Search results for: antiracist healthcare delivery

Authors: Abdul Mutalib Md Jani, Abdul Hadi Mahmud, Mohd Tajuddin Mohd Ali

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The rapid growth of interest in surface modification of nanostructures materials that exhibit improved structural and functional properties is attracting more researchers. The unique properties of highly ordered nanoporous anodic aluminium oxide (NAAO) membrane have been proposed as a platform for biosensing applications. They exhibit excellent physical and chemical properties with high porosity, high surface area, tunable pore sizes and excellent chemical resistance. In this study, NAAO was functionalized with 3-aminopropyltriethoxysilane (APTES) to prepared silane-modified NAAO. Amine functional groups are formed on the surface of NAAO during silanization and were characterized using Fourier Transform Infrared spectroscopy (FTIR). The synthesis of multi segment of peptide on NAAO surfaces can be realized by changing the surface chemistry of the NAAO membrane via click chemistry. By click reactions, utilizing alkyne terminated with amino group, various peptides tagged on NAAO can be envisioned from chiral natural or unnatural amino acids using standard coupling methods (HOBt, EDCI and HBTU). This strategy seemly versatile since coupling strategy of dipeptide with another amino acids, leading to tripeptide, tetrapeptide or pentapeptide, can be synthesized without purification. When an appropriate terminus is selected, multiple segments of amino acids can be successfully synthesized on the surfaces. The immobilized NAAO should be easily separated from the reaction medium by conventional filtration, thus avoiding complicated purification methods. Herein, we proposed to synthesize multi fragment peptide as a model for capturing and attaching various small biomolecules on NAAO surfaces and can be also applied as biosensing device, drug delivery systems and biocatalyst.

Keywords: nanoporous anodic aluminium oxide, silanization, peptide synthesise, click chemistry

Procedia PDF Downloads 283

Authors: Karlygash Tulendieva

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Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

Procedia PDF Downloads 241

Authors: Lukas Kober, Vladimir Littva, Vladimir Siska

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The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.

Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses

Procedia PDF Downloads 218

Authors: Ibrahim Khan, Waqas Khalid

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The Healthcare sector is known to consume a higher proportion of total energy consumption in the HVAC market owing to an excessive cooling and heating requirement in maintaining human thermal comfort in indoor conditions, catering to patients undergoing treatment in hospital wards, rooms, and intensive care units. The indoor thermal comfort conditions in selected hospitals of Islamabad, Pakistan, were measured on a real-time basis with the collection of first-hand experimental data using calibrated sensors measuring Ambient Temperature, Wet Bulb Globe Temperature, Relative Humidity, Air Velocity, Light Intensity and CO2 levels. The Experimental data recorded was analyzed in conjunction with the Thermal Comfort Questionnaire Surveys, where the participants, including patients, doctors, nurses, and hospital staff, were assessed based on their thermal sensation, acceptability, preference, and comfort responses. The Recorded Dataset, including experimental and survey-based responses, was further analyzed in the development of a correlation between operative temperature, operative relative humidity, and other measured operative parameters with the predicted mean vote and adaptive predicted mean vote, with the adaptive temperature and adaptive relative humidity estimated using the seasonal data set gathered for both summer – hot and dry, and hot and humid as well as winter – cold and dry, and cold and humid climate conditions. The Machine Learning Logistic Regression Algorithm was incorporated to train the operative experimental data parameters and develop a correlation between patient sensations and the thermal environmental parameters for which a new ML-based adaptive thermal comfort model was proposed and developed in our study. Finally, the accuracy of our model was determined using the K-fold cross-validation.

Keywords: predicted mean vote, thermal comfort, energy management, logistic regression, machine learning

Procedia PDF Downloads 64

Authors: Mikael Soini, Kari Björn

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Metropolia University of Applied Sciences (MUAS) Information and Communication Technology (ICT) Degree Programme provides full-time Bachelor-level undergraduate studies. ICT Degree Programme has seven different major options; this paper focuses on Health Technology. In Health Technology, a significant curriculum change in 2014 enabled transition from fragmented curriculum including dozens of courses to a new integrated curriculum built around three 30 ECTS themes. This paper focuses especially on the second theme called Customer Oriented Software Applications. From students’ point of view, the goal of this theme is to get familiar with existing health related ICT solutions and systems, understand business around health technology, recognize social and healthcare operating principles and services, and identify customers and users and their special needs and perspectives. This also acts as a background for health related web application development. Built web application is tested, developed and evaluated with real users utilizing versatile user centred development methods. This paper presents experiences obtained from the first implementation of Customer Oriented Software Applications theme. Student feedback was gathered with two questionnaires, one in the middle of the theme and other at the end of the theme. Questionnaires had qualitative and quantitative parts. Similar questionnaire was implemented in the first theme; this paper evaluates how the theme-based integrated curriculum has progressed in Health Technology major by comparing results between theme 1 and 2. In general, students were satisfied for the implementation, timing and synchronization of the courses, and the amount of work. However there is still room for development. Student feedback and teachers’ observations have been and will be used to develop the content and operating principles of the themes and whole curriculum.

