Search results for: service quality at front desk stations (sqafd)
10743 Comparative Study on Manet Using Soft Computing Techniques
Authors: Amarjit Singh, Tripatdeep Singh Dua, Vikas Attri
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Mobile Ad-hoc Network is a combination of several nodes that create dynamically a specific network without using any base infrastructure. In this study all the mobile nodes can depended upon each other to send any data. Mobile host can pick up data and forwarding to their destination path. Basically MANET depend upon their Quality of Service which is highly constraints to the user. To give better services we need to improve the QOS. In these days MANET QOS requirement to use soft computing techniques. These techniques depend upon their specific requirement and which exists using MANET concepts. Using a soft computing techniques various protocol and algorithms may be considered. In this paper, we provide comparative study review of existing work done in MANET using various kind of soft computing techniques. Our review research is based on their specific protocol or algorithm which provide concern solution of QOS need. We discuss about various protocol through which routing in MANET. In Second section we clear the concepts of Soft Computing and their types. In third section we review the MANET using different kind of soft computing techniques work done before. In forth section we need to understand the concept of QoS requirement which exists in MANET and we done comparative study on different protocol used before and last we conclude the purpose of using MANET with soft computing techniques metrics.Keywords: mobile ad-hoc network, fuzzy improved genetic approach, neural network, routing protocol, wireless mesh network
Procedia PDF Downloads 34910742 The Potency of Sandfish (Holothuria scraba) Flesh Powder to Improve Reproduction Quality of Man
Authors: E. Riani, T. T. Irawadi, S. Nurjanah, K. Syamsu, E. G. Said, Suprihatin, M. R. Cordova
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Especially coastal, Indonesian and Chinese communities have utilized sandfish to improve reproduction quality of men. This study aimed to examine the nutrition on sandfish flesh that has the potency to improve reproduction quality of men. The materials used were sandfish with weight of 200-500 g, and then analysis of proximate, analysis of amino acid, analysis of fatty acid and analysis of mineral contained in the sandfish were performed. The results showed that protein content (39.96%) was the main component of the flesh; the carbohydrate and fat were 25.43% and 4.18%, respectively. Sandfish powder contains several essential amino acids and nonessential amino acids. Nine of ten amino acids needed by human body are contained in sandfish powder, i.e. arginine, histidine, isoleucine, leucine, lysine, methionine, phenylalanine, tryptophan, threonine and valine; only tryptophan that are not contained in sandfish powder. Sandfish powder contains saturated fatty acid kaproat, kaprilat, kaprat, laurat, miristat, stearat, arakhidat and behenat; monosaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA). MUFA is composed of fatty acid oleat, while PUFA is composed fatty acid omega 3 (linonenat, eicosapentaenoic acid and docosahexaenoic acid) and omega 6 (linoleat and arakhidonat). The minerals contained in sandfish powder are macrominerals and microminerals. Based on the findings, the nutrition in sandfish powder has a good potency to improve reproduction of men, especially PUFA for the maturation of spermatozoa, zinc for production function and spermatogenesis, motility of spermatozoa, acromoson reaction; Mg for transformation of genetic information and motility of spermatozoa; calcium for spermatogenesis, capacity and fertilization of spermatozoa. Thus, sandfish flesh powder has the potency to improve reproduction quality of men.Keywords: sandfish flesh powder, nutrition, reproduction quality, men
Procedia PDF Downloads 45510741 Multi-Level Clustering Based Congestion Control Protocol for Cyber Physical Systems
Authors: Manpreet Kaur, Amita Rani, Sanjay Kumar
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The Internet of Things (IoT), a cyber-physical paradigm, allows a large number of devices to connect and send the sensory data in the network simultaneously. This tremendous amount of data generated leads to very high network load consequently resulting in network congestion. It further amounts to frequent loss of useful information and depletion of significant amount of nodes’ energy. Therefore, there is a need to control congestion in IoT so as to prolong network lifetime and improve the quality of service (QoS). Hence, we propose a two-level clustering based routing algorithm considering congestion score and packet priority metrics that focus on minimizing the network congestion. In the proposed Priority based Congestion Control (PBCC) protocol the sensor nodes in IoT network form clusters that reduces the amount of traffic and the nodes are prioritized to emphasize important data. Simultaneously, a congestion score determines the occurrence of congestion at a particular node. The proposed protocol outperforms the existing Packet Discard Network Clustering (PDNC) protocol in terms of buffer size, packet transmission range, network region and number of nodes, under various simulation scenarios.Keywords: internet of things, cyber-physical systems, congestion control, priority, transmission rate
Procedia PDF Downloads 30810740 Techno Economic Analysis for Solar PV and Hydro Power for Kafue Gorge Power Station
Authors: Elvis Nyirenda
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This research study work was done to evaluate and propose an optimum measure to enhance the uptake of clean energy technologies such as solar photovoltaics, the study also aims at enhancing the country’s energy mix from the overdependence on hydro power which is susceptible to droughts and climate change challenges The country in the years 2015 - 2016 and 2018 - 2019 had received rainfall below average due to climate change and a shift in the weather pattern; this resulted in prolonged power outages and load shedding for more than 10 hours per day. ZESCO Limited, the utility company that owns infrastructure in the generation, transmission, and distribution of electricity (state-owned), is seeking alternative sources of energy in order to reduce the over-dependence on hydropower stations. One of the alternative sources of energy is Solar Energy from the sun. However, solar power is intermittent in nature and to smoothen the load curve, investment in robust energy storage facilities is of great importance to enhance security and reliability of electricity supply in the country. The methodology of the study looked at the historical performance of the Kafue gorge upper power station and utilised the hourly generation figures as input data for generation modelling in Homer software. The average yearly demand was derived from the available data on the system SCADA. The two dams were modelled as natural battery with the absolute state of charging and discharging determined by the available water resource and the peak electricity demand. The software Homer Energy System is used to simulate the scheme incorporating a pumped storage facility and Solar photovoltaic systems. The pumped hydro scheme works like a natural battery for the conservation of water, with the only losses being evaporation and water leakages from the dams and the turbines. To address the problem of intermittency on the solar resource and the non-availability of water for hydropower generation, the study concluded that utilising the existing Hydro power stations, Kafue Gorge upper and Kafue Gorge Lower to work conjunctively with Solar energy will reduce power deficits and increase the security of supply for the country. An optimum capacity of 350MW of solar PV can be integrated while operating Kafue Gorge power station in both generating and pumping mode to enable efficient utilisation of water at Kafue Gorge upper Dam and Kafue Gorge Lower dam.Keywords: hydropower, solar power systems, energy storage, photovoltaics, solar irradiation, pumped hydro storage system, supervisory control and data acquisition, Homer energy
