Search results for: accessibility of care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4281

Search results for: accessibility of care

1551 Customer Experience Management in Food and Beverage Outlet at Indian School of Business: Methodology and Recommendations

Authors: Anupam Purwar

Abstract:

In conventional consumer product industry, stockouts are taken care by carrying buffer stock to check underserving caused by changes in customer demand, incorrect forecast or variability in lead times. But, for food outlets, the alternate of carrying buffer stock is unviable because of indispensable need to serve freshly cooked meals. Besides, the food outlet being the sole provider has no incentives to reduce stockouts, as they have no fear of losing revenue, gross profit, customers and market share. Hence, innovative, easy to implement and practical ways of addressing the twin problem of long queues and poor customer experience needs to be investigated. Current work analyses the demand pattern of 11 different food items across a routine day. Based on this optimum resource allocation for all food items has been carried out by solving a linear programming problem with cost minimization as the objective. Concurrently, recommendations have been devised to address this demand and supply side problem keeping in mind their practicability. Currently, the recommendations are being discussed and implemented at ISB (Indian School of Business) Hyderabad campus.

Keywords: F&B industry, resource allocation, demand management, linear programming, LP, queuing analysis

Procedia PDF Downloads 125
1550 Health and Climate Changes: "Ippocrate" a New Alert System to Monitor and Identify High Risk

Authors: A. Calabrese, V. F. Uricchio, D. di Noia, S. Favale, C. Caiati, G. P. Maggi, G. Donvito, D. Diacono, S. Tangaro, A. Italiano, E. Riezzo, M. Zippitelli, M. Toriello, E. Celiberti, D. Festa, A. Colaianni

Abstract:

Climate change has a severe impact on human health. There is a vast literature demonstrating temperature increase is causally related to cardiovascular problem and represents a high risk for human health, but there are not study that improve a solution. In this work, it is studied how the clime influenced the human parameter through the analysis of climatic conditions in an area of the Apulia Region: Capurso Municipality. At the same time, medical personnel involved identified a set of variables useful to define an index describing health condition. These scientific studies are the base of an innovative alert system, IPPOCRATE, whose aim is to asses climate risk and share information to population at risk to support prevention and mitigation actions. IPPOCRATE is an e-health system, it is designed to provide technological support to analysis of health risk related to climate and provide tools for prevention and management of critical events. It is the first integrated system of prevention of human risk caused by climate change. IPPOCRATE calculates risk weighting meteorological data with the vulnerability of monitored subjects and uses mobile and cloud technologies to acquire and share information on different data channels. It is composed of four components: Multichannel Hub. Multichannel Hub is the ICT infrastructure used to feed IPPOCRATE cloud with a different type of data coming from remote monitoring devices, or imported from meteorological databases. Such data are ingested, transformed and elaborated in order to be dispatched towards mobile app and VoIP phone systems. IPPOCRATE Multichannel Hub uses open communication protocols to create a set of APIs useful to interface IPPOCRATE with 3rd party applications. Internally, it uses non-relational paradigm to create flexible and highly scalable database. WeHeart and Smart Application The wearable device WeHeart is equipped with sensors designed to measure following biometric variables: heart rate, systolic blood pressure and diastolic blood pressure, blood oxygen saturation, body temperature and blood glucose for diabetic subjects. WeHeart is designed to be easy of use and non-invasive. For data acquisition, users need only to wear it and connect it to Smart Application by Bluetooth protocol. Easy Box was designed to take advantage from new technologies related to e-health care. EasyBox allows user to fully exploit all IPPOCRATE features. Its name, Easy Box, reveals its purpose of container for various devices that may be included depending on user needs. Territorial Registry is the IPPOCRATE web module reserved to medical personnel for monitoring, research and analysis activities. Territorial Registry allows to access to all information gathered by IPPOCRATE using GIS system in order to execute spatial analysis combining geographical data (climatological information and monitored data) with information regarding the clinical history of users and their personal details. Territorial Registry was designed for different type of users: control rooms managed by wide area health facilities, single health care center or single doctor. Territorial registry manages such hierarchy diversifying the access to system functionalities. IPPOCRATE is the first e-Health system focused on climate risk prevention.

Keywords: climate change, health risk, new technological system

Procedia PDF Downloads 858
1549 The Relation between Vitamin C and Oral Health

Authors: Mai Ashraf Talaat

Abstract:

Background: Vitamin C (ascorbic acid) is an essential nutrient for the development and repair of all body tissues. It can be obtained from a healthy diet or through supplementation. Due to its importance, vitamin C has become a mainstay in the treatment and prevention of many diseases and in maintaining immune, skin, bone and overall health. This review article aims to discuss the studies and case reports conducted to evaluate the effect of Vitamin C on oral health and the recent advances in oral medicine that involve the use of vitamin C. Data/Sources: The review was conducted for clinical studies, case reports and published literature in the English language that addresses this topic. An extensive search in the electronic databases of PubMed, PubMed Central, Web of Science, National Library of Medicine and ResearchGate was performed. Conclusion: Vitamin C is thought to treat periodontal diseases and gingival enlargement. It also affects biofilm formation and therefore, it helps in reducing caries incidence. Recently, vitamin C mesotherapy has been used to treat inflamed gingiva, bleeding gums and gingival hyperpigmentation. More research and randomized controlled trials are needed on this specific topic for more accurate judgment. Clinical significance: A minimally invasive approach - the usage of vitamin C in dental care could drastically reduce the need for surgical intervention.

Keywords: oral health, periodontology, vitamin C, Gingivitis

Procedia PDF Downloads 73
1548 Constructing Optimized Criteria of Objective Assessment Indicators among Elderly Frailty

Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

Procedia PDF Downloads 347
1547 Understanding Systemic Barriers (and Opportunities) to Increasing Uptake of Subcutaneous Medroxy Progesterone Acetate Self-Injection in Health Facilities in Nigeria

Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

Abstract:

Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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1546 A Socio-Pragmatic Investigation of Gender Enactment in New Month Text Messages

Authors: Esther Robert, Romanus Aboh

Abstract:

This paper undertakes a socio-pragmatic investigation of gender enactment in new month text messages. This study employs Gumperz’s Interactional Sociolinguistics as its theoretical point of reference to investigate how people create meaning through social interaction. This theory attempts to analyse any social interaction based on contextualization cues and presuppositions. This study explores the appropriateness of language used in texting. The text messages are collected from different mobile phones from different genders, which form the data for this paper. The study observes remarkable differences between genders in the use of informal language. The study reveals that men and women differ remarkably in conversational interaction as well as in writing. While it is observed that women are emotional, orderly, and meticulous, detailed and observed certain grammatical rules, men are casual, brief and appear to show evidence that less attention is paid to grammatical rules. Also, the study shows women as relaxing, showing love, care, concern with their emotive, spirit-raising and touching language, while mean are direct, short, and straight to the point. It is discovered through the study that women behave this way because of their brain-wiring. That is why language and communication matter more to women than to men and this reflects in their new month text messages.

