Search results for: early intervention services
6852 Municipal Employees’ Perceptions of Fairness of Human Resource Management Practices and Employee Organisational Commitment
Authors: Lineo Dzansi
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South African government has been mandated by the Constitution (Act 108 of 1996) to deliver basic services to all who live in it. However, service delivery has always been marred with much criticism and citizens’ dissatisfaction regarding the quality of services rendered to them. This is evidenced by public protests that are common in South Africa lately which they are mostly alleged to link with failure by the government through various municipalities to meet citizens’ service delivery expectations. Municipalities render services through people. People management plays a crucial role in influencing employee and organisational performance and it thus needs to be conducted in a fair and just manner. Literature confirms that there is a relationship between organisational justice perceptions and employee behaviour, and that positive or negative justice perceptions can have an influence on employee attitudes, commitment to their jobs and organisation. The nature of the attachments formed by individuals to their employing organisations depends on the manner in which the organisation treats them. This implies that Municipal employees’ commitment could be linked to fair or unfair perceptions of Human Resource Management practices within their organisations. Unfortunately, the political nature of municipal environment could be a fertile ground for appointments of people based on political affiliation as a reward for political patronage rather than on merit. This paper seeks to investigate the relationship between municipal employees’ perceptions of fairness of Human Resource Management practices and employee commitment from the organisational justice point of view. Research on organisational justice has shown that employees’ organisational justice perceptions link directly with job satisfaction and employee organisational commitment. Quantitative research methods were employed to collect and analyse data from selected managerial and non-managerial municipal employees within selected municipalities in Free State Province of South Africa. Employee commitment has positive relationships with HRM practices at the .05 and .01 levels of significance – indicating that the higher the levels of HRM practices in municipal employees the higher the organisational commitment of employees. Therefore, it is concluded that organisational commitment of municipal employees (EOC) is positively related to their perceptions of fairness of HRM practices (PHF) of municipalities. In other words, fair HRM practices of municipalities promote organisational commitment in municipal employees.Keywords: organisational Justice, HRM practices, employee organisational commitment, employee attitudes
Procedia PDF Downloads 736851 A Systematic Review of Forest School for Early Childhood Education in China: Lessons Learned from European Studies from a Perspective of Ecological System
Authors: Xiaoying Zhang
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Forest school – an outdoor educational experience that is undertaken in an outdoor environment with trees – becomes an emerging field of early childhood education recently. In China, the benefits of natural outdoor education to children and young people’s wellness have raised attention. Although different types of outdoor-based activities have been involved in some pre-school of China, few study and practice have been conducted in terms of the notion of forest school. To comprehend the impact of forest school for children and young people, this study aims to systematically review articles on the topic of forest school in preschool education from an ecological perspective, i.e. from individual level (e.g., behavior and mental health) to microsystem level (e.g., the relationship between teachers and children) to ecosystem level. Based on PRISMA framework flow, using the key words of “Forest School” and “Early Childhood Education” for searching in Web-of-science database, a total of 33 articles were identified. Sample participants of 13 studies were not preschool children, five studies were not on forest school theme, and two literature review articles were excluded for further analysis. Finally, 13 articles were eligible for thematic analysis. According to Bronfenbrenner's ecological systems theory, there are some fingdings, on the individual level, current forest school studies are concerned about the children behavioral experience in forest school, how these experience may relate to their achievement or to develop children’s wellbeing/wellness, and how this type of learning experience may enhance children’s self-awareness on risk and safety issues. On the microsystem/mesosystem level, this review indicated that pedagogical development for forest school, risk perception from teachers and parents, social development between peers, and adult’s role in the participation of forest school were concerned, explored and discussed most frequently. On the macrosystem, the conceptualization of forest school is the key theme. Different forms of presentation in various countries with diverse cultures could provide various models of forest school education. However, there was no study investigating forest school on an ecosystem level. As for the potential benefits of physical health and mental wellness that results from forest school, it informs us to reflect the system of preschool education from the ecological perspective for Chinese children. For instance, most Chinese kindergartens ignored the significance of natural outdoor activities for children. Preschool education in China is strongly oriented by primary school system, which means pre-school children are expected to be trained as primary school students to do different subjects, such as math. Hardly any kindergarteners provide the opportunities for children and young people to take risks in a natural environment like forest school does. However, merely copying forest school model for a Chinese preschool education system will be less effective. This review of different level concerns could inform us that the localization the idea of forest school to adapt to a Chinese political, educational and cultural background. More detailed results and profound discussions will be presented in the full paper.Keywords: early childhood education, ecological system, education development prospects in China, forest school
Procedia PDF Downloads 1516850 Barriers and Facilitators for Telehealth Use during Cervical Cancer Screening and Care: A Literature Review
Authors: Reuben Mugisha, Stella Bakibinga
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The cervical cancer burden is a global threat, but more so in low income settings where more than 85% of mortality cases occur due to lack of sufficient screening programs. There is consequently a lack of early detection of cancer and precancerous cells among women. Studies show that 3% to 35% of deaths could have been avoided through early screening depending on prognosis, disease progression, environmental and lifestyle factors. In this study, a systematic literature review is undertaken to understand potential barriers and facilitators as documented in previous studies that focus on the application of telehealth in cervical cancer screening programs for early detection of cancer and precancerous cells. The study informs future studies especially those from low income settings about lessons learned from previous studies and how to be best prepared while planning to implement telehealth for cervical cancer screening. It further identifies the knowledge gaps in the research area and makes recommendations. Using a specified selection criterion, 15 different articles are analyzed based on the study’s aim, theory or conceptual framework used, method applied, study findings and conclusion. Results are then tabulated and presented