Search results for: hospital policy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6025

Search results for: hospital policy

3745 The Relationship between Quality of Life and Sexual Satisfaction in Women with Severe Burns

Authors: Jafar Kazemzadeh, Soheila Rabiepoor, Saeedeh Alizadeh

Abstract:

Introduction: Burn, especially in women, can affect the quality of life and their quality of life due to a change in appearance. This study was designed to investigate the relationship between quality of life and sexual satisfaction in women with burn. Methods: This was a descriptive-analytical cross-sectional study conducted on 101 women with severe burns referring to Imam Khomeini Hospital in Urmia in 2016. The data gathering scales were demographic questionnaire, burn specific health scale-brief (BSHS-B) and index of sexual satisfaction (ISS). The data were analyzed using SPSS software version 16. Results: Mean score of quality of life was 102.94 ± 20.88 and sexual satisfaction was 57.03 ± 25.91. Also, there was a significant relationship between quality of life and its subscales with sexual satisfaction and some demographic variables (p < 0.05). Conclusion: According to the results of this study, it should be noted that interventional efforts for improving sexual satisfaction and thus improving the quality of life in these patients are important. The findings of this study appear to be effective in planning for women with a history of burns.

Keywords: burn, quality of life, sexual satisfaction, women

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3744 Creating Moments and Memories: An Evaluation of the Starlight 'Moments' Program for Palliative Children, Adolescents and Their Families

Authors: C. Treadgold, S. Sivaraman

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The Starlight Children's Foundation (Starlight) is an Australian non-profit organisation that delivers programs, in partnership with health professionals, to support children, adolescents, and their families who are living with a serious illness. While supporting children and adolescents with life-limiting conditions has always been a feature of Starlight's work, providing a dedicated program, specifically targeting and meeting the needs of the paediatric palliative population, is a recent area of focus. Recognising the challenges in providing children’s palliative services, Starlight initiated a research and development project to better understand and meet the needs of this group. The aim was to create a program which enhances the wellbeing of children, adolescents, and their families receiving paediatric palliative care in their community through the provision of on-going, tailored, positive experiences or 'moments'. This paper will present the results of the formative evaluation of this unique program, highlighting the development processes and outcomes of the pilot. The pilot was designed using an innovation methodology, which included a number of research components. There was a strong belief that it needed to be delivered in partnership with a dedicated palliative care team, helping to ensure the best interests of the family were always represented. This resulted in Starlight collaborating with both the Victorian Paediatric Palliative Care Program (VPPCP) at the Royal Children's Hospital, Melbourne, and the Sydney Children's Hospital Network (SCHN) to pilot the 'Moments' program. As experts in 'positive disruption', with a long history of collaborating with health professionals, Starlight was well placed to deliver a program which helps children, adolescents, and their families to experience moments of joy, connection and achieve their own sense of accomplishment. Building on Starlight’s evidence-based approach and experience in creative service delivery, the program aims to use the power of 'positive disruption' to brighten the lives of this group and create important memories. The clinical and Starlight team members collaborate to ensure that the child and family are at the centre of the program. The design of each experience is specific to their needs and ensures the creation of positive memories and family connection. It aims for each moment to enhance quality of life. The partnership with the VPPCP and SCHN has allowed the program to reach families across metropolitan and regional locations. In late 2019 a formative evaluation of the pilot was conducted utilising both quantitative and qualitative methodologies to document both the delivery and outcomes of the program. Central to the evaluation was the interviews conducted with both clinical teams and families in order to gain a comprehensive understanding of the impact of and satisfaction with the program. The findings, which will be shared in this presentation, provide practical insight into the delivery of the program, the key elements for its success with families, and areas which could benefit from additional research and focus. It will use stories and case studies from the pilot to highlight the impact of the program and discuss what opportunities, challenges, and learnings emerged.

Keywords: children, families, memory making, pediatric palliative care, support

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3743 User Satisfaction in Rama-Chest Mouthpiece for Flexible Bronchoscopy in Ramathibodi Hospital

Authors: Chariya Laohavich

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Background: Some limitations and complications have been found associated with commercial mouthpiece in bronchoscopic procedure. Therefore, we invented the Rama-chest mouthpiece from plastic normal saline bottle. Objective: The aim of this study was to compare user satisfaction in Rama-chest mouthpiece with the commercial mouthpiece. Methods: A prospective randomized controlled trial between commercial mouthpiece and Rama-chest mouthpiece was conducted on patients who were underwent bronchoscopy and required mouthpiece insertion from May to June 2014. The questionnaire about satisfaction was completed by the bronchoscopists, assistant nurses, and patients. Results: Thirty procedures in both groups were investigated. Mean satisfaction scores filled by the bronchoscopists and assistant nurses were not different between both groups. However, higher satisfaction score filled by the patients was found in Rama-chest mouthpiece than the comparator (p=0.011). Complications such as abrasion, pain, and itching were observed in commercial mouthpiece but not found in Rama-chest mouthpiece. Conclusion: We have introduced Rama-chest mouthpiece and proved its usefulness comparable to the commercial mouthpiece.

