Search results for: community health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12370

Search results for: community health

9430 Factor Structure of the Korean Version of Multidimensional Experiential Avoidance Questionnaire (MEAQ)

Authors: Juyeon Lee, Sungeun You

Abstract:

Experiential avoidance is one’s tendency to avoid painful internal experience, unwanted adverse thoughts, emotions, and physical sensations. The Multidimensional Experiential Avoidance Questionnaire (MEAQ) is a measure of experiential avoidance, and the original scale consisted of 62 items with six subfactors including behavioral avoidance, distress aversion, procrastination, distraction/suppression, repression/denial, and distress endurance. The purpose of this study was to examine the factor structure of the MEAQ in a Korean sample. Three hundred community adults and university students aged 18 to 35 participated in an online survey assessing experiential avoidance (MEAQ and Acceptance and Action Questionnaire-II; AAQ-II), depression (Patient Health Questionnaire-9; PHQ-9), anxiety (Generalized Anxiety Disoder-7; GAD-7), negative affect (Positive and Negative Affect Scale; PANAS), neuroticism (Big Five Inventory; BFI), and quality of life (Satisfaction with Life Scale; SWLS). Factor analysis with principal axis with direct oblimin rotation was conducted to examine subfactors of the MEAQ. Results indicated that the six-factor structure of the original scale was adequate. Eight items out of 62 items were removed due to insufficient factor loading. These items included 3 items of behavior avoidance (e.g., “When I am hurting, I would do anything to feel better”), 2 items of repression/denial (e.g., “I work hard to keep out upsetting feelings”), and 3 items of distress aversion (e.g., “I prefer to stick to what I am comfortable with, rather than try new activities”). The MEAQ was positively associated with the AAQ-II (r = .47, p < .001), PHQ-9 (r = .37, p < .001), GAD-7 (r = .34, p < .001), PANAS (r = .35, p < .001), and neuroticism (r = .24, p < .001), and negatively correlated with the SWLS (r = -.38, p < .001). Internal consistency was good for the MEAQ total (Cronbach’s α = .90) as well as all six subfactors (Cronbach’s α = .83 to .87). The findings of the study support the multidimensional feature of experiential avoidance and validity of the MEAQ in a sample of Korean adults.

Keywords: avoidance, experiential avoidance, factor structure, MEAQ

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9429 Peace through Language Policy as a Solution to the Ethnic Conflict in Sri Lanka

Authors: R. M. W. Rajapakshe

Abstract:

Sri Lanka, which is officially called the Democratic Socialist Republic of Sri Lanka is an island nation situated near India. It is a multi-lingual, multi- religious and multi – ethnic country, where Sinhalese form the majority and the Tamils form the largest ethnic minority. The composition of the population (ethnic basis) in Sri Lanka is as follows: Sinhalese: 74.5%, Tamil (Sri Lankan): 12.6%, Muslim: 7.5 %, Tamil (Indian): 5.5%, Malay: 0.3%, Burgher: 0.3 %, other: 0.2 %. The Tamil people use the Tamil language as their mother tongue and the Sinhala people use the Sinhala language as their mother tongue. A very few people in both communities use English as their mother tongue and however, a large number of people use English as a second language. The Sinhala Language was declared the only official language in Sri Lanka in 1959. However, it was not acceptable to Tamil politicians as well as to the common Tamil people and it was the beginning of long standing ethnic crisis which later became a military war where a lot of blood was shed. As a solution to the above ethnic crisis the thirteenth amendment to the constitution of Sri Lanka was introduced in 1987 and according to it both Sinhala and Tamil were declared official languages and English as the link language in Sri Lanka. Thus, a new programme namely, second language teaching programme under which Sinhala was taught to Tamil students and Tamil was taught to Sinhala students, was introduced at government schools. Language teaching includes knowledge of the culture of the target language. As all cultures are mixed and have common features students have reduced their enmity about the other community and learned to respect the other culture. On the other hand as all languages are mixed, students came to the understanding that there are no pure languages. Thus, they learned to respect the other language. In the case of Sri Lanka the Sinhala language is mixed with the Tamil language and vice versa. Thus, the development of second language teaching is the prominent way to solve the above ethnic problem and this study clearly shows it. However, the above programme suffers with lack of trained second language teachers, infrastructure facilities and insufficient funds and, they can be considered as the main obstacles to develop the second language teaching programme. Yet, there are no satisfactory answers to those problems. The data were collected from relevant books, articles and other documents based on research and forty five recordings, each with one hour duration, of natural conversations covering all factions of the Sinhala community.