Procedia PDF Downloads 11710739 Development of a Core Set of Clinical Indicators to Measure Quality of Care for Thyroid Cancer: A Modified-Delphi Approach
Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern
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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.Keywords: clinical registry, Delphi survey, quality indicators, quality of care
Procedia PDF Downloads 18010738 Applying Different Stenography Techniques in Cloud Computing Technology to Improve Cloud Data Privacy and Security Issues
Authors: Muhammad Muhammad Suleiman
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Cloud Computing is a versatile concept that refers to a service that allows users to outsource their data without having to worry about local storage issues. However, the most pressing issues to be addressed are maintaining a secure and reliable data repository rather than relying on untrustworthy service providers. In this study, we look at how stenography approaches and collaboration with Digital Watermarking can greatly improve the system's effectiveness and data security when used for Cloud Computing. The main requirement of such frameworks, where data is transferred or exchanged between servers and users, is safe data management in cloud environments. Steganography is the cloud is among the most effective methods for safe communication. Steganography is a method of writing coded messages in such a way that only the sender and recipient can safely interpret and display the information hidden in the communication channel. This study presents a new text steganography method for hiding a loaded hidden English text file in a cover English text file to ensure data protection in cloud computing. Data protection, data hiding capability, and time were all improved using the proposed technique.Keywords: cloud computing, steganography, information hiding, cloud storage, security
Procedia PDF Downloads 19210737 Artificial Intelligence Based Method in Identifying Tumour Infiltrating Lymphocytes of Triple Negative Breast Cancer
Authors: Nurkhairul Bariyah Baharun, Afzan Adam, Reena Rahayu Md Zin
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Tumor microenvironment (TME) in breast cancer is mainly composed of cancer cells, immune cells, and stromal cells. The interaction between cancer cells and their microenvironment plays an important role in tumor development, progression, and treatment response. The TME in breast cancer includes tumor-infiltrating lymphocytes (TILs) that are implicated in killing tumor cells. TILs can be found in tumor stroma (sTILs) and within the tumor (iTILs). TILs in triple negative breast cancer (TNBC) have been demonstrated to have prognostic and potentially predictive value. The international Immune-Oncology Biomarker Working Group (TIL-WG) had developed a guideline focus on the assessment of sTILs using hematoxylin and eosin (H&E)-stained slides. According to the guideline, the pathologists use “eye balling” method on the H&E stained- slide for sTILs assessment. This method has low precision, poor interobserver reproducibility, and is time-consuming for a comprehensive evaluation, besides only counted sTILs in their assessment. The TIL-WG has therefore recommended that any algorithm for computational assessment of TILs utilizing the guidelines provided to overcome the limitations of manual assessment, thus providing highly accurate and reliable TILs detection and classification for reproducible and quantitative measurement. This study is carried out to develop a TNBC digital whole slide image (WSI) dataset from H&E-stained slides and IHC (CD4+ and CD8+) stained slides. TNBC cases were retrieved from the database of the Department of Pathology, Hospital Canselor Tuanku Muhriz (HCTM). TNBC cases diagnosed between the year 2010 and 2021 with no history of other cancer and available block tissue were included in the study (n=58). Tissue blocks were sectioned approximately 4 µm for H&E and IHC stain. The H&E staining was performed according to a well-established protocol. Indirect IHC stain was also performed on the tissue sections using protocol from Diagnostic BioSystems PolyVue™ Plus Kit, USA. The slides were stained with rabbit monoclonal, CD8 antibody (SP16) and Rabbit monoclonal, CD4 antibody (EP204). The selected and quality-checked slides were then scanned using a high-resolution whole slide scanner (Pannoramic DESK II DW- slide scanner) to digitalize the tissue image with a pixel resolution of 20x magnification. A manual TILs (sTILs and iTILs) assessment was then carried out by the appointed pathologist (2 pathologists) for manual TILs scoring from the digital WSIs following the guideline developed by TIL-WG 2014, and the result displayed as the percentage of sTILs and iTILs per mm² stromal and tumour area on the tissue. Following this, we aimed to develop an automated digital image scoring framework that incorporates key elements of manual guidelines (including both sTILs and iTILs) using manually annotated data for robust and objective quantification of TILs in TNBC. From the study, we have developed a digital dataset of TNBC H&E and IHC (CD4+ and CD8+) stained slides. We hope that an automated based scoring method can provide quantitative and interpretable TILs scoring, which correlates with the manual pathologist-derived sTILs and iTILs scoring and thus has potential prognostic implications.Keywords: automated quantification, digital pathology, triple negative breast cancer, tumour infiltrating lymphocytes
Procedia PDF Downloads 11610736 Socio-Demographic Characteristics and Psychosocial Consequences of Sickle Cell Disease: The Case of Patients in a Public Hospital in Ghana
Authors: Vincent A. Adzika, Franklin N. Glozah, Collins S. K. Ahorlu
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Background: Sickle Cell Disease (SCD) is of major public-health concern globally, with majority of patients living in Africa. Despite its relevance, there is a dearth of research to determine the socio-demographic distribution and psychosocial impact of SCD in Africa. The objective of this study therefore was to examine the socio-demographic distribution and psychosocial consequences of SCD among patients in Ghana and to assess their quality of life and coping mechanisms. Methods: A cross-sectional research design was used, involving the completion of questionnaires on socio-demographic characteristics, quality of life of individuals, anxiety and depression. Participants were 387 male and female patients attending a sickle cell clinic in a public hospital. Results: Results showed no gender and marital status differences in anxiety and depression. However, there were age and level of education variances in depression but not in anxiety. In terms of quality of life, patients were more satisfied by the presence of love, friends, relatives as well as home, community and neighbourhood environment. While pains of varied nature and severity were the major reasons for attending hospital in SCD condition, going to the hospital as well as having Faith in God was the frequently reported mechanisms for coping with an unbearable SCD attacks. Multiple regression analysis showed that some socio-demographic and quality of life indicators had strong associations with anxiety and/or depression. Conclusion: It is recommended that a multi-dimensional intervention strategy incorporating psychosocial dimensions should be considered in the treatment and management of SCD.Keywords: anxiety, depression, sickle cell disease, socio-demographic quality of life, characteristics, Ghana
