Search results for: cross-sectoral collaboration in health care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11666

Search results for: cross-sectoral collaboration in health care

9326 Applied Linguistics: Language, Corpora, and Technology

Authors: M. Imran

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This research explores the intersections of applied linguistics, corpus linguistics, translation, and technology, aiming to present innovative cross-disciplinary tools and frameworks. It highlights significant contributions to language, corpora, and technology within applied linguistics, which deepen our understanding of these domains and provide practical resources for scholars, educators, and translators. By showcasing these advancements, the study seeks to enhance collaboration and application in language-related fields. The significance of applied linguistics is emphasized by some of the research that has been emphasized, which presents pedagogical perspectives that could enhance instruction and the learning results of student’s at all academic levels as well as translation trainees. Researchers provided useful data from language studies with classroom applications from an instructional standpoint.

Keywords: linguistics, language, corpora, technology

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9325 Where do Pregnant Women Miss Out on Nutrition? Analysis of Survey Data from 22 Countries

Authors: Alexis D'Agostino, Celeste Sununtunasuk, Jack Fiedler

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Background: Iron-folic acid (IFA) supplementation during antenatal care (ANC) has existed in many countries for decades. Despite this, low national coverage persists and women do not often consume appropriate amounts during pregnancy. USAID’s SPRING Project investigated pregnant women’s access to, and consumption of, IFA tablets through ANC. Cross-country analysis provided a global picture of the state of IFA-supplementation, while country-specific results noted key contextual issues, including geography, wealth, and ANC attendance. The analysis can help countries prioritize strategies for systematic performance improvements within one of the most common micronutrient supplementation programs aimed at reducing maternal anemia. Methodology: Using falter point analysis on Demographic and Health Survey (DHS) data collected from 162,958 women across 22 countries, SPRING identified four sequential falter points (ANC attendance, IFA receipt or purchase, IFA consumption, and number of tablets taken) where pregnant women fell out of the IFA distribution structure. SPRING analyzed data on IFA intake from DHS surveys with women of reproductive age. SPRING disaggregated these data by ANC participation during the most recent pregnancy, residency, and women’s socio-economic status. Results: Average sufficient IFA tablet use across all countries was only eight percent. Even in the best performing countries, only about one-third of pregnant women consumed 180 or more IFA tablets during their most recent pregnancy. ANC attendance was an important falter point for a quarter of women across all countries (with highest falter rates in Democratic Republic of the Congo, Nigeria, and Niger). Further analysis reveals patterns, with some countries having high ANC coverage but low IFA provision during ANC (DRC and Haiti), others having high ANC coverage and IFA provision but few women taking any tablets (Nigeria and Liberia), and countries that perform well in ANC, supplies, and initial consumption but where very few women consume the recommended 180 tablets (Malawi and Cambodia). Country-level analysis identifies further patterns of supplementation. In Indonesia, for example, only 62% of women in the poorest quintile took even one IFA tablet, while 86% of the wealthiest women did. This association between socioeconomic status and IFA intake held across nearly all countries where these data are available and was also visible in rural/urban comparisons. Analysis of ANC attendance data also suggests that higher numbers of ANC visits are associated with higher tablet intake. Conclusions: While it is difficult to disentangle which specific aspects of supply or demand cause the low rates of consumption, this tool allows policy-makers to identify major bottlenecks to scaling-up IFA supplementation during ANC. In turn, each falter point provides possible explanations of program performance and helps strategically identify areas for improved IFA supplementation. For example, improving the delivery of IFA supplementation in Ethiopia relies on increasing access to ANC, but also on identifying and addressing program gaps in IFA supply management and health workers’ practices in order to provide quality ANC services. While every country requires a customized approach to improving IFA supplementation, the multi-country analysis conducted by SPRING is a helpful first step in identifying country bottlenecks and prioritizing interventions.

Keywords: iron and folic acid, supplementation, antenatal care, micronutrient

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9324 Increased Availability and Accessibility of Family Planning Services: An Approach Leading to Improved Contraceptive Uptake and Reproductive Behavior of Women Living in Pakistan

Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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9323 Comprehensive Evaluation of Oral and Maxillofacial Radiology in "COVID-19"

Authors: Sahar Heidary, Ramin Ghasemi Shayan

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The recent coronavirus disease 2019 (COVID-19) occurrence has carried considerabletrials to the world health system, comprising the training of dental and maxillofacial radiology (DMFR). DMFR will keep avital role in healthcare throughout this disaster. Severe acute breathing disease coronavirus 2 (SARS-CoV-2), the virus producing the current coronavirus disease 2019 (COVID-19) pandemic, is not only extremely contagious but can make solemn consequences in susceptible persons comprising dental patients and dental health care personnel (DHCPs). Reactions to COVID-19 have been available by the Cores for Infection Switch and Inhibition and the American Dental Association, but a more detailed answer is necessary for the harmless preparation of oral and maxillofacial radiology. Our goal is to evaluation the existing information just how the illness threatens patients and DHCPs and how to define which patients are possible to be SARS-CoV-2 infected; study how the usage of private shielding utensils and contamination control measures based on recent top observes, and knowledge can decrease the danger of virus spread in radiologic trials; and scrutinize how intraoral radiography, with its actually superior danger of scattering the infection, might be changed by extraoralradiographic methods for definite diagnostic jobs. In the pandemic, teleradiology has been extensively recycled for diagnostic determinations of COVID-19 patients, for discussions with radiologists in crisis cases, or managing of distance among radiology clinics. Dentists can have the digital radiographic images of their emergency patients through online service area also by electronic message or messaging applications to view in their smart phones, laptops, or other electronic devices.

