Search results for: online community

Authors: David A. Scott, Michelle G. Scott

Abstract:

The problem of juvenile crime, school suspensions and oppositional behaviors indicates a need for a wide range of intervention programs for at-risk youth. Juvenile court systems and mental health agencies are examining alternative ways to deal with at-risk youth that will allow the adolescent to live within their home community. The previous trend that treatment away from home is more effective than treatment near one's community has shifted. Research now suggests that treatment be close to home for several reasons, such as increased treatment success, parental involvement, and reduced costs. Treatment options consist of a wide range of interventions, including outpatient, inpatient, and community-based services (therapeutic group homes, foster care and in-home preservation services). The juvenile justice system, families and other mental health agencies continue to seek the most effective treatment for at-risk youth in their communities. This research examines two possible treatment modalities, a multi-systemic outpatient program and a residential program. Research examining effective, evidence- based counseling will be discussed during this presentation. The presenter recently completed a three-year research grant examining effective treatment modalities for at-risk youth participating in a multi-systemic program. The presenter has also been involved in several research activities gathering data on effective techniques used in residential programs. The data and discussion will be broken down into two parts, each discussing one of the treatment modalities mentioned above. Data on the residential programs was collected on both a sample of 740 at- risk youth over a five-year period and also a sample of 63 participants during a one-year period residing in a residential programs. The effectiveness of these residential services was measured in three ways: services are evaluated by primary referral sources; follow-up data is obtained at various intervals after program participation to measure recidivism (what percentage got back into trouble with the Department of Juvenile Justice); and a more sensitive, "Offense Seriousness Score", has been computed and analyzed prior to, during and after treatment in the residential program. Data on the multi-systemic program was gathered over the past three years on 190 participants. Research will discuss pre and post test results, recidivism rates, academic performance, parental involvement, and effective counseling treatment modalities.

Keywords: at-risk youth, group homes, therapeutic group homes, recidivism rates

Procedia PDF Downloads 82

Authors: K. R. Mukuna

Abstract:

Teachers are faced many challenges in the South African rural schools such as stress, depression, lack of resources, poor working relationships, inflexible curriculum etc. These could affect their wellbeing and effectiveness at the workplace. As a result, the study had a significance in the teacher’s lives, and community due teachers worked under conditions that are unfavourable to perform their jobs effectively. Despite these conditions, they still managed to do their jobs and the community is uplifted. However, this study aimed to explore factors that enable teachers to cope with workplace adversities at a rural school district in the Free State Province. It adopted a qualitative case study as a research design. Semi-structured interviews and colleges had employed as tools to collect data. Ten participants (n=10; 5 males and 5 females) were selected through purposive and convenience sampling. All participants selected from a South African rural school. Sesotho culture was their home language, and most of them had 5 years of teaching experiences. The thematic findings revealed that they developed abilities to cope with and adjust to the social and cultural environment. These included self-efficacy, developing problem-solving skills, awareness of strengths and asserts, self-managing of emotions, and self-confidence. This study concluded that these psychosocial factors contributed to coping with teacher’s diversities, and effectively stabilized their wellbeing in the schools.

Keywords: psychosocial factors, teachers counselling, teacher stress, workplace adversity, rural school, teachers’ wellbeing, teachers’ resilience, teachers’ self-efficacy, social interaction

Procedia PDF Downloads 127

Authors: Ugoh Kelechi Melford, Anene O.

Abstract:

Introduction: Evidence has shown that there are increasing rates of new HIV and other STI infections occurring among Men who have Sex with Men (MSM) in Nigeria, with the prevalence 3 times higher than the general population as reported by the 2011 National Integrated Bio Behavioral Surveillance Survey. The poor state of health care and support services hinders our effort to control the high rates of these new infections among MSM. Methods: The Initiative for Improved Male Health (IMH-Initiative) works to provide a safe space for young MSM living with HIV to access comprehensive palliative care and support, as well as referrals for other services through drama and dance competitions. An STI assessment was conducted in IMH-Initiative’s Community Center in Calabar, for gay men and other MSM. An STI history was conducted for all clients who visited the community clinic specifically for HCT and STI counseling and referrals within a 5 month period, and their data were collated. Results: 61 MSM were diagnosed, and reported the following in the last 6 months. 49 where living with HIV. 46 had previous histories of untreated anal warts. 20 had previous histories of treated Gonorrhea by self-medication and herbs. 21 had untreated boils and rashes around the genitals. 10 clients where living with HIV, and reported untreated penile and rectal gonorrhea. All clients indicated that there were not comfortable discussing STI infections with staff of public hospitals. Conclusion: It is evident that a reasonable number of STI infections among MSM are not completely treated or ignored. This thereby increases the individual’s risk of HIV infection, and cripples HIV prevention programming in Nigeria. HIV programs targeting MSM must incorporate STI syndromic management, so as to increase access to non-stigmatized diagnosis and treatment of STIs. Also, access to STI drugs for clients cannot be overemphasized.

Keywords: MSM, IBBSS, STI, IMH

Procedia PDF Downloads 333

Authors: Sarif Ullah Patwary, Matthew Heinrich, Brandon Payne

Abstract:

The ubiquity of web 2.0 platforms, in the form of wikis, social media (e.g., Facebook, Twitter, etc.) and online review portals (e.g., Yelp), helps shape today’s apparel consumers’ purchasing decision. Online reviews play important role towards consumers’ apparel purchase decision. Each of the consumer reviews carries a sentiment (positive, negative or neutral) towards products. Commercially, apparel brands and retailers analyze sentiment of this massive amount of consumer review data to update their inventory and bring new products in the market. The purpose of this study is to analyze consumer reviews of selected apparel stores with a view to understand, 1) the difference of sentiment expressed through men’s and woman’s text reviews, 2) the difference of sentiment expressed through men’s and woman’s star-based reviews, and 3) the difference of sentiment between star-based reviews and text-based reviews. A total of 9,363 reviews (1,713 men and 7,650 women) were collected using Yelp Dataset Challenge. Sentiment analysis of collected reviews was carried out in two dimensions: star-based reviews and text-based reviews. Sentiment towards apparel stores expressed through star-based reviews was deemed: 1) positive for 3 or 4 stars 2) negative for 1 or 2 stars and 3) neutral for 3 stars. Sentiment analysis of text-based reviews was carried out using Bing Liu dictionary. The analysis was conducted in IPyhton 5.0. Space. The sentiment analysis results revealed the percentage of positive text reviews by men (80%) and women (80%) were identical. Women reviewers (12%) provided more neutral (e.g., 3 out of 5 stars) star reviews than men (6%). Star-based reviews were more negative than the text-based reviews. In other words, while 80% men and women wrote positive reviews for the stores, less than 70% ended up giving 4 or 5 stars in those reviews. One of the key takeaways of the study is that star reviews provide slightly negative sentiment of the consumer reviews. Therefore, in order to understand sentiment towards apparel products, one might need to combine both star and text aspects of consumer reviews. This study used a specific dataset consisting of selected apparel stores from particular geographical locations (the information was not given for privacy concern). Future studies need to include more data from more stores and locations to generalize the findings of the study.

