Search results for: descriptive phenomenology
214 The Positive Impact of Wheelchair Service Provision on the Health and Overall Satisfaction of Wheelchair Users with the Devices
Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward
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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production
Procedia PDF Downloads 96213 Experiences of Pediatric Cancer Patients and Their Families: A Focus Group Interview
Authors: Bu Kyung Park
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Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis
Procedia PDF Downloads 178212 Determinants of Unmet Need for Contraception among Currently Married Women in Rural and Urban Communities of Osun State, South-West Nigeria
Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu
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Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.Keywords: contraception, married women, Nigeria, rural, urban, unmet need
Procedia PDF Downloads 186211 Prevalence of Work-Related Musculoskeletal Disorder among Dental Personnel in Perak
Authors: Nursyafiq Ali Shibramulisi, Nor Farah Fauzi, Nur Azniza Zawin Anuar, Nurul Atikah Azmi, Janice Hew Pei Fang
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Background: Work related musculoskeletal disorders (WRMD) among dental personnel have been underestimated and under-reported worldwide and specifically in Malaysia. The problem will arise and progress slowly over time, as it results from accumulated injury throughout the period of work. Several risk factors, such as repetitive movement, static posture, vibration, and adapting poor working postures, have been identified to be contributing to WRMSD in dental practices. Dental personnel is at higher risk of getting this problem as it is their working nature and core business. This would cause pain and dysfunction syndrome among them and result in absence from work and substandard services to their patients. Methodology: A cross-sectional study involving 19 government dental clinics in Perak was done over the period of 3 months. Those who met the criteria were selected to participate in this study. Malay version of the Self-Reported Nordic Musculoskeletal Discomfort Form was used to identify the prevalence of WRMSD, while the intensity of pain in the respective regions was evaluated using a 10-point scale according to ‘Pain as The 5ᵗʰ Vital Sign’ by MOH Malaysia and later on were analyzed using SPSS version 25. Descriptive statistics, including mean and SD and median and IQR, were used for numerical data. Categorical data were described by percentage. Pearson’s Chi-Square Test and Spearman’s Correlation were used to find the association between the prevalence of WRMSD and other socio-demographic data. Results: 159 dentists, 73 dental therapists, 26 dental lab technicians, 81 dental surgery assistants, and 23 dental attendants participated in this study. The mean age for the participants was 34.9±7.4 and their mean years of service was 9.97±7.5. Most of them were female (78.5%), Malay (71.3%), married (69.6%) and right-handed (90.1%). The highest prevalence of WRMSD was neck (58.0%), followed by shoulder (48.1%), upper back (42.0%), lower back (40.6%), hand/wrist (31.5%), feet (21.3%), knee (12.2%), thigh 7.7%) and lastly elbow (6.9%). Most of those who reported having neck pain scaled their pain experiences at 2 out of 10 (19.5%), while for those who suffered upper back discomfort, most of them scaled their pain experience at 6 out of 10 (17.8%). It was found that there was a significant relationship between age and pain at neck (p=0.007), elbow (p=0.027), lower back (p=0.032), thigh (p=0.039), knee (p=0.001) and feet (p=0.000) regions. Job position also had been found to be having a significant relationship with pain experienced at the lower back (p=0.018), thigh (p=0.011), knee, and feet (p=0.000). Conclusion: The prevalence of WRMSD among dental personnel in Perak was found to be high. Age and job position were found to be having a significant relationship with pain experienced in several regions. Intervention programs should be planned and conducted to prevent and reduce the occurrence of WRMSD, as all harmful or unergonomic practices should be avoided at all costs.Keywords: WRMSD, ergonomic, dentistry, dental
Procedia PDF Downloads 78210 The Epidemiology of Dengue in Taiwan during 2014-15: A Descriptive Analysis of the Severe Outbreaks of Central Surveillance System Data
Authors: Chu-Tzu Chen, Angela S. Huang, Yu-Min Chou, Chin-Hui Yang
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Dengue is a major public health concern throughout tropical and sub-tropical regions. Taiwan is located in the Pacific Ocean and overlying the tropical and subtropical zones. The island remains humid throughout the year and receives abundant rainfall, and the temperature is very hot in summer at southern Taiwan. It is ideal for the growth of dengue vectors and would be increasing the risk on dengue outbreaks. During the first half of the 20th century, there were three island-wide dengue outbreaks (1915, 1931, and 1942). After almost forty years of dormancy, a DEN-2 outbreak occurred in Liuchiu Township, Pingtung County in 1981. Thereafter, more dengue outbreaks occurred with different scales in southern Taiwan. However, there were more than ten thousands of dengue cases in 2014 and in 2015. It did not only affect human health, but also caused widespread social disruption and economic losses. The study would like to reveal the epidemiology of dengue on Taiwan, especially the severe outbreak in 2015, and try to find the effective interventions in dengue control including dengue vaccine development for the elderly. Methods: The study applied the Notifiable Diseases Surveillance System database of the Taiwan Centers for Disease Control as data source. All cases were reported with the uniform case definition and confirmed by NS1 rapid diagnosis/laboratory diagnosis. Results: In 2014, Taiwan experienced a serious DEN-1 outbreak with 15,492 locally-acquired cases, including 136 cases of dengue hemorrhagic fever (DHF) which caused 21 deaths. However, a more serious DEN-2 outbreak occurred with 43,419 locally-acquired cases in 2015. The epidemic occurred mainly at Tainan City (22,760 cases) and Kaohsiung City (19,723 cases) in southern Taiwan. The age distribution for the cases were mainly adults. There were 228 deaths due to dengue infection, and the case fatality rate was 5.25 ‰. The average age of them was 73.66 years (range 29-96) and 86.84% of them were older than 60 years. Most of them were comorbidities. To review the clinical manifestations of the 228 death cases, 38.16% (N=87) of them were reported with warning signs, while 51.75% (N=118) were reported without warning signs. Among the 87 death cases reported to dengue with warning signs, 89.53% were diagnosed sever dengue and 84% needed the intensive care. Conclusion: The year 2015 was characterized by large dengue outbreaks worldwide. The risk of serious dengue outbreak may increase significantly in the future, and the elderly is the vulnerable group in Taiwan. However, a dengue vaccine has been licensed for use in people 9-45 years of age living in endemic settings at the end of 2015. In addition to carry out the research to find out new interventions in dengue control, developing the dengue vaccine for the elderly is very important to prevent severe dengue and deaths.Keywords: case fatality rate, dengue, dengue vaccine, the elderly
Procedia PDF Downloads 275209 Linguistic Competence Analysis and the Development of Speaking Instructional Material
Authors: Felipa M. Rico
