Search results for: accessibility score

Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

Abstract:

Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

Procedia PDF Downloads 222

Authors: Cristy Stagnar, Nina Hubig, Diana Ivankovic

Abstract:

The epigenome is a compelling candidate for mediating long-term responses to environmental effects modifying disease risk. The main goal of this research is to develop a machine learning-based DNA methylation score, which will be valuable in delineating the unique contribution of paternal epigenetic modifications to the germline impacting childhood health outcomes. It will also be a useful tool in validating self-reports of nonsmoking and in adjusting epigenome-wide DNA methylation association studies for this early-life exposure. Using secondary data from two population-based methylation profiling studies, our DNA methylation score is based on CpG DNA methylation measurements from cord blood gathered from children whose fathers smoked pre- and peri-conceptually. Each child’s mother and father fell into one of three class labels in the accompanying questionnaires -never smoker, former smoker, or current smoker. By applying different machine learning algorithms to the accessible resource for integrated epigenomic studies (ARIES) sub-study of the Avon longitudinal study of parents and children (ALSPAC) data set, which we used for training and testing of our model, the best-performing algorithm for classifying the father smoker and mother never smoker was selected based on Cohen’s κ. Error in the model was identified and optimized. The final DNA methylation score was further tested and validated in an independent data set. This resulted in a linear combination of methylation values of selected probes via a logistic link function that accurately classified each group and contributed the most towards classification. The result is a unique, robust DNA methylation score which combines information on DNA methylation and early life exposure of offspring to paternal smoking during pregnancy and which may be used to examine the paternal contribution to offspring health outcomes.

Keywords: epigenome, health outcomes, paternal preconception environmental exposures, supervised machine learning

Procedia PDF Downloads 185

Authors: Jana Atteah, Wid Jan, Yara AlHibshi, Rahaf AlRougi

Abstract:

Anyword is an AI copywriting tool that helps marketers create effective campaigns for specific audiences. It offers a wide range of templates for various platforms, brand voice guidelines, and valuable analytics insights. Anyword is used by top global companies and has been recognized as one of the "Fastest Growing Products" in the 2023 software awards. A recent study examined the utilization and impact of AI-powered writing tools, specifically focusing on the adoption of AI in writing pursuits and the use of the Anyword platform. The results indicate that a majority of respondents (52.17%) had not previously used Anyword, but those who had were generally satisfied with the platform. Notable productivity improvements were observed among 13% of the participants, while an additional 34.8% reported a slight increase in productivity. A majority (47.8%) maintained a neutral stance, suggesting that their productivity remained unaffected. Only a minimal percentage (4.3%) claimed that their productivity did not improve with the usage of Anyword AI. In terms of the quality of written content generated, the participants responded positively. Approximately 91% of participants gave Anyword AI a score of 5 or higher, with roughly 17% giving it a perfect score. A small percentage (approximately 9%) gave a low score between 0-2. The mode result was a score of 7, indicating a generally positive perception of the quality of content generated using Anyword AI. These findings suggest that AI can contribute to increased productivity and positively influence the quality of written content. Further research and exploration of AI tools in writing pursuits are warranted to fully understand their potential and limitations.

Keywords: artificial intelligence, marketing platforms, productivity, user interface

Procedia PDF Downloads 63

Authors: Hatem A. El-Mezayen, Ahmed Abdelmajeed, Fatehya Metwally, Usama Elsaly, Salwa Atef

Abstract:

Tumor metastasis involves the dissemination of malignant cells into the basement membrane and vascular system contributes to the circulating pool of these markers. In this context our aim has been focused on development of a non-invasive. Circulating tumor cells (CTCs) represent a unique liquid biopsy carrying comprehensive biological information of the primary tumor. Herein, we sought to develop a novel score based on the combination of the most significant CTCs biomarkers with and routine laboratory tests for accurate detection of metastatic breast cancer. Methods: Cytokeratin 18 (CK18), Cytokeratin 19 (CK19), and CA15.3 were assayed in metastatic breast cancer (MBC) patients (75), non-MBC patients (50) and healthy control (20). Results: Areas under receiving operating curve (AUCs) were calculated and used for construction on novel score. A novel score named MBC-CTCs = CA15.3 (U/L) × 0.08 + CK 18 % × 2.9 + CK19 × 3.1– 510. That function correctly classified 87% of metastatic breast cancer at cut-off value = 0.55. (i.e great than 0.55 indicates patients with metastatic breast cancer and less than 0.55 indicates patients with non-metastatic breast cancer). Conclusion: MBC-CTCs is a novel, non-invasive and simple can applied to discriminate patients with metastatic breast cancer.