Keywords: apparel, consumer review, sentiment analysis, gender

Procedia PDF Downloads 166

Authors: Erica Fellin, Albrecht Schulte-Hostedde

Abstract:

As the climate warms, the black-legged tick’s (Ixodes scapularis) range expands further north in Ontario, Canada, reaching new host populations that have not previously interacted with this blood-feeding parasite. Peromyscus mice in these northern areas are unfamiliar and inexperienced to the effects of these ticks compared to their southern counterparts that have adapted to living with these organisms. The purpose of this study was to see if there is a difference in physiology between these two groups – deer mice living in areas where tick populations have established and deer mice living in black-legged tick-free environments – looking specifically to see if there is significant variation in hemoglobin levels, which can negatively impact how these mice function in their environment. Along with this, a comparison of the parasite community structure on these mice hosts was analyzed to see if ticks change the composition of these micro-environments. Blood samples were collected from individual mice from populations where black-legged ticks were either present or absent to assess haemoglobin levels. At the same time, ectoparasites were collected from these same mice to determine parasite loads and species diversity. Haemoglobin levels were found to be lower when tick loads were high, and parasite diversity appeared to be higher when ticks were absent. Since black-legged ticks are carriers of many pathogens that can be passed on to humans, including Lyme’s disease, it is important to understand their movement and distribution across Ontario as well as their interactions with their hosts (and co-occurring parasites) in their environments.

Keywords: community ecology, hematology, hosts, parasites

Procedia PDF Downloads 141

Authors: Dewi Liesnoor Setyowati, Puji Hardati, Tri Marhaeni Puji Astuti, Muhammad Amin

Abstract:

Universitas Negeri Semarang (UNNES) is a university with a vision of conservation. The impact of the UNNES conservation is the existence of a positive response from the community for the effort of greening the campus and the planting of conservation value in the academic community. But in reality,  energy consumption in UNNES campus tends to increase. The objectives of the study were to analyze the energy consumption in the campus area, to analyze the absorption of emissions by trees and the awareness of UNNES citizens in reducing emissions. Research focuses on energy consumption, carbon emissions, and awareness of citizens in reducing emissions. Research subjects in this study are UNNES citizens (lecturers, students and employees). The research area covers 6 faculties and one administrative center building. Data collection is done by observation, interview and documentation. The research used a quantitative descriptive method to analyze the data. The number of trees in UNNES is 10,264. Total emission on campus UNNES is 7.862.281.56 kg/year, the tree absorption is 6,289,250.38 kg/year. In UNNES campus area there are still 1,575,031.18 kg/year of emissions, not yet absorbed by trees. There are only two areas of the faculty whose trees are capable of absorbing emissions. The awareness of UNNES citizens in reducing energy consumption is seen in change the habit of: using energy-saving equipment (65%); reduce energy consumption per unit (68%); do energy literacy for UNNES citizens (74%). UNNES leaders always provide motivation to the citizens of UNNES, to reduce and change patterns of energy consumption.

Keywords: energy consumption, carbon emission absorption, emission reduction, energy literation

Procedia PDF Downloads 249

Authors: T. Northcut, A. Rai, N. Perkins

Abstract:

Background: The COVID-19 pandemic has had a serious impact on academia in general and social work education in particular, changing permanently the way in which we approach educating students. The new reality of the pandemic coupled with the much-needed focus on racism across the country inspired and required educators to get creative with their teaching styles in order to disrupt the power imbalance in the classroom and attend to the multiple layers of needs of diverse students in precarious sociological and economic circumstances. This paper highlights research examining educators with distinctive positionalities and approaches to classroom instruction who use feminist and antiracist pedagogies while adapting to online teaching during the pandemic. Despite being feminist scholars, whose ideologies developed during different waves of feminism, our commitment to having student-led classrooms, liberation, and equity of all, and striving for social change, unified our feminist teaching pedagogies as well as provided interpersonal support. Methodology: Following a narrative qualitative inquiry methodology, the five authors of this paper came together to discuss our pedagogical styles and underlying values using Zoom in a series of six conversations. Narrative inquiry is an appropriate method to use when researchers are bound by common stories or personal experiences. The use of feminist pedagogy in the classroom before and during the pandemic guided the discussions. After six sessions, we reached the point of data saturation. All data from the dialogic process was recorded and transcribed. We used in vivo, narrative, and descriptive coding for the data analytic process. Results: Analysis of the data revealed several themes, which included (1) the influence of our positionalities as an intersection of race, sexual orientation, gender, and years of teaching experience in the classroom, (2) the meaning and variations between different liberatory pedagogical approaches, (3) the tensions between these approaches and institutional policies and practices, (4) the role of self-reflection in everyday teaching, (5) the distinctions between theory and practice and its utility for students, and (6) the challenges of applying a feminist-centered pedagogical approach during the pandemic while utilizing an online platform. As a collective, we discussed several challenges that limited the use of our feminist pedagogical approaches due to instruction through Zoom.

Keywords: feminist, pedagogy, COVID, zoom

Procedia PDF Downloads 44

Authors: Gisele Ragusa, Lilian Leung

Abstract:

There are essential needs for science, technology, engineering, and math (STEM) workforces nationally. This important need underscores the necessity of increasing numbers of students attending both two-year community colleges and universities, thereby enabling and supporting a larger pool of students to enter the workforce. The greatest number of students in STEM programs attend public higher education institutions, with an even larger majority beginning their academic experiences enrolled in two-year public colleges. Accordingly, this research explores the impact of experiences and academic support practices on two-year (community) college students’ academic achievement in STEM majors with a focus on supporting students who are the first in their families to attend college. This research is a result of three years of iterative trials of differing supports to improve such students’ academic success with a cross-student comparative research methodological structure involving peer-to-peer and faculty academic supports. Results of this research indicate that background experiences and a combination of peer-to-peer and faculty-led academic support practices, including supplementary instruction, peer mentoring, and study skills support, significantly improve students’ academic success in STEM majors. These results confirm the needs that first-generation students have in navigating their college careers and what can be effective in supporting them.