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Linguistic oral competence plays a vital role in attaining effective communication. Since the English language is considered as universally used language and has a high demand skill needed in the work-place, mastery is the expected output from learners. To achieve this, learners should be given integrated differentiated tasks which help them develop and strengthen the expected skills. This study aimed to develop speaking instructional supplementary material to enhance the English linguistic competence of Grade 9 students in areas of pronunciation, intonation and stress, voice projection, diction and fluency. A descriptive analysis was utilized to analyze the speaking level of performance of the students in order to employ appropriate strategies. There were two sets of respondents: 178 Grade 9 students selected through a stratified sampling and chosen at random. The other set comprised English teachers who evaluated the usefulness of the devised teaching materials. A teacher conducted a speaking test and activities were employed to analyze the speaking needs of students. Observation and recordings were also used to evaluate the students’ performance. The findings revealed that the English pronunciation of the students was slightly unclear at times, but generally fair. There were lapses but generally they rated moderate in intonation and stress, because of other language interference. In terms of voice projection, students have erratic high volume pitch. For diction, the students’ ability to produce comprehensible language is limited, and as to fluency, the choice of vocabulary and use of structure were severely limited. Based on the students’ speaking needs analyses, the supplementary material devised was based on Nunan’s IM model, incorporating context of daily life and global work settings, considering the principle that language is best learned in the actual meaningful situation. To widen the mastery of skill, a rich learning environment, filled with a variety instructional material tends to foster faster acquisition of the requisite skills for sustained learning and development. The role of IM is to encourage information to stick in the learners’ mind, as what is seen is understood more than what is heard. Teachers say they found the IM “very useful.” This implied that English teachers could adopt the materials to improve the speaking skills of students. Further, teachers should provide varied opportunities for students to get involved in real life situations where they could take turns in asking and answering questions and share information related to the activities. This would minimize anxiety among students in the use of the English language.Keywords: diction, fluency, intonation, instructional materials, linguistic competence
Procedia PDF Downloads 231208 Food Composition Tables Used as an Instrument to Estimate the Nutrient Ingest in Ecuador
Authors: Ortiz M. Rocío, Rocha G. Karina, Domenech A. Gloria
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There are several tools to assess the nutritional status of the population. A main instrument commonly used to build those tools is the food composition tables (FCT). Despite the importance of FCT, there are many error sources and variability factors that can be presented on building those tables and can lead to an under or over estimation of ingest of nutrients of a population. This work identified different food composition tables used as an instrument to estimate the nutrient ingest in Ecuador.The collection of data for choosing FCT was made through key informants –self completed questionnaires-, supplemented with institutional web research. A questionnaire with general variables (origin, year of edition, etc) and methodological variables (method of elaboration, information of the table, etc) was passed to the identified FCT. Those variables were defined based on an extensive literature review. A descriptive analysis of content was performed. Ten printed tables and three databases were reported which were all indistinctly treated as food composition tables. We managed to get information from 69% of the references. Several informants referred to printed documents that were not accessible. In addition, searching the internet was not successful. Of the 9 final tables, n=8 are from Latin America, and, n= 5 of these were constructed by indirect method (collection of already published data) having as a main source of information a database from the United States department of agriculture USDA. One FCT was constructed by using direct method (bromatological analysis) and has its origin in Ecuador. The 100% of the tables made a clear distinction of the food and its method of cooking, 88% of FCT expressed values of nutrients per 100g of edible portion, 77% gave precise additional information about the use of the table, and 55% presented all the macro and micro nutrients on a detailed way. The more complete FCT were: INCAP (Central America), Composition of foods (Mexico). The more referred table was: Ecuadorian food composition table of 1965 (70%). The indirect method was used for most tables within this study. However, this method has the disadvantage that it generates less reliable food composition tables because foods show variations in composition. Therefore, a database cannot accurately predict the composition of any isolated sample of a food product.In conclusion, analyzing the pros and cons, and, despite being a FCT elaborated by using an indirect method, it is considered appropriate to work with the FCT of INCAP Central America, given the proximity to our country and a food items list that is very similar to ours. Also, it is imperative to have as a reference the table of composition for Ecuadorian food, which, although is not updated, was constructed using the direct method with Ecuadorian foods. Hence, both tables will be used to elaborate a questionnaire with the purpose of assessing the food consumption of the Ecuadorian population. In case of having disparate values, we will proceed by taking just the INCAP values because this is an updated table.Keywords: Ecuadorian food composition tables, FCT elaborated by direct method, ingest of nutrients of Ecuadorians, Latin America food composition tables
Procedia PDF Downloads 423207 Assessing Children’s Probabilistic and Creative Thinking in a Non-formal Learning Context
Authors: Ana Breda, Catarina Cruz
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Daily, we face unpredictable events, often attributed to chance, as there is no justification for such an occurrence. Chance, understood as a source of uncertainty, is present in several aspects of human life, such as weather forecasts, dice rolling, and lottery. Surprisingly, humans and some animals can quickly adjust their behavior to handle efficiently doubly stochastic processes (random events with two layers of randomness, like unpredictable weather affecting dice rolling). This adjustment ability suggests that the human brain has built-in mechanisms for perceiving, understanding, and responding to simple probabilities. It also explains why current trends in mathematics education include probability concepts in official curriculum programs, starting from the third year of primary education onwards. In the first years of schooling, children learn to use a certain type of (specific) vocabulary, such as never, always, rarely, perhaps, likely, and unlikely, to help them to perceive and understand the probability of some events. These are keywords of crucial importance for their perception and understanding of probabilities. The development of the probabilistic concepts comes from facts and cause-effect sequences resulting from the subject's actions, as well as the notion of chance and intuitive estimates based on everyday experiences. As part of a junior summer school program, which took place at a Portuguese university, a non-formal learning experiment was carried out with 18 children in the 5th and 6th grades. This experience was designed to be implemented in a dynamic of a serious ice-breaking game, to assess their levels of probabilistic, critical, and creative thinking in understanding impossible, certain, equally probable, likely, and unlikely events, and also to gain insight into how the non-formal learning context influenced their achievements. The criteria used to evaluate probabilistic thinking included the creative ability to conceive events classified in the specified categories, the ability to properly justify the categorization, the ability to critically assess the events classified by other children, and the ability to make predictions based on a given probability. The data analysis employs a qualitative, descriptive, and interpretative-methods approach based on students' written productions, audio recordings, and researchers' field notes. This methodology allowed us to conclude that such an approach is an appropriate and helpful formative assessment tool. The promising results of this initial exploratory study require a future research study with children from these levels of education, from different regions, attending public or private schools, to validate and expand our findings.Keywords: critical and creative thinking, non-formal mathematics learning, probabilistic thinking, serious game