Keywords: engineering education, integrated curriculum, learning and teaching methods, learning experience

Procedia PDF Downloads 321

Authors: Hritwik Ghosh, Irfan Sadiq Rahat, Sachi Nandan Mohanty, J. V. R. Ravindra

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In the rapidly evolving landscape of medical diagnostics, the early detection and accurate classification of skin cancer remain paramount for effective treatment outcomes. This research delves into the transformative potential of Artificial Intelligence (AI), specifically Deep Learning (DL), as a tool for discerning and categorizing various skin conditions. Utilizing a diverse dataset of 3,000 images representing nine distinct skin conditions, we confront the inherent challenge of class imbalance. This imbalance, where conditions like melanomas are over-represented, is addressed by incorporating class weights during the model training phase, ensuring an equitable representation of all conditions in the learning process. Our pioneering approach introduces a hybrid model, amalgamating the strengths of two renowned Convolutional Neural Networks (CNNs), VGG16 and ResNet50. These networks, pre-trained on the ImageNet dataset, are adept at extracting intricate features from images. By synergizing these models, our research aims to capture a holistic set of features, thereby bolstering classification performance. Preliminary findings underscore the hybrid model's superiority over individual models, showcasing its prowess in feature extraction and classification. Moreover, the research emphasizes the significance of rigorous data pre-processing, including image resizing, color normalization, and segmentation, in ensuring data quality and model reliability. In essence, this study illuminates the promising role of AI and DL in revolutionizing skin cancer diagnostics, offering insights into its potential applications in broader medical domains.

Keywords: artificial intelligence, machine learning, deep learning, skin cancer, dermatology, convolutional neural networks, image classification, computer vision, healthcare technology, cancer detection, medical imaging

Procedia PDF Downloads 88

Authors: Akhil Teja Kambhampati, Mark A. Hoffman

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In the realm of infectious disease research, airborne viral transmission stands as a paramount concern due to its pivotal role in propagating pathogens within densely populated regions. However, amidst this landscape, the phenomenon of hygroscopic growth within respiratory bioaerosols remains relatively underexplored. Unlike pure water aerosols, the unique composition of respiratory bioaerosols leads to varied evaporation rates and hygroscopic growth patterns, influenced by factors such as ambient humidity, temperature, and airflow. This study addresses this gap by focusing on the behaviors of single respiratory bioaerosol utilizing salinity to induce saliva-like hygroscopic behavior. By employing mass, momentum, and energy equations, the study unveils the intricate interplay between evaporation and hygroscopic growth over time. The numerical model enables temporal analysis of bioaerosol characteristics, including size, temperature, and trajectory. The analysis reveals that due to evaporation, there is a reduction in initial size, which shortens the lifetime and distance traveled. However, when hygroscopic growth begins to influence the bioaerosol size, the rate of size reduction slows significantly. The interplay between evaporation and hygroscopic growth results in bioaerosol size within the inhalation range of humans and prolongs the traveling distance. Findings procured from the analysis are crucial for understanding the spread of infectious diseases, especially in high-risk environments such as healthcare facilities and public transportation systems. By elucidating the nuanced behaviors of respiratory bioaerosols, this study seeks to inform the development of more effective preventative strategies against pathogens propagation in the air, thereby contributing to public health efforts on a global scale.

Keywords: airborne viral transmission, high-risk environments, hygroscopic growth, evaporation, numerical modeling, pathogen propagation, preventative strategies, public health, respiratory bioaerosols

Procedia PDF Downloads 41

Authors: Murorunkwere Marie Claire

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Introduction: In Sub-Saharan Africa and specifically in Rwandan rural areas, mother-to-Child human immunodeficiency virus transmission remains a big challenge. This is mainly due to lack of awareness and ignorance among pregnant rural women, leading to neglect regular taking of prophylactic antiretroviral treatment and to persistently beliefs in traditional healers and home deliveries. This paper explores the factors associated with stagnant reduction in human immunodeficiency virus vertical transmission among pregnant rural women and provides solutions to tackle it. Methodology: The first phase of this research will be a qualitative survey was conducted to assess the knowledge, attitudes and practices towards vertical human immunodeficiency virus transmission among pregnant women in one rural district in Rwanda. The data generated from phase one of this research will be used to address the main factors revealed through community mobilization and motivation on attending required antenatal consultations and hospital deliveries, proper and regular antiretroviral treatment taking, and discouraging beliefs in traditional healers and home deliveries. Refresher training seminars will also be organized for healthcare providers qualified on conducting deliveries about current measures to maximize the reduction of chances that can lead to mother -child contamination (to avoid early rupture of membranes and to prevent any source of contamination). Results: This paper is expected to contribute in a significant reduction of the vertical human immunodeficiency virus transmission burden among pregnant rural women. Conclusion: Strong campaigns on prevention of mother- to-child human immunodeficiency virus transmission and community mobilization of pregnant rural women, and house to house education and continuous reminders as well as training seminars to health care personnel on updated measures is, key in addressing vertical human immunodeficiency virus transmission.

Keywords: attitudes transformation, community mobilisation, pregnant rural women, vertical HIV transmission

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Authors: Ava Zarif Sanayei, Sedigheh Sina

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During fluoroscopically guided procedures, healthcare workers, especially radiology trainees, are at risk of exposure to elevated radiation exposure. It is vital to prioritize their safety in such settings. However, there is limited data on their monthly or annual doses. This study aimed to evaluate the equivalent dose to the eyes of the student trainee, utilizing LiF: Mg, Ti (TLD-100) chips at the radiology department of a hospital in Shiraz, Iran. Initially, the dosimeters underwent calibration procedures with the assistance of ISO-PTW calibrated phantoms. Following this, a set of dosimeters was prepared To determine HP(3) value for a trainee involved in the main operation room and controlled area utilized for two months. Three TLD chips were placed in a holder and attached to her eyeglasses. Upon completion of the duration, the TLDs were read out using a Harshaw TLD reader. Results revealed that Hp(3) value was 0.31±0.04 mSv. Based on international recommendations, students in radiology training above 18 have an annual dose limit of 0.6 rem (6 mSv). Assuming a 12-month workload, staff radiation exposure stayed below the annual limit. However, the Trainee workload may vary due to different deeds. This study's findings indicate the need for consistent, precise dose monitoring in IR facilities. Students can undertake supervised internships for up to 500 hours, depending on their institution. These internships take place in health-focused environments offering radiology services, such as clinics, diagnostic imaging centers, and hospitals. Failure to do so might result in exceeding occupational radiation dose limits. A 0.5 mm lead apron effectively absorbs 99% of radiation. To ensure safety, technologists and staff need to wear this protective gear whenever they are in the room during procedures. Furthermore, maintaining a safe distance from the primary beam is crucial. In cases where patients need assistance and must be held for imaging, additional protective equipment, including lead goggles, gloves, and thyroid shields, should be utilized for optimal safety.