Keywords: higher education policy, student support, two-year colleges, STEM achievement

Procedia PDF Downloads 97

Authors: E. Happ, A. Albert Tóth

Abstract:

The aim of the research is to investigate the forms of the demands of leisure tourism in a West-Hungarian industrial city, Győr. Today, Győr is still a traditional industrial city, its industry is mainly based on vehicle industry, but the role of tourism is increasing in the life of the city as well. Because of the industrial nature and the strong economy of the city, the ratio of business tourists is high. It can be stated that MICE tourism is dominating in Győr. Developments of the last decade can help the city with new tourism products to increase the leisure tourism. The new types of tourism – besides business tourism – can help the providers to increase the occupancy rates and the demand at the weekends. The research demonstrates the theoretical background of the topic, and it shows the present situation of the tourism in Győr with secondary data. The secondary research contains statistical data from the Hungarian Statistical Office and the city council, and it is based on the providers’ data. The next part of the paper shows the potential types of leisure tourism with the help of primary research. The primary research contains the results of an online questionnaire with a sample of 1000 potential customers. It is completed with 10 in-depth interviews with tourism experts, who explained their opinions about the opportunities of leisure tourism in Győr from the providers’ side. The online questionnaire was filled out in spring 2017 by customers, who have already stayed in Győr or plan to visit the city. At the same time in-depth interviews were made with hotel managers, head of touristic institutions and employees at the council. Based on the research it can be stated that the touristic supply of Győr allows the increase of the leisure tourism ratio in the city. Primarily, the cultural and health tourism show potential development, but the supply side of touristic services can be developed in order to increase the number of guest nights. The tourism marketing needs to be strengthened in the city, and a distinctive marketing activity - from other cities - is needed as well. To conclude, although Győr is an industrial city, it has a transforming industrial part, and tourism is also strongly present in its economy. Besides the leading role of business tourism, different types of leisure tourism have the opportunity to take place in the city.

Keywords: business tourism, Győr, industrial city, leisure tourism, touristic demand

Procedia PDF Downloads 279

Authors: B. S. Premalatha, Mereen Rose Babu, Vaishali Prabhu

Abstract:

Background: Dysphagia must be assessed, either subjectively or objectively, in order to properly address the swallowing difficulty. Providing therapeutic care to patients with dysphagia via tele mode was one approach for providing clinical services during the COVID-19 epidemic. As a result, the teleassessment of dysphagia has increased in India. Aim: This study aimed to identify challenges faced by Indian SLPs while providing teleassessment to individuals with dysphagia during the outbreak of COVID-19 from 2020 to 2021. Method: After receiving approval from the institute's institutional review board and ethics committee, the current study was carried out. The study was cross-sectional in nature and lasted from 2020 to 2021. The study enrolled participants who met the inclusion and exclusion criteria of the study. It was decided to recruit roughly 246 people based on the sample size calculations. The research was done in three stages: questionnaire development and content validation, questionnaire administration. Five speech and hearing professionals' content verified the questionnaire for faults and clarity. Participants received questionnaires via various social media platforms such as e-mail and WhatsApp, which were written in Microsoft Word and then converted to Google Forms. SPSS software was used to examine the data. Results: In light of the obstacles that Indian SLPs encounter, the study's findings were examined. Only 135 people responded. During the COVID-19 lockdowns, 38% of participants said they did not deal with dysphagia patients. After the lockout, 70.4% of SLPs kept working with dysphagia patients, while 29.6% did not. From the beginning of the oromotor examination, the main problems in completing tele evaluation of dysphagia have been highlighted. Around 37.5% of SLPs said they don't undertake the OPME online because of difficulties doing the evaluation, such as the need for repeated instructions from patients and family members and trouble visualizing structures in various positions. The majority of SLPs' online assessments were inefficient and time-consuming. A bigger percentage of SLPs stated that they will not advocate tele evaluation in dysphagia to their colleagues. SLPs' use of dysphagia assessment has decreased as a result of the epidemic. When it came to the amount of food, the majority of people proposed a small amount. Apart from placing the patient for assessment and gaining less cooperation from the family, most SLPs found that Internet speed was a source of concern and a barrier. Hearing impairment and the presence of a tracheostomy in patients with dysphagia proved to be the most difficult conditions to treat online. For patients with NPO, the majority of SLPs did not advise tele-evaluation. In the anterior region of the oral cavity, oral meal residue was more visible. The majority of SLPs reported more anterior than posterior leakage. Even while the majority of SLPs could detect aspiration by coughing, many found it difficult to discern the gurgling tone of speech after swallowing. Conclusion: The current study sheds light on the difficulties that Indian SLPs experience when assessing dysphagia via tele mode, indicating that tele-assessment of dysphagia is still to gain importance in India.

Keywords: dysphagia, teleassessment, challenges, Indian SLP

Procedia PDF Downloads 138

Authors: R. Ueda

Abstract:

Today global society is seeking resilient partnership in local organizations and individuals, which realizes multi-stakeholders relationship. Although it is proposed by modern global framework of sustainable development, it is conceivable that such affiliation can be found out in the traditional local community in Japan, and that traditional spirit is tacitly sustaining in modern context of disaster mitigation in society and economy. Then this research is aiming to clarify and analyze implication for the global world by actual case studies. Regional and urban resilience is the ability of multi-stakeholders to cooperate flexibly and to adapt in response to changes in the circumstances caused by disasters, but there are various conflicts affecting coordination of disaster relief measures. These conflicts arise not only from a lack of communication and an insufficient network, but also from the difficulty to jointly draw common context from fragmented information. This is because of the weakness of our modern engineering which focuses on maintenance and restoration of individual systems. Here local ‘circles’ holistically includes local community and interacts periodically. Focusing on examples of resilient organizations and wisdom created in communities, what can be seen throughout history is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. And the wisdom of a solid and autonomous disaster prevention formed by the historical community called’ Waju’ – an area surrounded by circle embankment to protect the settlement from flood – lives on in government efforts of the coastal industrial island of today. Industrial company there collaborates to create a circle including common evacuation space, road access improvement and infrastructure recovery. These days, people here adopts new interface technology. Large-scale AR- Augmented Reality for more than hundred people is expressing detailed hazard by tsunami and liquefaction. Common experiences of the major disaster space and circle of mutual discussion are enforcing resilience. Collaboration spirit lies in the center of circle. A consistent key point is a virtuous cycle where the information and the knowledge are structured, the context to be adapted becomes clear, and an adaptation at a higher level is made possible, by which the collaboration between organizations is deepened and expanded. This writer believes that both self-governing human organizations and the societal implementation of technical systems are necessary. Infrastructure should be autonomously instituted by associations of companies and other entities in industrial areas for working closely with local governments. To develop advanced disaster prevention and multi-stakeholder collaboration, partnerships among industry, government, academia and citizens are important.