Procedia PDF Downloads 47710735 Dielectric Properties of NdTi₍₀.₅₋ₓ₎GeₓMo₀.₅O₄ Ceramics at Microwave Frequency
Authors: Yih-Chien Chen, Tse-Lung Lin
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The microwave characteristics of NdTi₍₀.₅₋ₓ₎GeₓMo₀.₅O₄ are studied to determine the feasibility of their use in the liquid sensor. The microwave characteristics of NdTi₍₀.₅₋ₓ₎GeₓMo₀.₅O₄ are determined using X-ray diffraction (XRD) patterns. The permittivity (𝜀r) of NdTi₍₀.₄₉₎Ge₀.₀₁Mo₀.₅O₄ that is sintered at 1425 ℃ for 4 h is 17.6, the unloaded quality factor (Qu×f) is 33,400 GHz, and it has a temperature coefficient at the resonance frequency (TCF) of -30.7 ppm/℃. The proposed liquid sensor is at the 5G FR1 bands.Keywords: NdTi₍₀.₅₋ₓ₎GeₓMo₀.₅O₄, X-ray diffraction pattern, permittivity, Unloaded quality factor
Procedia PDF Downloads 29310734 An Interrogation of Lecturer’s Skills in Assisting Visually Impaired Students during the COVID-19 Lockdown Era in Selected Universities in Zimbabwe
Authors: Esther Mafunda
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The present study interrogated the lecturer’s skills in supporting visually impaired students during the Covid-19 era at the University of Zimbabwe. It particularly assesses how the Covid-19 pandemic affected the learning experience of visually impaired students and which skills the lecturers possessed in order to assist the visually impaired students during online learning. Data was collected from lecturers and visually impaired students at the University of Zimbabwe Disability Resource Centre. Data was collected through the use of interviews and questionnaires. Using content analysis, it was established that visually impaired students faced challenges of lack of familiarity with the Moodle learning platform, marginalization, lack of professional training, and lack of training for parents and guardians. Lecturers faced challenges of lack of training, the curriculum, access, and technical know-how deficit. It was established that lecturers had to resort to social media platforms in order to assist visually impaired students. Visually impaired students also received assistance from their friends and family members. On the basis of the results of the research, it can be concluded that lecturers needed in-service training to be provided with the necessary skills and knowledge to teach students with visual impairments and provide quality education to students with visual impairments.Keywords: visual impairment, disability, covid-19, inclusive learning
Procedia PDF Downloads 9210733 The Hotel Logging Behavior and Factors of Tourists in Bankontee District, Samut Songkhram Province, Thailand
Authors: Aticha Kwaengsopha
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The purpose of this research was to study the behaviour and related factors that tourists utilized for making decisions to choose their accommodations at a tourist destination, Bangkontee district, Samut Songkhran Province, Thailand. The independent variables included gender, age, income, occupation, and region, while the three important dependent variables included selection behaviour, factors related selection process, and satisfaction of the accommodation service. A total of 400 Thai and international tourists were interviewed at tourist destination of Bangkontee. A questionnaire was used as the tool for collecting data. Descriptive statistics in this research included percentage, mean, and standard deviation. The findings revealed that the majority of respondents were single, female, and with the age between 23-30 years old. Most of the international tourists were from Asia and planned to stay in Thailand about 1-6 days. In addition, the majority of tourists preferred to travel in small groups of 3 persons. The majority of respondents used internet and word of mouth as the main tool to search for information. The majority of respondents spent most of their budget on food & drink, accommodation, and travelling. Even though the majority of tourists were satisfied with the quality of accommodation, the price range of accommodation, and the image of accommodation and the facilities of the accommodation, they indicated that they were not likely to re-visit Thailand in the near future.Keywords: behaviour, decision factors, tourists, media engineering
Procedia PDF Downloads 27510732 Assignment of Airlines Technical Members under Disruption
Authors: Walid Moudani
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The Crew Reserve Assignment Problem (CRAP) considers the assignment of the crew members to a set of reserve activities covering all the scheduled flights in order to ensure a continuous plan so that operations costs are minimized while its solution must meet hard constraints resulting from the safety regulations of Civil Aviation as well as from the airlines internal agreements. The problem considered in this study is of highest interest for airlines and may have important consequences on the service quality and on the economic return of the operations. In this communication, a new mathematical formulation for the CRAP is proposed which takes into account the regulations and the internal agreements. While current solutions make use of Artificial Intelligence techniques run on main frame computers, a low cost approach is proposed to provide on-line efficient solutions to face perturbed operating conditions. The proposed solution method uses a dynamic programming approach for the duties scheduling problem and when applied to the case of a medium airline while providing efficient solutions, shows good potential acceptability by the operations staff. This optimization scheme can then be considered as the core of an on-line Decision Support System for crew reserve assignment operations management.Keywords: airlines operations management, combinatorial optimization, dynamic programming, crew scheduling
Procedia PDF Downloads 35410731 Patient Experience in a Healthcare Setting: How Patients' Encounters Make for Better Value Co-creation
Authors: Kingsley Agyapong
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Research conducted in recent years has delved into the concept of patient-perceived value within the context of co-creation, particularly in the realm of doctor-patient interactions within healthcare settings. However, existing scholarly discourse lacks exploration regarding the emergence of patient-derived value in the co-creation process, specifically within encounters involving patients and stakeholders such as doctors, nurses, pharmacists, and other healthcare professionals. This study aims to fill this gap by elucidating the perspectives of patients regarding the value they derive from their interactions with multiple stakeholders in the delivery of healthcare services. The fieldwork was conducted at a university clinic located in Ghana. Data collection procedures involved conducting 20 individual interviews with key informants on distinct value accrued from co-creation practices and interactions with stakeholders. The key informants consisted of patients receiving care at the university clinic during the Malaria Treatment Process. Three themes emerged from both the existing literature and the empirical data collected. The first theme, labeled as "patient value needs in co-creation," encapsulates elements such as communication effectiveness, interpersonal interaction quality, treatment efficacy, and enhancements to the overall quality of life