Keywords: radiology, dental, oral, COVID-19, infection

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9322 Health of Riveted Joints with Active and Passive Structural Health Monitoring Techniques

Authors: Javad Yarmahmoudi, Alireza Mirzaee

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Many active and passive structural health monitoring (SHM) techniques have been developed for detection of the defects of plates. Generally, riveted joints hold the plates together and their failure may create accidents. In this study, well known active and passive methods were modified for the evaluation of the health of the riveted joints between the plates. The active method generated Lamb waves and monitored their propagation by using lead zirconate titanate (PZT) disks. The signal was analyzed by using the wavelet transformations. The passive method used the Fiber Bragg Grating (FBG) sensors and evaluated the spectral characteristics of the signals by using Fast Fourier Transformation (FFT). The results indicated that the existing methods designed for the evaluation of the health of individual plates may be used for inspection of riveted joints with software modifications.

Keywords: structural health monitoring, SHM, active SHM, passive SHM, fiber bragg grating sensor, lead zirconate titanate, PZT

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9321 Experience Marketing and Behavioral Intentions: An Exploratory Study Applied to Middle-Aged and Senior Pickleball Participated in Taiwan

Authors: Yi Yau, Chia-Huei Hsiao

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The elderly society is already a problem of globalization, and Taiwan will enter a super-aged society in 2025. Therefore, how to improve the health of the elderly and reduce the government's social burden is an important issue at present. Exercise is the best medical care, and it is also a healthy activity for people to live a healthy life. Facing the super-aged society in the future, it is necessary to attract them to participate in sports voluntarily through sports promotion so that they can live healthy and independent lives and continue to participate in society to enhance the well-being of the elderly. Experiential marketing and sports participation are closely related. In the past, it was mainly aimed at consumer behavior at the commercial level. At present, there are not many study objects focusing on participant behavior and middle-aged and elderly people. Therefore, this study takes the news emerged sport-Pickleball that has been loved by silver-haired people in recent years as the research sport. It uses questionnaire surveys and intentional sampling methods. The purpose of the group is to understand the middle-aged and elderly people’s experience and behavior patterns of Pickleball, explore the relationship between experiential marketing and participants' intentional behaviors, and predict which aspects of experiential marketing will affect their intentional behaviors. The findings showed that experience marketing is highly positively correlated with behavioral intentions, and experience marketing has a positive predictive power for behavioral intentions. Among them, "ACT" and "SENSE" are predictive variables that effectively predict behavioral intentions. This study proves the feasibility of pickleball for middle-aged and senior sports. It is recommended that in the future curriculum planning, try to simplify the exercise steps, increase the chances of contact with the sphere, and enhance the sensory experience to enhance the sense of success during exercise, and then generate exercise motivation, and ultimately change the exercise mode or habits and promote health.

Keywords: newly emerged sports, middle age and elderly, health promotion, ACT, SENSE

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9320 A Brief Study on the Mental Health vs. Mental Disorders in China, Suicide and the Entertainment Media

Authors: Patricia Portugal Marques de Carvalho Lourenço

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Mental Health, mental illnesses, and suicide are old topics made young. While broadly addressed on a global scale to various extents and degrees, mental health, mental disorders, and suicide remain to a large extent a, taboo in a number of societies such as the Chinese. The country’s report on mental health was scrutinized for an in-depth understanding of the prevalence of mental disorders domestically, emphasizing depression, which is more accentuated in rural settings than urban, affecting a significant number of students, retired individuals and that unemployed country-wise. Depression in China is linked to anxiety in younger years, both decreasing as the population grows in age. Mental health, mental disorders and suicide remain for the most part, “forgotten”, despite statistically significant and the media’s yet small efforts in educating the population about the terms i.e. through online/television dramas that approach the topics, trying to demystify them. Whereas crucial to openly address mental health, mental disorders, and suicide, the issues remain an ongoing challenge in China, where series draw light into a reality the media and the population do not broadly converse about. The media in general and the entertainment media, in particular, have a vital role in helping China acknowledge mental health, mental disorders and suicide, albeit having a long way to go in assisting the Chinese population in dealing with the health of their inner minds.

