Search results for: public health research
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 32399

Search results for: public health research

29549 Work demand and Prevalence of Work-Related Musculoskeletal Disorders: A Case Study of Pakistan Aviation Maintenance Workers

Authors: Muzamil Mahmood, Afshan Naseem, Muhammad Zeeshan Mirza, Yasir Ahmad, Masood Raza

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The purpose of this research is to analyze how aviation maintenance workers’ characteristics and work demand affect their development of work-related musculoskeletal disorders (WMSDs). Guided by literature on task characteristics, work demand, and WMSDs, data is collected from 128 aviation maintenance workers of private and public airlines. Data is then analyzed through descriptive and inferential statistics. It is found that task characteristics have a significant positive effect on WMSDs and an increase in tasks performed by aviation maintenance workers leads to increase in WMSDs. Work demand did not have a significant effect on WMSDs. The task characteristics of aviation maintenance workers moderates the relationship between their work demand and WMSDs. This reveals that task characteristics of aviation maintenance workers enhance the effect of work demand on WMSDs. The task characteristics of aviation maintenance workers are challenging and unpredictable. Subsequently, WMSDs are prevalent among aviation maintenance workers. The work demand of aviation maintenance workers does not influence their development of WMSDs. Pakistan Civil Aviation Authority should minimize the intensity of tasks assigned to aviation maintenance workers by introducing work dynamisms such as task sharing, job rotation, and probably teleworking to enhance flexibility. Human Resource and Recruitment Department need to consider the ability and fitness levels of potential aviation maintenance workers during recruitment. In addition, regular physical activities and ergonomic policies should be put in place by the management of the Pakistan Civil Aviation Authority to reduce the incidences of WMSDs.

Keywords: work related musculoskeletal disorders, ergonomics, occupational health and safety, human factors

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29548 Flipped Classroom in a European Public Health Program: The Need for Students' Self-Directness

Authors: Nynke de Jong, Inge G. P. Duimel-Peeters

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The flipped classroom as an instructional strategy and a type of blended learning that reverses the traditional learning environment by delivering instructional content, off- and online, in- and outside the classroom, has been implemented in a 4-weeks module focusing on ageing in Europe at the Maastricht University. The main aim regarding the organization of this module was implementing flipped classroom-principles in order to create meaningful learning opportunities, while educational technologies are used to deliver content outside of the classroom. Technologies used in this module were an online interactive real time lecture from England, two interactive face-to-face lectures with visual supports, one group session including role plays and team-based learning meetings. The cohort of 2015-2016, using educational technologies, was compared with the cohort of 2014-2015 on module evaluation such as organization and instructiveness of the module, who studied the same content, although conforming the problem-based educational strategy, i.e. educational base of the Maastricht University. The cohort of 2015-2016 with its specific organization, was also more profound evaluated on outcomes as (1) experienced duration of the lecture by students, (2) experienced content of the lecture, (3) experienced the extent of the interaction and (4) format of lecturing. It was important to know how students reflected on duration and content taken into account their background knowledge so far, in order to distinguish between sufficient enough regarding prior knowledge and therefore challenging or not fitting into the course. For the evaluation, a structured online questionnaire was used, whereby above mentioned topics were asked for to evaluate by scoring them on a 4-point Likert scale. At the end, there was room for narrative feedback so that interviewees could express more in detail, if they wanted, what they experienced as good or not regarding the content of the module and its organization parts. Eventually, the response rate of the evaluation was lower than expected (54%), however, due to written feedback and exam scores, we dare to state that it gives a good and reliable overview that encourages to work further on it. Probably, the response rate may be explained by the fact that resit students were included as well, and that there maybe is too much evaluation as some time points in the program. However, overall students were excited about the organization and content of the module, but the level of self-directed behavior, necessary for this kind of educational strategy, was too low. They need to be more trained in self-directness, therefore the module will be simplified in 2016-2017 with more clear and fewer topics and extra guidance (step by step procedure). More specific information regarding the used technologies will be explained at the congress, as well as the outcomes (min and max rankings, mean and standard deviation).

Keywords: blended learning, flipped classroom, public health, self-directness

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29547 Brief Cognitive Behavior Therapy (BCBT) in a Japanese School Setting: Preliminary Outcomes on a Single Arm Study

Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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29546 Expanding Access and Deepening Engagement: Building an Open Source Digital Platform for Restoration-Based Stem Education in the Largest Public-School System in the United States