Keywords: metastatic breast cancer, circulating tumor cells, cytokeratin, EpiCam

Procedia PDF Downloads 214

Authors: Eva Kirzner

Abstract:

Based on outcome studies published over the past two decades, in 2018, the ACC/AHA published new guidelines for the management of hypercholesterolemia that incorporate the use of coronary artery calcium (CAC) scanning as a decision tool for ascertaining which patients may benefit from statin therapy. This use is based on the recognition that the absence of calcium on CAC scanning (i.e., a CAC score of zero) usually signifies the absence of significant atherosclerotic deposits in the coronary arteries. Specifically, in patients with a high risk for atherosclerotic cardiovascular disease (ASCVD), initiation of statin therapy is generally recommended to decrease ASCVD risk. However, among patients with intermediate ASCVD risk, the need for statin therapy is less certain. However, there is a need for new outcome studies that provide evidence that the management of hypercholesterolemia based on these new ACC/AHA recommendations is safe for patients. Based on a Pub-Med and Google Scholar literature search, four relevant population-based or patient-based cohort studies that studied the relationship between CAC scanning, risk assessment or mortality, and statin therapy that were published between 2017 and 2021 were identified (see references). In each of these studies, patients were assessed for their baseline risk for atherosclerotic cardiovascular disease (ASCVD) using the Pooled Cohorts Equation (PCE), an ACC/AHA calculator for determining patient risk based on assessment of patient age, gender, ethnicity, and coronary artery disease risk factors. The combined findings of these four studies provided concordant evidence that a zero CAC score defines patients who remain at low clinical risk despite the non-use of statin therapy. Thus, these new studies confirm the use of CAC scanning as a safe tool for reducing the potential overuse of statin therapy among patients with zero CAC scores. Incorporating these new data suggest the following best practice: (1) ascertain ASCVD risk according to the PCE in all patients; (2) following an initial attempt trial to lower ASCVD risk with optimal diet among patients with elevated ASCVD risk, initiate statin therapy for patients who have a high ASCVD risk score; (3) if the ASCVD score is intermediate, refer patients for CAC scanning; and (4) and if the CAC score is zero among the intermediate risk ASCVD patients, statin therapy can be safely withheld despite the presence of an elevated serum cholesterol level.

Keywords: cholesterol, cardiovascular disease, statin therapy, coronary calcium

Procedia PDF Downloads 115

Authors: Khalid Al Saleh, Najlaa AlSayed

Abstract:

Background: Palliative care is changing from just ‘end of life care’ to care delivered earlier in the disease course. Metanalysis showed that Palliative Performance Scale (PPS) is associated with increased length of survival. The Palliative Care Center (PCC) in Kuwait is the only stand-alone center in Eastern Mediterranean Region with a capacity of 92 beds. We compared clinical characteristics between patients referred from the Specialized Cancer Center and general hospitals in Kuwait to PCC. Method: A cross Sectional survey was conducted since the opening of PCC in January 2011 to June 2013. Patients’ data on demographics, type of the cancer, PPS score and referring hospital were collected and analyzed. Results: Total number of the patients was 142. Mean age was 61.05±14.79 years, 66 patients (47.1%) were males and 74 (52.9%) were females. The most common cancers in males were lung (n=18, 27.3%) followed by head and neck cancers (n=8, 12.1%) and brain tumors (n=7, 10.6%) while in females, the most common cancers were breast cancer (n=12, 16.7%) followed by ovarian cancer (n=10, 13.9%) and Cancer Colon (n=8, 11.1%). Patients with PPS score 30% were 27.9% (n=39), 40% in 40.7% (n=57), and 50% in 17.1% (n=24) respectively. Patients referred from the Specialized Cancer Center had significantly higher portion of patients with PPS score > 30% (73.4%, n=94), compared to patients coming from general hospitals (33.3%, n=4), P value= 0.007. Conclusion: There is significant difference in PPS scores between patients referred from the Specialized Cancer Center compared to patients referred from general hospitals. We encourage that all cancer patients should be treated in Specialized Cancer Centers and earlier involvement of Palliative Care Centers to achieve better survival. Training workshops are needed for health care professionals working in general hospitals to raise awareness about earlier referral of patients to palliative care services.

Keywords: palliative care, kuwait, performance scale differences, pps score, specialized hospitals

Procedia PDF Downloads 305

Authors: Manar Aslan, Ayse Yildiz

Abstract:

The study was conducted descriptively to assess their hospital institutionalization of upper and mid-level managers of 18 hospitals affiliated to Public Hospitals Association. In its simplest form institutionalization is whatever the subject matter, is dominated by the rules of articulated and determined behavior in all kinds of business, interaction, and communication. Hospital service is a type of service carried out chained together. It should not be forgotten that this kind of services is carried out without barrier, and who and what to do with definite lines, hospital management is a process, and this process can be achieved through institutionalization. With the establishment of the Public Hospitals Unions in Turkey, all the state hospitals in the provinces have been gathered under this roof. One of the goals is to establish control mechanisms to ensure that hospitals reach pre-determined financial, medical, and administrative standards. In this way, the preparations for the institutionalization of units and hospital enterprises will be completed. The data of the study were collected by institutionalization management attitude scale (cronbach alpha: 0.98) of composed of 5 sub-dimensions and 52 questions in 18 hospitals’ managers (N=310) in the largest province in Turkey. The results of the study revealed that the total score taken by managers at the institutionalization scale was 200.80, and this was close to the maximum score. In addition, it was determined that the difference between the mean score of the scale and its sub-dimensions with the gender, the hospitals, and the management position.

Keywords: institutionalization, hospital, manager, evaluation

Procedia PDF Downloads 225

Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to secondhand smoke in women. Materials and Methods: This experimental study was performed in 2023in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to secondhand smoke.