Keywords: mental health, mental disorders, suicide, media, China, Chinese entertainment

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9319 Making Waves: Preparing the Next Generation of Bilingual Medical Doctors

Authors: Edith Esparza-Young, Ángel M. Matos, Yaritza Gonzalez, Kirthana Sugunathevan

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Introduction: This research describes the existing medical school program which supports a multicultural setting and bilingualism. The rise of Spanish speakers in the United States has led to the recruitment of bilingual medical students who can serve the evolving demographics. This paper includes anecdotal evidence, narratives and the latest research on the outcomes of supporting a multilingual academic experience in medical school and beyond. People in the United States will continue to need health care from physicians who have experience with multicultural competence. Physicians who are bilingual and possess effective communication skills will be in high demand. Methodologies: This research is descriptive. Through this descriptive research, the researcher will describe the qualities and characteristics of the existing medical school programs, curriculum, and student services. Additionally, the researcher will shed light on the existing curriculum in the medical school and also describe specific programs which help to serve as safety nets to support diverse populations. The method included observations of the existing program and the implementation of the medical school program, specifically the Accelerated Review Program, the Language Education and Professional Communication Program, student organizations and the Global Health Institute. Concluding Statement: This research identified and described characteristics of the medical school’s program. The research explained and described the current and present phenomenon of this medical program, which has focused on increasing the graduation of bilingual and minority physicians. The findings are based on observations of the curriculum, programs and student organizations which evolves and remains innovative to stay current with student enrollment.

Keywords: bilingual, English, medicine, doctor

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9318 Changes in Cognition of Elderly People: A Longitudinal Study in Kanchanaburi Province, Thailand

Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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9317 Additional Usage of Remdesivir with the Standard of Care in Patients with Moderate And Severe COVID-19: A Tertiary Hospital’s Experience

Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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9316 Surviral: An Agent-Based Simulation Framework for Sars-Cov-2 Outcome Prediction

Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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9315 Assessing Urban Health Disparities in South Asia: A Comparative Study Using the Urban Health Index

Authors: Fiza Azam, Sahar Zia, Fatima Nazir Ali, Aysha Hanif

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Health is a fundamental human right, and a healthy population is essential for the prosperity and sustainable development of any country. This research is aligned with United Nations' Goal 3: Good Health and Well-being. It aims to assess and rank key health indicators across selected South Asian countries. The study focuses on urban areas in these nations, drawing on data from the World Bank’s primary collection of relevant indicators and specific health determinants outlined by the World Health Organization (WHO). These determinants include the physical environment, income and social status, education, social support networks, and personal behavior. To evaluate disparities in urban health across the region, the Urban Health Index (UHI) developed by Georgia State University, USA, is employed, followed by a mapping technique including visualization through a choropleth map to identify the pattern of spatial variations in our key variables, such as socioeconomic indicators across the region. This index serves as a comparative tool to rank health outcomes, where higher UHI values indicate better health conditions. The findings reveal notable disparities across South Asia. Afghanistan, with the lowest UHI score of 0.0423, ranks first, indicating the least favorable urban health conditions. Pakistan follows with a UHI score of 0.1190. Bangladesh and India rank third and fourth with UHI scores of 0.3099 and 0.3250, respectively. The Maldives and Sri Lanka rank fifth and sixth, with UHI scores of 0.3432 and 0.3495. Bhutan is ranked seventh with a score of 0.4750. Nepal, with a UHI score of 0.5012, ranks eighth, indicating the best urban health conditions among the countries studied. The findings of this research are crucial for addressing health disparities, improving living conditions, and enhancing social well-being in the region. These insights can inform policy measures aimed at reducing inequalities and promoting sustainable urban health in South Asia.

Keywords: urban health index, health disparities, sustainable development, South Asia, World Health Organization, United Nations, living conditions, public health

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9314 Evaluation of Triage Performance: Nurse Practice and Problem Classifications

Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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9313 Childhood Cataract: A Socio-Clinical Study at a Public Sector Tertiary Eye Care Centre in India

Authors: Deepak Jugran, Rajesh Gill

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Purpose: To study the demographic, sociological, gender and clinical profile of the children presented for childhood cataract at a public sector tertiary eye care centre in India. Methodology: The design of the study is retrospective, and hospital-based data is available with the Central Registration Department of the PGIMER, Chandigarh. The majority of the childhood cataract cases are being reported in this hospital, yet not each and every case of childhood cataract approaches PGI, Chandigarh. Nevertheless, this study is going to be pioneering research in India, covering five-year data of the childhood cataract patients who visited the Advanced Eye Centre, PGIMER, Chandigarh, from 1.1.2015 to 31.12.2019. The SPSS version 23 was used for all statistical calculations. Results: A Total of 354 children were presented for childhood cataract from 1.1.2015 to 31.12.2019. Out of 354 children, 248 (70%) were male, and 106 (30%) were female. In-spite of 2 flagship programmes, namely the National Programme for Control of Blindness (NPCB) and Aayushman Bharat (PM JAY) for eradication of cataract, no children received any financial assistance from these two programmes. A whopping 99% of these children belong to the poor families. In most of these families, the mothers were house-wives and did not employ anywhere. These interim results will soon be conveyed to the Govt. of India so that a suitable mechanism can be evolved to address this pertinent issue. Further, the disproportionate ratio of male and female children in this study is an area of concern as we don’t know whether the prevalence of childhood cataract is lower in female children or they are not being presented on time in the hospital by the families. Conclusion: The World Health Organization (WHO) has categorized Childhood blindness resulting from cataract as a priority area and urged all member countries to develop institutionalized mechanisms for its early detection, diagnosis and management. The childhood cataract is an emerging and major cause of preventable and avoidable childhood blindness, especially in low and middle-income countries. In the formative years, the children require a sound physical, mental and emotional state, and in the absence of either one of them, it can severely dent their future growth. The recent estimate suggests that India could suffer an economic loss of US$12 billion (Rs. 88,000 Crores) due to blindness, and almost 35% of cases of blindness are preventable and avoidable if detected at an early age. Besides reporting these results to the policy makers, synchronized efforts are needed for early detection and management of avoidable causes of childhood blindness such as childhood cataract.