Keywords: annual dose limits, Hp(3), individual monitoring, radiation protection, TLD-100

Procedia PDF Downloads 77

Authors: Hind Bouami, Patrick Millot

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Medication dispensing system is a life-critical system whose failure may result in preventable adverse events leading to longer patient stays in hospitals or patient death. Automation has led to great improvements in life-critical systems as it increased safety, efficiency, and comfort. However, critical risks related to medical organization complexity and automated solutions integration can threaten drug dispensing security and performance. Knowledge about the system’s complexity aspects and human machine parameters to control for automated equipment’s security and performance will help operators to secure their automation process and to optimize their system’s reliability. In this context, this study aims to document the operator’s situation awareness about automation risks and parameters involved in automation security and performance. Our risk management approach has been deployed in the North Luxembourg hospital center’s pharmacy, which is equipped with automated drug dispensing systems since 2009. With more than 4 million euros of gains generated, North Luxembourg hospital center’s success story was enabled by the management commitment, pharmacy’s involvement in the implementation and improvement of the automation project, and the close collaboration between the pharmacy and Sinteco’s firm to implement the necessary innovation and organizational actions for automated solutions integration security and performance. An analysis of the actions implemented by the hospital and the parameters involved in automated equipment’s integration security and performance has been made. The parameters to control for automated equipment’s integration security and performance are human aspects (6.25%), technical aspects (50%), and human-machine interaction (43.75%). The implementation of an anthropocentric analysis system before automation would have prevented and optimized the control of risks related to automation.

Keywords: Automated drug delivery systems, Hospitals, Human-centered automated system, Risk management

Procedia PDF Downloads 138

Authors: Jasim Uddin, Rod Smith, Malcolm Gillies

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Surface irrigation is the most popular irrigation method all over the world. However, two issues: low efficiency and huge labour involvement concern irrigators due to scarcity in recent years. To address these issues, a smart automated furrow is conceptualised that can be operated using digital devices like smartphone, iPad or computer and a preliminary evaluation was conducted in this study. The smart automated system is the integration of commercially available software and hardware. It includes real-time surface irrigation optimisation software (SISCO) and Rubicon Water’s surface irrigation automation hardware and software. The automated system consists of automatic water delivery system with 300 mm flexible pipes attached to both sides of a remotely controlled valve to operate the irrigation. A water level sensor to obtain the real-time inflow rate from the measured head in the channel, advance sensors to measure the advance time to particular points of an irrigated field, a solar-powered telemetry system including a base station to communicate all the field sensors with the main server. On the basis of field data, the software (SISCO) is optimised the ongoing irrigation and determine the optimum cut-off for particular irrigation and send this information to the control valve to stop the irrigation in a particular (cut-off) time. The preliminary evaluation shows that the automated surface irrigation worked reasonably well without manual intervention. The evaluation of farmers managed irrigation events show the potentials to save a significant amount of water and labour. A substantial amount of economic and social benefits are expected in rural industries by adopting this system. The future outcome of this work would be a fully tested commercial adaptive real-time furrow irrigation system able to compete with the pressurised alternative of centre pivot or lateral move machines on capital cost, water and labour savings but without the massive energy costs.

Keywords: furrow irrigation, smart automation, infiltration, SISCO, real-time irrigation, adoptive control

Procedia PDF Downloads 453

Authors: Julius Y Asamoah

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Mobile money has seen faster adoption in the decade. Its emergence serves as an essential driver of financial inclusion and an innovative financial service delivery channel, especially to the unbanked population. The rising importance of mobile money services has caught policymakers and regulators' attention, seeking to understand the many issues emerging from this context. At the same time, it is unlocking the potential of knowledge of this new technology. Regulatory responses and support are essential, requiring significant changes to current regulatory practices in Ghana. The article aims to answer the following research questions: "What risk does an unregulated mobile money service pose to consumers and the financial system? "What factors stimulate and hinder the introduction of mobile payments in developing countries? The sample size used was 250 respondents selected from the study area. The study has adopted an analytical approach comprising a combination of qualitative and quantitative data collection methods. Actor-network theory (ANT) is used as an interpretive lens to analyse this process. ANT helps analyse how actors form alliances and enrol other actors, including non-human actors (i.e. technology), to secure their interests. The study revealed that government regulatory policies impact mobile money as critical to mobile money services in developing countries. Regulatory environment should balance the needs of advancing access to finance with the financial system's stability and draw extensively from Kenya's work as the best strategies for the system's players. Thus, regulators need to address issues related to the enhancement of supportive regulatory frameworks. It recommended that the government involve various stakeholders, such as mobile phone operators. Moreover, the national regulatory authority creates a regulatory environment that promotes fair practices and competition to raise revenues to support a business-enabling environment's key pillars as infrastructure.