Keywords: mouthpiece, bronchoscopist, bronchology, pulmonology and respiratory diseases

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3742 Empirical Investigation of Barriers to Industrial Energy Conservation Measures in the Manufacturing Small and Medium Enterprises (SME's) of Pakistan

Authors: Muhammad Tahir Hassan, Stas Burek, Muhammad Asif, Mohamed Emad

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Industrial sector in Pakistan accounts for 25% of total energy consumption in the country. The performance of this sector has been severely affected due to the adverse effect of current energy crises in the country. Energy conservation potentials of Pakistan’s industrial sectors through energy management can save wasted energy which would ultimately leads to economic and environmental benefits. However due to lack of financial incentives of energy efficiency and absence of energy benchmarking within same industrial sectors are some of the main challenges in the implementation of energy management. In Pakistan, this area has not been adequately explored, and there is a lack of focus on the need for industrial energy efficiency and proper management. The main objective of this research is to evaluate the current energy management performance of Pakistani industrial sector and empirical investigation of the existence of various barriers to industrial energy efficiency. Data was collected from the respondents of 192 small and medium-sized enterprises (SME’s) of Pakistan i.e. foundries, textile, plastic industries, light engineering, auto and spare parts and ceramic manufacturers and analysed using Statistical Package for the Social Sciences (SPSS) software. Current energy management performance of manufacturing SME’s in Pakistan has been evaluated by employing two significant indicators, ‘Energy Management Matrix’ and ‘pay-off criteria’, with modified approach. Using the energy management matrix, energy management profiles of overall industry and the individual sectors have been drawn to assess the energy management performance and identify the weak and strong areas as well. Results reveal that, energy management practices in overall surveyed industries are at very low level. Energy management profiles drawn against each sector suggest that performance of textile sector is better among all the surveyed manufacturing SME’s. The empirical barriers to industrial energy efficiency have also been ranked according to the overall responses. The results further reveal that there is a significant relationship exists among the industrial size, sector type and nature of barriers to industrial energy efficiency for the manufacturing SME’s in Pakistan. The findings of this study may help the industries and policy makers in Pakistan to formulate a sustainable energy policy to support industrial energy efficiency keeping in view the actual existing energy efficiency scenario in the industrial sector.

Keywords: barriers, energy conservation, energy management profile, environment, manufacturing SME's of Pakistan

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3741 Macroeconomic Implications of Artificial Intelligence on Unemployment in Europe

Authors: Ahmad Haidar

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Modern economic systems are characterized by growing complexity, and addressing their challenges requires innovative approaches. This study examines the implications of artificial intelligence (AI) on unemployment in Europe from a macroeconomic perspective, employing data modeling techniques to understand the relationship between AI integration and labor market dynamics. To understand the AI-unemployment nexus comprehensively, this research considers factors such as sector-specific AI adoption, skill requirements, workforce demographics, and geographical disparities. The study utilizes a panel data model, incorporating data from European countries over the last two decades, to explore the potential short-term and long-term effects of AI implementation on unemployment rates. In addition to investigating the direct impact of AI on unemployment, the study also delves into the potential indirect effects and spillover consequences. It considers how AI-driven productivity improvements and cost reductions might influence economic growth and, in turn, labor market outcomes. Furthermore, it assesses the potential for AI-induced changes in industrial structures to affect job displacement and creation. The research also highlights the importance of policy responses in mitigating potential negative consequences of AI adoption on unemployment. It emphasizes the need for targeted interventions such as skill development programs, labor market regulations, and social safety nets to enable a smooth transition for workers affected by AI-related job displacement. Additionally, the study explores the potential role of AI in informing and transforming policy-making to ensure more effective and agile responses to labor market challenges. In conclusion, this study provides a comprehensive analysis of the macroeconomic implications of AI on unemployment in Europe, highlighting the importance of understanding the nuanced relationships between AI adoption, economic growth, and labor market outcomes. By shedding light on these relationships, the study contributes valuable insights for policymakers, educators, and researchers, enabling them to make informed decisions in navigating the complex landscape of AI-driven economic transformation.

Keywords: artificial intelligence, unemployment, macroeconomic analysis, european labor market

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3740 Importance of Human Resources Training in an Information Age

Authors: A. Serap Fırat

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The aim of this study is to display conceptually the relationship and interaction between matter of human resources training and the information age. Fast development from industrial community to an information community has occurred and organizations have been seeking ways to overcome this change. Human resources policy and human capital with enhanced competence will have direct impact on work performance; therefore, this paper deals with the increased importance of human resource management due to the fact that it nurtures human capital. Researching and scanning are used as a method in this study. Both local and foreign literature and expert views are employed -as much as one could be- in the making of the theoretical framework of this study.

Keywords: human resources, information age, education, organization, occupation

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3739 Issues and Challenges of Information and Communication Technology Adoption and Application for Business-Related Performance among Agro-Based Small and Medium Entrepreneurs in the State of Selangor, Malaysia

Authors: Mohd Nizam Osman

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This study explores issues and challenges of information and communication technology (ICT) adoption and application for business-related performance of Agro-based small and medium-scale enterprises (SMEs) in the state of Selangor, Malaysia. Globally, SMEs have championed the socio-economic development of nations across the globe, including Malaysia. Thus, the objectives of this study explore issues and challenges of agro-based SMEs' adoption and usage of ICT, the business-related performance of SMEs via the adoption of ICT, and the impact of incentives on SMEs' adoption and use of ICT. The study was conducted in Selangor, Malaysia. A qualitative research approach was deployed for the study. Data for the study emanated from semi-structured interviews and field note observation of 14 informants who are registered as small-scale business owners and operators. Based on thematic analysis, data were triangulated to ensure consistency and validation of findings for the study. Findings revealed that SMEs are faced with a lack of funding, low expertise, and lack of storage, leading to an unsustainable supply of goods and services. Although effective communication, ease of business activities/transactions, and information search by way of research were among the business performance experienced by SMEs' adoption of ICT. Further findings showed that loan conditions and personal and business interests hindered SMEs' reception and access to programs, schemes, and incentives geared at aiding the continuous growth and development of agro-based SMEs. The study suggests the need for policy change in terms of diversification of channels of funding and access to funds to enable credit guarantee schemes and peer or community-based financing. Consequently, the study recommends the engagement of SMEs in policy decision-making to ascertain the type of incentives relevant to their business operations. Likewise, from a technological standpoint, the study suggests the expansion of the framework of technology acceptance with focuses on affordability, type of users, and level of usage.