Procedia PDF Downloads 14206 Factors Associated with Treatment Adherence among Pulmonary Tuberculosis Patients in New Delhi
Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal
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Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis
Procedia PDF Downloads 192205 The Mental Health Policy in the State of EspíRito Santo, Brazil: Judicialization
Authors: Fabiola Xavier Leal, Lara Campanharo, Sueli Aparecida Rodrigues Lucas
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The phenomenon of judicialization in health policy brings with it a great deal of problematization, but in general, it means that some issues that were previously solved by traditional political bodies are being decided by the Judiciary bodies. It is, therefore, a controversial topic that has generated many reflections both in the academic and political fields, considering that not only a dispute of public funds is at stake, but also the debate on access to social rights provided for in the Brazilian Federal Constitution of 1988 and in the various public policies, such as healthcare. With regard to the phenomenon in the Mental Health Policy focusing on people who use drugs, the disputes that permeate this scenario are evident: moral, cultural, sanitary, economic, psychological aspects. There are also the individual and collective dimensions of suffering. And in this process, we all question: What is the role of the Brazilian State in this matter? In this context, another question that needs to be answered is the amount spent on this procedure in the state of Espírito Santo (ES), Brazil (in the last 04 years, around R$121,978,591.44 were paid only for compulsory hospitalization of individuals) in the field in question, which is the financing of the services of the Psychosocial Care Network (RAPS). Therefore, this article aims to problematize the phenomenon of judicialization in Mental Health Policy through the compulsory hospitalization of people who use drugs in Espírito Santo (ES). We proposed a study that sought to understand how this has been occurring and making an impact on the provision of RAPS services in the Espírito Santo scenario. Therefore, the general objective of this study is to analyze the expenses with compulsory hospitalizations for drug use carried out by the State Health Department (SESA) between 2014 and 2019, in which we will seek to identify its destination and the impact of these actions on public health policy. For the purposes of this article, we will present the preliminary data of this study, such as the amount spent by the state and the receiving institutions. For data collection, the following data sources were used: documents available publicly on the Transparency Portal (payments made per year, institutions that received, subjects hospitalized, period and the amount of the daily rates paid); as well as the processes generated by SESA through its own system - ONBASE. For qualitative analysis, content analysis was used; and for quantitative analysis, descriptive statistics was used. Thus, we seek to problematize the issue of judicialization for compulsory hospitalizations, considering the current situation in which this resource has been widely requested to legitimize the war on drugs. This scenario highlights the moral-legal discourse, pointing out strategies through the control of bodies and through faith as an alternative.Keywords: compulsory hospitalization, drugs, judicialization, mental health
Procedia PDF Downloads 162204 Development Project, Land Acquisition and Rehabilitation: A Study of Navi Mumbai International Airport Project, India
Authors: Rahul Rajak, Archana Kumari Roy
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Purpose: Development brings about structural change in the society. It is essential for socio-economic progress of the society, but it also causes pain to the people who are forced to displace from their motherland. Most of the people who are displaced due to development are poor and tribes. Development and displacement are interlinked with each other in the sense development sometimes leads to displacement of people. These studies mainly focus on socio-economic profile of villages and villagers likely to be affected by the Airport Project and they examine the issues of compensation and people’s level of satisfaction. Methodology: The study is based on Descriptive design; it is basically observational and correlation study. Primary data is used in this study. Considering the time and resource constrains, 100 people were interviewed covering socio-economic and demographic diversities from 6 out of 10 affected villages. Due to Navi Mumbai International Airport Project ten villages have to be displaced. Out of ten villages, this study is based on only six villages. These are Ulwe, Ganeshpuri, Targhar Komberbuje, Chincpada and Kopar. All six villages situated in Raigarh district under the Taluka Panvel in Maharashtra. Findings: It is revealed from the survey that there are three main castes of affected villages that are Agri, Koli, and Kradi. Entire village population of migrated person is very negligible. All three caste have main occupation are agricultural and fishing activities. People’s perception revealed that due to the establishment of the airport project, they may have more opportunities and scope of development rather than the adverse effect, but vigorously leave a motherland is psychological effect of the villagers. Research Limitation: This study is based on only six villages, the scenario of the entire ten affected villages is not explained by this research. Practical implication: The scenario of displacement and resettlement signifies more than a mere physical relocation. Compensation is not only hope for villagers, is it only give short time relief. There is a need to evolve institutions to protect and strengthen the right of Individuals. The development induced displacement exposed them to a new reality, the reality of their legality and illegality of stay on the land which belongs to the state. Originality: Mumbai has large population and high industrialized city have put land at the center of any policy implication. This paper demonstrates through the actual picture gathered from the field that how seriously the affected people suffered and are still suffering because of the land acquisition for the Navi Mumbai International Airport Project. The whole picture arise the question which is how long the government can deny the rights to farmers and agricultural laborers and remain unwilling to establish the balance between democracy and development.Keywords: compensation, displacement, land acquisition, project affected person (PAPs), rehabilitation
Procedia PDF Downloads 302203 The Physiological Effects of Thyriod Disorders During the Gestatory Period on Fetal Neurological Development: A Descriptive Review
Authors: Vanessa Bennemann, Gabriela Laste, Márcia Inês Goettert