thematically to better inform readers about emerging facts on barriers and facilitators to telehealth implementation as documented in the reviewed articles, and how they consequently lead to evidence informed conclusions that are relevant to telehealth implementation for cervical cancer screening. Preliminary findings of this study underscore that use of low cost mobile colposcope is an appealing option in cervical cancer screening, particularly when coupled with onsite treatment of suspicious lesions. These tools relay cervical images to the online databases for storage and retrieval, they permit integration of connected devices at the point of care to rapidly collect clinical data for further analysis of the prevalence of cervical dysplasia and cervical cancer. Results however reveal the need for population sensitization prior to use of mobile colposcopies among patients, standardization of mobile colposcopy programs across screening partners, sufficient logistics and good connectivity, experienced experts to review image cases at the point-of-care as important facilitators to the implementation of mobile colposcope as a telehealth cervical cancer screening mechanism.Keywords: cervical cancer screening, digital technology, hand-held colposcopy, knowledge-sharing
Procedia PDF Downloads 2216849 Demonstration of Land Use Changes Simulation Using Urban Climate Model
Authors: Barbara Vojvodikova, Katerina Jupova, Iva Ticha
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Cities in their historical evolution have always adapted their internal structure to the needs of society (for example protective city walls during classicism era lost their defense function, became unnecessary, were demolished and gave space for new features such as roads, museums or parks). Today it is necessary to modify the internal structure of the city in order to minimize the impact of climate changes on the environment of the population. This article discusses the results of the Urban Climate model owned by VITO, which was carried out as part of a project from the European Union's Horizon grant agreement No 730004 Pan-European Urban Climate Services Climate-Fit city. The use of the model was aimed at changes in land use and land cover in cities related to urban heat islands (UHI). The task of the application was to evaluate possible land use change scenarios in connection with city requirements and ideas. Two pilot areas in the Czech Republic were selected. One is Ostrava and the other Hodonín. The paper provides a demonstration of the application of the model for various possible future development scenarios. It contains an assessment of the suitability or inappropriateness of scenarios of future development depending on the temperature increase. Cities that are preparing to reconstruct the public space are interested in eliminating proposals that would lead to an increase in temperature stress as early as in the assignment phase. If they have evaluation on the unsuitability of some type of design, they can limit it into the proposal phases. Therefore, especially in the application of models on Local level - in 1 m spatial resolution, it was necessary to show which type of proposals would create a significant temperature island in its implementation. Such a type of proposal is considered unsuitable. The model shows that the building itself can create a shady place and thus contribute to the reduction of the UHI. If it sensitively approaches the protection of existing greenery, this new construction may not pose a significant problem. More massive interventions leading to the reduction of existing greenery create a new heat island space.Keywords: climate model, heat islands, Hodonin, land use changes, Ostrava
Procedia PDF Downloads 1436848 A Review on Factors Influencing Implementation of Secure Software Development Practices
Authors: Sri Lakshmi Kanniah, Mohd Naz’ri Mahrin
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More and more businesses and services are depending on software to run their daily operations and business services. At the same time, cyber-attacks are becoming more covert and sophisticated, posing threats to software. Vulnerabilities exist in the software due to the lack of security practices during the phases of software development. Implementation of secure software development practices can improve the resistance to attacks. Many methods, models and standards for secure software development have been developed. However, despite the efforts, they still come up against difficulties in their deployment and the processes are not institutionalized. There is a set of factors that influence the successful deployment of secure software development processes. In this study, the methodology and results from a systematic literature review of factors influencing the implementation of secure software development practices is described. A total of 44 primary studies were analysed as a result of the systematic review. As a result of the study, a list of twenty factors has been identified. Some of factors that affect implementation of secure software development practices are: Involvement of the security expert, integration between security and development team, developer’s skill and expertise, development time and communication between stakeholders. The factors were further classified into four categories which are institutional context, people and action, project content and system development process. The results obtained show that it is important to take into account organizational, technical and people issues in order to implement secure software development initiatives.Keywords: secure software development, software development, software security, systematic literature review
Procedia PDF Downloads 3776847 Activation of Spermidine/Spermine N1-Acetyltransferase 1 (SSAT-1) as Biomarker in Breast Cancer
Authors: Rubina Ghani, Sehrish Zia, Afifa Fatima Rafique, Shaista Emad
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Background: Cancer is a leading cause of death worldwide, with breast cancer being the most common cancer in women. Pakistan has the highest rate of breast cancer cases among Asian countries. Early and accurate diagnosis is crucial for treatment outcomes and quality of life. Method: It is a case-control study with a sample size of 150. There were 100 suspected cancer cases, 25 healthy controls, and 25 diagnosed cancer cases. To analyze SSAT-1 mRNA expression in whole blood, Zymo Research Quick-RNA Miniprep and Innu SCRIPT—One Step RT-PCR Syber Green kits were used. Patients were divided into three groups: 100 suspected cancer cases, 25 controls, and 25 confirmed breast cancer cases. Result: The total mRNA was isolated, and the expression of SSAT-1 was measured using RT-qPCR. The threshold cycle (Ct) values were used to determine the amount of each mRNA. Ct values were then calculated by taking the difference between the CtSSAT-1 and Ct GAPDH, and further Ct values were calculated with the median absolute deviation for all the samples within the same experimental group. Samples that did not correlate with the results were taken as outliers and excluded from the analysis. The relative fold change is shown as 2^-Ct values. Suspected cases showed a maximum fold change of 32.24, with a control fold change of 1.31. Conclusion: The study reveals an overexpression of SSAT-1 in breast cancer. Furthermore, we can use SSAT-1 as a diagnostic, prognostic, and therapeutic marker for early diagnosis of cancer.Keywords: breast cancer, spermidine/spermine, qPCR, mRNA
Procedia PDF Downloads 376846 Innovation Management in E-Health Care: The Implementation of New Technologies for Health Care in Europe and the USA
Authors: Dariusz M. Trzmielak, William Bradley Zehner, Elin Oftedal, Ilona Lipka-Matusiak