Keywords: difference, emotionalised expressions, gender, texting

Procedia PDF Downloads 243
1545 A Conceptual Framework of Integrated Evaluation Methodology for Aquaculture Lakes

Authors: Robby Y. Tallar, Nikodemus L., Yuri S., Jian P. Suen

Abstract:

Research in the subject of ecological water resources management is full of trivial questions addressed and it seems, today to be one branch of science that can strongly contribute to the study of complexity (physical, biological, ecological, socio-economic, environmental, and other aspects). Existing literature available on different facets of these studies, much of it is technical and targeted for specific users. This study offered the combination all aspects in evaluation methodology for aquaculture lakes with its paradigm refer to hierarchical theory and to the effects of spatial specific arrangement of an object into a space or local area. Therefore, the process in developing a conceptual framework represents the more integrated and related applicable concept from the grounded theory. A design of integrated evaluation methodology for aquaculture lakes is presented. The method is based on the identification of a series of attributes which can be used to describe status of aquaculture lakes using certain indicators from aquaculture water quality index (AWQI), aesthetic aquaculture lake index (AALI) and rapid appraisal for fisheries index (RAPFISH). The preliminary preparation could be accomplished as follows: first, the characterization of study area was undertaken at different spatial scales. Second, an inventory data as a core resource such as city master plan, water quality reports from environmental agency, and related government regulations. Third, ground-checking survey should be completed to validate the on-site condition of study area. In order to design an integrated evaluation methodology for aquaculture lakes, finally we integrated and developed rating scores system which called Integrated Aquaculture Lake Index (IALI).The development of IALI are reflecting a compromise all aspects and it responds the needs of concise information about the current status of aquaculture lakes by the comprehensive approach. IALI was elaborated as a decision aid tool for stakeholders to evaluate the impact and contribution of anthropogenic activities on the aquaculture lake’s environment. The conclusion was while there is no denying the fact that the aquaculture lakes are under great threat from the pressure of the increasing human activities, one must realize that no evaluation methodology for aquaculture lakes can succeed by keeping the pristine condition. The IALI developed in this work can be used as an effective, low-cost evaluation methodology of aquaculture lakes for developing countries. Because IALI emphasizes the simplicity and understandability as it must communicate to decision makers and the experts. Moreover, stakeholders need to be helped to perceive their lakes so that sites can be accepted and valued by local people. For this site of lake development, accessibility and planning designation of the site is of decisive importance: the local people want to know whether the lake condition is safe or whether it can be used.

Keywords: aesthetic value, AHP, aquaculture lakes, integrated lakes, RAPFISH

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1544 Potential of Visualization and Information Modeling on Productivity Improvement and Cost Saving: A Case Study of a Multi-Residential Construction Project

Authors: Sara Rankohi, Lloyd Waugh

Abstract:

Construction sites are information saturated. Digitalization is hitting construction sites to meet the incredible demand of knowledge sharing and information documentations. From flying drones, 3D Lasers scanners, pocket mobile applications, to augmented reality glasses and smart helmet, visualization technologies help real-time information imposed straight onto construction professional’s field of vision. Although these technologies are very applicable and can have the direct impact on project cost and productivity, experience shows that only a minority of construction professionals quickly adapt themselves to benefit from them in practice. The majority of construction managers still tend to apply traditional construction management methods. This paper investigates a) current applications of visualization technologies in construction projects management, b) the direct effect of these technologies on productivity improvement and cost saving of a multi-residential building project via a case study on Mac Taggart Senior Care project located in Edmonton, Alberta. The research shows the imaged based technologies have a direct impact on improving project productivity and cost savings.

Keywords: image-based technologies, project management, cost, productivity improvement

Procedia PDF Downloads 348
1543 Modern Cardiac Surgical Outcomes in Nonagenarians: A Multicentre Retrospective Observational Study

Authors: Laurence Weinberg, Dominic Walpole, Dong-Kyu Lee, Michael D’Silva, Jian W. Chan, Lachlan F. Miles, Bradley Carp, Adam Wells, Tuck S. Ngun, Siven Seevanayagam, George Matalanis, Ziauddin Ansari, Rinaldo Bellomo, Michael Yii

Abstract:

Background: There have been multiple recent advancements in the selection, optimization and management of cardiac surgical patients. However, there is limited data regarding the outcomes of nonagenarians undergoing cardiac surgery, despite this vulnerable cohort increasingly receiving these interventions. This study describes the patient characteristics, management and outcomes of a group of nonagenarians undergoing cardiac surgery in the context of contemporary peri-operative care. Methods: A retrospective observational study was conducted of patients 90 to 99 years of age (i.e., nonagenarians) who had undergone cardiac surgery requiring a classic median sternotomy (i.e., open-heart surgery). All operative indications were included. Patients who underwent minimally invasive surgery, transcatheter aortic valve implantation and thoracic aorta surgery were excluded. Data were collected from four hospitals in Victoria, Australia, over an 8-year period (January 2012 – December 2019). The primary objective was to assess six-month mortality in nonagenarians undergoing open-heart surgery and to evaluate the incidence and severity of postoperative complications using the Clavien-Dindo classification system. The secondary objective was to provide a detailed description of the characteristics and peri-operative management of this group. Results: A total of 12,358 adult patients underwent cardiac surgery at the study centers during the observation period, of whom 18 nonagenarians (0.15%) fulfilled the inclusion criteria. The median (IQR) [min-max] age was 91 years (90.0:91.8) [90-94] and 14 patients (78%) were men. Cardiovascular comorbidities, polypharmacy and frailty, were common. The median (IQR) predicted in-hospital mortality by EuroSCORE II was 6.1% (4.1-14.5). All patients were optimized preoperatively by a multidisciplinary team of surgeons, cardiologists, geriatricians and anesthetists. All index surgeries were performed on cardiopulmonary bypass. Isolated coronary artery bypass grafting (CABG) and CABG with aortic valve replacement were the most common surgeries being performed in four and five patients, respectively. Half the study group underwent surgery involving two or more major procedures (e.g. CABG and valve replacement). Surgery was undertaken emergently in 44% of patients. All patients except one experienced at least one postoperative complication. The most common complications were acute kidney injury (72%), new atrial fibrillation (44%) and delirium (39%). The highest Clavien-Dindo complication grade was IIIb occurring once each in three patients. Clavien-Dindo grade IIIa complications occurred in only one patient. The median (IQR) postoperative length of stay was 11.6 days (9.8:17.6). One patient was discharged home and all others to an inpatient rehabilitation facility. Three patients had an unplanned readmission within 30 days of discharge. All patients had follow-up to at least six months after surgery and mortality over this period was zero. The median (IQR) duration of follow-up was 11.3 months (6.0:26.4) and there were no cases of mortality observed within the available follow-up records. Conclusion: In this group of nonagenarians undergoing cardiac surgery, postoperative six-month mortality was zero. Complications were common but generally of low severity. These findings support carefully selected nonagenarian patients being offered cardiac surgery in the context of contemporary, multidisciplinary perioperative care. Further, studies are needed to assess longer-term mortality and functional and quality of life outcomes in this vulnerable surgical cohort.

Keywords: cardiac surgery, mortality, nonagenarians, postoperative complications

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1542 Women’s Perceptions of DMPA-SC Self-Injection in Malawi

Authors: Mandayachepa C. Nyando, Lauren Suchman, Innocencia Mtalimanja, Address Malata, Tamanda Jumbe, Martha Kamanga, Peter Waiswa

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Background: Subcutaneous depot medroxyprogesterone acetate (DMPA-SC) is a new innovation in contraceptive methods that allow users to inject themselves with a hormonal contraceptive in their own homes. Self-injection (SI) of DMPA-SC has the potential to improve the accessibility of family planning to women who want it and who are capable of injecting themselves. Malawi started implementing this new innovation in 2018. SI was incorporated into the DMPA-SC delivery strategy from its outset. Methodology: This study involved two districts in Malawi where DMPA-SC SI was rolled out: Mulanje and Ntchisi. We used a qualitative cross-sectional study design where 60 in-depth interviews were conducted with women of reproductive age group stratified as 15-45 age band. These included women who were SI users, non-users, and any woman who was on any contraceptive methods. The women participants were tape-recorded, and data were transcribed and then analysed using Dedoose software, where themes were categorised into mother and child themes. Results: Women perceived DMPA SC SI as uniquely private, convenient, and less painful when self-injected. In terms of privacy, women in Mulanje and Ntchisi especially appreciated that self-injecting allowed them to use covertly from partners. Some men do not allow their spouses to use modern contraceptive methods; hence women prefer to use them covertly. “… but I first reach out to men because the strongest power is answered by men (MJ015).” In addition, women reported that SI offers privacy from family/community and less contact with healthcare providers. These aspects of privacy were especially valued in areas where there is a high degree of mistrust around family planning and among those who feel judged or antagonized purchasing contraception, such as young unmarried women. Women also valued the convenience SI provided in terms of their ability to save time by injecting themselves at home rather than visiting a healthcare provider and having more reliable access to contraception, particularly in the face of stockouts. SI allows for stocking up on doses to accommodate shifting work schedules in case of future stockouts or hard times, such as the period of COVID-19, where there was a limitation in the movement of the people. Conclusion: Our findings suggest that SI may meet the needs of many women in Malawi as long as the barriers are eliminated. The barriers women mentioned include fear of self-inject and proper storage of the DMPA SC SI, and these barriers can be eliminated by proper training. The findings also set the scene for policy revision and direction at a national level and integrate the approach with national family planning strategies in Malawi. Findings provide insights that may guide future implementation strategies, strengthen non-clinic family planning access programs and stimulate continued research.

Keywords: family planning, Malawi, Sayana press, self-injection

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1541 Carrot: A Possible Source of Multidrug-Resistant Acinetobacter Transmission

Authors: M. Dahiru, O. I. Enabulele

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The research wish to investigate the occurrence of multidrug- resistant Acinetobacter, in carrot and estimate the role of carrot in its transmission, in a rapidly growing urban population. Thus, 50 carrot samples were collected from Jakara wastewater irrigation farms and analyzed on MacConkey agar and screened by Microbact 24E (Oxoid) and susceptibility of isolates tested against 10 commonly used antibiotics. Acinetobacter baumannii and A. lwoffii were isolated in 22.00% and 16% of samples respectively. Resistance to ceporex and penicillin of 36.36% and 27.27% in A. baumannii, and sensitivity to ofloxacin, pefloxacin, gentimycin and co-trimoxazole, were observed. However, for A. lwoffii apart from 37.50% resistance to ceporex, it was also resistant to all other drugs tested. There was a similarity in the resistant shown by A. baumannii and A. lwoffii to fluoroquinolones drugs and β- lactame drugs families in addition to between sulfonamide and animoglycoside demonstrated by A. lwoffii. Interestingly, when resistant similarities to different antibiotics were compared for A. baumannii and A. lwoffii as a whole, significant correlation was observed at P < 0.05 to CPX to NA (46.2%), and SXT to AU (52.6%) respectively, and high multi drug resistance (MDR) of 27.27% and 62.50% by A. baumannii and A. lwoffii respectively and overall MDR of 42.11% in all isolates. The occurrence of multidrug-resistance pathogen in carrot is a serious challenge to public health care, especially in a rapidly growing urban population where subsistence agriculture contributes greatly to urban livelihood and source of vegetables.