Keywords: ICT adoption, business related performance, agro-based SMEs, ICT application for SMEs

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3738 Relations of Progression in Cognitive Decline with Initial EEG Resting-State Functional Network in Mild Cognitive Impairment

Authors: Chia-Feng Lu, Yuh-Jen Wang, Yu-Te Wu, Sui-Hing Yan

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This study aimed at investigating whether the functional brain networks constructed using the initial EEG (obtained when patients first visited hospital) can be correlated with the progression of cognitive decline calculated as the changes of mini-mental state examination (MMSE) scores between the latest and initial examinations. We integrated the time–frequency cross mutual information (TFCMI) method to estimate the EEG functional connectivity between cortical regions, and the network analysis based on graph theory to investigate the organization of functional networks in aMCI. Our finding suggested that higher integrated functional network with sufficient connection strengths, dense connection between local regions, and high network efficiency in processing information at the initial stage may result in a better prognosis of the subsequent cognitive functions for aMCI. In conclusion, the functional connectivity can be a useful biomarker to assist in prediction of cognitive declines in aMCI.

Keywords: cognitive decline, functional connectivity, MCI, MMSE

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3737 On the Efficiency of the Algerian FRR Sovereign Fund

Authors: Abdelkader Guendouz, Fatima Zohra Adel

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Since about two decades, the Algerian government created a new instrument in the field of its fiscal policy, which is the FRR (Fonds de Régulation des Recettes). The FRR is a sovereign fund, which the initial role was saving the surplus generated by the fixation of a referential oil price to establish the state budget in the aim equilibrium between budgetary incomes and public expenditures. After a while, the government turns to use this instrument in boosting the public investment more than keeping for funding a deficit budget in periods of crisis. This lead to ask some justified questions about the efficiency of this sovereign fund and its real role.

Keywords: FRR sovereign fund, public expenditures, public investment, efficiency

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3736 Machine Learning in Gravity Models: An Application to International Recycling Trade Flow

Authors: Shan Zhang, Peter Suechting

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Predicting trade patterns is critical to decision-making in public and private domains, especially in the current context of trade disputes among major economies. In the past, U.S. recycling has relied heavily on strong demand for recyclable materials overseas. However, starting in 2017, a series of new recycling policies (bans and higher inspection standards) was enacted by multiple countries that were the primary importers of recyclables from the U.S. prior to that point. As the global trade flow of recycling shifts, some new importers, mostly developing countries in South and Southeast Asia, have been overwhelmed by the sheer quantities of scrap materials they have received. As the leading exporter of recyclable materials, the U.S. now has a pressing need to build its recycling industry domestically. With respect to the global trade in scrap materials used for recycling, the interest in this paper is (1) predicting how the export of recyclable materials from the U.S. might vary over time, and (2) predicting how international trade flows for recyclables might change in the future. Focusing on three major recyclable materials with a history of trade, this study uses data-driven and machine learning (ML) algorithms---supervised (shrinkage and tree methods) and unsupervised (neural network method)---to decipher the international trade pattern of recycling. Forecasting the potential trade values of recyclables in the future could help importing countries, to which those materials will shift next, to prepare related trade policies. Such policies can assist policymakers in minimizing negative environmental externalities and in finding the optimal amount of recyclables needed by each country. Such forecasts can also help exporting countries, like the U.S understand the importance of healthy domestic recycling industry. The preliminary result suggests that gravity models---in addition to particular selection macroeconomic predictor variables--are appropriate predictors of the total export value of recyclables. With the inclusion of variables measuring aspects of the political conditions (trade tariffs and bans), predictions show that recyclable materials are shifting from more policy-restricted countries to less policy-restricted countries in international recycling trade. Those countries also tend to have high manufacturing activities as a percentage of their GDP.

Keywords: environmental economics, machine learning, recycling, international trade

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3735 Use of Opti-Jet Cs Md1mr Device for Biocide Aerosolisation in 3t Magnetic Resonance

Authors: Robert Pintaric, Joze Matela, Stefan Pintaric, Stanka Vadnjal

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Introduction: This work is aimed to represent the use of the OPTI-JET CS MD1 MR prototype for application of neutral electrolyzed oxidizing water (NEOW) in magnetic resonance rooms. Material and Methods: We produced and used OPTI-JET CS MD1 MR aerosolisator whereby was performed aerosolization. The presence of microorganisms before and after the aerosolisation was recorded with the help of cyclone air sampling. Colony formed units (CFU) was counted. Results: The number of microorganisms in magnetic resonance 3T room was low as expected. Nevertheless, a possible CFU reduction of 87% was recorded. Conclusions: The research has shown that the use of EOW for the air and hard surface disinfection can considerably reduce the presence of microorganisms and consequently the possibility of hospital infections. It has also demonstrated that the use of OPTI-JET CS MD1 MR is very good. With this research, we started new guidelines for aerosolization in magnetic resonance rooms. Future work: We predict that presented technique works very good but we must focus also on time capacity sensors, and new appropriate toxicological studies.

Keywords: biocide, electrolyzed oxidizing water (EOW), disinfection, microorganisms, OPTI-JET CS MD1MR

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3734 Management and Marketing Implications of Tourism Gravity Models

Authors: Clive L. Morley

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Gravity models and panel data modelling of tourism flows are receiving renewed attention, after decades of general neglect. Such models have quite different underpinnings from conventional demand models derived from micro-economic theory. They operate at a different level of data and with different theoretical bases. These differences have important consequences for the interpretation of the results and their policy and managerial implications. This review compares and contrasts the two model forms, clarifying the distinguishing features and the estimation requirements of each. In general, gravity models are not recommended for use to address specific management and marketing purposes.