Authors: Lauren B. Birney

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This project focuses upon the expansion of the existing "Curriculum and Community Enterprise for the Restoration of New York Harbor in New York City Public Schools" NSF EHR DRL 1440869, NSF EHR DRL 1839656 and NSF EHR DRL 1759006. This project is recognized locally as “Curriculum and Community Enterprise for Restoration Science,” or CCERS. CCERS is a comprehensive model of ecological restoration-based STEM education for urban public-school students. Following an accelerated rollout, CCERS is now being implemented in 120+ Title 1 funded NYC Department of Education middle schools, led by two cohorts of 250 teachers, serving more than 11,000 students in total. Initial results and baseline data suggest that the CCERS model, with the Billion Oyster Project (BOP) as its local restoration ecology-based STEM curriculum, is having profound impacts on students, teachers, school leaders, and the broader community of CCERS participants and stakeholders. Students and teachers report being receptive to the CCERS model and deeply engaged in the initial phase of curriculum development, citizen science data collection, and student-centered, problem-based STEM learning. The BOP CCERS Digital Platform will serve as the central technology hub for all research, data, data analysis, resources, materials and student data to promote global interactions between communities, Research conducted included qualitative and quantitative data analysis. We continue to work internally on making edits and changes to accommodate a dynamic society. The STEM Collaboratory NYC® at Pace University New York City continues to act as the prime institution for the BOP CCERS project since the project’s inception in 2014. The project continues to strive to provide opportunities in STEM for underrepresented and underserved populations in New York City. The replicable model serves as an opportunity for other entities to create this type of collaboration within their own communities and ignite a community to come together and address the notable issue. Providing opportunities for young students to engage in community initiatives allows for a more cohesive set of stakeholders, ability for young people to network and provide additional resources for those students in need of additional support, resources and structure. The project has planted more than 47 million oysters across 12 acres and 15 reef sites, with the help of more than 8,000 students and 10,000 volunteers. Additional enhancements and features on the BOP CCERS Digital Platform will continue over the next three years through funding provided by the National Science Foundation, NSF DRL EHR 1759006/1839656 Principal Investigator Dr. Lauren Birney, Professor Pace University. Early results from the data indicate that the new version of the Platform is creating traction both nationally and internationally among community stakeholders and constituents. This project continues to focus on new collaborative partners that will support underrepresented students in STEM Education. The advanced Digital Platform will allow for us connect with other countries and networks on a larger Global scale.

Keywords: STEM education, environmental restoration science, technology, citizen science

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29545 ‘Saying’ the Nuclear Power in France: Evolution of the Images and Perceptions of a Sensitive Theme

Authors: Jandot Aurélia

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As the nuclear power is a sensitive field leading to controversy, the quality of the communication about it is important. Between 1965 and 1981, in France, this one had gradually changed. This change is studied here in the main French news magazine L’Express, in connection with several parameters. As this represents a huge number of copies and occurrences, thus a considerable amount of information; this paper is focused on the main articles as well as the main “mental images”. These ones are important, as their aim is to direct the thought of the readers, and as they have led the public awareness to evolve. Over this 17 years, two trends are in confrontation: The first one is promoting the perception of the nuclear power, while the second one is discrediting it. These trends are organized in two axes: the evolution of engineering, and the risks. In both cases, the changes in the language allow discerning the deepest intentions of the magazine editing, over a period when the nuclear technology, to there a laboratory object accompanied with mystery and secret, has become a social issue seemingly open to all.

Keywords: French news magazine, mental images, nuclear power, public awareness

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29544 Information and Communication Technology in Architectural Education: The Challenges

Authors: Oluropo Stephen Ilesanmi, Oluwole Ayodele Alejo

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Architectural education, beyond training the students to become architects, impacts in them the appreciation of the responsibilities relating to public health, safety, and welfare. Architecture is no longer a personal philosophical or aesthetic pursuit by individuals, rather, it has to consider everyday needs of the people and use technology to give a liveable environment. In the present age, architectural education must have to grapple with the recent integration of technology, in particular, facilities offered by information and communication technology. Electronic technologies have moved architecture from the drawing board to cyberspace. The world is now a global village in which new information and methods are easily and quickly available to people at different poles of the globe. It is the position of this paper that in order to remain relevant in the ever-competing forces within the building industry, architectural education must show the impetus to continue to draw from technological advancements associated with the use of computers.

Keywords: architecture, education, communication, information, technology

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29543 Modeling Karachi Dengue Outbreak and Exploration of Climate Structure

Authors: Syed Afrozuddin Ahmed, Junaid Saghir Siddiqi, Sabah Quaiser

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Various studies have reported that global warming causes unstable climate and many serious impact to physical environment and public health. The increasing incidence of dengue incidence is now a priority health issue and become a health burden of Pakistan. In this study it has been investigated that spatial pattern of environment causes the emergence or increasing rate of dengue fever incidence that effects the population and its health. The climatic or environmental structure data and the Dengue Fever (DF) data was processed by coding, editing, tabulating, recoding, restructuring in terms of re-tabulating was carried out, and finally applying different statistical methods, techniques, and procedures for the evaluation. Five climatic variables which we have studied are precipitation (P), Maximum temperature (Mx), Minimum temperature (Mn), Humidity (H) and Wind speed (W) collected from 1980-2012. The dengue cases in Karachi from 2010 to 2012 are reported on weekly basis. Principal component analysis is applied to explore the climatic variables and/or the climatic (structure) which may influence in the increase or decrease in the number of dengue fever cases in Karachi. PC1 for all the period is General atmospheric condition. PC2 for dengue period is contrast between precipitation and wind speed. PC3 is the weighted difference between maximum temperature and wind speed. PC4 for dengue period contrast between maximum and wind speed. Negative binomial and Poisson regression model are used to correlate the dengue fever incidence to climatic variable and principal component score. Relative humidity is estimated to positively influence on the chances of dengue occurrence by 1.71% times. Maximum temperature positively influence on the chances dengue occurrence by 19.48% times. Minimum temperature affects positively on the chances of dengue occurrence by 11.51% times. Wind speed is effecting negatively on the weekly occurrence of dengue fever by 7.41% times.