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The gestational period is a phase in which the pregnant woman undergoes constant physiological and hormonal changes, which are part of the woman’s biological cycle, the development of the fetus, childbirth, and lactation. These are factors of response to the immunological adaptation of the human reproductive process that is directly related to the pregnancy’s well-being and development. Although most pregnancies occur without complications, about 15% of pregnant women will develop potentially fatal complications, implying maternal and fetal risk. Therefore, requiring specialized care for high-risk pregnant women (HRPW) with obstetric interventions for the survival of the mother and/or fetus. Among the risk factors that characterize HRPW are the women's age, gestational diabetes mellitus (GDM), autoimmune diseases, infectious diseases such as syphilis and HIV, hypertension (SAH), preeclampsia, eclampsia, HELLP syndrome, uterine contraction abnormalities, and premature placental detachment (PPD), thyroid disorders, among others. Thus, pregnancy has an impact on the thyroid gland causing changes in the functioning of the mother's thyroid gland, altering the thyroid hormone (TH) profiles and production as pregnancy progresses. Considering, throughout the gestational period, the interpretation of the results of the tests to evaluate the thyroid functioning depends on the stage in which the pregnancy is. Thyroid disorders are directly related to adverse obstetric outcomes and in child development. Therefore, the adequate release of TH is important for a pregnancy without complications and optimal fetal growth and development. Objective: Investigate the physiological effects caused by thyroid disorders in the gestational period. Methods: A search for articles indexed in PubMed, Scielo, and MDPI databases, was performed using the term “AND”, with the descriptors: Pregnancy, Thyroid. With several combinations that included: Melatonin, Thyroidopathy, Inflammatory processes, Cytokines, Anti-inflammatory, Antioxidant, High-risk pregnancy. Subsequently, the screening was performed through the analysis of titles and/or abstracts. The criteria were: including clinical studies in general, randomized or not, in the period of 10 years prior to the research, in the English literature; excluded: experimental studies, case reports, research in the development phase. Results: In the preliminary results, a total of studies (n=183) were found, (n=57) excluded, such as studies of cancer, diabetes, obesity, and skin diseases. Conclusion: To date, it has been identified that thyroid diseases can impair the fetus’s brain development. Further research is suggested on this matter to identify new substances that may have a potential therapeutic effect to aid the gestational period with thyroid diseases.Keywords: pregnancy, thyroid, melatonin, high-risk pregnancy
Procedia PDF Downloads 127202 Attitudes of Nursing Students Towards Caring Nurse-Patient Interaction
Authors: Şefika Dilek Güven, Gülden Küçükakça
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Objective: Learning the process of interaction with patient occurs within the process of nursing education. For this reason, it is considered to provide an opportunity for questioning and rearrangement of nursing education programs by assessing attitudes of nursing students towards caring nurse-patient interaction. Method: This is a descriptive study conducted in order to assess attitudes of nursing students towards caring nurse-patient interaction. The study was conducted with 318 students who were studying at nursing department of Semra and Vefa Küçük Health High School, Nevşehir Hacı Bektaş Veli University in 2015-2016 academic year and agreed to participate in the study. “Personal Information Form” prepared by the researchers utilizing the literature and “Caring Nurse-Patient Interaction Scale (CNPIS)”, who Turkish validity and reliability were conducted by Atar and Aştı, were used in the study. The Cronbach α coefficient of CNPIS was found as 0.973 in the study. Permissions of the institution and participants were received before starting to conduct study. Significance test of the difference between two means, analysis of variance, and correlation analysis were used to assess the data. Results: Average age of nursing students participating in the study was 20.72±1.91 and 74.8% were female, and 28.0% were the fourth-year students. 52.5% of the nursing students stated that they chose nursing profession willingly, 80.2% did not have difficulty in their interactions with patients, and 84.6% did not have difficulty in their social relationships. CNPIS total mean score of nursing students was found to be 295.31±40.95. When the correlation between total CNPIS mean score of the nursing students in terms of some variables was examined; it was determined there was a significant positive correlation between ages of the nursing students and total mean score of CNPIS (r=0.184, p=0.001). CNPIS total mean score was found to be higher in female students compared to male students, in 3rd–year students compared to students studying at other years, in those choosing their profession willingly compared to those choosing their profession unwillingly, in those not having difficulty in relations with the patients compared to those having difficulty, and in those not having difficulty in social relationships compared to those having difficulty. It was determined there was a significant difference between CNPIS total mean scores in terms of the year and state of having difficulty in social relationships (p<0,005). Conclusion: Nursing students had positive attitudes towards caring nurse-patient interactions, attitudes of nursing students, who were female, studying at 3rd year, chose nursing profession willingly, did not have difficulty in patient relations, and did not have difficulty in social relationships, towards caring nurse-patient interaction were found to be more positive. In the line with these results; it can be recommended to organize activities for introducing nursing profession to the youth preparing for the university, to use methods that will increase further communication skills to nursing students during their education, to support students in terms of communication skills, and to involve activities that will strengthen their social relationships.Keywords: nurse-patient interaction, nursing student, patient, communication
Procedia PDF Downloads 214201 The Current Application of BIM - An Empirical Study Focusing on the BIM-Maturity Level
Authors: Matthias Stange
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Building Information Modelling (BIM) is one of the most promising methods in the building design process and plays an important role in the digitalization of the Architectural, Engineering, and Construction (AEC) Industry. The application of BIM is seen as the key enabler for increasing productivity in the construction industry. The model-based collaboration using the BIM method is intended to significantly reduce cost increases, schedule delays, and quality problems in the planning and construction of buildings. Numerous qualitative studies based on expert interviews support this theory and report perceived benefits from the use of BIM in terms of achieving project objectives related to cost, schedule, and quality. However, there is a large research gap in analysing quantitative data collected from real construction projects regarding the actual benefits of applying BIM based on representative sample size and different application regions as well as different project typologies. In particular, the influence of the project-related BIM maturity level is completely unexplored. This research project examines primary data from 105 construction projects worldwide using quantitative research methods. Projects from the areas of residential, commercial, and industrial construction as well as infrastructure and hydraulic engineering were examined in application regions North America, Australia, Europe, Asia, MENA region, and South America. First, a descriptive data analysis of 6 independent project variables (BIM maturity level, application region, project category, project type, project