Keywords: gravity models, micro-economics, demand models, marketing

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3733 Corruption, Tax Systems and Inclusive Development

Authors: Lawrence Kwaku Amoako, Parrendah Adwoa Kpeli

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This paper analyses the implications of the corruption and tax system on inclusive development. We employ a sample of 45 countries between 2007 and 2020. We test for two related hypotheses; first, corruption hinders the smooth mobilisation of revenue through the tax system. Second, a rise in corruption amidst a defective tax system impairs inclusive development. We expect that a rise in the level of corruption in the economy will distort the tax system, thus affecting efficient revenue mobilisation and, subsequently, inclusive development. By extension, these findings have important policy implications for governments in containing corruption and building an effective tax system as it will help promote inclusive development.

Keywords: corruption, development, tax systems, tax complexity

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3732 Business Logic and Environmental Policy, a Research Agenda for the Business-to-Citizen Business Model

Authors: Mats Nilsson

Abstract:

The European electricity markets have been changing from a regulated market, to in some places a deregulated market, and are now experiencing a strong influence of renewable support systems. Firm’s that rely on subsidies have a different business logic than firms acting in a market context. The article proposes that an offspring to the regular business models, the business-to-citizen, should be used. The case of the European electricity market frames the concept of a business-citizen business model, and a research agenda for this concept is outlined.

Keywords: business logic, business model, subsidies, business-to-citizen

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3731 A Comparative Study of the Alternatives to Land Acquisition: India

Authors: Aparna Soni

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The much-celebrated foretold story of Indian city engines driving the growth of India has been scrutinized to have serious consequences. A wide spectrum of scholarship has brought to light the un-equalizing effects and the need to adopt a rights-based approach to development planning in India. Notably, these concepts and discourses ubiquitously entail the study of land struggles in the making of Urban. In fact, the very progression of the primitive accumulation theory to accumulation by dispossession, followed by ‘dispossession without development,’ thereafter Development without dispossession and now as Dispossession by financialization noticeably the last three developing in a span of mere three decades, is evidence enough to trace the centrality and evolving role of land in the making of urban India. India, in the last decade, has seen its regional governments actively experimenting with alternative models of land assembly (Amaravati and Delhi land pooling models, the loudly advertised ones). These are publicized as a replacement to the presumably cost and time antagonistic, prone to litigation land acquisition act of 2013. It has been observed that most of the literature treats these models as a generic large bracket of land expropriation and do not, in particular, try to differentially analyse to granularly find a pattern in these alternatives. To cater to this gap, this research comparatively studies these alternative land, assembly models. It categorises them based on their basic architecture, spatial and sectoral application, and governance frameworks. It is found that these alternatives are ad-hoc and fragmented pieces of legislation. These are fit for profit models commodifying land to ease its access by the private sector for real estate led growth. The research augments the literature on the privatization of land use planning in India. Further, it attempts to discuss the increasing role a landowner is expected to play in the future and suggests a way forward to safeguard them from market risks. The study involves a thematic analysis of the policy elements contained in legislative/policy documents, notifications, office orders. The study also derives from the various widely circulated print media information. With the present field-visit limitations, the study relies on documents accessed open-source in the public domain.

Keywords: commodification, dispossession, land acquisition, landowner

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3730 Prevalence and Correlates of Mental Disorders in Children and Adolescents in Mendefera Community, Eritrea

Authors: Estifanos H. Zeru

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Introduction: Epidemiological research is important to draw need-based rational public health policy. However, research on child and adolescent mental health in low and middle income countries, where socioeconomic, political, cultural, biological and other mental health hazards are in abundance, is almost nonexistent. To the author's knowledge, there is no published research in this field in Eritrea, whose child and adolescent population constitutes 53% of its total population. Study Aims and Objectives: The objective of this study was to determine the prevalence and patterns of DSM-IV psychiatric disorders and identify their socio-demographic correlates among children and adolescents in Mendefera, Eritrea. The study aims to provide local information to public health policymakers to guide policy in service development. Methodology: In a cross-sectional two stage procedure, both the Parent and Child versions of the SDQ were used to screen 314 children and adolescents aged 4-17 years, recruited by a multi-stage random sampling method. All parents/adult guardians also completed a socio-demographic questionnaire. All children and adolescents who screened positive for any of the SDQ abnormality sub-classes were selected for the second stage interview, which was conducted using the K-SADS-PL 2009 Working Draft version to generate specific DSM-IV diagnoses. All data gathered was entered into CSPro version 6.2 and was then transported in to and analyzed using SPSS version 20 for windows. Results: Prevalence of DSM-IV psychiatric disorders was found to be 13.1%. Adolescents 11-17 years old and males had higher prevalence than children 4-10 years old and females, respectively. Behavioral disorders were the commonest disorders (9.9%), followed by affective disorders (3.2%) and anxiety disorders (2.5). Chronic medical illness in the child, poor academic performance, difficulties with teachers in school, psychopathology in a family member and parental conflict were found to be independently associated with these disorders. Conclusion: Prevalence of child and adolescent psychiatric disorders in Eritrea is high. Promotion, prevention, treatment, and rehabilitation for child and adolescent mental health services need to be made widely available in the country. The socio-demographic correlates identified by this study can be targeted for intervention. The need for further research is emphasized.