Keywords: urban agriculture, public health, fluoroquinolone, sulfonamide, multidrug-resistance

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1540 Real-Time Fitness Monitoring with MediaPipe

Authors: Chandra Prayaga, Lakshmi Prayaga, Aaron Wade, Kyle Rank, Gopi Shankar Mallu, Sri Satya, Harsha Pola

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In today's tech-driven world, where connectivity shapes our daily lives, maintaining physical and emotional health is crucial. Athletic trainers play a vital role in optimizing athletes' performance and preventing injuries. However, a shortage of trainers impacts the quality of care. This study introduces a vision-based exercise monitoring system leveraging Google's MediaPipe library for precise tracking of bicep curl exercises and simultaneous posture monitoring. We propose a three-stage methodology: landmark detection, side detection, and angle computation. Our system calculates angles at the elbow, wrist, neck, and torso to assess exercise form. Experimental results demonstrate the system's effectiveness in distinguishing between good and partial repetitions and evaluating body posture during exercises, providing real-time feedback for precise fitness monitoring.

Keywords: physical health, athletic trainers, fitness monitoring, technology driven solutions, Google’s MediaPipe, landmark detection, angle computation, real-time feedback

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1539 Prevalence Of Periodontal Disease In Felines In The Outskirts Of The City Of Manaus, Brazil: An Epidemiological Study

Authors: Pármenas Costa Macedo do Nascimento

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Periodontal disease is the most common disease in the oral cavity of felines. It starts with the accumulation of bacteria on the tooth surface supporting the tissues of the periodontal tissue, namely gums, alveolar bone, cementum, and periodontal ligament. The main clinical symptom observed by the owner is bad breath, which may lead to local and systemic consequences depending on the stage of periodontal disease, such as bleeding and bone loss. Therefore, the study is important to educate tutors to take better care of the felines oral health in order to try to prevent the disease. For this epidemiological study, the target population has been felines, located on the outskirts of Manaus, in the state of Amazonas, with a geographic area of 155.68 km², with no defined breed, from October 1st to 10th, 2021, whose samples has been randomly selected, with a detailed profile. The variables of interest for this study have been: absence or presence of periodontal disease, gender, age (delimited by age group), and condition (domiciled or homeless). Using a sample of 40 felines from 4 districts of the east side of Manaus chosen at random, an oral exam has been made to identify the studied disease. The animal's apparent age, condition, sex, and presence or absence of periodontal disease has been noted. It has been observed that 70% (28/40) of them had periodontal disease, mostly females, aged between 0 and 5 years and domiciled, totaling 30% (12/40).

Keywords: felines, oral cavity, oral exam, periodontal disease

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1538 Content Monetization as a Mark of Media Economy Quality

Authors: Bela Lebedeva

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Characteristics of the Web as a channel of information dissemination - accessibility and openness, interactivity and multimedia news - become wider and cover the audience quickly, positively affecting the perception of content, but blur out the understanding of the journalistic work. As a result audience and advertisers continue migrating to the Internet. Moreover, online targeting allows monetizing not only the audience (as customarily given to traditional media) but also the content and traffic more accurately. While the users identify themselves with the qualitative characteristics of the new market, its actors are formed. Conflict of interests is laid in the base of the economy of their relations, the problem of traffic tax as an example. Meanwhile, content monetization actualizes fiscal interest of the state too. The balance of supply and demand is often violated due to the political risks, particularly in terms of state capitalism, populism and authoritarian methods of governance such social institutions as the media. A unique example of access to journalistic material, limited by monetization of content is a television channel Dozhd' (Rain) in Russian web space. Its liberal-minded audience has a better possibility for discussion. However, the channel could have been much more successful in terms of unlimited free speech. Avoiding state pressure and censorship its management has decided to save at least online performance and monetizing all of the content for the core audience. The study Methodology was primarily based on the analysis of journalistic content, on the qualitative and quantitative analysis of the audience. Reconstructing main events and relationships of actors on the market for the last six years researcher has reached some conclusions. First, under the condition of content monetization the capitalization of its quality will always strive to quality characteristics of user, thereby identifying him. Vice versa, the user's demand generates high-quality journalism. The second conclusion follows the previous one. The growth of technology, information noise, new political challenges, the economy volatility and the cultural paradigm change – all these factors form the content paying model for an individual user. This model defines him as a beneficiary of specific knowledge and indicates the constant balance of supply and demand other conditions being equal. As a result, a new economic quality of information is created. This feature is an indicator of the market as a self-regulated system. Monetized information quality is less popular than that of the Public Broadcasting Service, but this audience is able to make decisions. These very users keep the niche sectors which have more potential of technology development, including the content monetization ways. The third point of the study allows develop it in the discourse of media space liberalization. This cultural phenomenon may open opportunities for the development of social and economic relations architecture both locally and regionally.

Keywords: content monetization, state capitalism, media liberalization, media economy, information quality

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1537 Maternal Health Outcome and Economic Growth in Sub-Saharan Africa: A Dynamic Panel Analysis

Authors: Okwan Frank

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Maternal health outcome is one of the major population development challenges in Sub-Saharan Africa. The region has the highest maternal mortality ratio, despite the progressive economic growth in the region during the global economic crisis. It has been hypothesized that increase in economic growth will reduce the level of maternal mortality. The purpose of this study is to investigate the existence of the negative relationship between health outcome proxy by maternal mortality ratio and economic growth in Sub-Saharan Africa. The study used the Pooled Mean Group estimator of ARDL Autoregressive Distributed Lag (ARDL) and the Kao test for cointegration to examine the short-run and long-run relationship between maternal mortality and economic growth. The results of the cointegration test showed the existence of a long-run relationship between the variables considered for the study. The long-run result of the Pooled Mean group estimates confirmed the hypothesis of an inverse relationship between maternal health outcome proxy by maternal mortality ratio and economic growth proxy by Gross Domestic Product (GDP) per capita. Thus increasing economic growth by investing in the health care systems to reduce pregnancy and childbirth complications will help reduce maternal mortality in the sub-region.