Keywords: industrial recovery, multi-sakeholders, traditional culture, user experience, Waju

Procedia PDF Downloads 113

Authors: Pavel Porubiak, Lukas Kudlacek

Abstract:

Introduction Transplant tourism is a controversial method of obtaining an organ, and that goes all the more for a country such as China, where sources of evidence point out to the possibility of organs being harvested illegally. This research aimed at listing the individual countries these tourists come from, or which medical companies sell transplant related products in there, with China being used as an example. Materials and methods The methodology of scoping study was used for both parts of the research. The countries from which transplant tourists come to China were identified by a search through existing medical studies in the NCBI PubMed database, listed under the keyword ‘transplantation in China’. The search was not limited by any other criteria, but only the studies available for free – directly on PubMed or a linked source – were used. Other research studies on this topic were considered as well. The companies were identified through multiple methods. The first was an online search focused on medical companies and their products. The Bloomberg Service, used by stock brokers worldwide, was then used to identify the revenue of these companies in individual countries – if data were available – as well as their business presence in China. A search through the U.S. Securities and Exchange Commission was done in the same way. Also a search on the Chinese internet was done, and to obtain more results, a second online search was done as well. The results and discussion The extensive search has identified 14 countries with transplant tourists to China. The search for a similar studies or reports resulted in finding additional six countries. The companies identified by our research also amounted to 20. Eight of them are sourcing China with organ preservation products – of which one is just trying to enter the Chinese market, six with immunosuppressive drugs, four with transplant diagnostics, one with medical robots which Chinese doctors use for transplantation as well, and another one trying to enter the Chinese market with a consumable-type product also related to transplantation. The conclusion The question of the ethicality of transplant tourism may be very pressing, since as the research shows, just the sheer amount of participating countries, sourcing transplant tourists to another one, amounts to 20. The identified companies are facing risks due to the nature of transplantation business in China, as officially executed prisoners are used as sources, and widely cited pieces of evidence point out to illegal organ harvesting. Similar risks and ethical questions are also relevant to the countries sourcing the transplant tourists to China.

Keywords: China, illegal organ harvesting, transplant tourism, organ harvesting technology

Procedia PDF Downloads 134

Authors: Jong-Hyo Park, Eunyoung Choi, Jae-Yeon Lim, Seon-Suk Lee, Yeong-Rong Koo, Ji-Ung Kwon, Kyung-Sung Kim, Jong-Ik Lee, Juhan Park, Hyun-Kyu Lee, Won-Kyoung Oh, Jisang Lee, Jiwon Choe

Abstract:

Due to COVID-19, cyber violence among youths has soared as they spend more time online than before. In contrast to the deepening concerns, measurement tools that can assess the vulnerability of cyber violence in individual youths still need to be supplemented. The measurement tools lack consideration of various factors related to cyber violence among youths. Most of the tools are self-report questionnaires, and these adolescents' self-report questionnaire forms can underestimate the harmful behavior and overestimate the damage experience. Therefore, this study aims to develop a multi-report measurement tool for youths that can reliably measure individuals' ecological factors related to cyber violence. The literature review explored factors related to cyber violence, and the questions were constructed. The face validity of the questions was confirmed by conducting focus group interviews. Exploratory and confirmatory factor analyses (N=671) were also conducted for statistical validation. This study developed a multi-report measurement tool for cyber violence with 161 questions, consisting of six domains: online behavior, cyber violence awareness, victimization-perpetration-witness experience, coping efficacy (individuals, peers, teachers, and parents), psychological characteristics, and pro-social capabilities. In addition to self-report from a youth respondent, this measurement tool includes peers, teachers, and parents reporting for the respondent. It is possible to reliably measure the ecological factors of individual youths who are vulnerable or highly resistant to cyber violence. In schools, teachers could refer to the measurement results for guiding students, better understanding their cyber violence conditions, and assessing their pro-social capabilities. With the measurement results, teachers and police officers could detect perpetrators or victims and intervene immediately. In addition, this measurement tool could analyze the effects of the prevention and intervention programs for cyber violence and draw appropriate suggestions.

Keywords: adolescents, cyber violence, cyber violence measurement tool, measurement tool, multi-report measurement tool, youths

Procedia PDF Downloads 101

Authors: Julia Wong, Hua Beng Lim, Cheryl Ho, Gin Jen Gwee, Rachel Tay

Abstract:

In Singapore, a few hospitals and non-governmental social service agencies have been utilising animal-assisted therapy (AAT) in their practice in recent years, although the animals used (e.g., dogs, cats, and horses) and program modality may differ due to the different practice settings, client profiles, and intervention goals. This pilot study explores dog owners’ perceptions of AAT with a focus on examining the enablers and barriers towards volunteering with their dogs in AAT programs in Singapore. A qualitative, thematic analysis study was conducted using in-depth, semi-structured interviews with 16 dog owners. 3 of the dog owners had previous experience volunteering with their dogs serving elderly patients in a community hospital, while the rest of the dog owners had no previous experience volunteering with their dogs. The former group was recruited with the help of the hospital, while the latter group was recruited via word-of-mouth. Dog owners who had volunteering experiences in AAT program versus those who had none differed in their perceptions towards AAT. Dog owners who had volunteered with their dogs in an AAT program in a hospital felt that their volunteering experience were meaningful to patients and to themselves, as they were intrinsically motivated by the desire to serve the community. Those who had not volunteered were hesitant to volunteer with their dogs as they were not comfortable with strangers touching their dogs. They also felt that it would be a huge commitment in terms of time and money; most of them do not own a car as it is uneconomical, and pets are not allowed on Singapore’s public transport systems. This study is limited by its small sample size, and its findings are not generalisable. However, given that volunteers are an invaluable resource in healthcare settings, future studies can examine more stakeholders’ perceptions towards AAT.