Keywords: adolescents, children, correlates, DSM-IV psychiatric disorders, Eritrea, K-SAD-PL 2009, prevalence and correlates, SDQ

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3729 Genotyping of G/P No Typable Group a Rotavirus Strains Revealed G2 and G9 Genotype Circulations in Moroccan Children Fully Vaccinated with Rotarix™

Authors: H. Boulahyaoui, S. Alaoui Amine, C. Loutfi, H. El Annaz, N. Touil, El M. El Fahim, S. Mrani

Abstract:

Three Moroccan children fully vaccinated with Rotarix™ have been hospitalized for Rotavirus Gastroenteritis (RVGE) in the pediatric division of the Farabi Hospital, Oujda. Rotavirus G/P genotypes could not be typed because of their delayed crossing threshold (Ct) resolute with a group A rotavirus (RVA) real time RT-PCR. These strains were adapted to cell culture. All viruses replicated and caused extensive cytopathic effects after four or five passages in MA104 cell lines. Significant improvements have been obtained in the amount of viral particles. Each virus multiplied to a high titer (7.5 TCID50/ml). VP7 and VP4 partial gene sequencing revealed distinct genotypes compared to the Rotarix(®) vaccine strain. Two strains were of G2P[4] genotype whereas the third was G9P[8] genotype. Virus isolation while labor intensive, is recommended as a second test, especially when higher sensitivity for conventional RVA genotyping RT-PCR is needed. VP7 antigenic similarities between these strains and Rotarix were determined.

Keywords: esacpe-vaccine, Morocco, Rotarix, G2P[4], G9P[8]

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3728 Professional Stakeholders Perspectives on Community Participation in Transit-Oriented Development Projects: A Johannesburg Case Study

Authors: Kofi Quartey, Kola Ijasan

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Achieving densification around transit-oriented development projects has proven the most ideal way of facilitating urban sprawl whilst increasing the mobility of the majority of the urban populations, making parts of the city that were inaccessible, accessible. Johannesburg has undertaken TOD vision, which was initially called the corridors of freedom. The TOD, in line with the Sustainable Development Goal 11, seeks to establish inclusive, sustainable cities and, in line with the Joburg Growth Development Strategy, aims to create an equitable world-class African city. Equity and inclusivity should occur from the onset of planning and implementation of TOD projects through meaningful community participation. Stakeholder engagement literature from various disciplinary backgrounds has documented dissatisfaction of communities regarding the lack of meaningful participation in government-led development initiatives. The views of other project stakeholders such as project policy planners and project implementors and their challenges in undertaking community participation are, however, not taken into account in such instances, leaving room for a biased perspective. Document analysis was undertaken to determine what is expected of the Project stakeholders according to policy and whether they carried out their duties) seven interviews were also conducted with city entities and community representatives to determine their experiences and challenges with community participation in the various TOD projects attributed to the CoF vision. The findings of the study indicated that stakeholder engagement processes were best described as an ‘educative process’; where local communities were limited to being informed from the onset rather than having an active involvement in the planning processes. Most community members felt they were being informed and educated as to what was going to happen in spite of having their views and opinions collected – primarily due to project deadlines and budget constraints, as was confirmed by professional stakeholders. Some community members exhibited reluctance to change due to feelings of having projects being imposed on them, and the implications of the projects on their properties and lifestyles. It is recommended that community participation should remain a participatory and engaging process that creates an exchange of knowledge and understanding in the form of a dialogue between communities and project stakeholders until a consensus is reached.

Keywords: stakeholder engagement, transit oriented development, community participation, Johannesburg

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3727 Computed Tomography Brain and Inpatient Falls: An Audit Evaluating the Indications and Outcomes

Authors: Zain Khan, Steve Ahn, Kathy Monypenny, James Fink

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In Australian public hospitals, there were approximately 34,000 reported inpatient falls between 2015 to 2016. The gold standard for diagnosing intracranial injury is non-contrast enhanced brain computed tomography (CTB). Over a three-month timeframe, a total of one hundred and eighty (180) falls were documented between the hours of 4pm and 8am at a large metro hospital. Only three (3) of these scans demonstrated a positive intra-cranial finding. The rationale for scanning varied. The common indications included a fall with head strike, the presence of blood thinning medication, loss of consciousness, reduced Glasgow Coma Scale (GCS), vomiting and new neurological findings. There are several validated tools to aid in decision-making around ordering CTB scans in the acute setting, but no such accepted tool exists for the inpatient space. With further data collection, spanning a greater length of time and through involving multiple centres, work can be done towards generating such a tool that can be utilized for inpatient falls.

Keywords: computed tomography, falls, inpatient, intracranial hemorrhage

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3726 Gestational Diabetes Mellitus (GDM) Increasing Postpartum Screening to Prevent T2D

Authors: Boma Nellie S, Nambiar Ritu, K. Kanchanmala, T. Rashida, Israell Imelda, Moul Khusnud, Michael Marina

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Gestational diabetes (GDM) imparts an increased life long risk of developing Type 2 Diabetes Mellitus (T2DM) and cardiovascular disease in women. Once diagnosed with GDM women have up to 74% increased cumulative risk developing T2DM in 10-15 years. Identifying women at increased risk of developing T2DM and offering them pharmacological and lifestyle management interventions will delay or eliminate the development of diabetes in this population. While ADA recommends that all gestational diabetics be offered postnatal screening, worldwide the screening rates from 35-75% and Al Rahba Hospital with a robust universal antenatal screening program for GDM was at a dismal 9% in 2011. A multidisciplinary team was put together involving OB/Gyn Physicians, Midwives, Nurses (ward and OPD) Diabetic Educators, Dietitians, Medical Records, Laboratory & IT with the implementation of multiple strategies to increase the uptake of postpartum screening of the gestational diabetic.