Keywords: economic growth, maternal mortality, pool mean group, Sub-Saharan Africa

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1536 Vertical Village Buildings as Sustainable Strategy to Re-Attract Mega-Cities in Developing Countries

Authors: M. J. Eichner, Y. S. Sarhan

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Overall study purpose has been the evaluation of ‘Vertical Villages’ as a new sustainable building typology, reducing significantly negative impacts of rapid urbanization processes in third world capital cities. Commonly in fast-growing cities, housing and job supply, educational and recreational opportunities, as well as public transportation infrastructure, are not accommodating rapid population growth, exposing people to high noise and emission polluted living environments with low-quality neighborhoods and a lack of recreational areas. Like many others, Egypt’s capital city Cairo, according to the UN facing annual population growth rates of up to 428.000 people, is struggling to address the general deterioration of urban living conditions. New settlements typologies and urban reconstruction approach hardly follow sustainable urbanization principles or socio-ecologic urbanization models with severe effects not only for inhabitants but also for the local environment and global climate. The authors prove that ‘Vertical Village’ buildings can offer a sustainable solution for increasing urban density with at the same time improving the living quality and urban environment significantly. Inserting them within high-density urban fabrics the ecologic and socio-cultural conditions of low-quality neighborhoods can be transformed towards districts, considering all needs of sustainable and social urban life. This study analyzes existing building typologies in Cairo’s «low quality - high density» districts Ard el Lewa, Dokki and Mohandesen according to benchmarks for sustainable residential buildings, identifying major problems and deficits. In 3 case study design projects, the sustainable transformation potential through ‘Vertical Village’ buildings are laid out and comparative studies show the improvement of the urban microclimate, safety, social diversity, sense of community, aesthetics, privacy, efficiency, healthiness and accessibility. The main result of the paper is that the disadvantages of density and overpopulation in developing countries can be converted with ‘Vertical Village’ buildings into advantages, achieving attractive and environmentally friendly living environments with multiple synergies. The paper is documenting based on scientific criteria that mixed-use vertical building structures, designed according to sustainable principles of low rise housing, can serve as an alternative to convert «low quality - high density» districts in megacities, opening a pathway for governments to achieve sustainable urban transformation goals. Neglected informal urban districts, home to millions of the poorer population groups, can be converted into healthier living and working environments.

Keywords: sustainable, architecture, urbanization, urban transformation, vertical village

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1535 Challenges and Implications for Choice of Caesarian Section and Natural Birth in Pregnant Women with Pre-Eclampsia in Western Nigeria

Authors: F. O. Adeosun, I. O. Orubuloye, O. O. Babalola

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Although caesarean section has greatly improved obstetric care throughout the world, in developing countries there is a great aversion to caesarean section. This study was carried out to examine the rate at which pregnant women with pre-eclampsia choose caesarean section over natural birth. A cross-sectional study was conducted among 500 pre-eclampsia antenatal clients seen at the States University Teaching Hospitals in the last one year. The sample selection was purposive. Information on their educational background, beliefs and attitudes were collected. Data analysis was presented using simple percentages. Out of 500 women studied, 38% favored caesarean section while 62% were against it. About 89% of them understood what caesarean section is, 57.3% of those who understood what caesarean section is will still not choose it as an option. Over 85% of the women believed caesarean section is done for medical reasons. If caesarean section is given as an option for childbirth, 38% would go for it, 29% would try religious intervention, 5.5% would not choose it because of fear, while 27.5% would reject it because they believe it is culturally wrong. Majority of respondents (85%) who favored caesarean delivery are aware of the risk attached to choosing virginal birth but go an extra mile in sourcing funds for a caesarean session while over 64% cannot afford the cost of caesarean delivery. It is therefore pertinent to encourage research in prediction methods and prevention of occurrence, since this would assist patients to plan on how to finance treatment.

Keywords: caesarean section, choice, cost, pre eclampsia, prediction methods

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1534 Sociodemographic Risk Factors of Cervical Cancer in Imphal, Manipur

Authors: Arundhati Devi Maibam, K. Ingocha Singh

Abstract:

Cervical cancer is preventable if detected early. Determination of risk factors is essential to plan screening programmes to prevent the disease. To study the demographic risk factors of cervical cancer among Manipuri women, information on age, marital status, educational level, monthly family income and socioeconomic status were collected through a pre-tested interview schedule. In this study, 64 incident cases registered at the RT Dept, RIMS (Regional Institute of Medical Sciences), Imphal, Manipur, India during 2008-09 participated. Data were entered in Microsoft Excel and the results were expressed in percentages. Among the 64 patients with cervical cancer, 56 (88.9%) were in the age group of 40+ years. The majority of the patients were from rural areas (68.75%) and 31.25% were from urban areas. The majority of the patients were Hindus (73%), 55(85.9%) were of low educational level, 43(67.2%) were married, and 36 (56.25%) belonged to Class IV socioeconomic status. In conclusion, if detected early, cervical cancer is preventable and curable. The potential risk factors need to be identified and women in the risk group need to be motivated for screening. Affordable screening programmes and health care resources will help in lessening the burden of the disease.

Keywords: cervical cancer, Manipuri women, RIIMS, socio-demographic risk factors

Procedia PDF Downloads 270
1533 A Protocol of Procedures and Interventions to Accelerate Post-Earthquake Reconstruction

Authors: Maria Angela Bedini, Fabio Bronzini

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The Italian experiences, positive and negative, of the post-earthquake are conditioned by long times and structural bureaucratic constraints, also motivated by the attempt to contain mafia infiltration and corruption. The transition from the operational phase of the emergency to the planning phase of the reconstruction project is thus hampered by a series of inefficiencies and delays, incompatible with the need for rapid recovery of the territories in crisis. In fact, intervening in areas affected by seismic events means at the same time associating the reconstruction plan with an urban and territorial rehabilitation project based on strategies and tools in which prevention and safety play a leading role in the regeneration of territories in crisis and the return of the population. On the contrary, the earthquakes that took place in Italy have instead further deprived the territories affected of the minimum requirements for habitability, in terms of accessibility and services, accentuating the depopulation process, already underway before the earthquake. The objective of this work is to address with implementing and programmatic tools the procedures and strategies to be put in place, today and in the future, in Italy and abroad, to face the challenge of the reconstruction of activities, sociality, services, risk mitigation: a protocol of operational intentions and firm points, open to a continuous updating and implementation. The methodology followed is that of the comparison in a synthetic form between the different Italian experiences of the post-earthquake, based on facts and not on intentions, to highlight elements of excellence or, on the contrary, damage. The main results obtained can be summarized in technical comparison cards on good and bad practices. With this comparison, we intend to make a concrete contribution to the reconstruction process, certainly not only related to the reconstruction of buildings but privileging the primary social and economic needs. In this context, the recent instrument applied in Italy of the strategic urban and territorial SUM (Minimal Urban Structure) and the strategic monitoring process become dynamic tools for supporting reconstruction. The conclusions establish, by points, a protocol of interventions, the priorities for integrated socio-economic strategies, multisectoral and multicultural, and highlight the innovative aspects of 'inversion' of priorities in the reconstruction process, favoring the take-off of 'accelerator' interventions social and economic and a more updated system of coexistence with risks. In this perspective, reconstruction as a necessary response to the calamitous event can and must become a unique opportunity to raise the level of protection from risks and rehabilitation and development of the most fragile places in Italy and abroad.