Keywords: principal component analysis, dengue fever, negative binomial regression model, poisson regression model

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29542 Planning for Brownfield Regeneration in Malaysia: An Integrated Approach in Creating Sustainable Ex-Landfill Redevelopment

Authors: Mazifah Simis, Azahan Awang, Kadir Arifin

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The brownfield regeneration is being implemented in developped countries. However, as a group 1 developing country in the South East Asia, the rapid development and increasing number of urban population in Malaysia have urged the needs to incorporate the brownfield regeneration into its physical planning development. The increasing number of urban ex-landfills is seen as a new resource that could overcome the issues of inadequate urban green space provisions. With regards to the new development approach in urban planning, this perception study aims to identify the sustainable planning approach based on what the stakeholders have in mind. Respondents consist of 375 local communities within four urban ex-landfill areas and 61 landscape architect and town planner officers in the Malaysian Local Authorities. Three main objectives are set to be achieved, which are (i) to identify ex-landfill issues that need to be overcome prior to the ex-landfill redevelopment (ii) to identify the most suitable types of ex-landfill redevelopment, and (iii) to identify the priority function for ex-landfill redevelopment as the public parks. From the data gathered through the survey method, the order of priorities based on stakeholders' perception was produced. The results show different perception among the stakeholders, but they agreed to the development of the public park as the main development. Hence, this study attempts to produce an integrated approach as a model for sustainable ex-landfill redevelopment that could be accepted by the stakeholders as a beneficial future development that could change the image of 296 ex-landfills in Malaysia into the urban public parks by the year 2020.

Keywords: brownfield regeneration, ex-landfill redevelopment, integrated approach, stakeholders' perception

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29541 The Learning Loops in the Public Realm Project in South Verona: Air Quality and Noise Pollution Participatory Data Collection towards Co-Design, Planning and Construction of Mitigation Measures in Urban Areas

Authors: Massimiliano Condotta, Giovanni Borga, Chiara Scanagatta

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Urban systems are places where the various actors involved interact and enter in conflict, in particular with reference to topics such as traffic congestion and security. But topics of discussion, and often clash because of their strong complexity, are air and noise pollution. For air pollution, the complexity stems from the fact that atmospheric pollution is due to many factors, but above all, the observation and measurement of the amount of pollution of a transparent, mobile and ethereal element like air is very difficult. Often the perceived condition of the inhabitants does not coincide with the real conditions, because it is conditioned - sometimes in positive ways other in negative ways - from many other factors such as the presence, or absence, of natural elements such as trees or rivers. These problems are seen with noise pollution as well, which is also less considered as an issue even if it’s problematic just as much as air quality. Starting from these opposite positions, it is difficult to identify and implement valid, and at the same time shared, mitigation solutions for the problem of urban pollution (air and noise pollution). The LOOPER (Learning Loops in the Public Realm) project –described in this paper – wants to build and test a methodology and a platform for participatory co-design, planning, and construction process inside a learning loop process. Novelties in this approach are various; the most relevant are three. The first is that citizens participation starts since from the research of problems and air quality analysis through a participatory data collection, and that continues in all process steps (design and construction). The second is that the methodology is characterized by a learning loop process. It means that after the first cycle of (1) problems identification, (2) planning and definition of design solution and (3) construction and implementation of mitigation measures, the effectiveness of implemented solutions is measured and verified through a new participatory data collection campaign. In this way, it is possible to understand if the policies and design solution had a positive impact on the territory. As a result of the learning process produced by the first loop, it will be possible to improve the design of the mitigation measures and start the second loop with new and more effective measures. The third relevant aspect is that the citizens' participation is carried out via Urban Living Labs that involve all stakeholder of the city (citizens, public administrators, associations of all urban stakeholders,…) and that the Urban Living Labs last for all the cycling of the design, planning and construction process. The paper will describe in detail the LOOPER methodology and the technical solution adopted for the participatory data collection and design and construction phases.