experienced by patients during their interactions with healthcare professionals. The second theme, designated as "services that enhance patients' experience in value co-creation," pertains to patients' perceptions of services that contribute favourably to co-creation experiences, including initiatives related to health promotion and the provision of various in-house services that patients deem pertinent for augmenting their overall experiences. The third theme, titled "Challenges in the co-creation of patients' value," delineates obstacles encountered within the co-creation process, including health professionals' challenges in effectively following up with patients scheduled for review and prolonged waiting times for healthcare delivery. This study contributes to the patients' perceptions of value within the co-creation process during their interactions with service providers, particularly healthcare professionals. By gaining a deeper insight into this process, healthcare providers can enhance the delivery of patient-centered care, thereby leading to improved healthcare outcomes. The study further offers managerial implications derived from its findings, providing actionable insights for healthcare managers and policymakers aiming to optimize patient value creation in healthcare services. Furthermore, it suggests avenues for future research endeavors within healthcare settings.Keywords: patient, healthcare, co-creation, malaria
Procedia PDF Downloads 4710730 Factors Affecting Test Automation Stability and Their Solutions
Authors: Nagmani Lnu
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Test automation is a vital requirement of any organization to release products faster to their customers. In most cases, an organization has an approach to developing automation but struggles to maintain it. It results in an increased number of Flaky Tests, reducing return on investments and stakeholders’ confidence. Challenges grow in multiple folds when automation is for UI behaviors. This paper describes the approaches taken to identify the root cause of automation instability in an extensive payments application and the best practices to address that using processes, tools, and technologies, resulting in a 75% reduction of effort.Keywords: automation stability, test stability, Flaky Test, test quality, test automation quality
Procedia PDF Downloads 8410729 Development of a Decision Model to Optimize Total Cost in Food Supply Chain
Authors: Henry Lau, Dilupa Nakandala, Li Zhao
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All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation
Procedia PDF Downloads 22310728 Conceptualizing Health-Seeking Behavior among Adolescents and Youth with Substance Use Disorder in Urban Kwazulu-Natal. A Candidacy Framework Analysis
Authors: Siphesihle Hlongwane
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Background: Globally, alcohol consumption, smoking, and the use of illicit drugs kill more than 11.8 million people each year. In sub-Saharan Africa, substance abuse is responsible for more than 6.4% of all deaths recorded and about 4.7% of all Disability Adjusted Life Years (DALYs), with numbers still expected to grow if no drastic measures are taken to curb and address drug use. In a setting where substance use is rife, understanding contextual factors that influence an individual’s perceived eligibility to seek rehabilitation is paramount. Using the candidacy framework, we unpack how situational factors influence an individual’s perceived eligibility for healthcare uptake in adolescents and youth with substance use disorder (SUD). Methods: The candidacy framework is concerned with how people consider their eligibility for accessing a health service. The study collected and analyzed primary qualitative data to answer the research question. Data were collected between January and July 2022 on participants aged between 18 and 35 for drug users and 18 to 60 for family members. Participants include 20 previous and current drug users and 20 family members that experience the effects of addiction. A pre-drafted semi-structured interview guide was administered to a conveniently sampled population supplemented with a referral sampling method. Data were thematically analyzed using the NVivo 12pro software to manage the data. Findings: Our findings show that people with substance use disorders are aware of their drug use habits and acknowledge their candidacy for health services. Candidacy for health services is also acknowledged by those around them, such as family members and peers, and as such, information on the navigation of health services for drug users is shared by those who have attended health services, those affected by drug use, and this includes health service research by family members to identify accessible health services. While participants reported willingness to quit drug use if assistance is provided, the permeability of health care services is hindered by both individual determinations to quit drug use from long-time use and the availability of health services for drug users, such as rehabilitation centers. Our findings also show that drug users are conscious and can articulate their ailments; however, the hunt for the next dose of drugs and long waiting cues for health service acquisition overshadows their claim to health services. Participants reported a mixture of treatments prescribed, with some more gruesome than others prescribed, thus serving as both a facilitator and barrier for health service uptake. Despite some unorthodox forms of treatments prescribed in health care, the majority of those who enter treatment complete the process of treatment, although some are met with setbacks and sometimes relapse after treatment has finished. Conclusion: Drug users are able to ascertain their candidacy for health services; however, individual and environmental characteristics relating to drug use hinder the use of health services. Drug use interventions need to entice health service uptake as a way to improve candidacy for health use.Keywords: substance use disorder, rehabilitation, drug use, relapse, South Africa, candidacy framework
Procedia PDF Downloads 9810727 Social Network Based Decision Support System for Smart U-Parking Planning
Authors: Jun-Ho Park, Kwang-Woo Nam, Seung-Mo Hong, Tae-Heon Moon, Sang-Ho Lee, Youn-Taik Leem
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The aim of this study was to build ‘Ubi-Net’, a decision-making support system for systematic establishment in U-City planning. We have experienced various urban problems caused by high-density development and population concentrations in established urban areas. To address these problems, a U-Service contributes to the alleviation of urban problems by providing real-time information to citizens through network connections and related information. However, technology, devices, and information for consumers are required for systematic U-Service planning in towns and cities where there are many difficulties in this regard, and a lack of reference systems. Thus, this study suggests methods to support the establishment of sustainable planning by providing comprehensive information including IT technology, devices, news, and social networking services(SNS) to U-City planners through intelligent searches. In this study, we targeted Smart U-Parking Planning to solve parking problems in an ‘old’ city. Through this study, we sought to contribute to supporting advances in U-Space and the alleviation of urban problems.Keywords: desigin and decision support system, smart u-parking planning, social network analysis, urban engineering
Procedia PDF Downloads 42710726 ‘Call Before, Save Lives’: Reducing Emergency Department Visits through Effective Communication