Keywords: an operational protocol for reconstruction, operational priorities for coexistence with seismic risk, social and economic interventions accelerators of building reconstruction, the difficult post-earthquake reconstruction in Italy

Procedia PDF Downloads 120
1532 Pulmonary Complication of Chronic Liver Disease and the Challenges Identifying and Managing Three Patients

Authors: Aidan Ryan, Nahima Miah, Sahaj Kaur, Imogen Sutherland, Mohamed Saleh

Abstract:

Pulmonary symptoms are a common presentation to the emergency department. Due to a lack of understanding of the underlying pathophysiology, chronic liver disease is not often considered a cause of dyspnea. We present three patients who were admitted with significant respiratory distress secondary to hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. The first is a 27-year-old male with a 6-month history of progressive dyspnea. The patient developed a severe type 1 respiratory failure with a PaO₂ of 6.3kPa and was escalated to critical care, where he was managed with non-invasive ventilation to maintain oxygen saturation. He had an agitated saline contrast echocardiogram, which showed the presence of a possible shunt. A CT angiogram revealed significant liver cirrhosis, portal hypertension, and large para esophageal varices. Ultrasound of the abdomen showed coarse liver echo patter and enlarged spleen. Along with these imaging findings, his biochemistry demonstrated impaired synthetic liver function with an elevated international normalized ratio (INR) of 1.4 and hypoalbuminaemia of 28g/L. The patient was then transferred to a tertiary center for further management. Further investigations confirmed a shunt of 56%, and liver biopsy confirmed cirrhosis suggestive of alpha-1-antitripsyin deficiency. The findings were consistent with a diagnosis of hepatopulmonary syndrome, and the patient is awaiting a liver transplant. The second patient is a 56-year-old male with a 12-month history of worsening dyspnoea, jaundice, confusion. His medical history included liver cirrhosis, portal hypertension, and grade 1 oesophageal varices secondary to significant alcohol excess. On admission, he developed a type 1 respiratory failure with PaO₂ of 6.8kPa requiring 10L of oxygen. CT pulmonary angiogram was negative for pulmonary embolism but showed evidence of chronic pulmonary hypertension, liver cirrhosis, and portal hypertension. An echocardiogram revealed a grossly dilated right heart with reduced function, pulmonary and tricuspid regurgitation, and pulmonary artery pressures estimated at 78mmHg. His biochemical markers showed impaired synthetic liver function with an INR of 3.2, albumin of 29g/L, along with raised bilirubin of 148mg/dL. During his long admission, he was managed with diuretics with little improvement. After three weeks, he was diagnosed with portopulmonary hypertension and was commenced on terlipressin. This resulted in successfully weaning off oxygen, and he was discharged home. The third patient is a 61-year-old male who presented to the local ambulatory care unit for therapeutic paracentesis on a background of decompensated liver cirrhosis. On presenting, he complained of a 2-day history of worsening dyspnoea and a productive cough. Chest x-ray showed a large pleural effusion, increasing in size over the previous eight months, and his abdomen was visibly distended with ascitic fluid. Unfortunately, the patient deteriorated, developing a larger effusion along with an increase in oxygen demand, and passed away. Without underlying cardiorespiratory disease, in the presence of a persistent pleural effusion with underlying decompensated cirrhosis, he was diagnosed with hepatic hydrothorax. While each presented with dyspnoea, the cause and underlying pathophysiology differ significantly from case to case. By describing these complications, we hope to improve awareness and aid prompt and accurate diagnosis, vital for improving outcomes.

Keywords: dyspnea, hepatic hydrothorax, hepatopulmonary syndrome, portopulmonary syndrome

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1531 Runaway Girl Children and the Reasons: Qualitative Study in Government Girls Home Bangalore

Authors: Hazel Johanna J., Ntailang Mary Tariang

Abstract:

The paper “Runaway Girl Children and the Reasons: Qualitative Study In Government Girls Home Bangalore” explores the different reasons why children choose this last resort of running away rather than seeking proper help from the authorities. A qualitative study using a purposive sampling method was used to identify the participants based on the objectives. Girl runaway children between the age group of 12-18 years admitted to the Government Girls Home, Bangalore, were chosen for this study. Data was collected through in-depth interviews using semi-structured questions. Thematic analysis has been done using QDA Miner Lite. The main objectives of this study were to identify the reasons behind running away in children, to explore their childhood experiences and future dreams after they leave the Child Care Institution. The findings of this study derived five major themes that have caused the children to run away from their homes. The themes are child maltreatment and dysfunctional families, coerced into adulthood, forced work, adolescent dalliance, and aspirations. As a result, all the themes that emerged here are related to the family in one way or another. In conclusion, it is revealed that interpersonal family conflicts lead to the violation of child rights in so many ways, which in this context leads the child to run away from the comfort of their home.

Keywords: runaway children, dysfunctional family, abuse, child marriage, education

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1530 Telecontrolled Service Robots for Increasing the Quality of Life of Elderly and Disabled

Authors: Nayden Chivarov, Denis Chikurtev, Kaloyan Yovchev, Nedko Shivarov

Abstract:

This paper represents methods for improving the efficiency and precision of service mobile robot. This robot is used for increasing the quality of life of elderly and disabled people. The key concept of the proposed Intelligent Service Mobile Robot is its easier adaptability to achieve services for a wide range of Elderly or Disabled Person’s needs, by performing different tasks for supporting Elderly or Disabled Persons care. We developed robot autonomous navigation and computer vision systems in order to recognize different objects and bring them to the people. Web based user interface is developed to provide easy access and tele-control of the robot by any device through the internet. In this study algorithms for object recognition and localization are proposed for providing successful object recognition and accuracy in the positioning. Different methods for sending movement commands to the mobile robot system are proposed and evaluated. After executing some experiments to show the results of the research, we can summarize that these systems and algorithms provide good control of the service mobile robot and it will be more useful to help the elderly and disabled persons.