Keywords: air quality, co-design, learning loops, noise pollution, urban living labs

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29540 Empirical Study of Health Behaviors of Employees in Information Technology and Business Process Outsourcing

Authors: Yogesh Pawar

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The purpose of this paper is to investigate the behaviors of information technology (IT) and business process outsourcing (BPO) employees in relation to diet, exercise, sleep, stress, and social habits. This was a qualitative research study, using in-depth,semi-structured interviews. Descriptive data were collected from a two-stage purposive sample of 28 IT-BPO employees from two IT companies and one BPOs in Pune. The majority of interviewees reported having an unhealthy diet and/or sedentary lifestyle. Lack of time due to demanding work schedules was the largest barrier to diet and exercise. Given the qualitative study design and limited sampling frame, results may not be generalizable. However, the qualitative data suggests that Pune’s young IT-BPO employees may be at greater risk of lifestyle-related diseases than the general population. The data also suggests that interventions incorporating social influence may be a promising solution, particularly at international call centers. The results from this study provide qualitative insight on the motives for health behaviors of IT-BPO employees, as well as the barriers and facilitators for leading a healthy lifestyle in this industry. The findings provide the framework for future workplace wellness interventions.

Keywords: exercise, information technology, qualitative research, wellness

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29539 Access to Inclusive and Culturally Sensitive Mental Healthcare in Pharmacy Students and Residents

Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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29538 Perception of Neighbourhood-Level Built Environment in Relation to Youth Physical Activity in Malaysia

Authors: A. Abdullah, N. Faghih Mirzaei, S. Hany Haron

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Neighbourhood environment walkability on reported physical activity (PA) levels of students of Universiti Sains Malaysia (USM) in Malaysia. Compared with previous generations, today’s young people spend less time playing outdoors and have lower participation rates in PA. Research suggests that negative perceptions of neighbourhood walkability may be a potential barrier to adolescents’ PA. The sample consisted of 200 USM students (to 24 years old) who live outside of the main campus and engage in PA in sport halls and sport fields of USM. The data were analysed using the t-test, binary logistic regression, and discriminant analysis techniques. The present study found that youth PA was affected by neighbourhood environment walkability factors, including neighbourhood infrastructures, neighbourhood safety (crime), and recreation facilities, as well as street characteristics and neighbourhood design variables such as facades of sidewalks, roadside trees, green spaces, and aesthetics. The finding also illustrated that active students were influenced by street connectivity, neighbourhood infrastructures, recreation facilities, facades of sidewalks, and aesthetics, whereas students in the less active group were affected by access to destinations, neighbourhood safety (crime), and roadside trees and green spaces for their PAs. These results report which factors of built environments have more effect on youth PA and they message to the public to create more awareness about the benefits of PA on youth health.

Keywords: fear of crime, neighbourhood built environment, physical activities, street characteristics design

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29537 Qualitative and Quantitative Case Study Research Method on Social Science: Accounting Perspective

Authors: Bubaker F. Shareia

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The main aim of this paper is to set the parameters within which the study is to be conducted, specifically justifying the use of qualitative research, informed by theory. This paper argues that the social world is subjective in nature and may be accessed through the interpretive approach provided by the people involved in the context of the study. The paper defines and distinguishes between qualitative and quantitative research methodologies, explores Burrell and Morgan's framework for social research, and presents the study's adopted methodology and methods, with the rationale for these choices.

Keywords: accounting, methodologies, qualitative, quantitative research

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29536 The Nexus between Child Marriage and Women Empowerment with Physical Violence in Two Culturally Distinct States of India

Authors: Jayakant Singh, Enu Anand

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Background: Child marriage is widely prevalent in India. It is a form of gross human right violation that succumbs a child bride to be subservient to her husband within a marital relation. We investigated the relationship between age at marriage of women and her level of empowerment with physical violence experienced 12 months preceding the survey among young women aged 20-24 in two culturally distinct states- Bihar and Tamil Nadu of India. Methods: We used the information collected from 10514 young married women (20-24 years) at all India level, 373 in Bihar and 523 in Tamil Nadu from the third round of National Family Health Survey. Empowerment index was calculated using different parameters such as mobility, economic independence and decision making power of women using Principal Component Analysis method. Bivariate analysis was performed primarily using chi square for the test of significance. Logistic regression was carried out to assess the effect of age at marriage and empowerment on physical violence. Results: Lower level of women empowerment was significantly associated with physical violence in Tamil Nadu (OR=2.38, p<0.01) whereas child marriage (marriage before age 15) was associated with physical violence in Bihar (OR=3.27, p<0.001). The mean difference in age at marriage between those who experienced physical violence and those who did not experience varied by 7 months in Bihar and 10 months in Tamil Nadu. Conclusion: Culture specific intervention may be a key to reduction of violence against women as the results showed association of different factors contributing to physical violence in Bihar and Tamil Nadu. Marrying at an appropriate age perhaps is protective of abuse because it equips a woman to assert her rights effectively. It calls for an urgent consideration to curb both violence and child marriage with stricter involvement of family, civil society and the government. In the meanwhile physical violence may be recognized as a public health problem and integrate appropriate treatment to the victims within the health care institution.