Authors: Sandra Cardoso, Gaspar Pais, Judite Neves, Sandra Cavaca, Fernando Araújo
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In 2021, Portugal has 63 emergency department (ED) visits per 100 people annually, the highest numbers in Europe. While EDs provide a critical service, high use is indicative of inappropriate and inefficient healthcare. In Portugal, all ED have the Manchester Triage System (MTS), a clinical risk management tool to enable that patients are seen in order of clinical priority. In 2023, more than 40% of the ED visits were of non-urgent conditions (blue and green), that could be better managed in primary health care (PHC), meaning wrong use of resources and lack of health literacy. From 2017, the country has a phone line, SNS24 (Contact Centre of the National Health Service), for triage, counseling, and referral service, 24 hours/7 days a week. The pilot project ‘Call before, save lives’ was implemented in the municipalities of Póvoa de Varzim and Vila do Conde (around 150.000 residents), in May 2023, by the executive board of the Portuguese Health Service, with the support of the Shared Services of the Ministry of Health, and local authorities. This geographical area has short travel times, 99% of the population a family doctor and the region is organized in a health local unit (HLU), integrating PHC and the local hospital. The purposes of this project included to increase awareness to contact SNS 24, before going to an ED, and non-urgent conditions oriented to a family doctor, reducing ED visits. The implementation of the project involved two phases, beginning with: i) development of campaigns using local influencers (fishmonger, model, fireman) through local institutions and media; ii) provision of telephone installed on site to contact SNS24; iii) establishment of open consultation in PHC; iv) promotion of the use of SNS24; v) creation of acute consultations at the hospital for complex chronic patients; and vi) direct referral for home hospitalization by PHC. The results of this project showed an excellent level of access to SNS24, an increase in the number of users referred to ED, with great satisfaction of users and professionals. The second phase, initiated in January 2024, for access to the ED, the need for prior referral was established as an admission rule, except for certain situations, as trauma patients. If the patient refuses, their registration in the ED and subsequent screening in accordance with the MTS must be ensured. When the patient is non-urgent, shall not be observed in the ED, provided that, according to his clinical condition, is guaranteed to be referred to PHC or to consultation/day hospital, through effective scheduling of an appointment for the same or the following day. In terms of results, 8 weeks after beginning of phase 2, we assist of a decrease in self-reported patients to ED from 59% to 15%, and a reduction of around 7% of ED visits. The key for this success was an effective public campaign that increases the knowledge of the right use of the health system, and capable of changing behaviors.Keywords: contact centre of the national health service, emergency department visits, public campaign, health literacy, SNS24
Procedia PDF Downloads 6710725 Residential High-Rises and Meaningful Places: Missing Actions in the Isle of Dogs Regeneration
Authors: Elena Kalcheva, Ahmad Taki, Yuri Hadi
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Urban regeneration often includes residential high-rises as a way of optimum use of land. However, high-rises are in many cases connected to placelessness, this is not due to some intrinsic characteristic of the typology, but more to a failure to provide meaningful places in connection to them. The reason to study the Isle of the Dogs regeneration is the successful process that led to vibrant area with strong identity and social sustainability. Therefore, the purpose of this research is to identify the gaps into the sound strategy for the development of the area and in its implementation which will make the place more sustainable. The paper addresses four research questions: are the residential high-rises supporting a proper physical form; is there deployed properly scaled mix of land uses and functions in connection with residential high-rises; are there possible quality activities in quality places near the residential high-rises; and is there a strong sense of place created with the residential high-rise buildings and their surroundings. The methodology relies on observational survey of the researched area together with structured questions, to evaluate the external qualities of the residential high-rises and their surroundings. Visual information can help identify the mistakes and the omissions of the provided project examples. It can provide insight on how can be improved imageability, legibility and human scale. In this connection, the paper argues that although the quality of the architecture of the high-rises is superb, there is a failure to create meaningful, high quality public realm in connection with them. As such, it does not function as well as the designers intended to do: the functional quality of the public realm is quite low. The implications of the study suggest that actions need to take place in order to improve and foster further regeneration of the area.Keywords: high-rises, isle of the dogs, public realm, regeneration
Procedia PDF Downloads 28210724 Effects of Ultraviolet Treatment on Microbiological Load and Phenolic Content of Vegetable Juice
Authors: Kubra Dogan, Fatih Tornuk
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Due to increasing consumer demand for the high-quality food products and awareness regarding the health benefits of different nutrients in food minimal processing becomes more popular in modern food preservation. To date, heat treatment is often used for inactivation of spoilage microorganisms in foods. However, it may cause significant changes in the quality and nutritional properties of food. In order to overcome the detrimental effects of heat treatment, several alternatives of non-thermal microbial inactivation processes have been investigated. Ultraviolet (UV) inactivation is a promising and feasible method for better quality and longer shelf life as an alternative to heat treatment, which aims to inhibit spoilage and pathogenic microorganisms and to inactivate the enzymes in vegetable juice production. UV-C is a sub-class of UV treatment which shows the highest microcidal effect between 250-270 nm. The wavelength of 254 nm is used for the surface disinfection of certain liquid food products such as vegetable juice. Effects of UV-C treatment on microbiological load and quality parameter of vegetable juice which is a mix of celery, carrot, lemon and orange was investigated. Our results showed that storing of UV-C applied vegetable juice for three months, reduced the count of TMAB by 3.5 log cfu/g and yeast-mold by 2 log cfu/g compared to control sample. Total phenolic content was found to be 514.3 ± 0.6 mg gallic acid equivalent/L, and there wasn’t a significant difference compared to control. The present work suggests that UV-C treatment is an alternative method for disinfection of vegetable juice since it enables adequate microbial inactivation, longer shelf life and has minimal effect on degradation of quality parameters of vegetable juice.Keywords: heat treatment, phenolic content, shelf life, ultraviolet (UV-C), vegetable juice
Procedia PDF Downloads 21010723 Expert-Based Validated Measures for Improving Quality Healthcare Services Utilization among Elderly Persons: A Cross-Section Survey
Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene
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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.