Keywords: service robot, mobile robot, autonomous navigation, computer vision, web user interface, ROS

Procedia PDF Downloads 328
1529 CAM Use and Its Association with Quality of Life in a Sample of Lebanese Breast Cancer Patients: A Cross Sectional Study

Authors: Farah Naja, Romy Abi Fadel, Yasmin Aridi, Aya Zarif, Dania Hariri, Mohammad Alameddine, Anas Mugharbel, Maya Khalil, Zeina Nahleh, Arafat Tfayli

Abstract:

The objective of this study is to assess the prevalence and determinants of CAM use among breast cancer patients in Beirut, Lebanon. A secondary objective is to evaluate the association between CAM use and quality of life (QOL). A cross-sectional survey was conducted on 180 breast cancer patients recruited from two major referral centers in Beirut. In a face to face interview, participants completed a questionnaire comprised of three sections: socio-demographic and lifestyle characteristics, breast cancer condition, and CAM use. The assessment of QOL was carried using the FACT-B Arabic version. Prevalence of CAM use since diagnosis was 40%. CAM use was negatively associated with age, treatment at a philanthropic hospital and positively associated with having an advanced stage of disease. The most commonly used CAM was ‘Special food’ followed by ‘Herbal teas’. Only 4% of CAM users cited health care professionals as influencing their choice of CAM. One in four patients disclosed CAM use to their treating physician. There was no significant association between CAM use and QOL. The use of CAM therapies among breast cancer patients is prevalent in Lebanon. Efforts should be dedicated at educating physicians to discuss CAM use with their patients and advising patients to disclose of their use with their physicians.

Keywords: breast cancer , complementary medicine, alternative medicine, lebanon , quality of life

Procedia PDF Downloads 503
1528 When Helping Hurts: Addressing Violence in Healthcare Settings

Authors: Jason Maffia, Maria D’urso, Robert Crupi, Margaret Cartmell

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The emotional aspects of traumatic events such as workplace violence are often ignored, causing low productivity, disillusionment, and resentment within an organization. As a result, if workplace violence, particularly in healthcare settings, is not adequately addressed, it will become a phenomenon, undermining the peace and stability among the active communities while also posing a risk to the population's health and well-being. This review intends to identify the risk factors and the implications of workplace violence in healthcare settings and highlight the collaborative efforts needed in sustaining control and prevention measures against workplace violence. It is essential that health care organizations are prepared physically and emotionally for traumatic situations. This study explores the theoretical nature of addressing work-related violence in healthcare settings as well as traumatic stress reactivity and the context within which reactions occur and recovery takes place. Cognitive, social, and organizational influences on response are identified and used to tentatively offer explanations for identifying security risks, development, and implementation of de-escalation teams, CISM programs and training staff in violence prevention are among strategies hospitals are employing to keep workers and patients safe. General conclusion regarding the implications for intervention effectiveness and design are discussed.

Keywords: healthcare settings, stress reactions, traumatic events, workplace violence

Procedia PDF Downloads 71
1527 The Evaluation of the Patients Related to Numeric Pain Scales: The Case of Turkey

Authors: Maide Yesilyurt, Saide Faydalı

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Patients experience pain at different intensities in postoperative. The diagnosis of the pain, the assessment and the success of the treatment and care make the measurement of this finding compulsory. The aim of the study is to determine the evaluation differences numeric pain scales. The descriptive study was conducted with 360 patients with in postoperative. The data were obtained from questionnaires related to six numeric pain scales most preferred in clinical use, and a face-to-face interview technique was used by the researcher. Regarding to numeric pain scale, questions include forth positive and one negative statement. In evaluating the data; chi-square and Pearson correlation tests were used. For the study, the patients’ informed consents, the institution and the ethics committee received permission. In this study, patients' ages are between 18-80, 95.8% of the patients were not informed about pain assessment. Patients evaluated the 5-item numeric scale as the easy, can be answered quickly, accurate, and appropriate for clinical use and the 101 items numeric scale as complex than other scales. Regarding to numeric pain scales with positive statements between age, marital status, educational status, previous surgery, having chronic disease and getting information about pain assessment significant difference has been detected. All numeric pain scales are correlated to each other. As a result, it was determined that as the items in the numerical scales decreased, the patients were able to perceive the scales better, and the items in the scales increased, the patients were in trouble to understand.

Keywords: numeric pain scales, nurse, pain assessment, patient

Procedia PDF Downloads 282
1526 Unpleasant Symptom Clusters Influencing Quality of Life among Patients with Chronic Kidney Disease

Authors: Anucha Taiwong, Nirobol Kanogsunthornrat

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This predictive research aimed to investigate the symptom clusters that influence the quality of life among patients with chronic kidney disease, as indicated in the Theory of Unpleasant Symptoms. The purposive sample consisted of 150 patients with stage 3-4 chronic kidney disease who received care at an outpatient chronic kidney disease clinic of a tertiary hospital in Roi-Et province. Data were collected from January to March 2016 by using a patient general information form, unpleasant symptom form, and quality of life (SF-36) and were analyzed by using descriptive statistics, factor analysis, and multiple regression analysis. Findings revealed six core symptom clusters including symptom cluster of the mental and emotional conditions, peripheral nerves abnormality, fatigue, gastro-intestinal tract, pain and, waste congestion. Significant predictors for quality of life were the two symptom clusters of pain (Beta = -.220; p < .05) and the mental and emotional conditions (Beta=-.204; p<.05) which had predictive value of 19.10% (R2=.191, p<.05). This study indicated that the symptom cluster of pain and the mental and emotional conditions would worsen the patients’ quality of life. Nurses should be attentive in managing the two symptom clusters to facilitate the quality of life among patients with chronic kidney disease.