Keywords: women, health behaviour, smoke, belive

Procedia PDF Downloads 54

Authors: Atiwit Sinyoo, Sekh Thanprasertsuk, Sithiporn Agthong, Pasakorn Watanatada, Shaun Peter Qureshi, Saknan Bongsebandhu-Phubhakdi

Abstract:

Background: Since the SARS-CoV-2 virus became extensively disseminated throughout the world, online learning has become one of the most hotly debated topics in educational reform. While some studies have already shown the advantage of online learning, there are still questions concerning how online learning affects students’ learning behavior and academic achievement when each student learns in a different way. Hence, we aimed to develop a guide for preclinical medical students to avoid drawbacks and get benefits from online learning that possibly a double-edged sword. Methods: We used a multiple-choice questionnaire to evaluate the learning behavior of second-year Thai medical students in the neuroscience course. All traditional face-to-face lecture classes were video-recorded and promptly posted to the online learning platform throughout this course. Students could pick and choose whatever classes they wanted to attend, and they may use online learning as often as they wished. Academic performance was evaluated as summative score, spot exam score and pre-post-test improvement. Results: More frequently students used online learning platform, the less they attended lecture classes (P = 0.035). High proactive online learners (High PO) who were irregular attendee (IrA) had significantly lower summative scores (P = 0.026), spot exam score (P = 0.012) and pre-post-test improvement (P = 0.036). In the meanwhile, conditional attendees (CoA) who only attended classes with attendance check had significantly higher summative score (P = 0.025) and spot exam score (P = 0.001) if they were in the High PO group. Conclusions: The benefit and drawbacks edges of using an online learning platform were demonstrated in our research. Based on this double-edged sword effect, we believe that online learning is a valuable learning strategy, but students must carefully plan their study schedule to gain the “benefit edge” meanwhile avoiding its “drawback edge”.

Keywords: academic performance, assessment, attendance, online learning, preclinical medical students

Procedia PDF Downloads 158

Authors: G. Fatima, R. Bashir, M. Saeed Akhtar, M. Malik, M. Safder, D. Nayab

Abstract:

The main purpose of this quantitative study was to investigate challenges and difficulties being encountered by physically challenged students in inclusive settings at higher education level. A self-developed and validated questionnaire (Cronbach alpha: 0.879) was employed for data collected from a sample of fifty six (56) graduate and continuing students with physical disabilities (males:46, females:10) selected through snow ball sampling technique from colleges and universities of Pakistan. The participants were required to respond on three point criteria (no, to some extent, yes). Data were analyzed by using SPSS. Independent sample t-test and One Way Analysis of Variance (ANOVA) was run to compare mean scores of responses of physically challenged students on the basis of their gender, education, types of physical disability, types of institutions, provinces, and status. Frequencies were run to have an overall picture of challenges faced by physically challenged students. Major findings reflected that physically challenged students were encountering problems in transportation, accessibility, and financial support, etc. Conclusions were drawn and recommendations were made.

Keywords: physically challenged students, inclusive setting, higher education, accessibility

Procedia PDF Downloads 406

Authors: Nida Amin, Fahad Tanveer, Hina Shabbir, Ayesha Saeed, Attiqa Riaz

Abstract:

The gradual progression of corneal disorder keratoconus significantly impairs eyesight and quality of life, increasing the likelihood of depression. Using the Hospital Anxiety and Depression Scale (HADS) at the AL-Ibrahim Eye Hospital in Karachi, this study aimed to evaluate the occurrence of depression and anxiety symptoms in patients with keratoconus and to suggest better treatment. A descriptive-analytical study was conducted at Al-Ibrahim Eye Hospital Karachi from March to April 2022, and patients diagnosed with symptomatic keratoconus were recruited using a non-probability convenient sampling technique. After obtaining written informed consent from patients, keratoconus severity was assessed using visual acuity and corneal topography. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression (HADS) Scale. The data were analyzed using SPSS version 20.0. Spearman correlation coefficient. Of the 108 participants, 60 (56%) were female and 48 (44%) were male. Using the HADS scale, 44 (40.7%) patients were classified as normal with a HADS score of (0-7), 23 (21.3%) as borderline with a HADS score of (8-10) and 41 (38%) patients were diagnosed with anxiety and depression with a HADS score of (11-21). Depression and anxiety are highly prevalent among patients in advanced stages of the disease.