Keywords: child marriage, empowerment, India, physical violence

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29535 War Heritage: Different Perceptions of the Dominant Discourse among Visitors to the “Adem Jashari” Memorial Complex in Prekaz

Authors: Zana Llonçari Osmani, Nita Llonçari

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In Kosovo, public rhetoric and popular sentiment position the War of 1998-99 (the war) as central to the formation of contemporary Kosovo's national identity. This period was marked by the forced massive displacement of Kosovo Albanians, the destruction of entire settlements, the loss of family members, and the profound emotional trauma experienced by civilians, particularly those who actively participated in the war as members of the Kosovo Liberation Army (KLA). Amidst these profound experiences, the Prekaz Massacre (The Massacre) is widely regarded as the defining event that preceded the final struggles of 1999 and the long-awaited attainment of independence. This study aims to explore how different visitors perceive the dominant discourse at The Memorial, a site dedicated to commemorating the Prekaz Massacre, and to identify the factors that influence their perceptions. The research employs a comprehensive mixed-method approach, combining online surveys, critical discourse analysis of visitor impressions, and content analysis of media representations. The findings of the study highlight the significant role played by original material remains in shaping visitor perceptions of The Memorial in comparison to the curated symbols and figurative representations interspersed throughout the landscape. While the design elements and physical layout of the memorial undeniably hold significance in conveying the memoryscape, there are notable shortcomings in enhancing the overall visitor experience. Visitors are still primarily influenced by the tangible remnants of the war, suggesting that there is room for improvement in how design elements can more effectively contribute to the memorial's narrative and the collective memory of the Prekaz Massacre.

Keywords: critical discourse analysis, memorialisation, national discourse, public rhetoric, war tourism

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29534 Aging and Falls Profile from Hospital Databases

Authors: Nino Chikhladze, Tamar Dochviri, Nato Pitskhelauri, Maia Bitskhinashvili

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Population aging is a key social and demographic trend of the 21st century. Falls represent a prevalent geriatric syndrome that poses significant risks to the health and independence of older adults. The World Health Organization notes a lack of comprehensive data on falls in low- and middle-income countries, complicating the creation of effective prevention programs. To the authors’ best knowledge, no such studies have been conducted in Georgia. The aim of the study is to explore the epidemiology of falls in the elderly population. The hospitalization database of the National Center for Disease Control and Public Health of Georgia was used for the retrospective study. Falls-related injuries were identified using ICD-10 classifications using the class XIX (S and T codes) and class XX for the type of injury (V-Y codes). Statistical data analyses were done using SPSS software version 23.0. The total number of fall-related hospitalizations for individuals aged 65 and older from 2015 to 2021 was 29,697. The study revealed that falls accounted for an average of 63% (ranging from 59% to 66%) of all hospitalizations and 68% (ranging from 65% to 70%) of injury-related hospitalizations during this period. The 69% of all patients were women and 31%-men (Chi2=4482.1, p<0.001). The highest rate of hospitalization was in the age groups 80-84 and 75-79. The probability of fall-related hospitalization was significantly higher in women (p<0.001) compared to men in all age groups except 65-69 years. In the target age group of 65 years and older, the probability of hospitalization increased significantly with an increase in age (p<0.001). The study's results can be leveraged to create evidence-based awareness programs, design targeted multi-domain interventions addressing specific risk factors, and enhance the quality of geriatric healthcare services in Georgia.

Keywords: elderly population, falls, geriatric patients, hospitalization, injuries

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29533 How Social Capital Mediates the Relationships between Interpersonal Interaction and Health: Location-Based Augmented Reality Games

Authors: Chechen Liao, Pui-Lai To, Yi-Hui Wang

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Recently location-based augmented reality games (LBS+AR) have become increasingly popular as a major form of entertainment. Location-based augmented reality games have provided a lot of opportunities for face-to-face interaction among players. Prior studies also indicate that the social side of location-based augmented reality games are one of the major reasons for players to engage in the games. However, the impact of the usage of location-based augmented reality games has not been well explored. The study examines how interpersonal interaction affects social capital and health through playing location-based augmented reality games. The study also investigates how social capital mediates the relationships between interpersonal interaction and health. The study uses survey method to collect data. Six-hundred forty-seven questionnaires are collected. Structural equation modeling is used to investigate the relationships among variables. The causal relationships between variables in the research model are tested. The results of the study indicated that four interpersonal attraction attributes, including ability, proximity, similarity, and familiarity, are identified by ways of factor analysis. Interpersonal attraction is important for location-based augmented reality game-players to develop bonding and bridging social capital. Bonding and bridging social capital have a positive impact on the mental and social health of game-players. The results of the study provide academic and practical implications for future growth of location-based augmented reality games.