Keywords: childhood blindness, cataract, Who, Npcb

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9312 Developing Curricula for Signaling and Communication Course at Malaysia Railway Academy (MyRA) through Industrial Collaboration Program

Authors: Mohd Fairus Humar, Ibrahim Sulaiman, Pedro Cruz, Hasry Harun

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This paper presents the propose knowledge transfer program on railway signaling and communication by Original Equipment Manufacturer (OEM) Thales Portugal. The fundamental issue is that there is no rail related course offered by local universities and colleges in Malaysia which could be an option to pursue student career path. Currently, dedicated trainings related to the rail technology are provided by in-house training academies established by the respective rail operators such as Malaysia Railway Academy (MyRA) and Rapid Rail Training Centre. In this matter, the content of training and facilities need to be strengthened to keep up-to-date with the dynamic evolvement of the rail technology. This is because rail products have evolved to be more sophisticated and embedded with high technology components which no longer exist in the mechanical form alone but combined with electronics, information technology and others. These demand for a workforce imbued with knowledge, multi-skills and competency to deal with specialized technical areas. Talent is needed to support sustainability in Southeast Asia. Keeping the above factors in mind, an Industrial Collaboration Program (ICP) was carried out to transfer knowledge on curricula of railway signaling and communication to a selected railway operators and tertiary educational institution in Malaysia. In order to achieve the aim, a partnership was formed between Technical Depository Agency (TDA), Thales Portugal and MyRA for two years with three main stages of program implementation comprising of: i) training on basic railway signaling and communication for 1 month with Thales in Malaysia; ii) training on advance railway signaling and communication for 4 months with Thales in Portugal and; iii) a series of workshop. Two workshops were convened to develop and harmonize curricula of railway signaling and communication course and were followed by one training for installation equipment of railway signaling and Controlled Train Centre (CTC) system from Thales Portugal. With active involvement from Technical Depository Agency (TDA), railway operators, universities, and colleges, in planning, executing, monitoring, control and closure, the program module of railway signaling and communication course with a lab railway signaling field equipment and CTC simulator were developed. Through this program, contributions from various parties help to build committed societies to engage important issues in relation to railway signaling and communication towards creating a sustainable future.

Keywords: knowledge transfer program, railway signaling and communication, curricula, module and teaching aid simulator

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9311 Unleashing the Potential of Green Finance in Architecture: A Promising Path for Balkan Countries

Authors: Luan Vardari, Dena Arapi Vardari

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The Balkan countries, known for their diverse landscapes and cultural heritage, face the dual challenge of promoting economic growth while addressing pressing environmental concerns. In recent years, the concept of green finance has emerged as a powerful tool to achieve sustainable development and mitigate the environmental impact of various sectors, including architecture. This extended abstract explores the untapped potential of green finance in architecture within the Balkan region and highlights its role in driving sustainable construction practices and fostering a greener future. The abstract begins by defining green finance and emphasizing its relevance in the context of the architectural sector in Balkan countries. It underlines the benefits of green finance, such as economic growth, environmental conservation, and social well-being. Integrating green finance into architectural projects is important as a means to achieve sustainable development goals while promoting financial viability. Also, delves into the current state of green building practices in the Balkan countries and identifies the need for financial support to further drive adoption. It explores the existing regulatory frameworks and policies that promote sustainable architecture and discusses how green finance can complement these initiatives. Unique challenges faced by Balkan countries are highlighted, along with the potential opportunities that green finance presents in overcoming these challenges. We highlight successful sustainable architectural projects in the region to showcase the practical application of green finance in the Balkans. These projects exemplify the effective utilization of green finance mechanisms, resulting in tangible economic and environmental impacts, including job creation, energy efficiency, and reduced carbon emissions. The abstract concludes by identifying replicable models and lessons learned from these projects that can serve as a blueprint for future sustainable architecture initiatives in the Balkans. The importance of collaboration and knowledge sharing among stakeholders is emphasized. Engaging architects, financial institutions, governments, and local communities is crucial to promoting green finance in architecture. The abstract suggests the establishment of knowledge exchange platforms and regional/international networks to foster collaboration and facilitate the sharing of expertise among Balkan countries.