size, and BIM level) were carried out using statistical methods. With the help of statisticaldata analyses, the influence of the project-related BIM maturity level on 6 dependent project variables (deviation in planning time, deviation in construction time, number of planning collisions, frequency of rework, number of RFIand number of changes) was investigated. The study revealed that most of the benefits of using BIM perceived through numerous qualitative studies have not been confirmed. The results of the examined sample show that the application of BIM did not have an improving influence on the dependent project variables, especially regarding the quality of the planning itself and the adherence to the schedule targets. The quantitative research suggests the conclusion that the BIM planning method in its current application has not (yet) become a recognizable increase in productivity within the planning and construction process. The empirical findings indicate that this is due to the overall low level of BIM maturity in the projects of the examined sample. As a quintessence, the author suggests that the further implementation of BIM should primarily focus on an application-oriented and consistent development of the project-related BIM maturity level instead of implementing BIM for its own sake. Apparently, there are still significant difficulties in the interweaving of people, processes, and technology.Keywords: AEC-process, building information modeling, BIM maturity level, project results, productivity of the construction industry
Procedia PDF Downloads 65200 Increased Availability and Accessibility of Family Planning Services: An Approach Leading to Improved Contraceptive Uptake and Reproductive Behavior of Women Living in Pakistan
Authors: Lutaf Ali, Haris Ahmed, Hina Najmi
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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.Keywords: access, family planning, underserved population, socio-demographic facts
Procedia PDF Downloads 182199 Evaluating the Knowledge and Skill of Final Year Pharmacy Students in Maternal and Child Health at a University in South Africa
Authors: E. O. Egieyeh, N. Butler, R. Coetzee, M. Van Huyssteen, A. Bheekie
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Background: High rate of maternal and child mortality is a global concern. Nationally, it constitutes one of South Africa’s quadruple burdens of diseases. Pharmacists have a crucial role in maternal and child health care delivery and as such should be equipped with adequate knowledge and skill required to contribute to maternal and child well-being. The International Pharmaceutical Federation statement of policy (2013) outlines pharmacist-led interventions in accordance with the World Health Organisation’s interventions in maternal, new-born and child health care. The South African Pharmacy Council’s guideline on Good Pharmacy Practice (2010) also stipulates the minimum standards required to participate in reproductive, maternal and child care. Pharmacy schools are obliged to train pharmacy students to meet priority health needs of the population so that graduates are ‘fit for purpose’. The purpose of the study is to evaluate the knowledge and skill of final year pharmacy students at a university in South Africa to determine their preparedness to contribute effectively to maternal and child health care. Method: A quantitative, descriptive, non-randomized baseline study was conducted among the final year students at the School of Pharmacy. Data was collected using a questionnaire designed in sections to assess knowledge of contraception, maternal and child health directed at the primary care level and framed within the scope of practice required of an entry-level generalist pharmacist. Participants’ skill in infant growth assessment was assessed in a section of the questionnaire in a written format. Participants ticked the topics they had been exposed to on a curriculum content assessment tool which was not graded. A pilot study examined the clarity and suitability of question items, and duration to complete the questionnaire. A score of 50% in each section of the questionnaire indicated a pass. The questionnaire was delivered in campus lecture venue. Results: Of the 102 students in final year, 53 (52%) students consented to participate in the study. Only 13.2% of participants scored above 50% in each section. Forty five (85%) participants scored above 50% in the contraception section while 40 (75%) scored less than 50% in the skills assessment. Less than half (45.3%) of the participants had a total score above 50%. Being a parent or working part-time as pharmacist assistance did not have any influence on the performance of the participants. Evaluation of participants’ curriculum content exposure showed differences in exposure to the various topics. Exposure to contraception teaching received the most recognition. Conclusion: Maternal and child health curriculum content should be reviewed at the university to enhance the knowledge and skill of pharmacy graduates.Keywords: final year pharmacy students, knowledge and skill, maternal and child health, South Africa
Procedia PDF Downloads 140198 The Problems of Women over 65 with Incontinence Diagnosis: A Case Study in Turkey
Authors: Birsel Canan Demirbag, Kıymet Yesilcicek Calik, Hacer Kobya Bulut
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Objective: This study was conducted to evaluate the problems of women over 65 with incontinence diagnosis. Methods: This descriptive study was conducted with women over 65 with incontinence diagnosis in four Family Health Centers in a city in Eastern Black Sea region between November 1, and December 20, 2015. 203, 107, 178, 180 women over 65 were registered in these centers and 262 had incontinence diagnosis at least once and had an ongoing complaint. 177 women were volunteers for the study. During home visits and using face-to-face survey methodology, participants were given socio-demographic characteristics survey, Sandvik severity scale, Incontinence Quality of Life Scale, Urogenital Distress Inventory and a questionnaire including challenges experienced due to incontinence developed by the researcher. Data were analyzed with SPSS program using percentages, numbers, Chi-square, Man-Whitney U and t test with 95% confidence interval and a significance level p <0.05. Findings: 67 ± 1.4 was the mean age, 2.05 ± 0.04 was parity, 44.5 ± 2.12 was menopause age, 66.3% were primary school graduates, 45.7% had deceased spouse, 44.4% lived in a large family, 67.2% had their own room, 77.8% had income, 89.2% could meet self- care, 73.2% had a diagnosis of mixed incontinence, 87.5% suffered for 6-20 years % 78.2 had diuretics, antidepressants and heart medicines, 20.5% had urinary fecal cases, 80.5% had bladder training at least once, 90.1% didn’t have bladder diary calendar/control training programs, 31.1% had hysterectomy for prolapse, 97.1'i% was treated with lower urinary tract infection at least once, 66.3% saw a doctor to get drug in the last three months, 76.2 could not go out alone, 99.2 % had at least one chronic disease, 87.6 % had constipation complain, 2.9% had chronic cough., 45.1% fell due to a sudden rise for toilet. Incontinence Impact Questionnaire Average score was (QOL) 54.3 ± 21.1, Sandvik score was 12.1 ± 2.5, Urogenital Distress Inventory was 47.7 ± 9.2. Difficulties experienced due to incontinence were 99.5% feeling of unhappiness, 67.1% constant feeling of urine smell due to failing to change briefs frequently, % 87.2 move away from social life, 89.7 unable to use pad, 99.2% feeling of disturbing households / other individuals, 87.5% feel dizziness/fall due to sudden rise, 87.4% feeling of others’ imperceptions about the situation, % 94.3 insomnia, 78.2 lack of assistance, 84.7% couldn’t afford urine protection briefs. Results: With this study, it was found out that there were a lot of unsolved issues at individual and community level affecting the life quality of women with incontinence. In accordance with this common problem in women, to facilitate daily life it is obvious that regular home care training programs at institutional level in our country will be effective.Keywords: health problems, incontinence, incontinence quality of life questionnaire, old age, urinary urogenital distress inventory, Sandviken severity, women