Keywords: animal-assisted therapy, dog-assisted therapy, volunteers, complementary therapy

Procedia PDF Downloads 100

Authors: Christian Perrin, Nicholas Blagden, Louise Allen, Sarah Impey

Abstract:

Social workers in the UK and professionals globally are faced with a particular challenge when dealing with allegations of child sexual abuse (CSA) in the community. In the absence of a conviction or incontestable evidence, staff can often find themselves unable to take decisive action to remove a child from harm, even though there may be a credible threat to their welfare. Conversely, practitioners may over-calculate risk through fear of being accountable for harm. This is, in part, due to the absence of a structured and evidence-based risk assessment tool which can predict the likelihood of a person committing child sexual abuse. Such assessments are often conducted by forensic professionals who utilise offence-specific data and personal history information to calculate risk. In situations where only allegations underpin a case, this mode of assessment is not viable. There are further ethical issues surrounding the assessment of risk in this area which require expert consideration and sensitive planning. This paper explores this entangled problem extant in the wider call to prevent sexual and child sexual abuse in the community. To this end, 32 qualitative interviews were undertaken with social workers dealing with CSA cases. Results were analysed using thematic analysis and operationalised to formulate a risk and protection protocol for use in case management. This paper reports on the early findings associated with the initial indications of protocol reliability. Implications for further research and practice are discussed.

Keywords: sexual offending, child sexual offence, offender rehabilitation, risk assessment, offence prevention

Procedia PDF Downloads 109

Authors: E Tambo, O. O. Olalubi, E. C. Ugwu, J. Y. Ngogang

Abstract:

Despite the World Health Organization (WHO) declaration of international health emergency concern, the status quo of responses and efforts to stem the worst-recorded Ebola epidemic Ebola outbreak is still precariously inadequate in most of the affected in West. Mining natural resources have been shown to play a key role in both motivating and fuelling ethnic, civil and armed conflicts that have plagued a number of African countries over the last decade. Revenues from the exploitation of natural resources are not only used in sustaining the national economy but also armies, personal enrichment and building political support. Little is documented on the mining and ecological impact on the emergence and geographical distribution of Ebola in Africa over time and space. We aimed to provide a better understanding of the interconnectedness among issues of mining natural, resource management, mining conflict and post-conflict on Ebola outbreak and how wealth generated from abundant natural resources could be better managed in promoting research and development towards strengthening environmental, socioeconomic and health systems sustainability on Ebola outbreak and other emerging diseases surveillance and responses systems prevention and control, early warning alert, durable peace and sustainable development rather than to fuel conflicts, resurgence and emerging diseases epidemics in the perspective of community and national/regional approach. Our results showed the first assessment of systematic impact of all major minerals conflict events diffusion over space and time and mining activities on nine Ebola genesis and geo-distribution in affected countries across Africa. We demonstrate how, where and when mining activities in Africa increase ecological degradation, conflicts at the local level and then spreads violence across territory and time by enhancing the financial capacities of fighting groups/ethnics and diseases onset. In addition, led process of developing minimum standards for natural resource governance; improving governmental and civil society capacity for natural resource management, including the strengthening of monitoring and enforcement mechanisms; understanding the post-mining and conflicts community or national reconstruction and rehabilitation programmes in strengthening or developing community health systems and regulatory mechanisms. In addition the quest for the control over these resources and illegal mining across the landscape forest incursion provided increase environmental and ecological instability and displacement and disequilibrium, therefore affecting the intensity and duration of mining and conflict/wars and episode of Ebola outbreaks over time and space. We highlight the key findings and lessons learnt in promoting country or community-led process in transforming natural resource wealth from a peace liability to a peace asset. The imperative necessity for advocacy and through facilitating intergovernmental deliberations on critical issues and challenges affecting Africa community transforming exploitation of natural resources from a peace liability to outbreak prevention and control. The vital role of mining in increasing government revenues and expenditures, equitable distribution of wealth and health to all stakeholders, in particular local communities requires coordination, cooperative leadership and partnership in fostering sustainable developmental initiatives from mining context to outbreak and other infectious diseases surveillance responses systems in prevention and control, and judicious resource management.

Keywords: mining, mining conflicts, mines, ecological, Ebola, outbreak, mining companies, miners, impact

Procedia PDF Downloads 302

Authors: Eija Raatikainen

Abstract:

The aim of the study is to examine psychological safety in the context of change in working life and continuous learning in social- and educational organizations. The participants in the study are social workers and vocational teachers working as employees and supervisors in the capital region of Finland (public and private sectors). Research data has been collected during 2022-2023 using the qualitative method called empathy-based stories (MEBS). Research participants were asked to write short stories about situations related to their work and work community. As researchers, we created and varied the framework narratives (MEBS) in line with the aim of the study and theoretical background. The data were analyzed with content analysis. According to the results, the barriers and prerequisites for psychological safety at work could be located in four different working culture dimensions. The work culture dimensions were named as follows: 1) a work culture focusing on interaction and emotional culture between colleagues, 2) communal work culture, 3) a work culture that enables learning, and 4) a work culture focused on structures and operating models. All these have detailed elements of barriers and prerequisites of psychological safety at work. The results derived from the enlivening methods can be utilized when working with the work community and have discussed psychological safety at work. Also, the method itself (MEBS) can prevent open discussion and reflection on psychological safety at work because of the sensitivity of the topic. Method aloud to imagine, not just talk and share your experiences directly. Additionally, the results of the study can offer one tool or framework while developing phycological safety at work.

Keywords: psychological safety, empathy, empathy-based stories, working life

Procedia PDF Downloads 72

Authors: Arya Sarukkai

Abstract:

Due to increased technological advances and the high use of phones, tablets, computers, and other electronics, we continue to see rapid growth in the volume of e-waste. There are millions just throwing out their old devices, millions who have many devices and don’t know what to do with them, and there are millions who would benefit from receiving those devices. The thesis of this paper is that by creating an ecosystem of donors and recipients and providing the right incentives, we can reduce e-waste. We discuss a system for sustainable e-waste by building a marketplace between donors and recipients. We also summarize experimental results comparing different incentives and present a live web service that allows for e-waste supplies to reach schools and nonprofit institutions.

Keywords: E-waste ecosystems, marketplaces, e-waste web app, online services

Procedia PDF Downloads 197

Authors: Sara Shuger Fox, Oscar Reynaga

Abstract:

This session explains the process and lessons learned as Central College (USA) faculty and staff developed undergraduate research opportunities within the model of a short-term faculty-led study abroad program in Costa Rica. The program in Costa Rica increases access to research opportunities across the disciplines and was developed by faculty from English, Biology, and Exercise Science. Session attendees will benefit from learning how faculty and staff navigated the program proposal process at a small liberal arts college and, in particular, how the program was built to be inclusive of departments with lower enrollment, like those currently seen in the humanities. Vital to this last point, presenters will explain how they negotiated issues of research supervision and disciplinary authority in such a way that the program is open to students from multiple disciplines without forcing the program budget to absorb costs for multiple faculty supervisors traveling and living in-country. Additionally, session attendees will learn how scouting laid the groundwork for mutually beneficial relationships between the program and the communities with which it collaborates. Presenters will explain how they built a coalition of students, faculty advisors, study abroad staff and local research hosts to support the development of research questions that are of value not just to the students, but to the community in which the research will take place. This program also incorporates principles of fair-trade learning by intentionally reporting research findings to local community members, as well as encouraging students to proactively share their research as a way to connect with local people.