Keywords: cornea, keratoconus, anxiety, depression, corneal topography, mental health

Procedia PDF Downloads 35

Authors: Yen-Jong Chen, Jei-An Su

Abstract:

Public use facilities provide the basic infrastructure supporting the needs of urban sustainable development. These facilities include roads (streets), parking areas, green spaces, public schools, and city parks. However, how to acquire land with the proper location and size still remains uncertain in a capitalist economy where land is largely privately owned, such as in cities in Taiwan. The issue concerning the proper acquisition of reserved land for local public facilities (RLPF) policies has been continuously debated by the Taiwanese government for more than 30 years. Lately, the government has been re-evaluating projects connected with existing RLPF policies from the viewpoints of the needs of local residents, including the living environments of older adults. This challenging task includes addressing the requests of official bureau administrators, citizens whose property rights and current use status are affected, and other stakeholders, along with the means of development. To simplify the decision to acquire or release public land, we selected only public facilities that are needed for living in the local community, including parks, green spaces, plaza squares, and land for kindergartens, schools, and local stadiums. This study categorized these spaces as the community’s “leisure public facilities” (LPF). By constructing an accessibility index of the services of such multi-function facilities, we computed and produced a GIS map of spatial buffer zones for each LPF. Through these procedures, the service needs provided by each LPF were clearly identified. We then used spatial buffer zone envelope mapping to evaluate these service areas. The results obtained can help decide which RLPF should be acquired or released so that community services can be maximized under a limited budget.

Keywords: urban public facilities, community demand, accessibility, spatial buffer zone, Taiwan

Procedia PDF Downloads 82

Authors: Oktavian Prasetia Wardana, Martono Tri Utomo, Risa Etika, Kartika Darma Handayani, Dina Angelika, Wurry Ayuningtyas

Abstract:

Background: Critically ill neonates are newborn babies with high-risk factors that potentially cause disability and/or death. Scoring systems for determining the severity of the disease have been widely developed as well as some designs for use in neonates. The SNAPPE-II method, which has been used as a mortality predictor scoring system in several referral centers, was found to be slow in assessing the outcome of critically ill neonates in the Neonatal Intensive Care Unit (NICU). Objective: To analyze the predictive value of MSNS on the outcome of critically ill neonates at the time of arrival up to 24 hours after being admitted to the NICU. Methods: A longitudinal observational analytic study based on medical record data was conducted from January to August 2022. Each sample was recorded from medical record data, including data on gestational age, mode of delivery, APGAR score at birth, resuscitation measures at birth, duration of resuscitation, post-resuscitation ventilation, physical examination at birth (including vital signs and any congenital abnormalities), the results of routine laboratory examinations, as well as the neonatal outcomes. Results: This study involved 105 critically ill neonates who were admitted to the NICU. The outcome of critically ill neonates was 50 (47.6%) neonates died, and 55 (52.4%) neonates lived. There were more males than females (61% vs. 39%). The mean gestational age of the subjects in this study was 33.8 ± 4.28 weeks, with the mean birth weight of the subjects being 1820.31 ± 33.18 g. The mean MSNS score of neonates with a deadly outcome was lower than that of the lived outcome. ROC curve with a cut point MSNS score <10.5 obtained an AUC of 93.5% (95% CI: 88.3-98.6) with a sensitivity value of 84% (95% CI: 80.5-94.9), specificity 80 % (CI 95%: 88.3-98.6), Positive Predictive Value (PPV) 79.2%, Negative Predictive Value (NPV) 84.6%, Risk Ratio (RR) 5.14 with Hosmer & Lemeshow test results p>0.05. Conclusion: The MSNS score has a good predictive value and good calibration of the outcomes of critically ill neonates admitted to the NICU.

Keywords: critically ill neonate, outcome, MSNS, NICU, predictive value

Procedia PDF Downloads 69

Authors: Veronica Sri Lestari, Sitti Nurani Sirajuddin, Kasmiyati Kasim

Abstract:

The purpose of this research was to know the attitude of beef cattle farmers toward bio security practices. This research was conducted in Barru regency, South Sulawesi province, Indonesia, in 2014. Thirty beef cattle farmers were selected through random sampling. Primary and secondary data were collected through report, observation and deep interview by using questionnaire. Bio security practices consisted of 35 questions. Every answer of the question was scored based on three categories: score 1 (not important), score 2 (important) and 3 (very important). The results of this research showed that the attitude of beef cattle farmers toward bio security practices was categorized as important.

Keywords: attitude, beef cattle, biosecurity, farmers

Procedia PDF Downloads 296

Authors: Fatma Abdel Moneim Al Tawil

Abstract:

This study was undertaken to evaluate an educational program regarding scientific writing and presentation skills among university students. This interventional study used a one-group, pretest/posttest design and was conducted in Al Jouf University among four colleges in Saudi Arabia. Baseline students’ assessment was conducted for developing educational program. Interventional, one group, pretest/posttest study was designed to evaluate the effectiveness of the educational program. Three parts evaluation sheet with total scores of 30 was used for 113 students for the development of the program and 52 students for test pretest phase. Wilcoxon signed ranks showed statistically significant improvement in the combined overall program skills score from a median of 56.7 pre to a median of 86.7 post, (z = 6.231, p < 0.001). When compared to preprogram intervention, post interventions 51.9 % of students achieve excellent performance. While pre intervention no students (0.0 %) achieve this score. Regarding to scientific writing skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 60 pre to a median of 90 post, (z = 6.122, p < 0.001). None of students had excellent performance changed to 73.1%. Regarding to oral presentation skills, Wilcoxon signed ranks showed statistically significant improvement in the score from a median of 50 pre to a median of 80 post, (z = 6.153, p < 0.001). None of students had excellent performance changed to 48.1%. Such educational program needs to be incorporated into classroom delivery of the students’ curriculum. Scientific writing skills book needed to be developed to be recommended as a basic educational strategy for all university faculties.