Procedia PDF Downloads 311197 Bedouin of Silicon Wadi: A Case Study Analysis of the Multi-Level Perspectives and Factors Affecting Bedouin Entrepreneurialism as Obstacles to Entry into the Israeli High-Tech Industry
Authors: Frazer G. Thompson
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Israel is a nation of cultural and historical diversity, yet the success factors for a modern Bedouin-Arab high-tech entrepreneur seem to be different from those of other Jewish-Israeli citizens. The purpose of this descriptive narrative case study is to explore how an Arab-Israeli all Negev-Bedouin technology company has succeeded in the Israeli high-tech industry by utilizing technology and engineering career opportunities available to Bedouin youth for ‘Sadel Tech,’ at Be’er-Sheva, the Negev, Israel. Methods: The strategy of inquiry seeks to explore real-life contextual understandings, multi-level perspectives, and the cultural influences of personal, community, educational, and entrepreneurial factors. The research methodology includes in-depth one-on-one interviews, focus group sessions, and overt observation to explore the meaning and understanding of the constructs toward determining the effect all or a few of the elements may have on the overall success factors of the company. Results: Study results indicate that the state-run educational system in Israel fails to adequately integrate important aspects of Bedouin culture into the learning environment. However, Bedouin entrepreneurs are finding ways to compensate for these inadequacies by utilizing non-traditional methods of teaching, learning, and doing business. Government incentives for Bedouin start-ups are also recognized as contributors. Employees of Sadel live and work in the Negev, the Gaza Strip, and the West Bank, further informing the study that the traditions of tribal etiquette continue to contribute to modern Bedouin-Arab business culture. Conclusion: Bedouin's business success in Israel is a multi-dimensional concept. While cultural acumen plays a prominent and unique role for both Arab-Israelis and Jewish-Israelis in economic and entrepreneurial pursuits, the marginalization of the Bedouin continues to contribute to the lack of educational and professional opportunities for Bedouin in Israel. Although recognized as important at the government level, programs necessary to implement the infrastructure required to support Bedouin entrepreneurship in Israel remain infantile. The Israeli Government is providing opportunities through grants and other incentives for Bedouin entrepreneurial start-ups, indicating that Israel has recognized the impact of this growing demographic. However, although many Bedouin graduates from University each year with advanced degrees, opportunities for Bedouin within the Israeli high-tech sector remain scarce.Keywords: Bedouin education, Bedouin entrepreneur, economic anthropology, ethnic business opportunities, Israeli tech, Silicon Wadi
Procedia PDF Downloads 110196 A Descriptive Study on Comparison of Maternal and Perinatal Outcome of Twin Pregnancies Conceived Spontaneously and by Assisted Conception Methods
Authors: Aishvarya Gupta, Keerthana Anand, Sasirekha Rengaraj, Latha Chathurvedula
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Introduction: Advances in assisted reproductive technology and increase in the proportion of infertile couples have both contributed to the steep increase in the incidence of twin pregnancies in past decades. Maternal and perinatal complications are higher in twins than in singleton pregnancies. Studies comparing the maternal and perinatal outcomes of ART twin pregnancies versus spontaneously conceived twin pregnancies report heterogeneous results making it unclear whether the complications are due to twin gestation per se or because of assisted reproductive techniques. The present study aims to compare both maternal and perinatal outcomes in twin pregnancies which are spontaneously conceived and after assisted conception methods, so that targeted steps can be undertaken in order to improve maternal and perinatal outcome of twins. Objectives: To study perinatal and maternal outcome in twin pregnancies conceived spontaneously as well as with assisted methods and compare the outcomes between the two groups. Setting: Women delivering at JIPMER (tertiary care institute), Pondicherry. Population: 380 women with twin pregnancies who delivered in JIPMER between June 2015 and March 2017 were included in the study. Methods: The study population was divided into two cohorts – one conceived by spontaneous conception and other by assisted reproductive methods. Association of various maternal and perinatal outcomes with the method of conception was assessed using chi square test or Student's t test as appropriate. Multiple logistic regression analysis was done to assess the independent association of assisted conception with maternal outcomes after adjusting for age, parity and BMI. Multiple logistic regression analysis was done to assess the independent association of assisted conception with perinatal outcomes after adjusting for age, parity, BMI, chorionicity, gestational age at delivery and presence of hypertension or gestational diabetes in the mother. A p value of < 0.05 was considered as significant. Result: There was increased proportion of women with GDM (21% v/s 4.29%) and premature rupture of membranes (35% v/s 22.85%) in the assisted conception group and more anemic women in the spontaneous group (71.27% v/s 55.1%). However assisted conception per se increased the incidence of GDM among twin gestations (OR 3.39, 95% CI 1.34 – 8.61) and did not influence any of the other maternal outcomes. Among the perinatal outcomes, assisted conception per se increased the risk of having very preterm (<32 weeks) neonates (OR 3.013, 95% CI 1.432 – 6.337). The mean birth weight did not significantly differ between the two groups (p = 0.429). Though there were higher proportion of babies admitted to NICU in the assisted conception group (48.48% v/s 36.43%), assisted conception per se did not increase the risk of admission to NICU (OR 1.23, 95% CI 0.76 – 1.98). There was no significant difference in perinatal mortality rates between the two groups (p = 0.829). Conclusion: Assisted conception per se increases the risk of developing GDM in women with twin gestation and increases the risk of delivering very preterm babies. Hence measures should be taken to ensure appropriate screening methods for GDM and suitable neonatal care in such pregnancies.Keywords: assisted conception, maternal outcomes, perinatal outcomes, twin gestation
Procedia PDF Downloads 195195 Bio-Medical Equipment Technicians: Crucial Workforce to Improve Quality of Health Services in Rural Remote Hospitals in Nepal
Authors: C. M. Sapkota, B. P. Sapkota