Keywords: actor-network theory (ANT), cashless future, Developing countries, Ghana, Mobile Money

Procedia PDF Downloads 138

Authors: Natalie Frandsen

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Pursuing post-secondary education is a milestone for many Canadian youths. This transition involves many changes and opportunities for growth. However, this may also be a period where challenges arise. Perhaps not surprisingly, mental health challenges for post-secondary students are common. This poses difficulties for students and instructors. Common mental-health-related symptoms (e.g., low motivation, fatigue, inability to concentrate) can affect academic performance, and instructors may need to provide accommodations for these students without the necessary expertise. ‘Distance education’ has been growing and gaining momentum in Canada for three decades. As a consequence of the COVID-19 pandemic, post-secondary institutions have been required to deliver courses using ‘remote’ methods (i.e., various online delivery modalities). The learning challenges and subsequent academic performance issues experienced by students with mental-health-related disabilities studying online are not well understood. However, we can postulate potential factors drawing from learning theories, the relationship between mental-health-related symptoms and academic performance, and learning design. Identifying barriers and opportunities to academic performance is an essential step in ensuring that students with mental-health-related disabilities are able to achieve their academic goals. Completing post-secondary education provides graduates with more employment opportunities. It is imperative that our post-secondary institutions take a holistic view of learning by providing learning and mental health support while reducing structural barriers. Health-promoting universities and colleges infuse health into their daily operations and academic mandates. Acknowledged in this Charter is the notion that all sectors must take an active role in favour of health, social justice, and equity for all. Drawing from mental health promotion and Universal Design for Learning (UDL) frameworks, relevant adult learning concepts, and critical digital pedagogy, considerations for mental-health-promoting, online learning community development will be summarized. The education sector has the opportunity to create and foster equitable and mental health-promoting learning environments. This is of particular importance during a global pandemic when the mental health of students is being disproportionately impacted.

Keywords: academic performance, community, mental health promotion, online learning

Procedia PDF Downloads 137

Authors: Yunjia Yang, Yakun Yan, Peng Li, Gordon Xu, Timothy Mahony, Neena Mitter, Karishma Mody

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Sheep flystrike is one of the most economically important diseases affecting the Australian sheep and wool industry (>356M/annually). Currently, control of Lucillia cuprina relies almost exclusively on chemicals controls and the parasite has developed resistance to nearly all control chemicals used in the past. It is therefore critical to develop an alternative solution for the sustainable control and management of flystrike. RNA interference (RNAi) technologies have been successfully explored in multiple animal industries for developing parasites controls. This research project aims to develop a RNAi based biological control for sheep blowfly. Double-stranded RNA (dsRNA) has already proven successful against viruses, fungi and insects. However, the environmental instability of dsRNA is a major bottleneck with a protection window only lasting 5-7 days. Bentonite polymer (BenPol) technology can overcome this problem, as it can be tuned for controlled release of the dsRNA in the gut challenging pH environment of the blowfly larvae, prolonging its exposure time to and uptake by target cells. We have investigated four different BenPol carriers for their dsRNA loading capabilities of which three of them were able to afford dsRNA stability under multiple temperatures (4°C, 22°C, 40°C, 55°C) in the sheep serum. Based on stability results, we further tested dsRNA from potential targeted genes loaded with BenPol carrier in larvae feeding assay, and get three knockdowns. Our results, establish that the dsRNA when loaded on BenPol particles is stable unlike naked dsRNA which is rapidly degraded in the sheep serum. A stable nanoparticles delivery system that can protect and increase the inherent stability of the dsRNA molecules at higher temperatures in a complex biological fluid like serum, offers a great deal of promise for the future use of this approach for enhancing animal protection.

Keywords: RNA interference, Lucillia cuprina, polymer carriers, polymer stability

Procedia PDF Downloads 82

Authors: Luke Taylor, Samantha J. Hall, Kenneth I. Cumming, Jakki Bardsley, Scott S. P. Wildman

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Medway School of Pharmacy, as part of an Equality Diversity and Inclusivity (EDI) initiative run by the University of Kent, decided to take steps to try and negate disparities in numeracy competencies within students undertaking the Master of Pharmacy degree in order to combat a trend in pharmacy students’ numerical abilities upon entry. This included a research driven project 1) to identify if pharmacy students are aware of weaknesses in their numeracy capabilities, and 2) recognise where their numeracy skillset is lacking. In addition to gaining this student perspective, a number of actions have been implemented to support students in improving their numeracy competencies. Reflective and quantitative analysis has shown promising improvements for the final year cohort of 2014/15 when compared to previous years. The method of involving student feedback into the structure of numeracy teaching/support has proven to be extremely beneficial to both students and teaching staff alike. Students have felt empowered and in control of their own learning requirements, leading to increased engagement and attainment. School teaching staff have received quality data to help improve existing initiatives and to innovate further in the area of numeracy teaching. In light of the recognised improvements, further actions are currently being trialled in the area of numeracy support. This involves utilising Virtual Learning Environment platforms to provide individualised support as a supplement to the increased numeracy mentoring (staff and peer) provided to students. Mentors who provide group or one-to-one sessions are now given significant levels of training in dealing with situations that commonly arise from mentoring schemes. They are also provided with continued support throughout the life of their degree. Following results from this study, Medway School of Pharmacy hopes to drive increasing numeracy standards within Pharmacy (primarily through championing peer mentoring) as well as other healthcare professions including Midwifery and Nursing.