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The use of new technologies should create new value for all stakeholders in the healthcare system. The article focuses on demonstrating that technologies or products typically enable new functionality, a higher standard of service, or a higher level of knowledge and competence for clinicians. It also highlights the key benefits that can be achieved through the use of artificial intelligence, such as relieving clinicians of many tasks and enabling the expansion and greater specialisation of healthcare services. The comparative analysis allowed the authors to create a classification of new technologies in e-health according to health needs and benefits for patients, doctors, and healthcare systems, i.e., the main stakeholders in the implementation of new technologies and products in healthcare. The added value of the development of new technologies in healthcare is diagnosed. The work is both theoretical and practical in nature. The primary research methods are bibliographic analysis and analysis of research data and market potential of new solutions for healthcare organisations. The bibliographic analysis is complemented by the author's case studies of implemented technologies, mostly based on artificial intelligence or telemedicine. In the past, patients were often passive recipients, the end point of the service delivery system, rather than stakeholders in the system. One of the dangers of powerful new technologies is that patients may become even more marginalised. Healthcare will be provided and delivered in an increasingly administrative, programmed way. The doctor may also become a robot, carrying out programmed activities - using 'non-human services'. An alternative approach is to put the patient at the centre, using technologies, products, and services that allow them to design and control technologies based on their own needs. An important contribution to the discussion is to open up the different dimensions of the user (carer and patient) and to make them aware of healthcare units implementing new technologies. The authors of this article outline the importance of three types of patients in the successful implementation of new medical solutions. The impact of implemented technologies is analysed based on: 1) "Informed users", who are able to use the technology based on a better understanding of it; 2) "Engaged users" who play an active role in the broader healthcare system as a result of the technology; 3) "Innovative users" who bring their own ideas to the table based on a deeper understanding of healthcare issues. The authors' research hypothesis is that the distinction between informed, engaged, and innovative users has an impact on the perceived and actual quality of healthcare services. The analysis is based on case studies of new solutions implemented in different medical centres. In addition, based on the observations of the Polish author, who is a manager at the largest medical research institute in Poland, with analytical input from American and Norwegian partners, the added value of the implementations for patients, clinicians, and the healthcare system will be demonstrated.Keywords: innovation, management, medicine, e-health, artificial intelligence
Procedia PDF Downloads 206845 A Review on 3D Smart City Platforms Using Remotely Sensed Data to Aid Simulation and Urban Analysis
Authors: Slim Namouchi, Bruno Vallet, Imed Riadh Farah
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3D urban models provide powerful tools for decision making, urban planning, and smart city services. The accuracy of this 3D based systems is directly related to the quality of these models. Since manual large-scale modeling, such as cities or countries is highly time intensive and very expensive process, a fully automatic 3D building generation is needed. However, 3D modeling process result depends on the input data, the proprieties of the captured objects, and the required characteristics of the reconstructed 3D model. Nowadays, producing 3D real-world model is no longer a problem. Remotely sensed data had experienced a remarkable increase in the recent years, especially data acquired using unmanned aerial vehicles (UAV). While the scanning techniques are developing, the captured data amount and the resolution are getting bigger and more precise. This paper presents a literature review, which aims to identify different methods of automatic 3D buildings extractions either from LiDAR or the combination of LiDAR and satellite or aerial images. Then, we present open source technologies, and data models (e.g., CityGML, PostGIS, Cesiumjs) used to integrate these models in geospatial base layers for smart city services.Keywords: CityGML, LiDAR, remote sensing, SIG, Smart City, 3D urban modeling
Procedia PDF Downloads 1356844 Design and Application of NFC-Based Identity and Access Management in Cloud Services
Authors: Shin-Jer Yang, Kai-Tai Yang
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In response to a changing world and the fast growth of the Internet, more and more enterprises are replacing web-based services with cloud-based ones. Multi-tenancy technology is becoming more important especially with Software as a Service (SaaS). This in turn leads to a greater focus on the application of Identity and Access Management (IAM). Conventional Near-Field Communication (NFC) based verification relies on a computer browser and a card reader to access an NFC tag. This type of verification does not support mobile device login and user-based access management functions. This study designs an NFC-based third-party cloud identity and access management scheme (NFC-IAM) addressing this shortcoming. Data from simulation tests analyzed with Key Performance Indicators (KPIs) suggest that the NFC-IAM not only takes less time in identity identification but also cuts time by 80% in terms of two-factor authentication and improves verification accuracy to 99.9% or better. In functional performance analyses, NFC-IAM performed better in salability and portability. The NFC-IAM App (Application Software) and back-end system to be developed and deployed in mobile device are to support IAM features and also offers users a more user-friendly experience and stronger security protection. In the future, our NFC-IAM can be employed to different environments including identification for mobile payment systems, permission management for remote equipment monitoring, among other applications.Keywords: cloud service, multi-tenancy, NFC, IAM, mobile device
Procedia PDF Downloads 4356843 Contribution of Supply Chain Management Practices for Enhancing Healthcare Service Quality: A Quantitative Analysis in Delhi’s Healthcare Sector
Authors: Chitrangi Gupta, Arvind Bhardwaj
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This study seeks to investigate and quantify the influence of various dimensions of supply chain management (namely, supplier relationships, compatibility, specifications and standards, delivery processes, and after-sales service) on distinct dimensions of healthcare service quality (specifically, responsiveness, trustworthiness, and security) within the operational framework of XYZ Superspeciality Hospital, situated in Delhi. The name of the Hospital is not being mentioned here because of the privacy policy of the hospital. The primary objective of this research is to elucidate the impact of supply chain management practices on the overall quality of healthcare services offered within hospital settings. Employing a quantitative research design, this study utilizes a hypothesis-testing approach to systematically discern the relationship between supply chain management dimensions and the quality of health services. The findings of this study underscore the significant influence exerted by supply chain management dimensions, specifically supplier relationships, specifications and standards, delivery processes, and after-sales service, on the enhancement of healthcare service quality. Moreover, the study's results reveal that demographic factors such as gender, qualifications, age, and experience do not yield discernible disparities in the relationship between supply chain management and healthcare service quality.Keywords: supply chain management, healthcare, hospital operations, service delivery