Procedia PDF Downloads 6410722 Improving a Stagnant River Reach Water Quality by Combining Jet Water Flow and Ultrasonic Irradiation
Authors: A. K. Tekile, I. L. Kim, J. Y. Lee
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Human activities put freshwater quality under risk, mainly due to expansion of agriculture and industries, damming, diversion and discharge of inadequately treated wastewaters. The rapid human population growth and climate change escalated the problem. External controlling actions on point and non-point pollution sources are long-term solution to manage water quality. To have a holistic approach, these mechanisms should be coupled with the in-water control strategies. The available in-lake or river methods are either costly or they have some adverse effect on the ecological system that the search for an alternative and effective solution with a reasonable balance is still going on. This study aimed at the physical and chemical water quality improvement in a stagnant Yeo-cheon River reach (Korea), which has recently shown sign of water quality problems such as scum formation and fish death. The river water quality was monitored, for the duration of three months by operating only water flow generator in the first two weeks and then ultrasonic irradiation device was coupled to the flow unit for the remaining duration of the experiment. In addition to assessing the water quality improvement, the correlation among the parameters was analyzed to explain the contribution of the ultra-sonication. Generally, the combined strategy showed localized improvement of water quality in terms of dissolved oxygen, Chlorophyll-a and dissolved reactive phosphate. At locations under limited influence of the system operation, chlorophyll-a was highly increased, but within 25 m of operation the low initial value was maintained. The inverse correlation coefficient between dissolved oxygen and chlorophyll-a decreased from 0.51 to 0.37 when ultrasonic irradiation unit was used with the flow, showing that ultrasonic treatment reduced chlorophyll-a concentration and it inhibited photosynthesis. The relationship between dissolved oxygen and reactive phosphate also indicated that influence of ultra-sonication was higher than flow on the reactive phosphate concentration. Even though flow increased turbidity by suspending sediments, ultrasonic waves canceled out the effect due to the agglomeration of suspended particles and the follow-up settling out. There has also been variation of interaction in the water column as the decrease of pH and dissolved oxygen from surface to the bottom played a role in phosphorus release into the water column. The variation of nitrogen and dissolved organic carbon concentrations showed mixed trend probably due to the complex chemical reactions subsequent to the operation. Besides, the intensive rainfall and strong wind around the end of the field trial had apparent impact on the result. The combined effect of water flow and ultrasonic irradiation was a cumulative water quality improvement and it maintained the dissolved oxygen and chlorophyll-a requirement of the river for healthy ecological interaction. However, the overall improvement of water quality is not guaranteed as effectiveness of ultrasonic technology requires long-term monitoring of water quality before, during and after treatment. Even though, the short duration of the study conducted here has limited nutrient pattern realization, the use of ultrasound at field scale to improve water quality is promising.Keywords: stagnant, ultrasonic irradiation, water flow, water quality
Procedia PDF Downloads 19310721 An Investigation into Root Causes of Sabotage and Vandalism of Pipes: A Major Environmental Effluence in Niger Delta, Nigeria
Authors: Oshienemen Albert
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Human’s activities could be pointed as the root cause of almost all environmental damages/ disasters as we contribute to the activities that are currently damaging the ozone layers (global warming), unusual environmental changes and extreme weather conditions (climate change) in recent times. Nigeria just as every other disaster-prone nation is faced with different types of disasters and environmental calamities, starting from terrorist displacement disasters, flood, drought and oil spill hazards. Oil spillage as an environmental disaster has great consequences not just on the environment but on human health, economy and the entire populace that might be involved, which deem necessary to look into the root causes of the incidents and how it can be curtailed. The different incidents of oil spillages and other oil production consequent on the environment is alarming in the Nigerian context and cannot be overemphasized without a critical investigation and synthesis. This paper investigates the root causes of environmental pollution induced by oil spill hazards from petroleum activities within Niger Delta communities of effects and detailed the potential solutions to reduce the causal factors and reoccurrence of the incidents. This study adopts a desk-based approach, interviews with key members of communities which consist of chiefs, youth leaders, and key women within the high environmental damaged communities. Also, Interviews were conducted with environmental expertise representatives from the oil and gas sectors and representatives from oil spill-related agency. Data were analyzed using thematic techniques. The study shows different influencing factors of sabotage and vandalism of oil facilities as such; marginalization, deprivation of resources utility and resource derivation principles were identified as major contributors to vandalism and sabotage act. The study proposed potential strategies to curtail the root causes of sabotage and vandalism as the major causes of environmental devastations in Nigeria.Keywords: environment, oil spill hazards, Niger delta, Nigeria
Procedia PDF Downloads 19110720 Development of a Bus Information Web System
Authors: Chiyoung Kim, Jaegeol Yim