Keywords: scientific writing, presentation skills, university students, educational program

Procedia PDF Downloads 451

Authors: Qing Wu, Xuchun Ye, Qiuchen Wang, Kirsten Corazzini

Abstract:

Objective: It’s increasing acknowledged that patient engagement in healthcare and health literacy both have positive impact on patient outcome. Health literacy emphasizes the ability of individuals to understand and apply health information and manage health. Patients' health literacy affected their willingness to participate in decision-making, but its impact on the behavior and willingness of patient engagement in healthcare is not clear, especially in China. Therefore, this study aimed to explore the correlation between the behavior and willingness of patient engagement and health literacy. Methods: A cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale (AAHLS). A convenient sample of 443 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province and Zhejiang Province, from September 2016 to January 2017. Results: The mean score for the willingness was (4.41±0.45), and the mean score for the patient engagement behavior was (4.17±0.49); the mean score for the patient's health literacy was (2.36±0.29)，the average score of its three dimensions- the functional literacy, the Communicative/interactive literacy and the Critical literacy, was (2.26±0.38), (2.28±0.42), and (2.61±0.43), respectively. Patients' health literacy was positively correlated with their willingness of engagement (r = 0.367, P < 0.01), and positively correlated with patient engagement behavior (r = 0.357, P < 0.01). All dimensions of health literacy were positively correlated with the behavior and willingness of patient engagement in healthcare; the dimension of Communicative/interactive literacy (r = 0.312, P < 0.01; r = 0.357, P < 0.01) and the Critical literacy (r = 0.357, P < 0.01; r = 0.357, P < 0.01) are more relevant to the behavior and willingness than the dimension of basic/functional literacy (r=0.150, P < 0.01; r = 0.150, P < 0.01). Conclusions: The behavior and willingness of patient engagement in healthcare are positively correlated with health literacy and its dimensions. In clinical work, medical staff should pay attention to patients’ health literacy, especially the situation that low literacy leads to low participation and provide health information to patients through health education or communication to improve their health literacy as well as guide them to actively and rationally participate in their own health care.

Keywords: patient engagement, health literacy, healthcare, correlation

Procedia PDF Downloads 166

Authors: Raman Sharma, S. K. Jain

Abstract:

Aims and Objectives: Fixation of the mesh during laparoscopic total extraperitoneal (TEP) repair of inguinal hernia is thought to be necessary to prevent recurrence. However, mesh fixation may increase surgical complications and postoperative pain. Our objective was to compare the outcomes of nonfixation with fixation of polypropylene mesh by metal tacks during TEP repair of inguinal hernia. Methods: Forty patients aged 18 to72 years with inguinal hernia were included who underwent laparoscopic TEP repair of inguinal hernia with (n=20) or without (n=20) fixation of the mesh. The outcomes were operative duration, postoperative pain score, cost, in-hospital stay, time to return to normal activity, and complications. Results: Patients in whom the mesh was not fixed had shorter mean operating time (p < 0.05). We found no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications (P > 0.05). Moreover, a net cost savings was realized for each hernia repair performed without stapled mesh. Conclusions: TEP repair without mesh fixation resulted in the shorter operating time and lower operative cost with no difference between groups in the postoperative pain score, incidence of recurrence, in-hospital stay, time to return to normal activity and complications. All this contribute to make TEP repair without mesh fixation a better choice for repair of uncomplicated inguinal hernia, especially in developing nations with scarce resources.

Keywords: postoperative pain score, inguinal hernia, nonfixation of mesh, total extra peritoneal (TEP)

Procedia PDF Downloads 343

Authors: Arezoo Fallahi

Abstract:

Introduction: Exposure to second-hand smoke is an important global health problem and threatens the health of people, especially children and women. The aim of this study was to determine the effect of education based on the Health Belief Model on preventive behaviors of exposure to second-hand smoke in women. Materials and Methods: This experimental study was performed in 2022 in Sanandaj, west of Iran. Seventy-four people were selected by simple random sampling and divided into an intervention group (37 people) and a control group (37 people). Data collection tools included demographic characteristics and a second-hand smoke exposure questionnaire based on the Health Beliefs Model. The training in the intervention group was conducted in three one-hour sessions in the comprehensive health service centers in the form of lectures, pamphlets, and group discussions. Data were analyzed using SPSS software version 21 and statistical tests such as correlation, paired t-test, and independent t-test. Results: The intervention and control groups were homogeneous before education. They were similar in terms of mean scores of the Health Belief Model. However, after an educational intervention, some of the scores increased, including the mean perceived sensitivity score (from 17.62±2.86 to 19.75±1.23), perceived severity score (28.40±4.45 to 31.64±2), perceived benefits score (27.27±4.89 to 31.94±2.17), practice score (32.64±4.68 to 36.91±2.32) perceived barriers from 26.62±5.16 to 31.29±3.34, guide for external action (from 17.70±3.99 to 22/89 ±1.67), guide for internal action from (16.59±2.95 to 1.03±18.75), and self-efficacy (from 19.83 ±3.99 to 23.37±1.43) (P <0.05). Conclusion: The educational intervention designed based on the Health Belief Model in women was effective in performing preventive behaviors against exposure to second-hand smoke.