Keywords: ethnic crisis, official language, second language teaching, Sinhala, Tami

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9428 Management Support, Role Ambiguity and Role Ambiguity among Professional Nurses at National Health Insurance Pilot Sites in South Africa: An Interpretive Phenomenology

Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

Abstract:

The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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9427 Tracing Syrian Refugees Urban Mobilities: The Case of Egypt and Canada

Authors: N. Elgendy, N. Hussein

Abstract:

The current Syrian crisis has caused unprecedented practices of global mobility. The process of forced eviction and the resettlement of refugees could be seen through the insights of the “new mobilities paradigm”. The mobility of refugees in terms of meaning and practice is a subject that calls for further studies. There is a need for the development of an approach to human mobility to understand a practice that is turning into a phenomenon in the 21st century. This paper aims at studying, from a qualitative point of view, the process of movement within the six constituents of mobility defined as the first phase of the journey of a refugee. The second phase would include the process of settling in and re-defining the host country as new “home” to refugees. The change in the refugee state of mind and crossing the physical and mental borders from a “foreigner” to a citizen is encouraged by both the governmental policies and the local communities’ efforts to embrace these newcomers. The paper would focus on these policies of social and economic integration. The concept of integration connotes the idea that refugees would enjoy the opportunities, rights and services available to the citizens of the refugee’s new community. So, this paper examines this concept through showcasing the two hosting countries of Canada and Egypt, as they provide two contrasting situations in terms of cultural, geographical, economic and political backgrounds. The analysis would highlight the specific policies defined towards the refugees including the mass communication, media calls, and access to employment. This research is part of a qualitative research project on the process of Urban Mobility practiced by the Syrian Refugees, drawing on conversational interviews with new-settlers who have moved to the different hosting countries, from their home in Syria. It explores these immigrants’ practical and emotional relationships with the process of movement and settlement. It uses the conversational interviews as a tool to document analysis and draw relationships in an attempt to establish an understanding of the factors that contribute to the new-settlers feeling of home and integration within the new community.

Keywords: integration, mobility, policy, refugees

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9426 The Nexus between Social Entrepreneurship and Youth Empowerment

Authors: Aaron G. Laylo

Abstract:

This paper mainly assumes that social entrepreneurship contributes significantly to youth empowerment i.e., work and community engagement. Two questions are thus raised in order to establish this hypothesis: 1) First, how does social entrepreneurship contribute to youth empowerment?; and 2) secondly, why is social entrpreneurship significantly incremental to youth empowerment? This research aims a) to investigate on the social aspect of entrepreneurship; b) to explore challenges in youth empowerment particularly in respect to work and community engagement; and c) to inquire into whether social enterprises have truly served as a catalyst for, thus an effective response to, youth empowerment. It must be emphasized that young people, which comprise 1.8 billion in a world of seven billion are an asset; Apparently, how to maximize that potential is crucial. By utilizing exploratory research design, the paper endeavors to generate new ideas in regards to both components, develop tentative theories on social entrepreneurship, and refine certain issues that are under observation and seek scholarly attention— a rather emerging phenomenon vis a vis the challenge to empower a significant cluster of the society. Case studies will be utilized as an approach in order to comparatively analyze youth-driven social enterprises in the Philippines that have been widely recognized as successful insofar as social impact is concerned. As most scholars attested, social entrepreneurship is still at its infancy stage. Youth empowerment, meanwhile, is yet a vast area to explore insofar as academic research is concerned. Programs and projects that advocate the pursuit of these components abound. However, academic research is yet to be undertaken to see and understand their social and economic relevance. This research is also an opportunity for scholars to explore, understand, and make sense of the promise that lies in social entrepreneurship research and how it can serve as a catalyst for youth empowerment. Youth-driven social enterprises can be an influential tool in sustaining development across the globe as they intend to provide opportunities for optimal economic productivity that recognizes social inclusion. Ultimately, this study should be able to contribute to both research and development-in-practice communities for the greater good of the society. By establishing the nexus between these two components, the research may contribute to fostering greater exploration of the benefits that both may yield to human progress as well as the gaps that have to be filled in by various policy stakeholders relevant to these units.