Keywords: sustainable finance, renewable energy, Balkan region, investment opportunities, green infrastructure, ESG criteria, architecture

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9310 Self-Efficacy Psychoeducational Programme for Patients With End-Stage Renal Disease

Authors: H.C. Chen, S. W. C. Chan, K. Cheng, A. Vathsala, H. K. Sran, H. He

Abstract:

Background: End-stage renal disease (ESRD) is the last stage of chronic kidney disease. The numbers of patients with ESRD have increased worldwide due to the growing number of aging, diabetes and hypertension populations. Patients with ESRD suffer from physical illness and psychological distress due to complex treatment regimens, which often affect the patients’ social and psychological functioning. As a result, the patients may fail to perform daily self-care and self-management, and consequently experience worsening conditions. Aims: The study aims to examine the effectiveness of a self-efficacy psychoeducational programme on primary outcome (self-efficacy) and secondary outcomes (psychological wellbeing, treatment adherence, and quality of life) in patients with ESRD and haemodialysis in Singapore. Methodology: A randomised controlled, two-group pretest and repeated posttests design will be carried out. A total of 154 participants (n=154) will be recruited. The participants in the control group will receive a routine treatment. The participants in the intervention group will receive a self-efficacy psychoeducational programme in addition to the routine treatment. The programme is a two-session of educational intervention in a week. A booklet, two consecutive sessions of face-to-face individual education, and an abdominal breathing exercise are adopted in the programme. Outcome measurements include Dialysis Specific Self-efficacy Scale, Kidney Disease Quality of Life- 36 Hospital Anxiety and Depression Scale, Renal Adherence Attitudes Questionnaire and Renal Adherence Behaviour Questionnaire. The questionnaires will be used to measure at baseline, 1- and 3- and 6-month follow-up periods. Process evaluation will be conducted with a semi-structured face to face interview. Quantitative data will be analysed using SPSS21.0 software. Qualitative data will be analysed by content analysis. Significance of the study: This study will identify a clinically useful and potentially effective approach to help patients with end-stage renal disease and haemodialysis by enhancing their self-efficacy in self-care behaviour, and therefore improving their psychological wellbeing, treatment adherence and quality of life. This study will provide information to develop clinical guidelines to improve patients’ disease self-management and to enhance health-related outcomes. Hopefully it will help reducing disease burden.

Keywords: end-stage renal disease (ESRD), haemodialysis, psychoeducation, self-efficacy

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9309 Metabolic Variables and Associated Factors in Acute Pancreatitis Patients Correlates with Health-Related Quality of Life

Authors: Ravinder Singh, Pratima Syal

Abstract:

Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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9308 Impact of Acculturation Stress and Work-Family Conflict on the Health and Wellbeing of African Immigrants in the US: A Case Study of Ghanaian Immigrants

Authors: Rodlyn Remina Hines

Abstract:

Africans who migrate to the United States (U.S.) go through an acculturation period. When they join the U.S. workforce during the period they are still acquainting to the new geographic area and culture, they may experience work and family conflict in addition to the stressors of acculturation. This study investigated the impact of acculturation stress and work-family conflict on the health and wellbeing of African immigrants in the U.S. using a growing immigrant population. Ghanaian immigrants (n = 100, males= 43%; females= 56%) residing in New York and Massachusetts, United States (U.S.), were recruited via purposive sampling to investigate the role acculturation stress and work-family conflict play on the health and wellbeing of African immigrants in the U.S. Using the Sociocultural theory, three hypotheses were proposed: (1) High acculturation stress will lead to high work-family conflict, (2) High work-family conflict will result in poor health and wellbeing, and (3) Work-family conflict will mediate the relationship between acculturation stress and health and wellbeing. The results fully supported the first hypothesis and partially supported the second and third. High acculturation stress led to high work-family conflict. Although high work-family conflict resulted in poorer health and wellbeing, high family support mediated work-family conflict and health and wellbeing. Participants who reported poor health also reported a lack of family or other support and those who reported strong family or other support also reported excellent health and wellbeing even with high work-family conflict. The latter group did not expect their health and wellbeing to get worse. I draw on these findings to conclude that African immigrants in the U.S. experience significant acculturation stress and work-family conflict resulting in poor health and wellbeing during their acculturation period if there is a lack of family or other support. These findings have implications for practitioners and policymakers.