Keywords: Costa Rica, research, sustainability, transdisciplinary

Procedia PDF Downloads 1060

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

Procedia PDF Downloads 164

Authors: Haresh Sharma, Jaimini Luharia

Abstract:

The ecology in the Western Himalayan region transforms with the change in altitude. This change is observed in terms of topography, species of flora and fauna and the quality of the soil. The current study focuses on women of indigenous communities of Pangi Valley, which is located in the state of Himachal Pradesh, India. The valley is bifurcated into three different areas –Saichu, Hudan Bhatori, and Sural Bhatori valleys. It is one of the most remote, rugged and difficult to access tribal regions of Chamba district. The altitude of the valley ranges from 2,000 m to 6,000 m above sea level. The Pangi valley is inhabited by ‘Pangwals’ and ‘Bhots’ tribes of the Himalayas who speak their local tribal language called’ Pangwali’. The valley is cut-off from the mainland due to heavy snow and lack of proper roads during peak winters. Due to difficult geographical location, the daily lives of the people are constantly challenged, and they are most of the times deprived of benefits targeted through government programs. However, the indigenous communities earn their livelihood through livestock and forest-based produce while some of them migrate to nearby places for better work. The current study involves snowball sampling methodology for data collection along with in-depth interviews of women members of Self-Help Groups and women farmers. The findings reveal that the lives of these indigenous communities largely depend on forest-based products. So, it creates all the more significance of enhancing, maintaining, and consuming natural resources sustainably. Under such circumstances, the women of the community play a significant role of guardians in conservation and protection of the forests. They are the custodians of traditional knowledge of environment conservation practices that have been followed for many years in the region. The present study also sought to establish a relationship between some of the development initiatives undertaken by the women in the valley that stimulate sustainable mountain economy and conservation practices. These initiatives include cultivation of products like hazelnut, ‘Gucchi’ rare quality mushroom, medicinal plants exclusively found in the region, thereby promoting long term sustainable conservation of agro-biodiversity of the Western Himalayan region. The measures taken by the community women are commendable as they ensure access and distribution of natural resources as well as manage them for future generations. Apart from this, the tribal women have actively formed Self-Help Groups promoting financial inclusion through various activities that augment ownership and accountability towards the overall development of the communities. But, the results also suggest that there’s not enough recognition given to women’s role in forests conservation practices due to several local socio-political reasons. There are not enough research studies done on communities of Pangi Valley due to inaccessibility created out of lack of proper roads and other resources. Also, there emerged a need to concretize indigenous and traditional knowledge of conservation practices followed by women in the community.

Keywords: forest conservation, indigenous community women, sustainable livelihoods, sustainable development, poverty alleviation, Western Himalayas

Procedia PDF Downloads 120

Authors: Muhammad Imran Nisar, Fyezah Jehan, Tauseef Akhund, Sadia Shakoor, Kanwal Nayani, Furqan Kabir, Asad Ali, Anita Zaidi

Abstract:

Pneumococcal Vaccine -10 (PCV 10) was included in the Expanded Program of immunization (EPI) in Sindh, Pakistan in February 2013. This study was carried out immediately before the introduction of PCV 10 to establish baseline pneumococcal carriage and prevalent serotypes in naso-pharynx of children 3-11 months of age in an urban and rural community in Sindh, Pakistan. An additional sample of children aged 12 to 59 months was drawn from the urban community. Nasopharyngeal specimens were collected from a random sample of children. Samples were processed in a central laboratory in Karachi. Pneumococci were cultured on 5% Sheep Blood Agar and serotyping was performed using CDC standardized sequential multiplex PCR assay on bacterial colonies. Serotypes were then categorized into vaccine (PCV-10 and PCV-13) type and non-vaccine types. A total of 670 children were enrolled. Carriage rate for pneumococcus based on culture positivity was 74% and 79.5 % in the infant group in Karachi and Matiari respectively. Carriage rate was 78.2% for children aged 12 to 59 months in Karachi. Proportion of PCV 10 serotypes in infants was 38.8% and 33.5% in Karachi and Matiari respectively. In the older age group in Karachi, the proportion was 30.6%. Most common serotypes were 6A, 6B, 23F, 19A and 18C. This survey establishes vaccine and non-vaccine serotype carriage rate in a vaccine-naïve pediatric population among rural and urban communities in Sindh province. Annually planned surveys in the same communities will inform change in carriage rate after the introduction and uptake of PCV 10 in these communities.

Keywords: Naso-Pharyngeal carriage, Pakistan, PCV10, Pneumococcus

Procedia PDF Downloads 301

Authors: Kornanong Yuenyongchaiwat, Duangnate Pepatsitipong, Panthip Sangprasert

Abstract:

High blood pressure and diabetes have been suggested as being non-communicable disease (NCDs), and there is one of the components of the definition of metabolic syndrome. Therefore, the purpose of this study was to evaluate the effect of a 12-week pedometer based community walking intervention on change in resting blood pressure and blood glucose in participants with overweight in the community setting. Method: Participants were recruited both males and females who had a sedentary lifestyle aged 35-59 years (mean aged 49.67 years). A longitudinal quasi-experimental study was designed with 35 overweight participants who had body mass index ≥ 25 kg/m2. These volunteers were assigned to the 12-week pedometer-based walking program (an accumulated at least 10,000 steps a day). Blood pressure and blood glucose were measured initially before and after 12-week intervention. Results: Systolic blood pressure and heart rate were significantly lower in 30 individuals who had accumulated 10,000 steps d-1 in the intervention group at 12 week follow-up (-13.74 mmHg and 5.3 bpm, respectively). In addition, reduction in blood glucose (-14.89 mmol) in the intervention participants was statistically significant (p < .001). A regression analysis indicated that reductions in systolic blood pressure were significantly related to the increase in steps per day. Conclusion: The accumulation of least 10,000 steps d-1 resulted in decreased resting systolic blood pressure and blood glucose in overweight participants. This has also shown that an increase in physical activity in overweight participants with sedentary lifestyle by accumulating at least 10,000 steps a day can reduce the risk of cardiovascular disease (e.g., hypertension and diabetes).