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Bus service is often either main or the only public transportation available in cities. In metropolitan areas, both subways and buses are available whereas in the medium sized cities buses are usually the only type of public transportation available. Bus Information Systems (BIS) provide current locations of running buses, efficient routes to travel from one place to another, points of interests around a given bus stop, a series of bus stops consisting of a given bus route, and so on to users. Thanks to BIS, people do not have to waste time at a bus stop waiting for a bus because BIS provides exact information on bus arrival times at a given bus stop. Therefore, BIS does a lot to promote the use of buses contributing to pollution reduction and saving natural resources. BIS implementation costs a huge amount of budget as it requires a lot of special equipment such as road side equipment, automatic vehicle identification and location systems, trunked radio systems, and so on. Consequently, medium and small sized cities with a low budget cannot afford to install BIS even though people in these cities need BIS service more desperately than people in metropolitan areas. It is possible to provide BIS service at virtually no cost under the assumption that everybody carries a smartphone and there is at least one person with a smartphone in a running bus who is willing to reveal his/her location details while he/she is sitting in a bus. This assumption is usually true in the real world. The smartphone penetration rate is greater than 100% in the developed countries and there is no reason for a bus driver to refuse to reveal his/her location details while driving. We have developed a mobile app that periodically reads values of sensors including GPS and sends GPS data to the server when the bus stops or when the elapsed time from the last send attempt is greater than a threshold. This app detects the bus stop state by investigating the sensor values. The server that receives GPS data from this app has also been developed. Under the assumption that the current locations of all running buses collected by the mobile app are recorded in a database, we have also developed a web site that provides all kinds of information that most BISs provide to users through the Internet. The development environment is: OS: Windows 7 64bit, IDE: Eclipse Luna 4.4.1, Spring IDE 3.7.0, Database: MySQL 5.1.7, Web Server: Apache Tomcat 7.0, Programming Language: Java 1.7.0_79. Given a start and a destination bus stop, it finds a shortest path from the start to the destination using the Dijkstra algorithm. Then, it finds a convenient route considering number of transits. For the user interface, we use the Google map. Template classes that are used by the Controller, DAO, Service and Utils classes include BUS, BusStop, BusListInfo, BusStopOrder, RouteResult, WalkingDist, Location, and so on. We are now integrating the mobile app system and the web app system.Keywords: bus information system, GPS, mobile app, web site
Procedia PDF Downloads 21610719 Conceptual Study on 4PL and Activities in Turkey
Authors: Berna Kalkan, Kenan Aydin
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Companies give importance customer satisfaction to compete the developing and changing market. This is possible when customer reaches the right product, right quality, place, time and cost. In this regard, the extension of logistics services has played active role on formation and development of the different logistics services concept. The concept of logistics services has played important role involved in the healing of economic indicators today. Companies can use logistics providers, thus have competitive advantage and low cost, reducing time, tobe flexibility. In recent years, Fourth Party Logistics (4PL) has emerged as a new concept that includes relationship between suppliers and firms in outsourcing. 4PL provider is an integrator that offers comprehensive supply chain solutions with the technology, resources and capabilities that it possesses. Also, 4PL has attracted as a popular research topic attention in the recent past. In this paper, logistics outsourcing and 4PL concepts are analyzed and a literature review on 4PL activities is given. Also, the previous studies in literature and the approaches that are used in previous studies in literature is presented by analysing on 4PL activities. In this context, a field study will be applied to 4PL providers and service buyer in Turkey. If necessary, results related to this study will be shared in scientific areas.Keywords: fourth party logistics, literature review, outsourcing, supply chain management
Procedia PDF Downloads 17810718 Valorization of Beer Brewing Wastes by Composting
Authors: M. E. Silva, I. Brás
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The aim of this work was to study the viability of recycling the residual yeast and diatomaceous earth (RYDE) slurry generated by the beer brewing industry by composting with animal manures, as well as to evaluate the quality of the composts obtained. Two pilot composting trials were carried out with different mixes: cow manure/RYDE slurry (Pile CM) and sheep manure/RYDE slurry (Pile SM). For all piles, wood chips were applied as bulking agent. The process was monitored by evaluating standard physical and chemical parameters. The compost quality was assessed by the heavy metals content and phytotoxicity. Both piles reached a thermophilic phase in the first day, however having different trends. The pH showed a slight alkaline character. The C/N reached values lower than 19 at the end of composting process. Generally, all the piles exhibited absence of heavy metals. However, the pile SM exhibited phytotoxicity. This study showed that RYDE slurry can be valorized by composting with cow manure.Keywords: beer brewing wastes, compost, valorization, quality
Procedia PDF Downloads 44310717 Assessing the Impacts of Frugivorous Birds on Dispersal and Recruitment of Invasive Phytolacca Americana in an Urban Landscape
Authors: Ning Li, Yaner Yan, Yajun Qiao, Shu-qing An
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Although seed dispersal is considered to be a key process determining the spatial structure and spread of invasive plant populations, few studies have explicitly addressed the link between dispersal vector behaviour, and seedling recruitment to gain insight into the process of exotic species invasion within a urban landscape. The present study tests the effects of native bird species on the dispersal and recruitment of invasive Phytolacca Americana in an urban garden. We found the invasive population of American pokeweed attracted both generalist species and specialist species to forage and disperse its seeds, with generalists Pycnonotus sinensis and Urocissa erythrorhyncha being by far the most important dispersers. Seedling numbers of P. Americana was strongly affected by perching behavior of bird dispersers. Moreover, two main disperser species, P. sinensis and U. erythrorhyncha govern a high quality dispersal service for P. Americana. Our results highlight the ability of invasive P. americana to recruit seed dispersal agents in urban habitats. However, if the newly recruited species could use the seedling safe site for perching shelter, the invasive plants will get a high regenerate rate in the invasive new habitats thus enhancing their invasive ability.Keywords: frugivorous birds, phytolacca americana, seed dispersal, urban landscape
