconduct, released in February 2019, has had a significant impact on the financial advice industry. The recommendations released in the Commissioner’s final report include changes to ongoing fee arrangements, a new disciplinary system for financial advisers, and mandatory reporting of compliance concerns. This thesis aims to explore the impact of the Royal Commission’s recommendations on the operating model of financial advice firms in terms of advice products, processes, delivery models, and customer segments. Also, this research seeks to investigate whether the Royal Commission’s outcome has accelerated the use of enhanced technology solutions within the operating model of financial advice firms. And to identify the key challenges confronting financial advice firms whilst implementing the Commissioner’s recommendations across their operating models. In order to achieve the objectives of this thesis, a qualitative research design has been adopted through semi-structured in-depth interviews with 24 financial advisers and managers who are engaged in the operation of financial advice services. The study used the thematic analysis approach to interpret the qualitative data collected from the interviews. The findings of this thesis reveal that customer-centric operating models will become more prominent across the financial advice industry in response to the Commissioner’s final report. And the Royal Commission’s outcome has accelerated the use of advice technology solutions within the operating model of financial advice firms. In addition, financial advice firms have started more than before using simpler and more automated web-based advice services, which enable financial advisers to provide simple advice in a greater scale, and also to accelerate the use of robo-advice models and digital delivery to mass customers in the long term. Furthermore, the study identifies process and technology changes as, long with technical and interpersonal skills development, as the key challenges encountered financial advice firms whilst implementing the Commissioner’s recommendations across their operating models.Keywords: hayne royal commission, financial planning advice, operating model, advice products, advice processes, delivery models, customer segments, digital advice solutions
Procedia PDF Downloads 929130 A Nuclear Negotiation Qualitative Case Study with Force Field Analysis
Authors: Onur Yuksel
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In today’s complex foreign relations between countries, the nuclear enrichment and nuclear weapon have become a threat for all states in the world. There are couple isolated states which have capacity to produce nuclear weapons such as Iran and North Korea. In this article, Iran nuclear negotiation was analyzed in terms of its relations especially with The United States in order to find the important factors that affect the course of the ongoing nuclear negotiation. In this sense, the Force Field Analysis was used by determining and setting forth Driving and Restraining Forces of the nuclear negotiations in order to see the big picture and to develop strategies that may improve the long-term ongoing Iran nuclear negotiations. It is found that Iran nuclear negotiation heavily depends on breaking down the idea of Iran’s supporting terrorist organizations and being more transparent about nuclear and uranium enrichment. Also, it was found that Iran has to rebuild its relations with Western countries, especially with the United States. In addition, the counties— who contribute to Iran nuclear negotiations— will need to work on the dynamics and drivers of the Israel and Iran relations in order to peacefully transform the conflict between the two states.Keywords: driving force, Iran nuclear negotiation, restraining force, the force field analysis
Procedia PDF Downloads 1629129 Implementation and Use of Person-Centered Care in Europe: A Literature Review
Authors: Kristina Rosengren, Petra Brannefors, Eric Carlstrom
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Background: Implementation and use of person-centered care (PCC) is increasing worldwide, and why the current study intends to increase knowledge regarding how PCC is used in different European countries. Purpose: To describe the extent of person-centred care in 23 European countries in relation to use specific countries healthcare system (Beveridge, Bismarck, Mixed/OOP). Methods: The study was conducted by literature review inspired by Spice, both scientific empirical studies (Cinahl, Medline, Scopus) as well as grey literature (Google) were used. Totally 1194 documents were included divided into Cinahl n=139, Medline n=245, Scopus n=493 and Google n=317. Data were analysed with descriptive (percentage, range) regarding content and scope of PCC/country according to content and scope of PCC in each country, grouped into the healthcare system (Beveridge, Bismarck, Mixed/OOP) and geographic placement. Results: PCC were most common in UK (England, Scotland, Wales, North Ireland), n=481, 40.3%, Sweden (n=231, 19.3%), The Netherlands (n=80, 6.7%), Ireland (n=79, 6.6%) and Norway (n=61, 5.1%); and less common in Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Beveridge healthcare system (12/23=0.5217, 52.2%) show 85 percent of documents with advantage of scientific literature valued 2.92 (n=999, 0.55-4.07), compare to advantage of grey literature in Bismarck (10/23=0.4347, 43.5%) with 15 percentage valued 2.35 (n=190, 0-3.27) followed by Mixed/OOP (1/23=4%) with 0.4 valued 2.25. Conclusions: Seven out of 10 countries with Beveridge health system used PCC compare to less-used PCC in countries with the Bismarck system. Research, as well as national regulations regarding PCC, are important tools to motivate the advantage of PCC in clinical practice. Moreover, implementation of PCC needs a systematic approach, from national (politicians), regional (guideline) and local (specific healthcare settings) levels visualized by decision-making as law, mission, policies, and routines in clinical practice to establish a well-integrated phenomenon in Europe.Keywords: Beveridge, Bismarck, Europe, evidence-based, literature review, person-centered care
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