Keywords: attainment, ethnicity, numeracy, pharmacy, support

Procedia PDF Downloads 236

Authors: Evgeny V. Blagin, Aleksandr I. Dovgjallo, Dmitry A. Uglanov

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This article deals with research of the working process in the thermocompressor which operates on cryogenic working fluid. Thermocompressor is device suited for the conversation of heat energy directly to the potential energy of pressure. Suggested thermocompressor is suited for operation during liquid natural gas (LNG) re-gasification and is placed after evaporator. Such application of thermocompressor allows using of the LNG cold energy for rising of working fluid pressure, which then can be used for electricity generation or another purpose. Thermocompressor consists of two chambers divided by the regenerative heat exchanger. Calculation algorithm for unsteady calculation of thermocompressor working process was suggested. The results of this investigation are to change of thermocompressor’s chambers temperature and pressure during the working cycle. These distributions help to find out the parameters, which significantly influence thermocompressor efficiency. These parameters include regenerative heat exchanger coefficient of the performance (COP) dead volume of the chambers, working frequency of the thermocompressor etc. Exergy analysis was performed to estimate thermocompressor efficiency. Cryogenic thermocompressor operated on nitrogen working fluid was chosen as a prototype. Calculation of the temperature and pressure change was performed with taking into account heat fluxes through regenerator and thermocompressor walls. Temperature of the cold chamber significantly differs from the results of steady calculation, which is caused by friction of the working fluid in regenerator and heat fluxes from the hot chamber. The rise of the cold chamber temperature leads to decreasing of thermocompressor delivery volume. Temperature of hot chamber differs negligibly because losses due to heat fluxes to a cold chamber are compensated by the friction of the working fluid in the regenerator. Optimal working frequency was selected. Main results of the investigation: -theoretical confirmation of thermocompressor operation capability on the cryogenic working fluid; -optimal working frequency was found; -value of the cold chamber temperature differs from the starting value much more than the temperature of the hot chamber; -main parameters which influence thermocompressor performance are regenerative heat exchanger COP and heat fluxes through regenerator and thermocompressor walls.

Keywords: cold energy, liquid natural gas, thermocompressor, regenerative heat exchanger

Procedia PDF Downloads 583

Authors: Zahid Ullah, Atlas Khan

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The rapid advancements in data collection, storage, and processing capabilities have led to an explosion of data in various domains. In this era of big data, mathematical sciences play a crucial role in uncovering valuable insights and driving informed decision-making through data analytics. The purpose of this abstract is to present the latest advances in mathematical sciences and their application in harnessing the power of data analytics. This abstract highlights the interdisciplinary nature of data analytics, showcasing how mathematics intersects with statistics, computer science, and other related fields to develop cutting-edge methodologies. It explores key mathematical techniques such as optimization, mathematical modeling, network analysis, and computational algorithms that underpin effective data analysis and interpretation. The abstract emphasizes the role of mathematical sciences in addressing real-world challenges across different sectors, including finance, healthcare, engineering, social sciences, and beyond. It showcases how mathematical models and statistical methods extract meaningful insights from complex datasets, facilitating evidence-based decision-making and driving innovation. Furthermore, the abstract emphasizes the importance of collaboration and knowledge exchange among researchers, practitioners, and industry professionals. It recognizes the value of interdisciplinary collaborations and the need to bridge the gap between academia and industry to ensure the practical application of mathematical advancements in data analytics. The abstract highlights the significance of ongoing research in mathematical sciences and its impact on data analytics. It emphasizes the need for continued exploration and innovation in mathematical methodologies to tackle emerging challenges in the era of big data and digital transformation. In summary, this abstract sheds light on the advances in mathematical sciences and their pivotal role in unveiling the power of data analytics. It calls for interdisciplinary collaboration, knowledge exchange, and ongoing research to further unlock the potential of mathematical methodologies in addressing complex problems and driving data-driven decision-making in various domains.

Keywords: mathematical sciences, data analytics, advances, unveiling

Procedia PDF Downloads 95

Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

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The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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Authors: Abdelhalim. N. Mohammed, Mohammed. Y. Esmail

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In the course of recent decades, medical imaging has been dominated by the use of costly film media for review and archival of medical investigation, however due to developments in networks technologies and common acceptance of a standard digital imaging and communication in medicine (DICOM) another approach in light of World Wide Web was produced. Web technologies successfully used in telemedicine applications, the combination of web technologies together with DICOM used to design a web-based and open source DICOM viewer. The Web server allowance to inquiry and recovery of images and the images viewed/manipulated inside a Web browser without need for any preinstalling software. The dynamic site page for medical images visualization and processing created by using JavaScript and HTML5 advancements. The XAMPP ‘apache server’ is used to create a local web server for testing and deployment of the dynamic site. The web-based viewer connected to multiples devices through local area network (LAN) to distribute the images inside healthcare facilities. The system offers a few focal points over ordinary picture archiving and communication systems (PACS): easy to introduce, maintain and independently platforms that allow images to display and manipulated efficiently, the system also user-friendly and easy to integrate with an existing system that have already been making use of web technologies. The wavelet-based image compression technique on which 2-D discrete wavelet transform used to decompose the image then wavelet coefficients are transmitted by entropy encoding after threshold to decrease transmission time, stockpiling cost and capacity. The performance of compression was estimated by using images quality metrics such as mean square error ‘MSE’, peak signal to noise ratio ‘PSNR’ and compression ratio ‘CR’ that achieved (83.86%) when ‘coif3’ wavelet filter is used.