Keywords: education, women, exposure to secondhand smoke, health belief model

Procedia PDF Downloads 72

Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki

Abstract:

The assessment variables of the accessibility and the sustainability of access infrastructure for remote regions may vary significant by location and a wide range of factors may affect the decision process. In this paper, the environmental disturbance implications of transportation system to key demand and supply variables impact the economic system in remote destination are descripted. According to a systemic approach, the key sustainability variables deals with decision making process that have to be included in strategic plan for the critical transport infrastructure development and their relationship to regional socioeconomic system are presented. The application deals with the development of railway in remote destinations, where the traditional CBA not include the external cost generated by the environmental impacts that may have a range of diverse impacts on transport infrastructure and services. The analysis output provides key messages to decision and policy makers towards sustainable development of transport infrastructure, especially for remote destinations where accessibility is a key factor of regional economic development and social stability. The key conclusion could be essential useful for relevant applications in remote regions in the same latitude.

Keywords: sustainable development in remote regions, transport infrastructure, strategic planning, sustainability variables

Procedia PDF Downloads 353

Authors: Nopadol Burananat, Kedsara Tripaichayonsak

Abstract:

This research aims to study the level of expectations and participation of personnel in implementing educational quality assurance of programs in Graduate School, Rajabhat Suan Sunandha University. The sample used in this study is 60 participants. The tool used for data collection is a questionnaire constructed by the researcher. The analysis is done by frequency, percentage, mean and standard deviation. It was found that the level of expectations personnel in Graduate School, Suan Sunandha Rajabhat University in implementing educational quality assurance is at high level. The category which received the most score is Action, followed by Check, Do and Plan, respectively. For the level of participation of personnel at program level of Graduate School, Suan Sunandha Rajabhat University in implementing educational quality assurance, the overall score is at high level. The category which received the most score is Action, followed by Do, Check and Plan, respectively.

Keywords: participation, implementation of educational quality assurance, educational quality assurance, expectations and participation

Procedia PDF Downloads 384

Authors: Melissa James Maceachern

Abstract:

This study examines a financial aid program that is designed to “keep residents at home” to attend higher education by providing financial aid as an incentive or discount in their first year of university following high school graduation. This study offers insight into financial matters for higher education students that can assist in providing policy direction for student financing. In particular, this study found that students appeared to value the bursary but none of the key metrics related to participation or conversion to the home institution indicated that the bursary impacted enrolment or participation. One key metric, student loans received by direct entry high school students did indicate a decline in the number of recipients. This study also identified accessibility issues to higher education that are of importance when considering the declining youth populations, future labour market needs and the need to sustain higher education institutions. This is undoubtedly a challenging period of time given the changing social and demographic forces within Canada. A comprehensive examination of the policy and programs to address these forces needs to be undertaken. This study highlights the importance of utilizing financial aid in combination with other policy to assist students in accessing higher education.

Keywords: accessibility, participation, financing, government

Procedia PDF Downloads 416

Authors: Hee-Jung Seo, Yunjung Lee, Areum Han, Heeyoung Park, Se-Hyuk Park

Abstract:

The purpose of this study was to analyze the relationship between happiness and depression among people with disabilities and to analyze the social phenomenon of leisure activities among them to promote physical and leisure activities for people with disabilities. The research methods included analyzing differences in happiness according to depression classification. A total of 281 people with disabilities were analyzed using SPSS WIN Ver. 29.0. In addition, the SumTrend platform was used to analyze terms related to 'leisure activities for the disabled.' The findings can be summarized into two main points: First, there were significant differences in happiness according to depression classification. Second, there were 20 mentions before COVID-19, 34 mentions after COVID-19, and currently 43 mentions, with high positive rates observed in each period. Based on these results, the following conclusions were drawn: First, measures for people with disabilities include strengthening online resources and services, social distancing response policies, improving accessibility, and providing support and financial assistance. Second, measures for non-disabled individuals emphasize the need for education and information provision, promoting dialogue and interaction, ensuring accessibility, and promoting inclusive cultural awareness and attitude change.

Keywords: leisure activities, individuals with disabilities, COVID-19 pandemic, depression

Procedia PDF Downloads 48

Authors: Semachew M. Kassa, Africa M Geremew, Tezera F. Azmatch, Nandyala Darga Kumar

Abstract:

Frequency ratio (FR) and analytical hierarchy process (AHP) methods are developed based on past landslide failure points to identify the landslide susceptibility mapping because landslides can seriously harm both the environment and society. However, it is still difficult to select the most efficient method and correctly identify the main driving factors for particular regions. In this study, we used fourteen landslide conditioning factors (LCFs) and five soft computing algorithms, including Random Forest (RF), Support Vector Machine (SVM), Logistic Regression (LR), Artificial Neural Network (ANN), and Naïve Bayes (NB), to predict the landslide susceptibility at 12.5 m spatial scale. The performance of the RF (F1-score: 0.88, AUC: 0.94), ANN (F1-score: 0.85, AUC: 0.92), and SVM (F1-score: 0.82, AUC: 0.86) methods was significantly better than the LR (F1-score: 0.75, AUC: 0.76) and NB (F1-score: 0.73, AUC: 0.75) method, according to the classification results based on inventory landslide points. The findings also showed that around 35% of the study region was made up of places with high and very high landslide risk (susceptibility greater than 0.5). The very high-risk locations were primarily found in the western and southeastern regions, and all five models showed good agreement and similar geographic distribution patterns in landslide susceptibility. The towns with the highest landslide risk include Amhara Saint Town's western part, the Northern part, and St. Gebreal Church villages, with mean susceptibility values greater than 0.5. However, rainfall, distance to road, and slope were typically among the top leading factors for most villages. The primary contributing factors to landslide vulnerability were slightly varied for the five models. Decision-makers and policy planners can use the information from our study to make informed decisions and establish policies. It also suggests that various places should take different safeguards to reduce or prevent serious damage from landslide events.

Keywords: artificial neural network, logistic regression, landslide susceptibility, naïve Bayes, random forest, support vector machine

Procedia PDF Downloads 82

Authors: Trina Isabel D. Santiago, Juan Raphael M. Perez, Maria Angelica O. Soriano, Teresita B. Suing, Jumee F. Tayaban

Abstract:

To achieve universal healthcare for everyone, the World Health Organization has emphasized the importance of National Medicines Policies for increased accessibility and utilization of high-quality and affordable medications. In the Philippines, significant challenges have been identified surrounding the sustainability of essential medicines, resulting in limited access such as high cost and dominance and market dominance and monopoly of multinational companies (MNCs) in the Philippine pharmaceutical industry. These identified challenges have been addressed by several initiatives, such as the Philippine National Drug Policy and Generics Act of 1988 (Republic Act 6675), to attempt to reduce drug prices. Despite these efforts, the concerns with drug accessibility and affordability continue to persist; hence, Republic Act 9502 was enacted. This paper attempts to review RA 9502 in the pursuit of making medicines more affordable for Filipinos, analyze and critique the problems and challenges associated with the law, and provide recommendations to address identified problems and challenges. A literature search and review, as well as an analysis of the law, has been done to evaluate the policy. RA 9502 recognizes the importance of market competition in drug price reduction and quality medicine accessibility. Contentious issues prior to enactment of the law include 1) parallel importation, pointing out that the drug price will depend on the global market price, 2) contrasting approaches in the drafting of the law as the House version focused on medicine price control while the Senate version prioritized market competition, and 3) MNCs opposing the amendments with concerns on discrimination, constitutional violations, and noncompliance with international treaty obligations. There are also criticisms and challenges with the implementation of the law in terms of content or modeling, interpretation and implementation, and other external factors or hindrances. The law has been criticized for its narrow scope as it only covers specific essential medicines with no cooperation with the national health insurance program. Moreover, the law has sections taking advantage of the TRIPS flexibilities, which disallow smaller countries to reap the benefits of flexibilities. The sanctions and penalties have an insignificant role in implementation as they only ask for a small portion of the income of MNCs. Proposed recommendations for policy improvement include aligning existing legislation through strengthened price regulation and expanded law coverage, strengthening penalties to promote law adherence, and promoting research and development to encourage and support local initiatives. Through these comprehensive recommendations, the issues surrounding the policy can be addressed, and the goal of enhancing the affordability and accessibility of medicines in the country can be achieved.

Keywords: drug accessibility, drug affordability, price regulation, Republic Act 9502

Procedia PDF Downloads 45

Authors: Sharareh Hekmat, Michelle Lane

Abstract:

Pregnancy during adolescence affects both the growth and development of mother and baby, particularly in low socioeconomic and food insecure areas. This mixed methods study is aimed at discovering a need for a community-based probiotic yogurt program to assist pregnant women in the Mukuru slum Nairobi, Kenya. Surveys were conducted with pregnant women (14-25 years old, n=43), which included questionnaires on dietary intake, food access, and health/quality of life perception. The frequency and means procedure was used to analyze maternal characteristics, Women’s Dietary Diversity Score (WDDS) and Household Hunger Scale. 24-hour recalls were analyzed via ESHA Food Processor, and median nutrient intakes were reported as a percent of recommendations. An environmental scan was conducted to assess food availability, accessibility, and quality. WDDS reflected a low-moderate diet variation (3.86 food groups out of 9, SD ± 1.3) among the women. The 24-hour recall suggested an inadequate intake of many nutrients, most significantly B12, potassium and calcium. 86% of women reported little to no household hunger. However, the environmental scan revealed low quality and poor sanitation of food. This study provides evidence that a probiotic program would be desirable, and contribute to the nutritional status of women in the Mukuru community.