Procedia PDF Downloads 676842 Evaluating the Impact of a Child Sponsorship Program on Paediatric Health and Development in Calauan, Philippines: A Retrospective Audit
Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning
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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines
Procedia PDF Downloads 1096841 Measuring the Resilience of e-Governments Using an Ontology
Authors: Onyekachi Onwudike, Russell Lock, Iain Phillips
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The variability that exists across governments, her departments and the provisioning of services has been areas of concern in the E-Government domain. There is a need for reuse and integration across government departments which are accompanied by varying degrees of risks and threats. There is also the need for assessment, prevention, preparation, response and recovery when dealing with these risks or threats. The ability of a government to cope with the emerging changes that occur within it is known as resilience. In order to forge ahead with concerted efforts to manage reuse and integration induced risks or threats to governments, the ambiguities contained within resilience must be addressed. Enhancing resilience in the E-Government domain is synonymous with reducing risks governments face with provisioning of services as well as reuse of components across departments. Therefore, it can be said that resilience is responsible for the reduction in government’s vulnerability to changes. In this paper, we present the use of the ontology to measure the resilience of governments. This ontology is made up of a well-defined construct for the taxonomy of resilience. A specific class known as ‘Resilience Requirements’ is added to the ontology. This class embraces the concept of resilience into the E-Government domain ontology. Considering that the E-Government domain is a highly complex one made up of different departments offering different services, the reliability and resilience of the E-Government domain have become more complex and critical to understand. We present questions that can help a government access how prepared they are in the face of risks and what steps can be taken to recover from them. These questions can be asked with the use of queries. The ontology focuses on developing a case study section that is used to explore ways in which government departments can become resilient to the different kinds of risks and threats they may face. A collection of resilience tools and resources have been developed in our ontology to encourage governments to take steps to prepare for emergencies and risks that a government may face with the integration of departments and reuse of components across government departments. To achieve this, the ontology has been extended by rules. We present two tools for understanding resilience in the E-Government domain as a risk analysis target and the output of these tools when applied to resilience in the E-Government domain. We introduce the classification of resilience using the defined taxonomy and modelling of existent relationships based on the defined taxonomy. The ontology is constructed on formal theory and it provides a semantic reference framework for the concept of resilience. Key terms which fall under the purview of resilience with respect to E-Governments are defined. Terms are made explicit and the relationships that exist between risks and resilience are made explicit. The overall aim of the ontology is to use it within standards that would be followed by all governments for government-based resilience measures.Keywords: E-Government, Ontology, Relationships, Resilience, Risks, Threats
Procedia PDF Downloads 3376840 Characterization of Femur Development in Mice: A Computational Approach
Authors: Moncayo Donoso Miguelangel, Guevara Morales Johana, Kalenia Flores Kalenia, Barrera Avellaneda Luis Alejandro, Garzon Alvarado Diego Alexander
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In mammals, long bones are formed by ossification of a cartilage mold during early embryonic development, forming structures called secondary ossification centers (SOCs), a primary ossification center (POC) and growth plates. This last structure is responsible for long bone growth. During the femur growth, the morphology of the growth plate and the SOCs may vary during different developmental stages. So far there are no detailed morphological studies of the development process from embryonic to adult stages. In this work, we carried out a morphological characterization of femur development from embryonic period to adulthood in mice. 15, 17 and 19 days old embryos and 1, 7, 14, 35, 46 and 52 days old mice were used. Samples were analyzed by a computational approach, using 3D images obtained by micro-CT imaging. Results obtained in this study showed that femur, its growth plates and SOCs undergo morphological changes during different stages of development, including changes in shape, position and thickness. These variations may be related with a response to mechanical loads imposed for muscle development surrounding the femur and a high activity during early stages necessary to support the high growth rates during first weeks and years of development. This study is important to improve our knowledge about the ossification patterns on every stage of bone development and characterize the morphological changes of important structures in bone growth like SOCs and growth plates.Keywords: development, femur, growth plate, mice
Procedia PDF Downloads 3456839 Working with Interpreters: Using Role Play to Teach Social Work Students
Authors: Yuet Wah Echo Yeung
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Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.Keywords: role play, social learning theory, social work practice, working with interpreters
Procedia PDF Downloads 1796838 Identification and Optimisation of South Africa's Basic Access Road Network
Authors: Diogo Prosdocimi, Don Ross, Matthew Townshend
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Road authorities are mandated within limited budgets to both deliver improved access to basic services and facilitate economic growth. This responsibility is further complicated if maintenance backlogs and funding shortfalls exist, as evident in many countries including South Africa. These conditions require authorities to make difficult prioritisation decisions, with the effect that Road Asset Management Systems with a one-dimensional focus on traffic volumes may overlook the maintenance of low-volume roads that provide isolated communities with vital access to basic services. Given these challenges, this paper overlays the full South African road network with geo-referenced information for population, primary and secondary schools, and healthcare facilities to identify the network of connective roads between communities and basic service centres. This connective network is then rationalised according to the Gross Value Added and number of jobs per mesozone, administrative and functional road classifications, speed limit, and road length, location, and name to estimate the Basic Access Road Network. A two-step floating catchment area (2SFCA) method, capturing a weighted assessment of drive-time to service centres and the ratio of people within a catchment area to teachers and healthcare workers, is subsequently applied to generate a Multivariate Road Index. This Index is used to assign higher maintenance priority to roads within the Basic Access Road Network that provide more people with better access to services. The relatively limited incidence of Basic Access Roads indicates that authorities could maintain the entire estimated network without exhausting the available road budget before practical economic considerations get any purchase. Despite this fact, a final case study modelling exercise is performed for the Namakwa District Municipality to demonstrate the extent to which optimal relocation of schools and healthcare facilities could minimise the Basic Access Road Network and thereby release budget for investment in roads that best promote GDP growth.Keywords: basic access roads, multivariate road index, road prioritisation, two-step floating catchment area method