Keywords: GDM, postnatal screening, preventing type 2 diabetes, lifestyle management

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3725 A Multilingual Model in the Multicultural World

Authors: Marina Petrova

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Language policy issues related to the preservation and development of the native languages of the Russian peoples and the state languages of the national republics are increasingly becoming the focus of recent attention of educators and parents, public and national figures. Is it legal to teach the national language or the mother tongue as the state language? Due to that dispute language phobia moods easily evolve into xenophobia among the population. However, a civilized, intelligent multicultural personality can only be formed if the country develops bilingualism and multilingualism, and languages as a political tool help to find ‘keys’ to sufficiently closed national communities both within a poly-ethnic state and in internal relations of multilingual countries. The purpose of this study is to design and theoretically substantiate an efficient model of language education in the innovatively developing Republic of Sakha. 800 participants from different educational institutions of Yakutia worked at developing a multilingual model of education. This investigation is of considerable practical importance because researchers could build a methodical system designed to create conditions for the formation of a cultural language personality and the development of the multilingual communicative competence of Yakut youth, necessary for communication in native, Russian and foreign languages. The selected methodology of humane-personal and competence approaches is reliable and valid. Researchers used a variety of sources of information, including access to related scientific fields (philosophy of education, sociology, humane and social pedagogy, psychology, effective psychotherapy, methods of teaching Russian, psycholinguistics, socio-cultural education, ethnoculturology, ethnopsychology). Of special note is the application of theoretical and empirical research methods, a combination of academic analysis of the problem and experienced training, positive results of experimental work, representative series, correct processing and statistical reliability of the obtained data. It ensures the validity of the investigation’s findings as well as their broad introduction into practice of life-long language education.

Keywords: intercultural communication, language policy, multilingual and multicultural education, the Sakha Republic of Yakutia

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3724 Challenges and Proposals for Public Policies Aimed At Increasing Energy Efficiency in Low-Income Communities in Brazil: A Multi-Criteria Approach

Authors: Anna Carolina De Paula Sermarini, Rodrigo Flora Calili

Abstract:

Energy Efficiency (EE) needs investments, new technologies, greater awareness and management on the side of citizens and organizations, and more planning. However, this issue is usually remembered and discussed only in moments of energy crises, and opportunities are missed to take better advantage of the potential of EE in the various sectors of the economy. In addition, there is little concern about the subject among the less favored classes, especially in low-income communities. Accordingly, this article presents suggestions for public policies that aim to increase EE for low-income housing and communities based on international and national experiences. After reviewing the literature, eight policies were listed, and to evaluate them; a multicriteria decision model was developed using the AHP (Analytical Hierarchy Process) and TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) methods, combined with fuzzy logic. Nine experts analyzed the policies according to 9 criteria: economic impact, social impact, environmental impact, previous experience, the difficulty of implementation, possibility/ease of monitoring and evaluating the policies, expected impact, political risks, and public governance and sustainability of the sector. The results found in order of preference are (i) Incentive program for equipment replacement; (ii) Community awareness program; (iii) EE Program with a greater focus on low income; (iv) Staggered and compulsory certification of social interest buildings; (v) Programs for the expansion of smart metering, energy monitoring and digitalization; (vi) Financing program for construction and retrofitting of houses with the emphasis on EE; (vii) Income tax deduction for investment in EE projects in low-income households made by companies; (viii) White certificates of energy for low-income. First, the policy of equipment substitution has been employed in Brazil and the world and has proven effective in promoting EE. For implementation, efforts are needed from the federal and state governments, which can encourage companies to reduce prices, and provide some type of aid for the purchase of such equipment. In second place is the community awareness program, promoting socio-educational actions on EE concepts and with energy conservation tips. This policy is simple to implement and has already been used by many distribution utilities in Brazil. It can be carried out through bids defined by the government in specific areas, being executed by third sector companies with public and private resources. Third on the list is the proposal to continue the Energy Efficiency Program (which obliges electric energy companies to allocate resources for research in the area) by suggesting the return of the mandatory investment of 60% of the resources in projects for low income. It is also relatively simple to implement, requiring efforts by the federal government to make it mandatory, and on the part of the distributors, compliance is needed. The success of the suggestions depends on changes in the established rules and efforts from the interested parties. For future work, we suggest the development of pilot projects in low-income communities in Brazil and the application of other multicriteria decision support methods to compare the results obtained in this study.

Keywords: energy efficiency, low-income community, public policy, multicriteria decision making

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3723 Mobility Management for Pedestrian Accident Predictability and Mitigation Strategies Using Multiple

Authors: Oscar Norman Nekesa, Yoshitaka Kajita

Abstract:

Tom Mboya Street is a vital urban corridor within the spectrum of Nairobi city, it experiences high volumes of pedestrian and vehicular traffic. Despite past intervention measures to lessen this catastrophe, rates have remained high. This highlights significant safety concerns that need urgent attention. This study investigates the correlation and pedestrian accident predictability with significant independent variables using multiple linear regression to model to develop effective mobility management strategies for accident mitigation. The methodology involves collecting and analyzing data on pedestrian accidents and various related independent variables. Data sources include the National Transport and Safety Authority (NTSA), Kenya National Bureau of Statistics, and Nairobi City County records, covering five years. This study aims to investigate that traffic volumes (pedestrian and vehicle), Vehicular speed, human factors, illegal parking, policy issues, urban-land use, built environment, traffic signals conditions, inadequate lighting, and insufficient traffic control measures significantly have predictability with the rate of pedestrian accidents. Explanatory variables related to road design and geometry are significant in predictor models for the Tom Mboya Road link but less influential in junction along the 5 km stretch road models. The most impactful variable across all models was vehicular traffic flow. The study recommends infrastructural improvements, enhanced enforcement, and public awareness campaigns to reduce accidents and improve urban mobility. These insights can inform policy-making and urban planning to enhance pedestrian safety along the dense packed Tom Mboya Street and similar urban settings. The findings will inform evidence-based interventions to enhance pedestrian safety and improve urban mobility.