Keywords: DICOM, discrete wavelet transform, PACS, HIS, LAN

Procedia PDF Downloads 162

Authors: Oktay Celenk, Ugur Karanfil, Iskender Demir, Samir Lamrini, Jorg Neumann, Arif Demir

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Due to its favourable material characteristics, fiber reinforced plastics are amongst the main topics of all actual lightweight construction megatrends. Especially in transportation trends ranging from aeronautics over the automotive industry to naval transportation (yachts, cruise liners) the expected economic and environmental impact is huge. In naval transportation components like yacht bodies, antenna masts, decorative structures like deck lamps, light houses and pool areas represent cheap and robust solutions. Commercially available laser tools like carbon dioxide gas lasers (CO₂), frequency tripled solid state UV lasers, and Neodymium-YAG (Nd:YAG) lasers can be used. These tools have emission wavelengths of 10 µm, 0.355 µm, and 1.064 µm, respectively. The scientific goal is first of all the generation of a parameter matrix for laser processing of each used material for a Tm-fiber laser system (wavelength 2 µm). These parameters are the heat affected zone, process gas pressure, work piece feed velocity, intensity, irradiation time etc. The results are compared with results obtained with well-known material processing lasers, such as a Yb-fiber lasers (wavelength 1 µm). Compared to the CO₂-laser, the Tm-laser offers essential advantages for future laser processes like cutting, welding, ablating for repair and drilling in composite part manufacturing (components of cruise liners, marine pipelines). Some of these are the possibility of beam delivery in a standard fused silica fiber which enables hand guided processing, eye safety which results from the wavelength, excellent beam quality and brilliance due to the fiber nature. There is one more feature that is economically absolutely important for boat, automotive and military projects manufacturing that the wavelength of 2 µm is highly absorbed by the plastic matrix and thus enables selective removal of it for repair procedures.

Keywords: Thulium (Tm) fiber laser, laser processing of fiber-reinforced plastics (FRP), composite, heat affected zone

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Authors: Anna Ching-Yu Wong

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This study aims to identify the quality and effectiveness of the adult programs provided by the public library using the ServQUAL Method and the National Library Public Programs Assessment guidelines (NIPPA, June 2019). ServQUAl covers several variables, namely: tangible, reliability, responsiveness, assurance, and empathy. NIPPA guidelines focus on program characteristics, particularly on the outcomes – the level of satisfaction from program participants. The reached populations were adults who participated in library adult programs at a small-town public library in Kansas. This study was designed as quantitative evaluative research which analyzed the quality and effectiveness of the library adult programs by analyzing the role of each factor based on ServQUAL and the NIPPA's library program assessment guidelines. Data were collected from November 2019 to January 2020 using a questionnaire with a Likert Scale. The data obtained were analyzed in a descriptive quantitative manner. The impact of this research can provide information about the quality and effectiveness of existing programs and can be used as input to develop strategies for developing future adult programs. Overall the result of ServQUAL measurement is in very good quality, but still, areas need improvement and emphasis in each variable: Tangible Variables still need improvement in indicators of the temperature and space of the meeting room. Reliability Variable still needs improvement in the timely delivery of the programs. Responsiveness Variable still needs improvement in terms of the ability of the presenters to convey trust and confidence from participants. Assurance Variables still need improvement in the indicator of knowledge and skills of program presenters. Empathy Variable still needs improvement in terms of the presenters' willingness to provide extra assistance. The result of program outcomes measurement based on NIPPA guidelines is very positive. Over 96% of participants indicated that the programs were informative and fun. They learned new knowledge and new skills and would recommend the programs to their friends and families. They believed that together, the library and participants build stronger and healthier communities.

Keywords: ServQual model, ServQual in public libraries, library program assessment, NIPPA library programs assessment

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Authors: Marta Fonseca, Pedro Marvão, Beatriz Oliveira, Bruno Heleno, Pedro Carreiro-Martins, Nuno Neuparth, António Rendas

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Background: Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are: 1) What studies have been published on concept mapping in undergraduate medical education? 2) What was the impact of CMs on students’ critical thinking? 3) How and why have these interventions had an educational impact? Methods: Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles, and abstracts, and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the structured approach to the reporting in healthcare education of evidence synthesis statement and BEME guidance. Results: Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students’ knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both teaching and learning methods. Conclusions: CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increase our confidence that the positive effects are consistent.

Keywords: concept map, medical education, undergraduate, critical thinking, meaningful learning

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Authors: Peter Collett, Mike Pynn, Haseeb Ur Rahman

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For the last few years across the UK there has been a push towards implementing treatment escalation plans (TEP) for every patient admitted to hospital. This is a paper form which is completed by a junior doctor then countersigned by the consultant responsible for the patient's care. It is designed to address what level of care is appropriate for the patient in question at point of entry to hospital. It helps decide whether the patient would benefit for ward based, high dependency or intensive care. They are completed to ensure the patient's best interests are maintained and aim to facilitate difficult decisions which may be required at a later date. For example, a frail patient with significant co-morbidities, unlikely to survive a pathology requiring an intensive care admission is admitted to hospital the decision can be made early to state the patient would not benefit from an ICU admission. This decision can be reversed depending on the clinical course of the patient's admission. It promotes discussions with the patient regarding their wishes to receive certain levels of healthcare. This poster describes the steps taken in the Aneurin Bevan University Health Board (ABUHB) when implementing the TEP form. The team implementing the TEP form campaigned for it's use to the board of directors. The directors were eager to hear of experiences of other health boards who had implemented the TEP form. The team presented the data produced in a number of health boards and demonstrated the proposed form. Concern was raised regarding the legalities of the form and that it could upset patients and relatives if the form was not explained properly. This delayed the effectuation of the TEP form and further research and discussion would be required. When COVID 19 reached the UK the National Institute for Health and Clinical Excellence issued guidance stating every patient admitted to hospital should be issued a TEP form. The TEP form was accelerated through the vetting process and was approved with immediate effect. The TEP form in ABUHB has now been in circulation for a month. An audit investigating it's uptake and a survey gathering opinions have been conducted.