Keywords: acculturation stress, work-family conflict, Ghanaian immigrants, health and wellbeing

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9307 Analysis of Scholarly Communication Patterns in Korean Studies

Authors: Erin Hea-Jin Kim

Abstract:

This study aims to investigate scholarly communication patterns in Korean studies, which focuses on all aspects of Korea, including history, culture, literature, politics, society, economics, religion, and so on. It is called ‘national study or home study’ as the subject of the study is itself, whereas it is called ‘area study’ as the subject of the study is others, i.e., outside of Korea. Understanding of the structure of scholarly communication in Korean studies is important since the motivations, procedures, results, or outcomes of individual studies may be affected by the cooperative relationships that appear in the communication structure. To this end, we collected 1,798 articles with the (author or index) keyword ‘Korean’ published in 2018 from the Scopus database and extracted the institution and country of the authors using a text mining technique. A total of 96 countries, including South Korea, was identified. Then we constructed a co-authorship network based on the countries identified. The indicators of social network analysis (SNA), co-occurrences, and cluster analysis were used to measure the activity and connectivity of participation in collaboration in Korean studies. As a result, the highest frequency of collaboration appears in the following order: S. Korea with the United States (603), S. Korea with Japan (146), S. Korea with China (131), S. Korea with the United Kingdom (83), and China with the United States (65). This means that the most active participants are S. Korea as well as the USA. The highest rank in the role of mediator measured by betweenness centrality appears in the following order: United States (0.165), United Kingdom (0.045), China (0.043), Japan (0.037), Australia (0.026), and South Africa (0.023). These results show that these countries contribute to connecting in Korean studies. We found two major communities among the co-authorship network. Asian countries and America belong to the same community, and the United Kingdom and European countries belong to the other community. Korean studies have a long history, and the study has emerged since Japanese colonization. However, Korean studies have never been investigated by digital content analysis. The contributions of this study are an analysis of co-authorship in Korean studies with a global perspective based on digital content, which has not attempted so far to our knowledge, and to suggest ideas on how to analyze the humanities disciplines such as history, literature, or Korean studies by text mining. The limitation of this study is that the scholarly data we collected did not cover all domestic journals because we only gathered scholarly data from Scopus. There are thousands of domestic journals not indexed in Scopus that we can consider in terms of national studies, but are not possible to collect.

Keywords: co-authorship network, Korean studies, Koreanology, scholarly communication

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9306 Communication About Health and Fitness in Media and Its Hidden Message About Objectification

Authors: Emiko Suzuki

Abstract:

Although fitness is defined as the body’s ability to respond to the demand of physical activity without undue fatigue in health science, in media oftentimes physical activity is presented as means to an attractive body rather than a fit and healthy one. Of all types of media, Instagram is becoming an increasingly persuasive source of information and advice on health and fitness, where individuals conceptualize what health and fitness mean for them. However, this user-generated and unregulated platform can be problematic, as it can communicate misleading information about health and fitness and possibly leading individuals to psychological problems such as eating disorders. In fact, previous research has shown that some messages that were posted with a tag that related to inspire others to do fitness, in fact, encouraged distancing the self from the internal needs of the body. For this reason, this present study aims to explore how health and fitness are communicated on Instagram by analyzing images and texts. A content analysis of images that were labeled with particular hashtags was performed, followed by a thematic analysis of texts from the same set of images. The result shows an interesting insight about messages about how health and fitness are communicated from companies through media, then digested and further shared among communities on Instagram. The study explores how the use of visual focused way of communicating health and fitness can lead to the dehumanization of human bodies.

Keywords: Instagram, fitness, dehumanization, body image, embodiment

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9305 Direct Visualization of Shear Induced Structures in Wormlike Micellar Solutions by Microfluidics and Advanced Microscopy

Authors: Carla Caiazza, Valentina Preziosi, Giovanna Tomaiuolo, Denis O'Sullivan, Vincenzo Guida, Stefano Guido

Abstract:

In the last decades, wormlike micellar solutions have been extensively used to tune the rheological behavior of home care and personal care products. This and other successful applications underlie the growing attention that both basic and applied research are devoting to these systems, and to their unique rheological and flow properties. One of the key research topics is the occurrence of flow instabilities at high shear rates (such as shear banding), with the possibility of appearance of flow induced structures. In this scenario, microfluidics is a powerful tool to get a deeper insight into the flow behavior of a wormlike micellar solution, as the high confinement of a microfluidic device facilitates the onset of the flow instabilities; furthermore, thanks to its small dimensions, it can be coupled with optical microscopy, allowing a direct visualization of flow structuring phenomena. Here, the flow of a widely used wormlike micellar solution through a glass capillary has been studied, by coupling the microfluidic device with μPIV techniques. The direct visualization of flow-induced structures and the flow visualization analysis highlight a relationship between solution structuring and the onset of discontinuities in the velocity profile.