Keywords: dietary diversity, pregnant women, probiotics, urban slum, Kenya

Procedia PDF Downloads 190

Authors: Anne Eugenia Wright

Abstract:

This study examines issues in accessibility to maritime cultural heritage. Using the Pillar Dollar Wreck in Biscayne National Park, Florida, this study presents an approach to public outreach based on the concept of Design for All. Design for All advocates creating products that are accessible and functional for all users, including those with visual, hearing, learning, mobility, or economic impairments. As a part of this study, a small exhibit was created that uses 3D products as a way to bring maritime cultural heritage to the public. It was presented to the public at East Carolina University’s Joyner Library. Additionally, this study presents a methodology for 3D printing scaled photogrammetry models of archaeological sites in full color. This methodology can be used to present a realistic depiction of underwater archaeological sites to those who are incapable of accessing them in the water. Additionally, this methodology can be used to present underwater archaeological sites that are inaccessible to the public due to conditions such as visibility, depth, or protected status. This study presents a practical use for 3D photogrammetry models, as well as an accessibility strategy to expand the outreach potential for maritime archaeology.

Keywords: Underwater Archaeology, 3D Printing, Photogrammetry, Design for All

Procedia PDF Downloads 138

Authors: Makram Ben Jeddou

Abstract:

The ABC classification is widely used by managers for inventory control. The classical ABC classification is based on the Pareto principle and according to the criterion of the annual use value only. Single criterion classification is often insufficient for a closely inventory control. Multi-criteria inventory classification models have been proposed by researchers in order to take into account other important criteria. From these models, we will consider the ZF model in order to make a sensitive analysis on the composite score calculated for each item. In fact, this score based on a normalized average between a good and a bad optimized index can affect the ABC items classification. We will then focus on the weights assigned to each index and propose a classification compromise.

Keywords: ABC classification, multi criteria inventory classification models, ZF-model

Procedia PDF Downloads 508

Authors: Resham Badri

Abstract:

Cities today are unable to justify equitable distribution of theirsocio- economic and infrastructural benefits to the marginalized urban poor, and the emergence of a pressing pandemic like COVID-19 has amplified its impact. Lack of identity, vulnerability, and inaccessibility contribute to exclusion. Owing to systemic gaps in institutional processes, urban development policiesfail to represent and cater to the urban poor. This paper aims to be a roadmap for the Indian Government to understand the significance of the designation of a navigable spatial identity to slum dwellers in the form of a digital address, which can form the fundamental basis of identification to enable accessibility to not only basic servicesbut also other utilities. Capitalizing on such a granular and technology backed approach shall allow to target and reach out to the urban poor strategically andaid effective urban governance. This paper adopts a three-pronged approach;(i) Policy analysis- understanding gaps in existing urban policies of India, such as the Pradhan Mantri Awas Yojana, Swachh Bharat Mission, and Adhaar Card policy, (ii) Program Evaluation- analyzing a case study, where slum dwellers in Kolhapur city in India have been provided with navigable addresses using Google Plus Codes and have gained access to basic services, vaccinations, and other emergency deliveries in COVID-19 times, (iii) Policy recommendation. This designation of a navigable spatial identity has tremendous potential to form the foundation on which policies can further base their data collection and service delivery processes to not only provide basic services but also other infrastructural and social welfare initiatives. Hence, a massive window of opportunity lies in addressing the unaddressed to elevate their living standards and respond to their basic needs.

Keywords: policy analysis, urban poor, navigable spatial identity, accessibility

Procedia PDF Downloads 81

Authors: Jorge Urrutia-Mosquera, Luz Flórez-Calderón, Yasna Cortés

Abstract:

We assessed the state of progress in terms of urban sustainability indicators and studied the impact of current land use conditions and the level of spatial accessibility to basic urban amenities on travel patterns and sustainable mobility in Santiago de Chile. We determined the spatial impact of urban facilities on sustainable travel patterns through the statistical analysis, data visualisation, and weighted regression models. The results show a need to diversify land use in more than 60% of the communes, although in 85% of the communes, accessibility to public spaces is guaranteed. The findings also suggest improving access to early education facilities, as only 26% of the communes meet the sustainability standard, negatively impacting travel in sustainable modes. It is also observed that the level of access to urban facilities generates spatial heterogeneity in the city, which negatively affects travel patterns in terms of time over 60 minutes and modes of travel in private vehicles. The results obtained allow us to identify opportunities for public policy intervention to promote and adopt sustainable mobility.

Keywords: land use, urban sustainability, travel patterns, spatial heterogeneity, GWR model, sustainable mobility

Procedia PDF Downloads 81

Authors: Samuel Ibbi Ibrahim, Isaiah Ndalassan Ibrahim

Abstract:

Accessibility and availability of good quality water have become a major concern among different users. This paper examines the caustic importance of water security in relation to people’s desire for survival. It observed the democratic ideology of national policy on domestic water supply and demand and its implementation for national and societal development. It used analogy on equilibrium approach to ascertain the household water security. In most communities, it is glaring that several public water management in operation for several years are hardly performing efficiently to reach equilibrium demand. Moreover most settlements being rural or urban lack effective public water system that could ensure regular supplies to the population. The terrain and gradual declining of efficient rainfall northward poses great challenge to the region in managing water supply and demand adequately. This study itemized the need for the government to get clear strategy for a sustainable development on better water efficiency. Partnership in providing workable policy on water security is considered apparently important. It is also suggested that water plant treatment should be established in every medium-sized towns in the country.

Keywords: good quality of water, water accessibility, water availability, water sustainable

Procedia PDF Downloads 527