Keywords: acute medicine, clinical governance, intensive care, patient centered decision making

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Authors: Visa I. Tyakaray, M. Abdulaziz, O. Badmus, N. Karaye, M. Dalhat, A. Shehu, I. Bello, T. Hussaini, S. Akar, G. Effah, P. Nguku

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Introduction: Nigeria has recorded outbreaks of meningitis in the past, being in the meningitis belt. A multi-state outbreak of Cerebrospinal Meningitis (CSM) from Neisseria meningitides occurred in 2017 involving 24 states, and Kano State reported its first two confirmed CSM cases on 22nd March, 2017. We conducted the outbreak investigation to characterize the outbreak, determine its associated risk factors and institute appropriate control measures. Method: We conducted an unmatched Case-control study with ratio 1:2. A case was defined as any person with sudden onset of fever (>38.5˚C rectal or 38.0˚C axillary) and one of the following: neck stiffness, altered consciousness or bulging fontanelle in toddlers while a control was defined as any person who resides around the case such as family members, caregivers, neighbors, and healthcare personnel. We reviewed and validated line list and conducted active case search in health facilities and neighboring communities. Descriptive, bivariate, stratified and multivariate analysis were performed. Laboratory confirmation was by Latex agglutination and/or Culture. Results: We recruited 48 cases with median age of 11 years (1 month – 65 years), attack rate was 2.4/100,000 population with case fatality rate of 8%; 34 of 44 local government areas were affected.On stratification, age was found to be a confounder. Independent factors associated with the outbreak were age (Adjusted Odds Ratio, AOR =6.58; 95% Confidence Interval (CI) =2.85-15.180, history of Vaccination (AOR=0.37; 95% CI=0.13-0.99) and history of travel (AOR=10.16; (1.99-51.85). Laboratory results showed 22 positive cases for Neisseria meningitides types C and A/Y. Conclusion: Major risk factors associated with this outbreak were age (>14years), not being vaccinated and history of travel. We sensitized communities and strengthened case management. We recommended immediate reactive vaccination and enhanced surveillance in bordering communities.

Keywords: cerebrospinal, factors, Kano-Nigeria, meningitis, risk

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: Kathryn Rooney, Kaitlyn Eddy, Evan Landers, Weihui Li

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The international mortality rate for neonates and infants has been declining at a disproportionally low rate when compared to the overall decline in child mortality in recent decades. A significant portion of infant deaths could be prevented with the implementation of low-cost and easy to use physiological monitoring devices, by enabling early identification of symptoms before they progress into life-threatening illnesses. The oral diagnostic device discussed in this paper serves to continuously monitor the key vital signs of body temperature, respiratory rate, heart rate, and oxygen saturation. The device mimics an infant pacifier, designed to be easily tolerated by infants as well as orthodontically inert. The fundamental measurements are gathered via thermistors and a pulse oximeter, each encapsulated in medical-grade silicone and wired internally to a microcontroller chip. The chip then translates the raw measurements into physiological values via an internal algorithm, before outputting the data to a liquid crystal display screen and an Android application. Additionally, a biological sample collection chamber is incorporated into the internal portion of the device. The movement within the oral chamber created by sucking on the pacifier-like device pushes saliva through a small check valve in the distal end, where it is accumulated and stored. The collection chamber can be easily removed, making the sample readily available to be tested for various diseases and analytes. With the vital sign monitoring and sample collection offered by this device, abnormal fluctuations in physiological parameters can be identified and appropriate medical care can be sought. This device enables preventative diagnosis for infants who may otherwise have gone undiagnosed, due to the inaccessibility of healthcare that plagues vast numbers of underprivileged populations.

Keywords: neonate mortality, infant mortality, low-cost diagnostics, vital signs, saliva testing, preventative care

Procedia PDF Downloads 153

Authors: Zelalem B. Gurmessa, Ignatius W. Ferreira, Henry F. Wissink

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The aim of this paper is to critically examine the factors contributing to academic brain drain in the Sub-Saharan Africa with specific reference to the higher education sector. Africa in general and Sub-Saharan African (SSA) countries, in particular, are experiencing an exodus of highly trained, qualified and competent human resources to other developing and developed countries thereby threatening the overall development of the relevant regions and impeding both public and private service delivery systems in the nation states. The region is currently in a dire situation in terms of health care services, education, science, and technology. The contribution of SSA countries to Science, Technology and Innovation is relatively minimal owing to the migration of skilled professionals due to both push and pull factors. The phenomenon calls for both international and trans-boundary, regional, national and institutional interventions to curb the exodus. Based on secondary data and the review of the literature, the article conceptualizes the antecedents and impacts of human capital flight or brain drain in the SSA countries from a higher education perspective. To this end, the article explores the magnitude, causes, and impacts of brain drain in the region. Despite the lack of consistent data on the magnitude of academic brain drain in the region, a critical analysis of the existing sources shows that pay disparity between developing and developed countries, the lack of enabling working conditions at source countries, fear of security due to political turmoil or unrest, the availability of green pastures and opportunity for development in the receiving countries were identified as major factors contributing to academic brain drain in the region. This hampers the socio-economic, technological and political development of the region. The paper also recommends that further research can be undertaken on the magnitude, causes, characteristics and impact of brain drain on the sustainability and competitiveness of SSA higher education institutions in the region.