Keywords: health, interpersonal interaction, location-based augmented reality games, social capital

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29532 Exploration of Abuse of Position for Sexual Gain by UK Police

Authors: Terri Cole, Fay Sweeting

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Abuse of position for sexual gain by police is defined as behavior involving individuals taking advantage of their role to pursue a sexual or improper relationship. Previous research has considered whether it involves ‘bad apples’ - individuals with poor moral ethos or ‘bad barrels’ – broader organizational flaws which may unconsciously allow, minimize, or do not effectively deal with such behavior. Low level sexual misconduct (e.g., consensual sex on duty) is more common than more serious offences (e.g., rape), yet the impact of such behavior can have severe implications not only for those involved but can also negatively undermine public confidence in the police. This ongoing, collaborative research project has identified variables from 514 historic case files from 35 UK police forces in order to identify potential risk indicators which may lead to such behavior. Quantitative analysis using logistic regression and the Cox proportion hazard model has resulted in the identification of specific risk factors of significance in prediction. Factors relating to both perpetrator background such as a history of intimate partner violence, debt, and substance misuse coupled with in work behavior such as misusing police systems increase the risk. Findings are able to provide pragmatic recommendations for those tasked with identifying potential or investigating suspected perpetrators of misconduct.

Keywords: abuse of position, forensic psychology, misconduct, sexual abuse

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29531 Integrating Music on Construction Sites: Key Benefits and Cautions: A Literature Perspective

Authors: Oluwatayomi Daniel Fadumo, Chinyere Celestina Esimone

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The construction industry, as a massive human capital-related sector, requires an always motivated workforce. The inability to maintain this state has been found to hamper productivity which ultimately leads to poor project delivery, infrastructural development decline, and low morale among citizens. The need to develop an approach to keep this set of people inspired before, during, and after work becomes a necessity; this paper aims to evaluate the key benefits and cautions in integrating music on construction sites in Nigeria to improve effective project delivery. In attaining this, the study identified the advantages of music on construction sites, evaluated the key considerations in introducing music on construction sites, and recommended measures for the effective integration of music on construction sites in Nigeria. The study is a descriptive research through the use of secondary data gleaned from relevant literature, journals, and research sites. The study concluded that different forms of music genres can be implemented ranging from Pop music, rock, metal, and classical music. Introducing music has the advantage of industrial branding, improving workers` morale, setting the pace for working, helping in information retention, and improving mental health and happiness. The key consideration, however, is to provide the right volume and music that doesn’t pose health and safety challenges. The study finally recommended that for effective integration of music on construction sites in Nigeria, policies should be drafted regulating its use, specific radio customized for the site be introduced and that research-based music, proven to have previously helped, should be given to a group of workers.

Keywords: music, construction sites, workers, construction industry, construction management practice

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29530 Administrative and Legal Instruments of Disciplining Maintenance (alimony) Debtors in Poland - A Critical Analysis of their Effectiveness

Authors: Tomasz Kosicki

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The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

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29529 An Understanding of Corporate Social Responsibility in State-Owned Enterprises: The Case of Zimbabwe Revenue Authority

Authors: Melody Mandevere, Roselyn Cheruiyot

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Through Corporate Social Responsibility (CSR), organizations contribute to a stable environment that leads to a predictable climate for investment and trade. Organizations are now deviating from traditional CSR, where it was believed that the only responsibility of an organization is to meet its shareholder's needs. Organizations and society now believe that an organization has many stakeholders that it must satisfy for it to be viable. The function of State-Owned Enterprises (SOEs) is not profit making but providing service and accomplishing public policy objectives. SOEs demand consideration in the current economic climate because they represent an important part of the economies of many countries. Given the importance and complex relationship of the stakeholders in SOE, the paper seeks to examine how full name first Zimra is implementing its CSR activities. SOE managers are responsible for CSR implementation and stakeholder engagement. ZIMRA is one of the parastatals that plays a crucial role in the Zimbabwean economy. It is, therefore, important to understand how Zimra is implementing CSR. Qualitative research was used for the research. Interviews were contacted with Zimra managers to understand how they are implementing CSR. Although Zimra managers understand the CSR concept, the organization does not have a CSR strategy that includes their stakeholders, which may have a negative impact on stakeholder perception and the organization's reputation. The funding of the CSR strategy is also not sustainable.

Keywords: corporate social responsibility, managers, stakeholders, state-owned enterprises

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29528 Health Care Delivery Services at Subdistrict Health Promoting Hospitals on The Islands in Thailand

Authors: Tassana Boontong, Vilaivan Thongcharoen, Orapan Thosingha, Suphamon Chansakul, Anorut Jenwitheesuk, Chanin Chakkrapopyodhin, Isara Phiwchai, Mattika Chaichan, Rungnapha Khiewchaum

Abstract:

According to Thailand health policy, subdistrict health promoting hospitals (SHPHs) serve as forefront facilities for inclusive health care service. Those services include health promotion, disease prevention, primary medical care and rehabilitation. However, SHPHs residing in some distant area, such as SHPHs residing on the islands, would deliver different services relevant to health needs of the local people and the tourists. This research aimed to study health care delivery services at SHPHs on the islands in Thailand. Data were collected using questionnaires. The result revealed that in Thailand, there are 58 SHPHs on the islands. During data collection process, the researchers were not allowed to collect data in 5 SHPHs in the southern part due to Covid-19 pandemic. The report is based on 53 SHPHs on the islands. Numbers of health care personnel were 201, 72.14 % were female, with the ages ranged from 22 to 60 years (mean = 35.56 years). About 53% were community health personnel, while 26.08% were professional nurses. In regard to work experiences, the range of year varied from less than 1 year to 30 years, with the mean of 8.36 years. The majority of their responsibilities focused on providing primary medical care (86.34%), caring of people with chronic illnesses (85.30%) and providing medical care procedures for patients with chronic illnesses at home (84.36%). Nurses were main health care personnel in performing primary medical care. Due to difficulty transportation from the islands to the mainland, nurses had to provide prompt emergency medical care while the patients arrived with emergency and critical illnesses such as severe head trauma, stroke or coronary artery disease. Although some medical procedures were complex and not covered by nursing and midwifery license, they decided to protect patients from life- threatening conditions and make them stable before transportation. In SHPHs, the workload exceeded manpower, health care personnel had to work overtime almost every day. In the famous tourist islands, health care personnel had to carry 3-4 folds of their workload during the holidays because of the large crowds of foreign and Thai tourists. It is recommended that SHPHs on the islands should scale up the level of services to cover advanced medical care. Health care personnel, in particular, professional nurses, should be equipped with emergency and critical care skills. The expected outcomes of the services should emphasize on rescuing patients with emergency and life-threatening illnesses and providing comprehensive care for people living on or visiting the islands.

Keywords: distant area, islands, sub district health promoting hospital, heath care services, Thailand

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29527 A Comparative Study of the Proposed Models for the Components of the National Health Information System

Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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29526 Data Science-Based Key Factor Analysis and Risk Prediction of Diabetic

Authors: Fei Gao, Rodolfo C. Raga Jr.

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This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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29525 The Influence of Hydrolyzed Cartilage Collagen on General Mobility and Wellbeing of an Active Population

Authors: Sara De Pelsmaeker, Catarina Ferreira da Silva, Janne Prawit

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Recent studies show that enzymatically hydrolysed collagen is absorbed and distributed to joint tissues, where it has analgesic and active anti-inflammatory properties. Reviews of the associated relevant literature also support this theory. However, these studies are all using hydrolyzed collagen from animal hide or skin. This study looks into the effect of daily supplementation of hydrolyzed cartilage collagen (HCC), which has a different composition. A consumer study was set up using a double-blind placebo-controlled design with a control group using twice a day 0.5gr of maltodextrin and an experimental group using twice 0.5g of HCC, over a trial period of 12 weeks. A follow-up phase of 4 weeks without supplementation was taken into the experiment to investigate the ‘wash-out’ phase. As this consumer study was conducted during the lockdown periods, a specific app was designed to follow up with the participants. The app had the advantage that in this way, the motivation of the participants was enhanced and the drop-out range of participants was lower than normally seen in consumer studies. Participants were recruited via various sports and health clubs across the UK as we targeted a general population of people that considered themselves in good health. Exclusion criteria were ‘not experiencing any medical conditions’ and ‘not taking any prescribed medication’. A minimum requirement was that they regularly engaged in some level of physical activity. The participants had to log the type of activity that they conducted and the duration of the activity. Weekly, participants were providing feedback on their joint health and subjective pain using the validated pain measuring instrument Visual Analogue Scale (VAS). The weekly repoAbstract Public Health and Wellbeing Conferencerting section in the app was designed with simplicity and based on the accuracy demonstrated in previous similar studies to track subjective pain measures of participants. At the beginning of the trial, each participant indicated their baseline on joint pain. The results of this consumer study indicated that HCC significantly improved joint health and subjective pain scores compared to the placebo group. No significant differences were found between different demographic groups (age or gender). The level of activity, going from high intensive training to regular walking, did not significantly influence the effect of the HCC. The results of the wash-out phase indicated that when the participants stopped the HCC supplementation, their subjective pain scores increased again to the baseline. In conclusion, the results gave a positive indication that the daily supplementation of HCC can contribute to the overall mobility and wellbeing of a general active population

Keywords: VAS-score, food supplement, mobility, joint health

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29524 Development of Distance Training Packages for Teacher on Education Management for Learners with Special Needs

Authors: Jareeluk Ratanaphan

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The purposed of this research were; 1. To survey the teacher’s needs on knowledge about special education management for special needs student 2. Development of distance training packages for teacher on special education management for special needs student 3. to study the effects of using the packages on trainee’s achievement 4. to study the effects of using the packages on trainee’s opinion on the distance training packages. The design of the experiment was research and development. The research sample for survey were 86 teachers, and 22 teachers for study the effects of using the packages on achievement and opinion. The research instrument comprised: 1) training packages on special education management for special needs student 2) achievement test 3) questionnaire. Mean, percentage, standard deviation, t-test and content analysis were used for data analysis. The findings of the research were as follows: 1. The teacher’s needs on knowledge about teaching for a learner with learning disability, mental retardation, autism, physical and health impairment and research in special education. 2. The package composed of special education management for special needs student document and manual of distance training packages. The document consisted by the name of packages, the explanation for the educator, content’s structure, concept, objectives, content and activities. Manual of distance training packages consisted by the explanation about a document, objectives, explanation about using the package, training schedule, and evaluation. The efficiency of packages was established at 79.50/81.35. 3. The results of using the packages were the posttest average scores of trainee’s achievement were higher than the pretest. 4. The trainee’s opinion on the package was at the highest level.