Procedia PDF Downloads 2316837 Reconsidering the Palaeo-Environmental Reconstruction of the Wet Zone of Sri Lanka: A Zooarchaeological Perspective
Authors: Kelum N. Manamendra-Arachchi, Kalangi Rodrigo
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Bones, teeth, and shells have been acknowledged over the last two centuries as evidence of chronology, Palaeo-environment, and human activity. Faunal traces are valid evidence of past situations because they have properties that have not changed over long periods of time. Sri Lanka has been known as an Island, which has a diverse variation of prehistoric occupation among ecological zones. Defining the Paleoecology of the past societies has been an archaeological thought developed in the 1960s. It is mainly concerned with the reconstruction from available geological and biological evidence of past biota, populations, communities, landscapes, environments, and ecosystems. Sri Lanka has dealt with this subject and considerable research has been already undertaken. The fossil and material record of Sri Lanka’s Wet Zone tropical forests continues from c. 38,000–34,000 ybp. This early and persistent human fossil, technical, and cultural florescence, as well as a collection of well-preserved tropical-forest rock shelters with associated ' on-site ' Palaeoenvironmental records, makes Sri Lanka a central and unusual case study to determine the extent and strength of early human tropical forest encounters. Excavations carried out in prehistoric caves in the low country wet zone has shown that in the last 50,000 years, the temperature in the lowland rainforests has not exceeded 5 degrees. Based on Semnopithecus Priam (Gray Langur) remains unearned from wet zone prehistoric caves, it has been argued that periods of momentous climate changes during the LGM and Terminal Pleistocene/Early Holocene boundary, with a recognizable preference for semi-open ‘Intermediate’ rainforest or edges. Continuous Genus Acavus and Oligospira occupation along with uninterrupted horizontal pervasive of Canarium sp. (‘kekuna’ nut) have proven that temperatures in the lowland rain forests have not changed by at least 5 oC over the last 50,000 years. Site Catchment or Territorial analysis cannot be no longer defensible, due to time-distance based factors as well as optimal foraging theory failed as a consequences of prehistoric people were aware of the decrease in cost-benefit ratio and located sites, and generally played out a settlement strategy that minimized the ratio of energy expanded to energy produced.Keywords: palaeo-environment, prehistory, palaeo-ecology, zooarchaeology
Procedia PDF Downloads 1226836 The Key Role of a Bystander Improving the Effectiveness of Cardiopulmonary Resuscitation Performed in Extra-Urban Areas
Authors: Leszek Szpakowski, Daniel Celiński, Sławomir Pilip, Grzegorz Michalak
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The aim of the study was to analyse the usefulness of the 'E-rescuer' pilot project planned to be implemented in a chosen area of Eastern Poland in the cases of suspected sudden cardiac arrests in the extra-urban areas. Inventing an application allowing to dispatch simultaneously both Medical Emergency Teams and the E-rescuer to the place of the accident is the crucial assumption of the mentioned pilot project. The E-rescuer is defined to be the trained person able to take effective basic life support and to use automated external defibrillator. Having logged in using a smartphone, the E-rescuer's readiness is reported online to provide cardiopulmonary resuscitation exactly at the given location. Due to the accurately defined location of the E-rescuer, his arrival time is possible to be precisely fixed, and the substantive support through the displayed algorithms is capable of being provided as well. Having analysed the medical records in the years 2015-2016, cardiopulmonary resuscitation was considered to be effective when an early indication of circulation was provided, and the patient was taken to hospital. In the mentioned term, there were 2.291 cases of a sudden cardiac arrest. Cardiopulmonary resuscitation was taken in 621 patients in total including 205 people in the urban area and 416 in the extra-urban areas. The effectiveness of cardiopulmonary resuscitation in the extra-urban areas was much lower (33,8%) than in the urban (50,7%). The average ambulance arrival time was respectively longer in the extra-urban areas, and it was 12,3 minutes while in the urban area 3,3 minutes. There was no significant difference in the average age of studied patients - 62,5 and 64,8 years old. However, the average ambulance arrival time was 7,6 minutes for effective resuscitations and 10,5 minutes for ineffective ones. Hence, the ambulance arrival time is a crucial factor influencing on the effectiveness of cardiopulmonary resuscitation, especially in the extra-urban areas where it is much longer than in the urban. The key role of trained E-rescuers being nearby taking basic life support before the ambulance arrival can effectively support Emergency Medical Services System in Poland.Keywords: basic life support, bystander, effectiveness, resuscitation
Procedia PDF Downloads 2036835 Livonian Werewolves, 1500-1700s: A Sociological Assessment of Their Historical Significance and Origins through the Case of Old Thiess
Authors: Liu Jiaxin
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This paper seeks to do an in-depth investigation on the phenomenon of Early Modern era (1500-1700s) Livonian werewolves. Noting their uniqueness in comparison to contemporaneous werewolves hailing from other geographic areas, the paper suggests that the Livonian werewolf is a metaphor for Livonian society at that time, one which was characterized by social turmoil and strict class hierarchy. This metaphor was utilized by different classes to establish their own interests in society, and thus the paper concludes that the werewolf is a mutable artifact whose value is contingent on its social context. This is demonstrated by the particular case of Old Thiess—a poor, elderly Livonian peasant who gave an unorthodox and anomalous testimony when accused of being a werewolf. In his court statement, it is shown how Thiess was, in fact, alluding to social tensions by lambasting the rich German elite and establishing the righteousness of the peasantry, of which he was a member. A close reading method was utilized on the trial transcript of Old Thiess with heavy reference to Carlo Ginzburg and Bruce Lincoln’s collaborative work Old Thiess, a Livonian werewolf: a classic case in comparative perspective. Through a contextual reading of Livonia’s social atmosphere, the paper draws connections between the content of the trial to wider societal disturbances happening at the time. The thesis—that the werewolf is a flexible metaphor for the social milieu—is further buttressed by numerous contemporaneous sources that had similar messages as Thiess’ transcript, which are discussed as well.Keywords: early-modern baltic, Livonia, Old Thiess, social history, werewolves
Procedia PDF Downloads 1056834 Comparative Study of Analgesic Efficacy of Ultrasound Guided Femoral Nerve Block Versus Intravenous Fentanyl Injection in Fracture Femur Patients at Emergency Department
Authors: Asmaa Hamdy, Israa Nassar, Tarek Aly