Keywords: blood glucose, blood pressure, diabetes, hypertension, physical activity, walking

Procedia PDF Downloads 280

Authors: Lee Bih Ni

Abstract:

This paper discusses that good learning involves all academic groups in the school. Blended learning is learning outside the classroom. Google Classroom is a free service learning app for schools, non-profit organizations and anyone with a personal Google account. Facilities accessed through computers and mobile phones are very useful for school teachers and students. Blended learning classrooms using both traditional and technology-based methods for teaching have become the norm for many educators. Using Google Classroom gives students access to online learning. Even if the teacher is not in the classroom, the teacher can provide learning. This is the supervision of the form of the teacher when the student is outside the school.

Keywords: blended learning, learning app, google classroom, schools

Procedia PDF Downloads 146

Authors: Daniel Angwenyi

Abstract:

Relationships between protected area managers and adjacent communities, as well as communities' attitudes, views and perceptions of these areas, are critical for the success of conservation efforts. It is, therefore, of utmost importance for protected area managers and administrators understand how local communities view these areas and their management, so that they can build sustainable working relationships. This paper is based on a survey of 375 semi-structured questionnaires administered to household heads, living at distances ranging from the edge of the reserves to 50 km away from the reserve boundary across Great Fish River, Mkambati, Hluleka, and Tsolwana in the Eastern Cape Province, South Africa. The paper provides a longitudinal assessment of households’ knowledge on the role of reserves and how the reserves. In addition to households’ knowledge, the paper also provides an assessment of their attitudes towards the location and management, as well as views on the best way to manage the reserves. For 79% of community members reserves are important as they were seen to conserve biodiversity and valuable ecological systems necessary for sustaining life. Most (75%) respondents indicated that closely located reserves gave them opportunities to learn about nature conservation and to subsidize their incomes through tourism ventures. However, 58% had a problem with reserves’ staff, due to restrictions on resource use, which negatively impacted their livelihoods. Over half (51%) of the households were of the view that sustainable conservation can only be achieved through an integrated approach, where local communities’ and conservation needs are given equal weighting. Thus, it is concluded that reserve management should look at communities as active partners in the running of protected areas if sustainable conservation objectives are to be realised.

Keywords: nature conservation, conservation knowledge, local communities, views, protected areas

Procedia PDF Downloads 147

Authors: E. O. Aluta, C. A. Booth, D. G. Proverbs, T. Appleby

Abstract:

Challenges in the effective management of potable water have attracted global attention in recent years and remain many world regions’ major priorities. Scarcity and unavailability of potable water may potentially escalate poverty, obviate democratic expression of views and militate against inter-sectoral development. These challenges contra-indicate the inherent potentials of the resource. Thus, while creation of poverty may be regarded as a broad-based problem, it is capable of reflecting life-span reduction diseases, the friction of interests manifesting in threats and warfare, the relegation of democratic principles for authoritarian definitions and Human Rights abuse. The challenges may be identified as manifestations of ineffective management of potable water resource and therefore, regarded as major problems in environmental protection. In reaction, some nations have re-examined their laws and policies, while others have developed innovative projects, which seek to ameliorate difficulties of providing sustainable potable water. The problems resonate in Nigeria, where the legal framework supporting the supply and management of potable water has been criticized as ineffective. This has impacted more on rural community members, often regarded as ‘voiceless’. At that level, the participation of non-state actors has been identified as an effective strategy, which can improve water supply. However, there are indications that there is no pragmatic application of this, resulting in over-centralization and top-down management. Thus, this study focuses on how the participatory process may enable the development of participatory water governance framework, for use in Nigeria rural communities. The Rural Advisory Board (RAB) is proposed as a governing body to promote proximal relationships, institute democratisation borne out of participation, while enabling effective accountability and information. The RAB establishes mechanisms for effectiveness, taking into consideration Transparency, Accountability and Participation (TAP), advocated as guiding principles of decision-makers. Other tools, which may be explored in achieving these are, Laws and Policies supporting the water sector, under the direction of the Ministries and Law Courts, which ensure non-violation of laws. Community norms and values, consisting of Nigerian traditional belief system, perceptions, attitude and reality (often undermined in favour of legislations), are relied on to pave the way for enforcement. While the Task Forces consist of community members with specific designation of duties, which ensure compliance and enforceability, a cross-section of community members are assigned duties. Thus, the principle of participation is pragmatically reflected. A review of the literature provided information on the potentials of the participatory process, in potable water governance. Qualitative methodology was explored by using the semi-structured interview as strategy for inquiry. The purposive sampling strategy, consisting of homogeneous, heterogeneous and criterion techniques was applied to enable sampling. The samples, sourced from diverse positions of life, were from the study area of Delta State of Nigeria, involving three local governments of Oshimili South, Uvwie and Warri South. From the findings, there are indications that the application of the participatory process is inhered with empowerment of the rural community members to make legitimate demands for TAP. This includes the obviation of mono-decision making for the supply and management of potable water. This is capable of restructuring the top-down management to a top-down/bottom-up system.

Keywords: participation, participatory process, participatory water governance, rural advisory board

Procedia PDF Downloads 386

Authors: Zelalem Markos Borko

Abstract:

The quality of life of people with blindness is significantly influenced by the level of resilience they possess. A qualitative approach of the descriptive phenomenological design was employed to address basic study objectives. The researcher purposely selected three blind graduate students from Sidist Kilo Campus and conducted a semi-structured interview to gather data. Data were analyzed by using thematic coding techniques. The present study found that personal characteristics such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication have shaped resiliency for successful university students with visual disabilities. The finding showed that the school environment is the place in which blind students had developed/experienced social, psychological, and economical competency and hope for their academic and entire life success. Furthermore, the finding showed that blind students had experienced individual, family, school, and community-related risks in the success track. Therefore, governmental and non-governmental organizations should provide training for students with visual impairments that focus on the individual traits that shape resilience for academic success, such as commitment, living hope, motivation, positive self-esteem, self-confidence, and communication and also community-oriented training should be to break the social stigma and discriminations for the individuals with the visual impairment.