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Background: Continuous developments in science and technology are increasing the availability of thousands of medical devices – all of which should be of good quality and used appropriately to address global health challenges. It is obvious that bio medical devices are becoming ever more indispensable in health service delivery and among the key workforce responsible for their design, development, regulation, evaluation and training in their use: biomedical technician (BMET) is the crucial. As a pivotal member of health workforce, biomedical technicians are an essential component of the quality health service delivery mechanism supporting the attainment of the Sustainable Development Goals. Methods: The study was based on cross sectional descriptive design. Indicators measuring the quality of health services were assessed in Mechi Zonal Hospital (MZH) and Sagarmatha Zonal Hospital (SZH). Indicators were calculated based on the data about hospital utilization and performance of 2018 available in Medical record section of both hospitals. MZH had employed the BMET during 2018 but SZH had no BMET in 2018.Focus Group Discussion with health workers in both hospitals was conducted to validate the hospital records. Client exit interview was conducted to assess the level of client satisfaction in both the hospitals. Results: In MZH there was round the clock availability and utilization of Radio diagnostics equipment, Laboratory equipment. Operation Theater was functional throughout the year. Bed Occupancy rate in MZH was 97% but in SZH it was only 63%.In SZH, OT was functional only 54% of the days in 2018. CT scan machine was just installed but not functional. Computerized X-Ray in SZH was functional only in 72% of the days. Level of client satisfaction was 87% in MZH but was just 43% in SZH. MZH performed all (256) the Caesarean Sections but SZH performed only 36% of 210 Caesarean Sections in 2018. In annual performance ranking of Government Hospitals, MZH was placed in 1st rank while as SZH was placed in 19th rank out of 32 referral hospitals nationwide in 2018. Conclusion: Biomedical technicians are the crucial member of the human resource for health team with the pivotal role. Trained and qualified BMET professionals are required within health-care systems in order to design, evaluate, regulate, acquire, maintain, manage and train on safe medical technologies. Applying knowledge of engineering and technology to health-care systems to ensure availability, affordability, accessibility, acceptability and utilization of the safer, higher quality, effective, appropriate and socially acceptable bio medical technology to populations for preventive, promotive, curative, rehabilitative and palliative care across all levels of the health service delivery.Keywords: biomedical equipment technicians, BMET, human resources for health, HRH, quality health service, rural hospitals
Procedia PDF Downloads 118194 Sexuality and Quality of Life Among Older Adults
Authors: Ahuva Even-Zohar, Shoshi Werner
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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.Keywords: men, older adults, quality of life, sexuality, women
Procedia PDF Downloads 59193 The Confluence between Autism Spectrum Disorder and the Schizoid Personality
Authors: Murray David Schane
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Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions
Procedia PDF Downloads 105192 Migration, Labour Market, Capital Formation, and Social Security: A Study of Livelihoods of the Urban Poor in Two Different Cities of West Bengal in India
Authors: Arup Pramanik
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Most of the cities in the developing countries like Siliguri Municipal Corporation Area (SMCA) and Raiganj Municipality (RM) in West Bengal, India are changing typically in terms of demographic, economic and social relationship due to rapid pace of urbanization. The mushrooming growth of slums in SMCA and RM is the direct consequence of urbanization and migration due to regional imbalance, unbalanced growth process which is posing a serious threat to sustainable development of the country. Almost all the slums happen to be a breeding ground for poverty, negligence, and disease. Unpredictable growth of slums and poverty alleviation has now become a serious challenge to the global and national policy makers for the development of the slum dwellers. The ethical dimension of the poor in the cities like SMCA and RM stands on equal opportunities, inclusive and harmonious living without discrimination of any kind. But, the migrant slum dwellers in SMCA and RM do not possess high skill or education to enable them to find well paid employment in the formal sector and the surplus urban labour force is compelled to generate its own means of employment and survival in the informal sector. The survey data of the households has been analysedin terms of percentage, descriptive statistics which includes mean, Standard Deviation (SD), ANOVA (Mean Difference) etc., to analyse the socio economic variables of the households. The study shows that the migrant labour forces living in the slums are derived from the social security measures in both the municipal areas of SMCA and RM. The urban poor in the cities of SMCA and RM rely heavily on social capital amongst all the capital assets to help them ‘get by’ and ‘get ahead’. Despite, the slum dwellers in the study areas are vulnerable with respect to other determinants of capital assets. It is noteworthy that Indian plans of anti-poverty programmes was in a proper place even after the neo-liberal regime, where the basic idea behind the massive shift of various welfare and service oriented strategy to poverty reduction strategy for the benefit of the urban poor with the trickle down effects. But, the overall impact of the trickledown effect was unsatisfactory. The objective of the Paper is to assess the magnitude of migration and absorption in the urban labour market. Issues relating to capital formation, social security measures and the support of the Welfare State in order to meet 'Sustainable Development Goals'. This study also highlights the quality of life of urban poor migrants in terms of capital formation and livelihoods.Keywords: migration, slums, labour market, capital formation, social security
Procedia PDF Downloads 108191 Household Socioeconomic Factors Associated with Teenage Pregnancies in Kigali City, Rwanda
Authors: Dieudonne Uwizeye, Reuben Muhayiteto
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Teenage pregnancy is a challenging problem for sustainable development due to restrictions it poses to socioeconomic opportunities for young mothers, their children and families. Being unable to take appropriate economic and social responsibilities, teen mothers get trapped into poverty and become economic burden to their family and country. Besides, teenage pregnancy is also a health problem because children born to very young mothers are vulnerable with greater risk of illnesses and deaths, and teenage mothers are more likely to be exposed to greater risk of maternal mortality and to other health and psychological problems. In Kigali city, in Rwanda, teenage pregnancy rate is currently high and its increase in recent years is worrisome. However, only individual factors influencing the teenage pregnancy tend to be the basis of interventions. It is important to understand the important socioeconomic factors at the household level that are associated with teenage pregnancy to help government, parents, and other stakeholders to appropriately address the problem with sustainable measures. This study analyzed secondary data from the Fifth Rwanda Demographic and Health Survey (RDHS-V 2014-2015) conducted by the National Institute of Statistics of Rwanda (NISR). The aim was to examine household socio-economic factors that are associated with incidence of teenage pregnancies in Kigali city. In addition to descriptive analysis, Pearson’s Chi Square and Binary Logistic Regression were used in the analysis. Findings indicate that marital status and age of household head, number of members in a household, number of rooms used for sleeping, educational level of the household head and household's wealth are significantly associated with teenage pregnancy in Rwanda ( p< 0.05). It was found that teenagers living with parents, those having parents with higher education and those from richer families are less likely to become pregnant. Age of household head was pinpointed as factor to teenage pregnancy, with teenage-headed households being more vulnerable. The findings also revealed that household composition correlates with the probability of teenage pregnancy (p < 0.05) with teenagers from households with less number of members being more vulnerable. Regarding the size of the house, the study suggested that the more rooms available in households, the less incidences of teenage pregnancy are likely to be observed (p < 0.05). However, teenage pregnancy was not significantly associated with physical violence among parents (p = 0.65) and sex of household heads (p = 0.52), except in teen-headed households of which female are predominantly heads. The study concludes that teenage pregnancy remains a serious social, economic and health problem in Rwanda. The study informs government officials, parents and other stakeholders to take interventions and preventive measures through community sex education, policies and strategies to foster effective parental guidance, care and control of young girls through meeting their necessary social and financial needs within households.Keywords: household socio-economic factors, Rwanda, Rwanda demographic and health survey, teenage pregnancy