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Introduction: Femoral fractures are the most common presentation in the Emergency Department (ED), and they can present as isolated injuries or as part of a polytrauma situation. To provide optimum pain management care to these patients, practitioners must be well prepared and current with utilizing modern evidence-based knowledge and practices. Management of pain associated with fracture femur in the emergency department has a critical role in the satisfaction of patients and preventing further complications. This study aimed to evaluate the analgesic efficacy of ultrasound-guided femoral nerve block compared with intravenous fentanyl in fractures of the femur in patients presented to the Emergency Department. Patients and Methods: Fifty patients with femur fractures were divided into two groups: Group A: In this group (twenty-five patients) were given intravenous fentanyl 2 micro-grams/kg and re-assessed for pain by Visual Analogue Score (VAS). Group B: In this group (twenty-five patients) underwent ultrasonography-guided femoral nerve block and were re-assessed for pain by VAS. Results: VAS score on the movement of the fractured limb between group A and group B at a 10-minute post-intervention period shows P= 0.043, and hence the difference is significant. VAS score on the movement of the fractured limb between group A and group B during a 10-minute post-intervention period showed a significant difference. Seventeen patients in group A had major PID with a percentage of 63% VS 10 patients in group B with a percentage of 37%. conclusion: both femoral nerve block and intravenous fentanyl are effective in relieving pain in patients with femur fractures. But femoral nerve block provides better and more intense analgesia and major pain intensity difference in less time. Moreover, the use of FNB had fewer side effects and more Hemodynamics stability compared to opioids.Keywords: femur fracture, nerve block, fentanyl, ultrasound guided
Procedia PDF Downloads 1006833 Dependence of Premature Births from Periodontal Status of Pregnant Women
Authors: Sonila Robo, Ilma Robo, Eduart Kapaj, Saimir Heta
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Background: Early birth is 37 weeks or less, pregnancy maturity! Clinically active presence, or positive culture of vaginal secretions, means excessive production of cytokines and prostaglandins also encountered in amniotic fluid. Bacterial vaginosis appears with their clinical outbreak in a combination of bacteria. Some of these bacteria are basic members in the creation of bacterial plaque. Objective: The purpose of this study is to find the link between the presence of specific bacteria in the mouth, bacterial vaginosis as one of the causes of premature birth, and the latter. Methods: The study was applied to 30 pregnant women in the burden pathology ward at Fier maternity, divided into two groups. The first group consisting of 20 women in the 2-month period, August-September. The number of women in the ward was 10 days maximum! All women were treated with cortisone and serum IV, magnesium sulphate, antibiotic prophylaxis! Results: 55% of women were under the age of 25 and 45% of women were over the age of 25. The age effect is mentioned for classifying the diseases that causes Actinomyces. Under the age of 25, a teenager and a 25-year-old are chronically ill. The final index was G2! All females were positive for the presence of salicylic acid in saliva and vaginal secretions. Conclusions:Premature birth is a complex process with some gynecological reasons, but in high percentage of cases there is coverage with the presence of infection by Actinomyces Actinomycetemcomitans in the oral cavity, which depending on the age causes two different types of periodontitis with special characteristics.Keywords: early birth, periodontal status, bacterial vaginosis, actinomyces actinomycetemcomitans
Procedia PDF Downloads 876832 Prediction of Compressive Strength of Concrete from Early Age Test Result Using Design of Experiments (Rsm)
Authors: Salem Alsanusi, Loubna Bentaher
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Response Surface Methods (RSM) provide statistically validated predictive models that can then be manipulated for finding optimal process configurations. Variation transmitted to responses from poorly controlled process factors can be accounted for by the mathematical technique of propagation of error (POE), which facilitates ‘finding the flats’ on the surfaces generated by RSM. The dual response approach to RSM captures the standard deviation of the output as well as the average. It accounts for unknown sources of variation. Dual response plus propagation of error (POE) provides a more useful model of overall response variation. In our case, we implemented this technique in predicting compressive strength of concrete of 28 days in age. Since 28 days is quite time consuming, while it is important to ensure the quality control process. This paper investigates the potential of using design of experiments (DOE-RSM) to predict the compressive strength of concrete at 28th day. Data used for this study was carried out from experiment schemes at university of Benghazi, civil engineering department. A total of 114 sets of data were implemented. ACI mix design method was utilized for the mix design. No admixtures were used, only the main concrete mix constituents such as cement, coarse-aggregate, fine aggregate and water were utilized in all mixes. Different mix proportions of the ingredients and different water cement ratio were used. The proposed mathematical models are capable of predicting the required concrete compressive strength of concrete from early ages.Keywords: mix proportioning, response surface methodology, compressive strength, optimal design
Procedia PDF Downloads 2676831 Acceptance towards Counselling Services among Flood Victims in Selangor
Authors: Husni Mohd Radzi, Lilie Zahara Ramly, Sapora Sipon, Salhah Abdullah
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Malaysia have been experiencing series of huge floods all around the country for the past decades despide planned development done by local authorities. The floods incurred due to factors like natural climate change or man-made disaster. Floods have caused a lot of damages, destructions and losses in term of infrastructure, financial implications and physical health. However, other damaging aspect was not being given much attention are the psychological need of the flood victim. The traumatic impact from the natural disaster like floods may cause serious psychological and spiritual deterioration. Many flood relief shelters in the past did not provide counseling services for flood victims to consult, and as a result, it contributes to added stress among the flood victims, as the issue were not being addressed. Some studies indicates that flood victims did not look for counseling service being offered. A total of 257 flood victim was involved in this study. Main area of the study was Kg Bukit Changgang, Kg. Rancangan Tanah Belia, Kg. Labohan Dagang and Kg.Olak Lempit in Kuala Langat, Selangor. The flood victims have responded to the survey given and the data was analyze using SPSS for descriptive information and other measures. At least 13 victims were reported to have experienced moderate to severe level of stress and anxiety over the flood disaster incidents and a total of 88 respondents admitted to have at least thought and consider getting counseling service.Keywords: perception, acceptance towards counseling, counseling service for flood victim, disaster
Procedia PDF Downloads 3196830 Monitoring and Evaluation in Community-Based Tourism: An Analysis and Model
Authors: Ivan Gunass Govender, Andrea Giampiccoli