Keywords: multiple linear regression, urban mobility, traffic management, Nairobi, Tom Mboya street, infrastructure conditions., pedestrian safety, correlation and prediction

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3722 Assessing Local Authorities’ Interest in Addressing Urban Challenges through Nature Based Solutions in Romania

Authors: Athanasios A. Gavrilidis, Mihai R. Nita, Larissa N. Stoia, Diana A. Onose

Abstract:

Contemporary global environmental challenges must be primarily addressed at local levels. Cities are under continuous pressure as they must ensure high quality of life levels for their citizens and at the same time to adapt and address specific environmental issues. Innovative solutions using natural features or mimicking natural systems are endorsed by the scientific community as efficient approaches for both mitigating climate change effects and the decrease of environmental quality and for maintaining high standards of living for urban dwellers. The aim of this study was to assess whether Romanian cities’ authorities are considering nature-based innovation as solutions for their planning, management, and environmental issues. Data were gathered by applying 140 questionnaires to urban authorities throughout the country. The questionnaire was designed for assessinglocal policy makers’ perspective over the efficiency of nature-based innovations as a tool to address specific challenges. It also focused on extracting data about financing sources and challenges they must overcome for adopting nature-based approaches. The gather results from the municipalities participating in our study were statistically processed, and they revealed that Romanian city managers acknowledge the benefits of nature-based innovations, but investments in this sector are not on top of their priorities. More than 90% of the selected cities have agreed that in the last 10 years, their major concern was to expand the grey infrastructure (roads and public amenities) using traditional approaches. When asked how they would react if faced with different socio-economic and environmental challenges, local urban managers indicated investments nature-based solutions as a priority only in case of biodiversity loss and extreme weather, while for other 14 proposed scenarios, they would embrace the business-as-usual approach. Our study indicates that while new concepts of sustainable urban planning emerge within the scientific community, local authorities need more time to understand and implement them. Without the proper knowledge, personnel, policies, or dedicated budgets, local administrators will not embrace nature-based innovations as solutions for their challenges.

Keywords: nature based innovations, perception analysis, policy making, urban planning

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3721 Increasing Adherence to Preventative Care Bundles for Healthcare-Associated Infections: The Impact of Nurse Education

Authors: Lauren G. Coggins

Abstract:

Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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3720 The Relationship between Facebook, Religiosity and Academic Performance

Authors: Nooraisah Katmon, Hartini Jaafar, Hazianti Abdul Halim, Jessnor Elmy Mat Jizat

Abstract:

Our study empirically examines the effect of student activities on Facebook and religion on academic performance. We extend prior research in this area in a number of ways. First, given the paucity of the research in this area particularly from the Asian context, we provide the evidence from developing country like Malaysia. Second, our sample drawn from Sultan Idris Education University in Malaysia, where graduates from these universities are unique since they are expected to be able to work in both education and industry environment, and presumed to play significant roles in shaping the development of future student’s intellectual at the Malaysian secondary school and Malaysian economy in general. Third, we control for religiosity aspect when examining the association between Facebook and academic performance, something that has been predominantly neglected by the prior studies. Fourth, unlike prior studies that circulating around the Christian sphere in measuring religiosity, we provide evidence from the Islamic perspective where the act of worships and practices are much more comprehensive rather than the Christian counterparts. Fifth, we examine whether Facebook activities and religiosity are complementary or substitutive each other in improving student’s academic performance. Our sample comprise of 60 undergraduates. Our result exhibit that students with high number of friends on facebook and frequent engagement on facebook activities, such as sharing links, send message, posting photo, tagging video as well as spending long hours on facebook generally are associated with lower academic performance. Our results also reported that student’s engagement in religious activities promotes better academic performance. When we examine the potential interaction effect between facebook and religiosity, our result revealed that religiosity is effective in reducing student’s interest on facebook, hence lead to better academic achievement. In other words, religious student will be less interested in joining activities on facebook and make them more perform than their counterparts. Our findings from this study should be able to assist the university management in shaping university policies and curriculum to regulate and manage student’s activities in order to enhance overall student’s quality. Moreover, the findings from this study are also of use to the policy maker such as Malaysian Communication and Multimedia Commissions to regulate the policy on the student’s access and activities on facebook.

Keywords: facebook, religiosity, academic performance, effect of student activities

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3719 Dengue Death Review: A Tool to Adjudge the Cause of Dengue Mortality and Use of the Tool for Prevention of Dengue Deaths

Authors: Gagandeep Singh Grover, Vini Mahajan, Bhagmal, Priti Thaware, Jaspreet Takkar

Abstract:

Dengue is a mosquito-borne viral disease endemic in many countries in the tropics and sub-tropics. The state of Punjab in India shows cyclical and seasonal variation in dengue cases. The Case Fatality Rate of Dengue has ranged from 0.6 to 1.0 in the past years. The department has initiated a review of the cases that have died due to dengue in order to know the exact cause of the death in a case of dengue. The study has been undertaken to know the other associated co-morbidities and factors causing death in a case of dengue. The study used the predesigned proforma on which the records (medical and Lab) were recorded and reviewed by the expert committee of the doctors. This study has revealed that cases of dengue having co-morbidities have a longer stay in the hospital. Fluid overload and co-morbidities have been found as major factors leading to death, however, in a confirmed case of dengue hepatorenal shutdown was found to be a major cause of mortality. The data obtained will help in sensitizing the treating physicians in order to decrease the mortality due to dengue in future.