Keywords: distance training package, teacher, learner with special needs

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29523 Muslim Husbands’ Participation in Women’s Health and Illness: A Descriptive Exploratory Study Applied to Muslim Women in Indonesia

Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner

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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.

Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness

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29522 Domestic Violence Against Iranian Deaf People

Authors: Laleh Golamrej Eliasi, Mahsa Tahzibi, Mohammad Torkashvand Moradabadi

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TheIranian Ear, Throat, Nose, Head, and Neck Research Center has estimated that three to five percent of Iran’s population has moderate to profound hearing disorders. The prevalence of hearing loss in provincial centers is equal to 4.7 per thousand live births (362 cases). The deaf community has limited access to information and health services due to language and communication barriers. Communication and language limitations isolate and limit deaf people from social media, health services, and communication with caregivers and health providers.Limitedcommunicationwith the deaf has led to a lack of knowledge and information about domestic violence against the deaf (DVAD) in this target group in Iran. To fill this knowledge gap, deaf living in Iranwere selected as the target group to assess their views on DVAD. This study is implemented in the socio-ecological approach framework to assess the impacts of individual characteristics, interpersonal relationships, community, and society components on DVAD. Semi-structured interviews with the Iranian deaf and Content analysis are used to find the participants’ point of view on DVAD, its risk factors, and the reduction approach to DVAD. The main purpose is to obtain information about participants' views on the subject. The findings can be used to improve culturally safe social work knowledge and practices with a bottom-up approach to reduce DV and increase their well-being. Therefore, this research can have important effects on the sustainable development of services and supports the welfare and inclusion of the deaf.

Keywords: domestic violence, Iranian deaf, social work, content analysis

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29521 Nonviolent Communication and Disciplinary Area of Social Communication: Case Study on the International Circulation of Ideas from a Brazilian Perspective

Authors: Luiza Toschi

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This work presents part of an empirical and theoretical master's degree meta-research that is interested in the relationship between the disciplinary area of Social Communication, to be investigated with the characteristics of the Bourdieusian scientific field, and the emergence of public interest in Nonviolent Communication (NVC) in Brazil and the world. To this end, the state of the art of this conceptual and practical relationship is investigated based on scientific productions available in spaces of academic credibility, such as conferences and scientific journals renowned in the field. From there, agents and the sociological aspects that make them contribute or not to scientific production in Brazil and the world are mapped. In this work, a brief dive into the international context is presented to understand if and how nonviolent communication permeates scientific production in communication in a systematic way. Using three accessible articles published between 2013 and 2022 in the 117 magazines classified as Quartiles Q1 in the Journal Ranking of Communication, the international production on the subject is compared with the Brazilian one from its context. The social conditions of the international circulation of ideas are thus discussed. Science is a product of its social environment, arising from relations of interest and power that compete in the political dimension at the same time as in the epistemological dimension. In this way, scientific choices are linked to the resources mobilized from or through the prestige and recognition of peers. In this sense, an object of interest stands out to a scientist for its academic value, but also and inseparably that which has a social interest within the collective, their social stratification, and the context of legitimacy created in their surroundings, influenced by cultural universalism. In Brazil, three published articles were found in congresses and journals that mention NVC in their abstract or keywords. All were written by Public Relations undergraduate students. Between the most experienced researchers who guided or validated the publications, it is possible to find two professionals who are interested in the Culture of Peace and Dialogy. Likewise, internationally, only three of the articles found mention the term in their abstract or title. Two analyze journalistic coverage based on the principles of NVC and Journalism for Peace. The third is from one of the Brazilian researchers identified as interested in dialogic practices, who analyses audiovisual material and promotes epistemological reflections. If, on the one hand, some characteristics inside and outside Brazil are similar: small samples, relationship with peace studies, and female researchers, two of whom are Brazilian, on the other hand, differences are obvious. If within the country, the subject is mostly Organizational Communication, outside this intersection, it is not presented explicitly. Furthermore, internationally, there is an interest in analyzing from the perspective of NVC, which has not been found so far in publications in Brazil. Up to the present moment, it is possible to presume that, universally, the legitimacy of the topic is sought by its association with conflict conciliation research and communication for peace.

Keywords: academic field sociology, international circulation of ideas, meta research in communication, nonviolent communication

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29520 Developing and integrated Clinical Risk Management Model

Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

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Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

Procedia PDF Downloads 245