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A developmental state should use community engagement to facilitate socio-economic development for disadvantaged groups and individual members of society through empowerment, social justice, sustainability, and self-reliance. In this regard, community-based tourism (CBT) as a growing market should be an indigenous effort aided by external facilitation. Since this form of tourism presents its own preconditions, characteristics, and challenges, it could be guided by higher education institutions engagement. In particular, the facilitation should not only serve to assist the community members to reach their own goals; but rather also focus on learning through knowledge creation and sharing with the engagement of higher education institutions. While the increased relevance of CBT has produced various CBT manuals (or handbooks/guidelines) documents aimed to ‘teach’ and assist various entities in CBT development, this research aims to analyse the current monitoring & evaluation (M&E) manuals and thereafter, propose an M&E model for CBT. It is important to mention that all too often effective monitoring is seldom carried out thus risking the long-term sustainability and improvement of the CBT ventures. Therefore, the proposed model will also consider some inputs external to the tourism field, but in relation to local economic development (LED) matters from the previously proposed development monitoring and evaluation system framework. M&E should be seen as fundamental components of any CBT initiative, and the whole CBT intervention should be evaluated. In this context, M&E in CBT should go beyond strict ‘numerical’ economic matters and should be understood in a holistic development. In addition, M&E in CBT should not consider issues in various ‘compartments’ such as tourists, tourism attractions, CBT owners/participants, and stakeholder engagement but as interdependent components of a macro-ecosystem. Finally, the external facilitation process should be structured in a way to promote community self-reliance in both the intervention and the M&E process. The research will attempt to propose an M&E model for CBT so as to enhance the CBT possibilities of long-term growth and success through effective collaborations with key stakeholders.Keywords: community-based tourism, community-engagement, monitoring and evaluation, stakeholders
Procedia PDF Downloads 3036829 Construction Engineering and Cocoa Agriculture: A Synergistic Approach for Improved Livelihoods of Farmers
Authors: Felix Darko-Amoah, Daniel Acquah
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In contemporary ecosystems for developing countries like Ghana, the need to explore innovative solutions for sustainable livelihoods of farmers is more important than ever. With Ghana’s population growing steadily and the demand for food, fiber and shelter increasing, it is imperative that the construction industry and agriculture come together to address the challenges faced by farmers in the country. In order to enhance the livelihoods of cocoa farmers in Ghana, this paper provides an innovative strategy that aims to integrate the areas of civil engineering and cash crop agriculture. This study focuses on cocoa cultivation in poorer nations, where farmers confront a variety of difficulties include restricted access to financing, subpar infrastructure, and insufficient support services. We seek to improve farmers' access to financing, improve infrastructure, and provide support services that are essential to their success by combining the fields of building engineering and cocoa production. The findings of the study are beneficial to cocoa producers, community extension agents, and construction engineers. In order to accomplish our objectives, we conducted 307 of field investigations in particular cocoa growing communities in the Western Region of Ghana. Several studies have shown that there is a lack of adequate infrastructure and financing, leading to low yields, subpar beans, and low farmer profitability in developing nations like Ghana. Our goal is to give farmers access to better infrastructure, better financing, and support services that are crucial to their success through the fusion of construction engineering and cocoa production. Based on data gathered from the field investigations, the results show that the employment of appropriate technology and methods for developing structures, roads, and other infrastructure in rural regions is one of the essential components of this strategy. For instance, we find that using affordable, environmentally friendly materials like bamboo, rammed earth, and mud bricks can assist to cut expenditures while also protecting the environment. By applying simple relational techniques to the data gathered, the results also show that construction engineers are crucial in planning and building infrastructure that is appropriate for the local environment and circumstances and resilient to natural disasters like floods. Thus, the convergence of construction engineering and cash crop cultivation is another crucial component of the agriculture-construction interplay. For instance, farmers can receive financial assistance to buy essential inputs, such as seeds, fertilizer, and tools, as well as training in proper farming methods. Moreover, extension services can be offered to assist farmers in marketing their crops and enhancing their livelihoods and revenue. In conclusion, our analysis of responses from the 307 participants depicts that the combination of construction engineering and cash crop agriculture offers an innovative approach to improving farmers' livelihoods in cocoa farming communities in Ghana. In conclusion, by inculcating the findings of this study into core decision-making, policymakers can help farmers build sustainable and profitable livelihoods by addressing challenges such as limited access to financing, poor infrastructure, and inadequate support services.Keywords: cocoa agriculture, construction engineering, farm buildings and equipment, improved livelihoods of farmers
Procedia PDF Downloads 906828 Conception and Misconceptions About Mental Health in Gwafan Community of Jos North Nigeria
Authors: Tabitha D. Hussein, Arigu M. Sunday
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This paper is an attempt to gauge the conception and misconception of mental health in the Gwafan community, Jos North Plateau State, Nigeria (West Africa), to ascertain which side of the scale the pendulum swings. Mental health education and awareness are necessary for healthy community development. However, in a society such as ours in Nigeria (Africa) that is not knowledge-based, it is easy for people to embrace hearsay, speculations, superstition, and the supernatural. The objectives of this paper are two folds: first, to examine the level of awareness of the people on mental health, or the lack of it; second, to ascertain their access to mental health services and good practices. The methodology adopted is qualitative research, and the instrument used is T-test related. The findings include, first, the fact that a larger population has misconceptions about Mental Health. Second, this misconception is a result of a lack of basic knowledge of Mental Health. Based on the aforementioned, the paper recommends that there is a need for more Mental Health Education among the populace and access to Mental Health services and practices (Preventative and Curative). The paper concludes that in a society that is not knowledgebase, every attempt should be made to shift people’s mindset from superstitious knowledge to evidence-based knowledge, which can empower them to make informed decisions not only on mental Health but on associative Health issues that can aid their wellbeing, livelihood and sustainable development as a whole.Keywords: conceptions, misconceptions, mental health, knowledge, superstition, service delivery
Procedia PDF Downloads 496827 Robotic Process Automation in Accounting and Finance Processes: An Impact Assessment of Benefits
Authors: Rafał Szmajser, Katarzyna Świetla, Mariusz Andrzejewski