Procedia PDF Downloads 54710716 Sexuality and Quality of Life Among Older Adults
Authors: Ahuva Even-Zohar, Shoshi Werner
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Context: Sexuality is an important aspect of overall quality of life for individuals across different age groups and health conditions. Sexual interest and activity continue to be important and play a role in people's life as they age. Despite this, there is limited research on the sexual health of older adults. Research Aim: The study aims to examine the knowledge, attitudes, and sexual activity of older adults and to explore the relationship between sexual activity and quality of life among this population. Methodology: The study involved 203 Jewish participants from Israel, with an average age of 69.59. The participants completed questionnaires administered through an Internet panel. The questionnaires measured variables such as knowledge about and attitudes towards sexuality, sexual activity, quality of life, and socio-demographic information. Findings: The study found that a majority of the participants reported engaging in sexual activity, with most of them experiencing full sexual intercourse. Approximately half of the participants expressed high levels of satisfaction with their sexual activity. The results indicated that older adults demonstrated a moderate level of knowledge and permissive attitudes towards sexuality in later life. Moreover, higher levels of knowledge and permissive attitudes were associated with increased sexual activity. The frequency of sexual activity was identified as a predictor of quality of life, with a mediating effect on the relationship between attitudes towards older adults' sexuality and quality of life. Notably, men and older adults who were married or in a relationship reported higher frequencies of sexual activity compared to women and older adults without a partner. Furthermore, a majority of participants did not seek professional help or discuss their sexual concerns with a therapist. Theoretical Importance: This research contributes to our understanding of a topic that is often considered taboo - sexuality among older adults. It highlights that older adults maintain an interest in sexual activity, and that engaging in such activity contributes to their overall quality of life. Data Collection and Analysis Procedures: The data for this study were collected using structured questionnaires administered through an Internet panel. The questionnaires included closed-ended questions, allowing for quantitative data analysis. Descriptive statistics and regression analysis were performed to examine the relationships between the variables. Questions Addressed: This study aimed to address the following questions: What is the level of knowledge and attitudes towards sexuality among older adults? How prevalent is sexual activity among older adults and what factors are associated with it? How does sexual activity impact the quality of life of older adults? Do older adults seek professional help for their sexual concerns? Conclusion: The main conclusion drawn from this research is that sexuality is a crucial aspect of older adults' lives and significantly contributes to their quality of life. The study emphasizes the need for educational programs aimed at older adults and professionals, which promote the understanding and benefits of sexuality in later life. It also suggests that professionals should actively encourage older individuals to seek help and support when experiencing difficulties related to sexuality.Keywords: men, older adults, quality of life, sexuality, women
Procedia PDF Downloads 7110715 Need for a Tailor Made HIV Prevention Services to the Migrants Community: Evidence from Implementing Migrant Service Delivery System (MSDS) among Migrant Workers, National AIDS Control Program, and India
Authors: Debasish Chowdhury, Sunil Mekale, Sarvanamurthy Sakthivel, Sukhvinder Kaur, Rambabu Khambampati, Ashok Agarwal
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Introduction: The migrant intervention in India was initiated during the National AIDS Control Program (NACP) Phase-2 (2002-2007). HIV Sentinel surveillance Studies (HSS) conducted in 2012-13 indicated higher HIV prevalence among migrants (0.99%) compared to general populations (0.35%). Migrants continue to bear a heightened risk of HIV infection which results from the condition and structure of the migration process. USAID PHFI-PIPPSE project in collaboration with the National AIDS Control Organization (NACO) developed a unique system called Migrant Service Delivery System (MSDS) to capture migrants profile with respect to their risk profile and to provide tailor made services to them. Description: MSDS is a web-based system, designed and implemented to increase service uptake among migrants through evidence based planning. 110 destination migrants Targeted Intervention (TI) from 11 states were selected for study with varied target populations in terms of occupations; to understand occupation related risk behaviors among the migrants. Occupation wise registration data of high risk vulnerable migrants were analyzed through MSDS for the period April 2014–June 2016. Analysis was made on specific indicators among these occupational groups to understand the risk behavior and their vulnerability to HIV and STIs. Findings: Out of total HIV positive migrant’s workers (N= 847) enrolled in MSDS HIV rate is found to be highest among Auto-Rickshaw (18.66%) followed by Daily wage laborers (14.46%), Loom workers (10.73%), Industrial workers (10.04%) and Construction worker 7.93%. With 45.14% positivity, industrial workers are found to be most vulnerable to Sexually Transmitted Infections (STIs) (N=10057) among all occupational categories followed by loom workers (16.28%), Skilled worker (Furniture, Jeweler)-7.14%, daily wage laborers (5.45%). Conclusion: MSDS is an effective tool to assess migrants’ risk and their vulnerability to HIV for designing evidence informed program. This system calls for a replication across all destination TIs by NACO for differential strategies for different occupation groups to ensure better yield through scientific planning of intervention among high risk and high vulnerable migrants.Keywords: migrants, migrant service delivery system, risk, vulnerability
Procedia PDF Downloads 27110714 A Multi-Perspective, Qualitative Study into Quality of Life for Elderly People Living at Home and the Challenges for Professional Services in the Netherlands
Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar
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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning
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