Keywords: blind students, risk and protective factors, lived experience, success

Procedia PDF Downloads 81

Authors: Siuzan Uorner

Abstract:

The era of late modernity is characterized, on the one hand, by social disintegration, values of personal freedom, tolerance, and self-expression. Boundaries between the accessible and the elitist, normal and abnormal are blurring. On the other hand, traditional social institutions, such as religion (especially Russian Orthodox Church), exist, criticizing lifestyle and worldview other than conventionally structured canons. Despite the declared values and opportunities in late modern society, people's freedom is ambivalent. Personal identity and its aspects are becoming a subject of choice. Hence, combinations of identity aspects can be incompatible. Our theoretical framework is based on P. Ricoeur's concept of narrative identity and hermeneutics, E. Goffman’s theory of social stigma, self-presentation, discrepant roles and W. James lectures about varieties of religious experience. This paper aims to reconstruct ways of coping with incompatible identities of Orthodox gays (an extreme sampling of a combination of sexual orientation and religious identity in a heteronormative society). This study focuses on the discourse of Orthodox gay parishioners and ROC gay priests in Russia (sampling ‘hard to reach’ populations because of the secrecy of gay community in ROC and sensitivity of the topic itself). We conducted a qualitative research design, using in-depth personal semi-structured online-interviews. Recruiting of informants took place in 'Nuntiare et Recreare' (Russian movement of religious LGBT) page in VKontakte through the post with an invitation to participate in the research. In this work, we analyzed interview transcripts using axial coding. We chose the Grounded Theory methodology to construct a theory from empirical data and contribute to the growing body of knowledge in ways of harmonizing incompatible identities in late modern societies. The research has found that there are two types of conflicts Orthodox gays meet with: canonic contradictions (postulates of Scripture and its interpretations) and problems in social interaction, mainly with ROC priests and Orthodox parishioners. We have revealed semantic meanings of most commonly used words that appear in the narratives (words such as ‘love’, ‘sin’, ‘religion’ etc.). Finally, we have reconstructed biographical patterns of LGBT social movements’ involvement. This paper argues that all incompatibilities are harmonizing in the narrative itself. As Ricoeur has suggested, the narrative configuration allows the speaker to gather facts and events together and to compose causal relationships between them. Sexual orientation and religious identity are getting along and harmonizing in the narrative.

Keywords: gay priests, incompatible identities, narrative identity, Orthodox gays, religious identity, ROC, sexual orientation

Procedia PDF Downloads 137

Authors: R. Tariq, R. Lee

Abstract:

Background: Additional demands placed on senior clinical teams with ongoing COVID-19 management has accelerated the need to harness the wider healthcare professional resources and upskill them to take on greater clinical responsibility safely. The UK NHS Long Term Plan (2019)¹ emphasises the importance of expanding Advanced Practitioners’ (APs) roles to take on more clinical diagnostic responsibilities to cope with increased demand. In acute settings, APs are often the first point of care for patients and require training to take on initial triage responsibilities efficiently and safely. Critically, their roles include determining which onward services the patients may require, and assessing whether they can be treated at home, avoiding unnecessary admissions to the hospital. Dem Dx is a Clinical Reasoning Platform (CRP) that claims to help frontline healthcare professionals independently assess and triage patients. It guides the clinician from presenting complaints through associated symptoms to a running list of differential diagnoses, media, national and institutional guidelines. The objective of this study was to compare the clinical referral rates and guidelines adherence registered by the HMR Urgent Community Care Team (UCCT)² and Dem Dx recommendations using retrospective cases. Methodology: 192 cases seen by the UCCT were anonymised and reassessed using Dem Dx clinical pathways. We compared the UCCT’s performance with Dem Dx regarding the appropriateness of onward referrals. We also compared the clinical assessment regarding adherence to NICE guidelines recorded on the clinical notes and the presence of suitable guidance in each case. The cases were audited by two medical doctors. Results: Dem Dx demonstrated appropriate referrals in 85% of cases, compared to 47% in the UCCT team (p<0.001). Of particular note, Dem Dx demonstrated an almost 65% (p<0.001) improvement in the efficacy and appropriateness of referrals in a highly experienced clinical team. The effectiveness of Dem Dx is in part attributable to the relevant NICE and local guidelines found within the platform's pathways and was found to be suitable in 86% of cases. Conclusion: This study highlights the potential of clinical decision support, as Dem Dx, to improve the quality of onward clinical referrals delivered by a multidisciplinary team in primary care. It demonstrated that it could support healthcare professionals in making appropriate referrals, especially those that may be overlooked by providing suitable clinical guidelines directly embedded into cases and clear referral pathways. Further evaluation in the clinical setting has been planned to confirm those assumptions in a prospective study.

Keywords: advanced practitioner, clinical reasoning, clinical decision-making, management, multidisciplinary team, referrals, triage

Procedia PDF Downloads 149

Authors: Atucungwiire Rwebiita

Abstract:

Introduction: In Uganda, provision of adolescent sexual reproductive health and rights (SRHR) services for key population is still hindered by negative attitudes, stigma and discrimination (S&D) at both the community and facility levels. To address this barrier, Integrated Community Based Initiatives (ICOBI) with support from SIDA is currently implementing a quality improvement (QI) innovative approach for strengthening the capacity of key population (KP) peer leaders and health workers to deliver friendly SRHR services without S&D. Methods: Our innovative approach involves continuous mentorship and coaching of 8 QI teams at 8 health facilities and their catchment areas. Each of the 8 teams (comprised of 5 health workers and 5 KP peer leaders) are facilitated twice a month by two QI Mentors in a 2-hour mentorship session over a period of 4 months. The QI mentors were provided a 2-weeks training on QI approaches for reducing S&D against young key populations in the delivery of SRHR Services. The mentorship sessions are guided by a manual where teams base to analyse root causes of S&D and develop key performance indicators (KPIs) in the 1st and 2nd second sessions respectively. The teams then develop action plans in the 3rd session and review implementation progress on KPIs at the end of subsequent sessions. The KPIs capture information on the attitude of health workers and peer leaders and the general service delivery setting as well as clients’ experience. A dashboard is developed to routinely track the KPIs for S&D across all the supported health facilities and catchment areas. After 4 months, QI teams share documented QI best practices and tested change packages on S&D in a learning and exchange session involving all the teams. Findings: The implementation of this approach is showing positive results. So far, QI teams have already identified the root causes of S&D against key populations including: poor information among health workers, fear of a perceived risk of infection, perceived links between HIV and disreputable behaviour. Others are perceptions that HIV & STIs are divine punishment, sex work and homosexuality are against religion and cultural values. They have also noted the perception that MSM are mentally sick and a danger to everyone. Eight QI teams have developed action plans to address the root causes of S&D. Conclusion: This approach is promising, offers a novel and scalable means to implement stigma-reduction interventions in facility and community settings.

Keywords: key populations, sexual reproductive health and rights, stigma and discrimination , quality improvement approach

Procedia PDF Downloads 173