Keywords: flow instabilities, flow-induced structures, μPIV, wormlike micelles

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9304 Good Death as Perceived by the Critically Ill Patients' Family Member

Authors: Wanlapa Kunsongkeit

Abstract:

When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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9303 Expectation and Satisfaction of Health Spa Business Service, Ranong Province, Thailand

Authors: Supattra Pranee

Abstract:

The purposes of this research are to study the current business of health spa and to study the customers’ level of expectation as well as level of satisfaction of the health spa business in Ranong, Thailand. This paper drew upon data collected from health spa customers by using questionnaire. In addition, an in-depth interview was utilized to collect data from health spa entrepreneurs. The findings revealed that the health spa business is growing very fast and the coming ASEAN Economic Community (AEC) will ameliorate the business growth and increase the customer base. There is a need to improve staff’s ability to communicate in English. However, the economic size of Ranong province is still small which has resulted in the hesitation of investors to increase their investment in this business. The findings also revealed four categories of level of expectation and satisfaction as follows: (1) Service: overall, customers had a high expectation with a mean of 3.80 and 0.873 SD and a high level of satisfaction with a mean of 3.66 and 0.704 SD. (2) Staff: overall, customers had a high expectation with a mean of 3.95 and 0.865 SD and a high level of satisfaction with a mean of 3.84 and 0.783 SD. (3) Product, Equipment, and Tools: overall, customers had a high expectation with a mean of 4.02 and 0.913 SD and a high level of satisfaction with a mean of 3.88 and 0.772 SD. (4) Place, Atmosphere, and Environment: overall, customers had a high expectation with a mean of 3.95 and 0.906 SD and a high level of satisfaction with a mean of 3.86 and 0.785 SD.

Keywords: expectation, health spa business, satisfaction, ranong province

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9302 Religion and Sustainable Development: A Comparative Study of Buddhist and Christian Farmers’ Contribution to the Environmental Protection in Taiwan

Authors: Jijimon Alakkalam Joseph

Abstract:

The UN 2030 Agenda for Sustainable Development claims to be a comprehensive and integrated plan of action for prosperity for people and the planet, including almost all dimensions of human existence. Nevertheless, critics have pointed out the exclusion of the religious dimension from development discussions. Care for the earth is one of the vital aspects of sustainable development. Farmers all over the world contribute much to environmental protection. Most farmers are religious believers, and religious ideologies influence their agricultural practices. This nexus between faith and agriculture has forced policymakers to include religion in development discussions. This paper delves deeper into this religion and sustainable development connection. Buddhism and Christianity have contributed much to environmental protection in Taiwan. However, interviews conducted among 40 Taiwanese farmers (10 male and female farmers from Buddhism and Christianity) show that their faith experiences make them relate to the natural environment differently. Most of the Buddhist farmers interviewed admitted that they chose their religious adherence, while most of the Christian farmers inherited their faith. The in-depth analysis of the interview data collected underlines the close relationship between religion and sustainable development. More importantly, concerning their intention to care for the earth, farmers whose religious adherence is ‘chosen’ are self-motivated and more robust compared to those whose religious adherence is ‘inherited’.

Keywords: Buddhism, Christianity, environmental protection, sustainable development

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9301 Findings in Vascular Catheter Cultures at the Laboratory of Microbiology of General Hospital during One Year

Authors: P. Christodoulou, M. Gerasimou, S. Mantzoukis, N. Varsamis, G. Kolliopoulou, N. Zotos

Abstract:

Abstract— Purpose: The Intensive Care Unit (ICU) environment is conducive to the growth of microorganisms. A variety of microorganisms gain access to the intravascular area and are transported throughout the circulatory system. Therefore, examination of the catheters used in ICU patients is of paramount importance. Material and Method: The culture medium is a catheter tip, which is enriched with Tryptic soy broth (TSB). After one day of incubation, the broth is passaged in the following selective media: Blood, Mac conkey No. 2, chocolate, Mueller Hinton, Chapman, and Saboureaud agar. The above selective media is incubated for 2 days. After this period, if any number of microbial colonies is detected, gram staining is performed and then the microorganisms are identified by biochemical techniques in the automated Microscan (Siemens) system followed by a sensitivity test in the same system using the minimum inhibitory concentration (MIC) technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017, the Microbiology Laboratory received 84 catheters from the ICU. 42 were found positive. Of these, S. epidermidis was identified at 8, A. baumannii in 10, K. pneumoniae in 6, P. aeruginosa in 6, P. mirabilis in 3, S. simulans in 1, S. haemolyticus in 4, S. aureus in 3 and S. hominis in 1. Conclusions: The results show that the placement and maintenance of the catheters in ICU patients are relatively successful, despite the unfavorable environment of the unit.

Keywords: culture, intensive care unit, microorganisms, vascular catheters

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9300 High-Value Health System for All: Technologies for Promoting Health Education and Awareness

Authors: M. P. Sebastian

Abstract:

Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: big data, education, healthcare, information communication technologies (ICT), patients, technologies

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9299 Household Socioeconomic Factors Associated with Teenage Pregnancies in Kigali City, Rwanda

Authors: Dieudonne Uwizeye, Reuben Muhayiteto

Abstract:

Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.

Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy

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9298 Contemporary Paradoxical Expectations of the Nursing Profession and Revisiting the ‘Nurses’ Disciplinary Boundaries: India’s Historical and Gendered Perspective

Authors: Neha Adsul, Rohit Shah

Abstract:

Background: The global history of nursing is exclusively a history of deep contradictions as it seeks to negotiate inclusion in an already gendered world. Although a powerful 'clinical gaze exists, nurses have toiled to re-negotiate and subvert the 'medical gaze' by practicing the 'therapeutic gaze' to tether back 'care into nursing practice.' This helps address the duality of the 'body' and 'mind' wherein the patient is not just limited to being an object of medical inquiry. Nevertheless, there has been a consistent effort to fit 'nursing' into being an art or an emerging science over the years. Especially with advances in hospital-based techno-centric medical practices, the boundaries between technology and nursing practices are becoming more blurred as the technical process becomes synonymous with nursing, eroding the essence of nursing care. Aim: This paper examines the history of nursing and offers insights into how gendered relations and the ideological belief of 'nursing as gendered work' have propagated to the subjugation of the nursing profession. It further aims to provide insights into the patriarchally imbibed techno-centrism that negates the gendered caregiving which lies at the crux of a nurse's work. Method: A literature search was carried out using Google Scholar, Web of Science and PubMed databases. Search words included: technology and nursing, medical technology and nursing, history of nursing, sociology and nursing and nursing care. The history of nursing is presented in a discussion that weaves together the historical events of the 'Birth of the Clinic' and the shift from 'bed-side medicine' to 'hospital-based medicine' that legitimizes exploitation of the bodies of patients to the 'medical gaze while the emergence of nursing as acquiescent to instrumental, technical, positivist and dominant views of medicine. The resultant power asymmetries, wherein in contemporary nursing, the constant struggle of nurses to juggle between being the physicians "operational right arm" to harboring that subjective understanding of the patients to refrain from de-humanizing nursing-care. Findings: The nursing profession suffers from being rendered invisible due to gendered relations having patrifocal societal roots. This perpetuates a notion rooted in the idea that emphasizes empiricism and has resulted in theoretical and epistemological fragmentation of the understanding of body and mind as separate entities. Nurses operate within this structure while constantly being at the brink of being pushed beyond the legitimate professional boundaries while being labeled as being 'unscientific' as the work does not always corroborate and align with the existing dominant positivist lines of inquiries. Conclusion: When understood in this broader context of how nursing as a practice has evolved over the years, it provides a particularly crucial testbed for understanding contemporary gender relations. Not because nurses like to live in a gendered work trap but because the gendered relations at work are written in a covert narcissistic patriarchal milieu that fails to recognize the value of intangible yet utmost necessary 'caring work in nursing. This research urges and calls for preserving and revering the humane aspect of nursing care alongside the emerging tech-savvy expectations from nursing work.

Keywords: nursing history, technocentric, power relations, scientific duality

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9297 Business Intelligence Dashboard Solutions for Improving Decision Making Process: A Focus on Prostate Cancer

Authors: Mona Isazad Mashinchi, Davood Roshan Sangachin, Francis J. Sullivan, Dietrich Rebholz-Schuhmann

Abstract:

Background: Decision-making processes are nowadays driven by data, data analytics and Business Intelligence (BI). BI as a software platform can provide a wide variety of capabilities such as organization memory, information integration, insight creation and presentation capabilities. Visualizing data through dashboards is one of the BI solutions (for a variety of areas) which helps managers in the decision making processes to expose the most informative information at a glance. In the healthcare domain to date, dashboard presentations are more frequently used to track performance related metrics and less frequently used to monitor those quality parameters which relate directly to patient outcomes. Providing effective and timely care for patients and improving the health outcome are highly dependent on presenting and visualizing data and information. Objective: In this research, the focus is on the presentation capabilities of BI to design a dashboard for prostate cancer (PC) data that allows better decision making for the patients, the hospital and the healthcare system related to a cancer dataset. The aim of this research is to customize a retrospective PC dataset in a dashboard interface to give a better understanding of data in the categories (risk factors, treatment approaches, disease control and side effects) which matter most to patients as well as other stakeholders. By presenting the outcome in the dashboard we address one of the major targets of a value-based health care (VBHC) delivery model which is measuring the value and presenting the outcome to different actors in HC industry (such as patients and doctors) for a better decision making. Method: For visualizing the stored data to users, three interactive dashboards based on the PC dataset have been developed (using the Tableau Software) to provide better views to the risk factors, treatment approaches, and side effects. Results: Many benefits derived from interactive graphs and tables in dashboards which helped to easily visualize and see the patients at risk, better understanding the relationship between patient's status after treatment and their initial status before treatment, or to choose better decision about treatments with fewer side effects regarding patient status and etc. Conclusions: Building a well-designed and informative dashboard is related to three important factors including; the users, goals and the data types. Dashboard's hierarchies, drilling, and graphical features can guide doctors to better navigate through information. The features of the interactive PC dashboard not only let doctors ask specific questions and filter the results based on the key performance indicators (KPI) such as: Gleason Grade, Patient's Age and Status, but may also help patients to better understand different treatment outcomes, such as side effects during the time, and have an active role in their treatment decisions. Currently, we are extending the results to the real-time interactive dashboard that users (either patients and doctors) can easily explore the data by choosing preferred attribute and data to make better near real-time decisions.

Keywords: business intelligence, dashboard, decision making, healthcare, prostate cancer, value-based healthcare

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