Procedia PDF Downloads 169190 Pathogenic Escherichia Coli Strains and Their Antibiotic Susceptibility Profiles in Cases of Child Diarrhea at Addis Ababa University, College of Health Sciences, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Benyam Zenebe, Tesfaye Sisay, Gurja Belay, Workabeba Abebe
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Background: The prevalence and antibiogram of pathogenic E. coli strains, which cause diarrhea vary from region to region, and even within countries in the same geographical area. In Ethiopia, diagnostic approaches to E. coli induced diarrhea in children less than five years of age are not standardized. The aim of this study was to determine the involvement of pathogenic E. coli strains in child diarrhea and determine the antibiograms of the isolates in children less than 5 years of age with diarrhea at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A purposive study that included 98 diarrheic children less than five years of age was conducted at Addis Ababa University College of Health Sciences, TikurAnbessa Specialized Hospital, Addis Ababa, Ethiopia to detect pathogenic E. coli biotypes. Stool culture was used to identify presumptive E. coliisolates. Presumptive isolates were confirmed by biochemical tests, and antimicrobial susceptibility tests were performed on confirmed E. coli isolates by the disk diffusion method. DNA was extracted from confirmed isolates by a heating method and subjected to Polymerase Chain Reaction or the presence of virulence genes. Amplified PCR products were analyzed by agarose gel electrophoresis. Data were collected on child demographics and clinical conditions using administered questionnaires. The prevalence of E. coli strains from the total diarrheic children, and the prevalence of pathogenic strains from total E. coli isolates along with their susceptibility profiles; the distribution of pathogenic E.coli biotypes among different age groups and between the sexes were determined by using descriptive statistics. Result: Out of 98 stool specimens collected from diarrheic children less than 5 years of age, 75 presumptive E. coli isolates were identified by culture; further confirmation by biochemical tests showed that only 56 of the isolates were E. coli; 29 of the isolates were found in male children and 27 of them in female children. Out of the 58 isolates of E. coli, 25 pathotypes belonging to different classes of pathogenic strains: STEC, EPEC, EHEC, EAEC were detected by using the PCR technique. Pathogenic E. coli exhibited high rates of antibiotic resistance to many of the antibiotics tested. Moreover, they exhibited multiple drug resistance. Conclusion: This study found that the isolation rate of E. coli and the involvement of antibiotic-resistant pathogenic E. coli in diarrheic children is prominent, and hence focus should be given on the diagnosis and antimicrobial sensitivity testing of pathogenic E. coli at Addis Ababa University College of Health Sciences TikurAnbessa Specialized Hospital. Among antibiotics tested, Cefotitan could be a drug of choice to treat E. coli.Keywords: antibiotic susceptibility profile, children, diarrhea, E. coli, pathogenic
Procedia PDF Downloads 222189 Assessment of the Growth Enhancement Support Scheme in Adamawa State, Nigeria
Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene
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The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers
Procedia PDF Downloads 99188 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital
Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon
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Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania
Procedia PDF Downloads 321187 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy
Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes
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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation
Procedia PDF Downloads 386186 Investigation of a Technology Enabled Model of Home Care: the eShift Model of Palliative Care
Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons
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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team
Procedia PDF Downloads 406185 Rural Entrepreneurship as a Response to Climate Change and Resource Conservation
Authors: Omar Romero-Hernandez, Federico Castillo, Armando Sanchez, Sergio Romero, Andrea Romero, Michael Mitchell
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Environmental policies for resource conservation in rural areas include subsidies on services and social programs to cover living expenses. Government's expectation is that rural communities who benefit from social programs, such as payment for ecosystem services, are provided with an incentive to conserve natural resources and preserve natural sinks for greenhouse gases. At the same time, global climate change has affected the lives of people worldwide. The capability to adapt to global warming depends on the available resources and the standard of living, putting rural communities at a disadvantage. This paper explores whether rural entrepreneurship can represent a solution to resource conservation and global warming adaptation in rural communities. The research focuses on a sample of two coffee communities in Oaxaca, Mexico. Researchers used geospatial information contained in aerial photographs of the geographical areas of interest. Households were identified in the photos via the roofs of households and georeferenced via coordinates. From the household population, a random selection of roofs was performed and received a visit. A total of 112 surveys were completed, including questions of socio-demographics, perception to climate change and adaptation activities. The population includes two groups of study: entrepreneurs and non-entrepreneurs. Data was sorted, filtered, and validated. Analysis includes descriptive statistics for exploratory purposes and a multi-regression analysis. Outcomes from the surveys indicate that coffee farmers, who demonstrate entrepreneurship skills and hire employees, are more eager to adapt to climate change despite the extreme adverse socioeconomic conditions of the region. We show that farmers with entrepreneurial tendencies are more creative in using innovative farm practices such as the planting of shade trees, the use of live fencing, instead of wires, and watershed protection techniques, among others. This result counters the notion that small farmers are at the mercy of climate change and have no possibility of being able to adapt to a changing climate. The study also points to roadblocks that farmers face when coping with climate change. Among those roadblocks are a lack of extension services, access to credit, and reliable internet, all of which reduces access to vital information needed in today’s constantly changing world. Results indicate that, under some circumstances, funding and supporting entrepreneurship programs may provide more benefit than traditional social programs.Keywords: entrepreneurship, global warming, rural communities, climate change adaptation
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