Keywords: brain drain, higher education, sub-Saharan Africa, sustainable development

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Authors: Anupam Chanda

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Presently Packaging plays a significant role for drug discoveries. The process of selecting materials and the type of packaging also offers an opportunity for the Packaging scientist to look for biological delivery choices. Most injectable protein products were supplied in some sort of glass vial, prefilled syringe, cartridge. Those product having high Ph content there is a chance of “delamination “from inner surface of glass vial. With protein-based drugs, the biggest issue is the effect of packaging derivatives on the protein’s threedimensional and surface structure. These are any effects that relate to denaturation or aggregation of the protein due to oxidation or interactions from contaminants or impurities in the preparation. The potential for these effects needs to be carefully considered in choosing the container and the container closure system to avoid putting patients in jeopardy. Cause of Delamination : -Formulations with a high pH include phosphate and citrate buffers increase the risk of glass delamination. -High alkali content in glass could accelerate erosion. -High temperature during the vial-forming process increase the risk of glass delamination. -Terminal sterilization (irradiated at 20-40 kGy for 150 min) also is a risk factor for specific products(veterinary parenteral administration),could cause delamination. -High product-storage temperatures and long exposure times can increase the rate and severity of glass delamination. How to prevent Delamination -Treating the surface of the glass vials with materials, such as ammonium sulfate or siliconization can reduce the rate of glass erosion. -Consider alternative sterilization methods only in rare cases. -The correct specification for the glass to ensure its suitability for the pH of the product. -Use Cyclic olefin copolymer(COC)/Cyclic olefin Polymer(COP) Adsorption of protein and Solutions: Option#1 Coat with linear methoxylated polyglycerol and hyperbranchedmethoxylated polyglycerol. Option#2 Thehyperbranched non-methoxylated coating performed best. Option#3 Coat with hyperbranched polyglycerol Option#4 Right selection of Sterilization of glass vial/syringe.

Keywords: delamination of glass, ptrotien adoptions inside the glass surface, extractable & leachable solutions, injectable designs for new drugs

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Authors: Sofiya An, Akbota Kanderzhanova, Assel Akhmetova, Faye Foster, Chee K. Chan

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Healthcare, education and social support for children with autism in Kazakhstan has been evolving and transforming over the last three decades. There is still limited knowledge of the use of complementary and alternative medicine by families caring for autistic children in this post-Soviet region. An exploratory qualitative focus group study of Kazakhstani families was carried out to capture and understand their experiences of using complementary and alternative (CAM) medicine. A total of six focus groups were conducted in five cities across the country including Nur-Sultan, Almaty, Kyzylorda, Karaganda and Taraz. The perceived factors driving the availability, choice, and use of complementary and alternative medicine by families of autistic children in the country were distilled and evaluated. The data collected was analyzed using a framework analysis and themes and subthemes were developed. Two major themes stood out. The first was the “unmet needs”, which relates to the predisposing factors that motivate parents to CAM uptake, and the second was the “chasing hope”, which relates to the enabling factors that facilitate parents’ uptake of CAM. Fear of missing out (FOMO) is a latent underlying motivation underscoring these two themes as well. Parents of autism spectrum disorder (ASD) children in Kazakhstan have to deal with many challenges when seeking treatment for their children with ASD. They are prepared and resort to try out whatever CAM interventions available. The motivation and rationale of choice of use is driven by the lack of options and the hope of any potential positive outcome rather than from rational decisions based on efficacy or the evidence-based data of CAM. Parents get desperate and are willing to try CAM regardless of and independent of their cultural and belief systems and they do not want to miss out just in case it might work. This study also gives an international and cross-cultural perspective on the motives, choice and practice of parents with ASD children using CAM in Kazakhstan, a Central Asian country.

Keywords: autism spectrum disorder, Central Asia, complementary and alternative medicine, cross-cultural perspective, qualitative research

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Authors: Sohail Bawani, Kausar S. Khan, Rozina Karmaliani, Shehnaz Mir

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Action research (AR) is one of the types of health systems research (HSR), and participatory action research (PAR) is known for being effective in health systems strengthening (HSS). The current literature on PAR for HSS cites numerous examples and case studies that led to improve health services; build child health information system; increase knowledge and awareness of people about health problems, and identify pathways for institutional and policy change by engaging people in research. But examples of marginalized communities being agents of change in health governance are not common in health systems research (HSR). This approach to PAR is at the heart of Paolo Freire’s Social Transformation Theory and Critical Consciousness building, which was used to design a community-based PAR study in the Northern/mountainous areas of Pakistan. The purpose of the study was to understand the place and role of marginalized communities in strengthening existing health governance structure (health facility and village health committees and health boards) by taking marginalized communities as partners. Community meetings were carried out to identify who is living at the social, political, cultural and economic margins in 40 different villages. Participatory reflection and analysis (PRA) tools were used during the meeting to facilitate identification. Focus group discussions were conducted with marginalized groups using PRA tools and family ethnographies with marginalized families identified through group discussions. Findings of the study revealed that for the marginalized health systems constitute more than just delivery of health services, but it also embraces social determinants that surround systems and its governance. The paper argues that from Frerian perspective people’s participation should not only be limited to knowledge generation. People must be seen active users of the knowledge that they generate for achieving better health outcomes that they want to achieve in the time to come. PAR provides a pathway to the marginalized in playing a role in health governance. The study dissemination planned shall engage the marginalized in a dialogue with service providers so that together a role for the marginalized can be outlined.

Keywords: participatory action research, health systems, marginalized, health services

Procedia PDF Downloads 285