Keywords: dengue, death, morbidities, DHF, DSS

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3718 Applicability of the Rapid Estimate of Adult Health Literacy in Medicine (Short Form) among Patients in Dakshina Kannada District, Karnataka, India

Authors: U. P. Rathnakar, Medha Urval, K. Ashok Shenoy

Abstract:

Introduction: There are many tools available for the measurement of health literacy. REALM (Rapid Estimate of Adult Literacy in Medicine) is a very commonly used tool in advanced countries. It comes in two forms-one with 66 words and shorter version (REALM-SF) with seven words. We decided to test the applicability of shorter version of the REALM test among our patients. Methodology: REALM (SF) was tested among 200 patients in a tertiary hospital. Discussion and conclusion: From the analysis of results, when the results of pronunciation indicate adequate levels of HL skills, analysis of comprehension shows that mere reading skills is likely to be misleading. So it is proposed that in Indian population who have adequate reading skills without adequate comprehension the REALM-SF test tool in its present form may not be an ideal testing tool for assessing HL.

Keywords: health literacy, REALM, short form, India

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3717 Surgical Skills in Mulanje

Authors: Nick Toossi, Joseph Hartland

Abstract:

Background: Malawi is an example of a low resource setting which faces a chronic shortage of doctors and other medical staff. This shortfall is made up for by clinical officers (COs), who are para-medicals trained for 4 years. The literature suggests to improve outcomes surgical skills training specifically should be promoted for COs in district and mission hospitals. Accordingly, the primary author was tasked with developing a basic surgical skills teaching package for COs of Mulanje Mission Hospital (MMH), Malawi, as part of a 4th year medical student External Student Selected Component field trip. MMH is a hospital based in the South of Malawi near the base of Mulanje Mountain and works in an extremely isolated environment with some of the poorest communities in the country. Traveling to Malawi the medical student author performed an educational needs assessment to develop and deliver a bespoke basic surgical skills teaching package. Methodology: An initial needs assessment identified the following domains: basic surgical skills (instrument naming & handling, knot tying, suturing principles and suturing techniques) and perineal repair. Five COs took part in a teaching package involving an interactive group simulation session, overseen by senior clinical officers and surgical trainees from the UK. Non-organic and animal models were used for simulation practice. This included the use of surgical skills boards to practice knot tying and ox tongue to simulate perineal repair. All participants spoke and read English. The impact of the session was analysed in two different ways. The first was via a pre and post Single Best Answer test and the second a questionnaire including likert’s scales and free text response questions. Results: There was a positive trend in pre and post test scores on competition of the course. There was increase in the mean confidence of learners before and after the delivery of teaching in basic surgical skills and simulated perineal repair, especially in ‘instrument naming and handling’. Whilst positively received it was discovered that learners desire more frequent surgical skills teaching sessions in order to improve and revise skills. Feedback suggests that the learners were not confident in retaining the skills without regular input. Discussion: Skills and confidence were improved as a result of the teaching provided. Learner's written feedback suggested there was an overall appetite for regular surgical skills teaching in the clinical environment and further opportunities to allow for deliberate self-practice. Surgical mentorship schemes facilitating supervised theatre time among trainees and lead surgeons along with improving access to surgical models/textbooks were some of the simple suggestions to improve surgical skills and confidence among COs. Although, this study is limited by population size it is reflective of the small, isolated and low resource environment in which this healthcare is delivered. This project does suggest that current surgical skills packages used in the UK could be adapted for employment in low resource settings, but it is consistency and sustainability that staff seek above all in their on-going education.

Keywords: clinical officers, education, Malawi, surgical skills

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3716 Study on Varying Solar Blocking Depths in the Exploration of Energy-Saving Renovation of the Energy-Saving Design of the External Shell of Existing Buildings: Using Townhouse Residences in Kaohsiung City as an Example

Authors: Kuang Sheng Liu, Yu Lin Shih*, Chun Ta Tzeng, Cheng Chen Chen

Abstract:

Buildings in the 21st century are facing issues such as an extreme climate and low-carbon/energy-saving requirements. Many countries in the world are of the opinion that a building during its medium- and long-term life cycle is an energy-consuming entity. As for the use of architectural resources, including the United Nations-implemented "Global Green Policy" and "Sustainable building and construction initiative", all are working towards "zero-energy building" and "zero-carbon building" policies. Because of this, countries are cooperating with industry development using policies such as "mandatory design criteria", "green procurement policy" and "incentive grants and rebates programme". The results of this study can provide a reference for sustainable building renovation design criteria. Aimed at townhouses in Kaohsiung City, this study uses different levels of solar blocking depth to carry out evaluation of design and energy-saving renovation of the outer shell of existing buildings by using data collection and the selection of representative cases. Using building resources from a building information model (BIM), simulation and efficiency evaluation are carried out and proven with simulation estimation. This leads into the ECO-efficiency model (EEM) for the life cycle cost efficiency (LCCE) evalution. The buildings selected by this research sit in a north-south direction set with different solar blocking depths. The indoor air-conditioning consumption rates are compared. The current balcony depth of 1 metre as the simulated EUI value acts as a reference value of 100%. The solar blocking of the balcony is increased to 1.5, 2, 2.5 and 3 metres for a total of 5 different solar-blocking balcony depths, for comparison of the air-conditioning improvement efficacy. This research uses different solar-blocking balcony depths to carry out air-conditioning efficiency analysis. 1.5m saves 3.08%, 2m saves 6.74%, 2.5m saves 9.80% and 3m saves 12.72% from the air-conditioning EUI value. This shows that solar-blocking balconies have an efficiency-increasing potential for indoor air-conditioning.

Keywords: building information model, eco-efficiency model, energy-saving in the external shell, solar blocking depth.

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