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Robotic process automation (RPA) is a technology of repeatable business processes performed using computer programs, robots that simulate the work of a human being. This approach assumes replacing an existing employee with the use of dedicated software (software robots) to support activities, primarily repeated and uncomplicated, characterized by a low number of exceptions. RPA application is widespread in modern business services, particularly in the areas of Finance, Accounting and Human Resources Management. By utilizing this technology, the effectiveness of operations increases while reducing workload, minimizing possible errors in the process, and as a result, bringing measurable decrease in the cost of providing services. Regardless of how the use of modern information technology is assessed, there are also some doubts as to whether we should replace human activities in the implementation of the automation in business processes. After the initial awe for the new technological concept, a reflection arises: to what extent does the implementation of RPA increase the efficiency of operations or is there a Business Case for implementing it? If the business case is beneficial, in which business processes is the greatest potential for RPA? A closer look at these issues was provided by in this research during which the respondents’ view of the perceived advantages resulting from the use of robotization and automation in financial and accounting processes was verified. As a result of an online survey addressed to over 500 respondents from international companies, 162 complete answers were returned from the most important types of organizations in the modern business services industry, i.e. Business or IT Process Outsourcing (BPO/ITO), Shared Service Centers (SSC), Consulting/Advisory and their customers. Answers were provided by representatives of the positions in their organizations: Members of the Board, Directors, Managers and Experts/Specialists. The structure of the survey allowed the respondents to supplement the survey with additional comments and observations. The results formed the basis for the creation of a business case calculating tangible benefits associated with the implementation of automation in the selected financial processes. The results of the statistical analyses carried out with regard to revenue growth confirmed the correctness of the hypothesis that there is a correlation between job position and the perception of the impact of RPA implementation on individual benefits. Second hypothesis (H2) that: There is a relationship between the kind of company in the business services industry and the reception of the impact of RPA on individual benefits was thus not confirmed. Based results of survey authors performed simulation of business case for implementation of RPA in selected Finance and Accounting Processes. Calculated payback period was diametrically different ranging from 2 months for the Account Payables process with 75% savings and in the extreme case for the process Taxes implementation and maintenance costs exceed the savings resulting from the use of the robot.Keywords: automation, outsourcing, business process automation, process automation, robotic process automation, RPA, RPA business case, RPA benefits
Procedia PDF Downloads 1376826 The Effectiveness of a Program Based on the Employment of the Proposed Folk Songs to Enrich the Visual Expressive Drawings with the Artistic Connotations for the Early Stage Childhood
Authors: Ahmed Mousa, Huda Mazeed
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The research aims to determine the appropriate songs and artistic indications for the kindergarten child. In addition, it aims to use the songs of folk to develop expressive visual drawings with artistic connotations for the kindergarten child. The current research used a one group semi-experimental approach to identify the impact of songs on expressive children's drawings. The research community is represented in the educational administration in Giza Governorate for the academic year (2018 - 2019). The sample was taken from the kindergarten of Gamal Abdel Nasser School of Dokki Educational Administration in Giza Governorate. The study was applied to the second level children sample (5-6 years), where they numbered 20 children, males and females. The research results show that there are statistically significant differences between the average scores of the children of the experimental group in the pre and post-measurements on the observation card for children after hearing the songs of social and national folk in favor of post measurement. Moreover, the results demonstrate that there are no statistically significant differences between the average scores of children in the experimental group in the measurements, the post and follow-up, on the observation card of children's drawings for social and national folk.Keywords: folk songs, visual expressive, artistic connotations, early childhood
Procedia PDF Downloads 1766825 Human Immunodeficiency Virus Infection/AIDS Abandoned Children in Kenya
Authors: Ruth Muturi Wanjiku
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HIV/AIDS in Kenya for unborn and young kids. HIV/AIDS is a significant health concern in Kenya, with an estimated 1.5 million people living with the disease. Unfortunately, many of these individuals are unaware of their HIV status, and the disease continues to spread among the population or unborn kids. HIV/AIDS can be transmitted from an infected mother during pregnancy, childbirth, or breastfeeding. However, with early testing and treatment, the risk of mother-to-child transmission can be significantly reduced. Therefore, it is crucial for pregnant women to get tested and receive appropriate medical care. For young kids, HIV/AIDS education is critical to preventing the spread of the disease. It is essential to teach children about the importance of safe sex practices, avoiding risky behaviors such as sharing needles and getting tested regularly. Additionally, children should be taught about the stigma surrounding HIV/AIDS and encouraged to treat individuals living with the disease with compassion and respect. In conclusion, HIV/AIDS is a significant health concern in Kenya that affects individuals of all ages. For unborn kids, early testing and treatment are critical to reducing the risk of mother-to-child transmission. For young kids, education about HIV/AIDS and safe sex practices is essential to preventing the spread of the disease and reducing stigma. It is essential to promote awareness and encourage individuals to get tested and seek medical care if they believe they may be infected with HIV/AIDS.Keywords: AIDS, HIV, children, pregnant
Procedia PDF Downloads 696824 An Audit of the Diagnosis of Asthma in Children in Primary Care and the Emergency Department
Authors: Abhishek Oswal
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Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit
Procedia PDF Downloads 1446823 Factors Affecting Households' Decision to Allocate Credit for Livestock Production: Evidence from Ethiopia
Authors: Kaleb Shiferaw, Berhanu Geberemedhin, Dereje Legesse
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Access to credit is often viewed as a key to transform semi-subsistence smallholders into market oriented producers. However, only a few studies have examined factors that affect farmers’ decision to allocate credit on farm activities in general and livestock production in particular. A trivariate probit model with double selection is employed to identify factors that affect farmers’ decision to allocate credit on livestock production using data collected from smallholder farmers in Ethiopia. After controlling for two sample selection bias – taking credit for the production season and decision to allocate credit on farm activities – land ownership and access to a livestock centered extension service are found to have a significant (p<0.001) effect on farmers decision to use credit for livestock production. The result showed farmers with large land holding, and access to a livestock centered extension services are more likely to utilize credit for livestock production. However since the effect of land ownership squared is negative the effect of land ownership for those who own a large plot of land lessens. The study highlights the fact that improving access to credit does not automatically translate into more productive households. Improving farmers’ access to credit should be followed by a focused extension services.Keywords: livestock production, credit access, credit allocation, household decision, double sample selection
Procedia PDF Downloads 327