Keywords: chronic kidney disease, symptom clusters, predictors of quality of life, pre-dialysis

Procedia PDF Downloads 309
1525 Developing of Attitude towards Using Complementary Treatments Scale in Turkey

Authors: Ayşegül Bilge, Merve Uğuryol, Şeyda Dülgerler, Mustafa Yıldız

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The purpose of this research is to prove the Attitude towards Using Complementary Treatments Scale reliability and validity. The research is a methodological type of research that has been planned to determine the validity and reliability of the Attitude towards Using Complementary Treatments Scale. The scale has been developed by the researchers. In the scale, there are 23 questions including complementary and modern therapies individuals apply when they have health problems 4-item Likert-type evaluation has been carried out in preparing the questionnaire. High score obtained from the scale indicates a positive attitude towards complementary therapies. In the course of validity assessment of the scale, expert opinion has been received, and the content validity of the scale has been determined by using Kendall coefficient correlation test (Wa=0.200, p = 0.460). In the course of the reliability assessment of the scale, total score correlations of 23 materials have been examined, and those under 0.20 correlation limit has been removed from the scale correlation. As a result, the scale was left to be 13 items. In the internal consistency tests of the analyses, Cronbach's alpha value has been found to be 0.79. As a result, of the validity analyses of the Attitude towards Using Complementary Treatments Scale, the content and language validity analyses has been found to be at the expected level. It has been determined to be a highly reliable scale as the result of the reliability analyses. In conclusion, Attitude towards Using Complementary Treatments Scale is a valid and reliable scale.

Keywords: alternative health care, complementary treatment, instrument development, nursing practice

Procedia PDF Downloads 392
1524 Massachusetts Homeschool Policy: An Interpretive Analysis of Homeschool Regulation and Oversight

Authors: Lauren Freed

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This research proposal outlines an examination of homeschool oversight in the Massachusetts educational system amid the backdrop of ideological differences between various parties with contributing interests. This mixed methodology study will follow an interpretive policy research approach, involving the use of existing data, surveys, and focus groups. The aim is to capture distinct sets of meanings, values, feelings, and beliefs by principal stakeholders, while exploring the ways in which they/each interact with, interpret, and implement homeschool guidelines set forth by the Massachusetts Supreme Judicial Court Decision Care and Protection of Charles (1987). This analysis will identify and contextualize the attitudes, administrative choices, financial implications, and educational impacts that result from the process and practice of enacting current homeschool oversight policy in Massachusetts. The following question will guide this study: How do districts, homeschooling parents, and Massachusetts Department of Elementary and Secondary Education (DESE) regulate, fund, collect, interpret, implement and report Massachusetts homeschool oversight policy? The resulting analysis will produce a unique and original baseline snapshot of qualitative and quantifiable point-in-time data based on the registered homeschool population in the state of Massachusetts.

Keywords: alternative education, homeschooling, home education, home schooling policy

Procedia PDF Downloads 178
1523 Co-Designing Health as a Social Community Centre: The Case of a 'Doctors of the World Project' in Brussels

Authors: Marco Ranzato, Maguelone Vignes

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The co-design process recently run by the trans-disciplinary urban laboratory Metrolab Brussels for outlining the architecture of a future integrated health centre in Brussels (Belgium) has highlighted that a buffer place open to the local community is the appropriate cornerstone around which organizing a space where diverse professionals and patients are together. In the context of the migrants 'crisis' in Europe, the growing number of vulnerable people in Brussels and the increasing complexity of the health and welfare systems, the NGO Doctors of the World (DoW) has launched a project funded by The European Regional Development Fund, and aiming to create a new community centre combining social and health services in a poor but changing neighborhood of Brussels. Willing not to make a 'ghetto' of this new integrated service, the NGO looks at hosting different publics in order to make the poorest, marginal and most vulnerable people access to a regular kind of service. As a trans-disciplinary urban research group, Metrolab has been involved in the process of co-designing the architecture of the future centre with a set of various health professionals, social workers, and patients’ representatives. Metrolab drawn on the participants’ practice experiences and knowledge of hosting different kinds of publics and professions in a same structure in order to imagine what rooms should fit into the centre, what atmosphere they should convey, how should they be interrelated and organized, and, concurrently, how the building should fit into the urban frame of its neighborhood. The result is that, in order for an integrated health centre framed in the landscape of a disadvantaged neighborhood to function, it has to work as social community centre offering accessibility and conviviality to diverse social groups. This paper outlines the methodology that Metrolab used to design and conduct, in close collaboration with DoW, a series of 3 workshops. Through sketching and paper modeling, the methodology made participants talk about their experience by projecting them into a situation. It included a combination of individual and collective work in order to sharp participants’ eyes on architectural forms, explicit their thoughts and experience through inter-subjectivity and imagine solutions to the challenges they raised. Such a collaborative method encompasses several challenges about patients’ participation and representation, replicability of the conditions of success and the plurality of the research findings communication formats. This paper underlines how this participatory process has contributed to build knowledge on the few-documented topic of the architecture of community health centres. More importantly, the contribution builds on this participatory process to discuss the importance of adapting the architecture of the new integrated health centre to the changing population of Brussels and to the issues of its specific neighborhood.

Keywords: co-design, health, social innovation, urban lab

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1522 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

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Background: The societal impact of antibiotic resistance is a major public health concern. The increase in the incidence of resistant bacteria can ultimately be fatal. Objective: To analyse the appropriateness of antibiotic prescribing in Dundee Dental Hospital, ultimately improving the safety and quality of patient care. Methods: Two examiners independently cross-checked approximately fifty consecutive prescriptions, and corresponding patient case notes, for three data collection cycles between August 2014–September 2015. The Scottish Dental Clinical Effectiveness Program (SDCEP) Drug Prescribing for Dentistry guidelines was the standard utilised. The criteria: clinical justification, regime justification, and review arrangements was measured, and compared to the standard. Results: Cycle one revealed 42% of antibiotic prescriptions were appropriate. Interventions included: multiple staff meetings, an introduction of a checklist attached to the prescription pack, and production of patient leaflets explaining indications for antibiotics. Cycle two and three revealed 44%, and 30% compliance, respectively. Conclusion: The results of the audit have yet to meet target standards set out in prescribing guidelines. However, steps are being taken and change has occurred on a cultural level.

Keywords: antibiotic resistance, antibiotic stewardship, dental infection, hygiene standards

Procedia PDF Downloads 217