Keywords: social entpreneurship, youth, empowerment, social inclusion

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9425 Nurturing Resilient Families: Strategies for Positive Parenting and Emotional Well-Being

Authors: Xu Qian

Abstract:

This abstract explores the importance of building resilience within families and offers evidence-based strategies for promoting positive parenting and enhancing emotional well-being. It emphasizes the role of effective communication, conflict resolution, and fostering a supportive environment to strengthen family bonds and promote healthy child development. Introduction: The well-being and resilience of families play a crucial role in fostering healthy child development and promoting overall emotional well-being. This abstract highlights the significance of nurturing resilient families and provides evidence-based strategies for positive parenting. By focusing on effective communication, conflict resolution, and creating a supportive environment, families can strengthen their bonds and enhance emotional well-being for both parents and children. Methods: This abstract draws upon a comprehensive review of existing research and literature on resilient families, positive parenting, and emotional well-being. The selected studies employ various methodologies, including surveys, interviews, and longitudinal observations, to investigate the factors contributing to family resilience and the strategies that promote positive parenting practices. The findings from these studies serve as the foundation for the strategies discussed in this abstract. Results: The results of the reviewed studies demonstrate that effective communication within families is a key factor in building resilience and promoting emotional well-being. Open and honest communication allows family members to express their thoughts, feelings, and concerns, fostering trust and understanding. Conflict resolution skills, such as active listening, compromise, and problem-solving, are vital in managing conflicts constructively and preventing negative consequences on family dynamics and children's well-being. Creating a supportive environment that nurtures emotional well-being is another critical aspect of promoting resilient families. This includes providing emotional support, setting clear boundaries, and promoting positive discipline strategies. Research indicates that consistent and responsive parenting approaches contribute to improved self-regulation skills, emotional intelligence, and overall mental health in children. Discussion: The discussion centers on the implications of these findings for promoting positive parenting and emotional well-being. It emphasizes the need for parents to prioritize self-care and seek support when facing challenges. Parental well-being directly influences the quality of parenting and the overall family environment. By attending to their own emotional needs, parents can better meet the needs of their children and create a nurturing atmosphere. Furthermore, the importance of fostering resilience in children is highlighted. Resilient children are better equipped to cope with adversity, adapt to change, and thrive in challenging circumstances. By cultivating resilience through supportive relationships, encouragement of independence, and providing opportunities for growth, parents can foster their children's ability to bounce back from setbacks and develop essential life skills. Conclusion: In conclusion, nurturing resilient families is crucial for positive parenting and enhancing emotional well-being. This abstract presents evidence-based strategies that emphasize effective communication, conflict resolution, and creating a supportive environment. By implementing these strategies, parents can strengthen family bonds, promote healthy child development, and enhance overall family resilience. Investing in resilient families not only benefits individual family members but also contributes to the well-being of the broader community.

Keywords: childrearing families, family education, children's mental health, positive parenting, emotional health

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9424 From Within a Domestic Violence Shelter Identifying the Sociological and Psychological Impact of Refugee Muslim Women and Children in America

Authors: Asma Inge-Hanif, Ayyub Ansari Hanif

Abstract:

The impact of conflicts, the subsequent refugee migration to America and their attempted use of societal resources implicate the lack of further humanitarian aid as a consequence of the abrupt decrease in services and policy changes stemming from new governmental mandates and Executive Orders. Statistical research data indicates a substantial decline in access to standardized health services by refugee women creating a significant alteration in the management of their maternal health care in America, previously shown to result in decreased mortality and morbidity. Studying nursing at Howard University in Washington, D.C., observed doctors were not always sensitive to the needs and modesty concerns of immigrant Muslim women - often unintentionally. Among health care professionals, the prevailing belief should be that every man, woman and child has the right to quality care in a dignified manner and the achievement of optimal health and well-being, regardless of race, creed, socio-economic level or status. In 1987 Muslimat Al Nisaa Health and Social Services Center was established to care for underserved and uninsured women and children. This Center, plus the subsequent shelter, provided direct access to those homeless, refugees, human trafficking and women victims of domestic violence was established and provides the data for this study. Understanding specific culture, social, economic and religious nuances respects their diversity and addressing their basic human needs that they achieve optimal success. The ultimate goal being to facilitate the rescue and housing of those whom escaped from a country/communities where girls are devalued, brought, sold and abused.

Keywords: women, refugee, domestic violence, health care

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9423 Evaluating the Performance of 28 EU Member Countries on Health2020: A Data Envelopment Analysis Evaluation of the Successful Implementation of Policies

Authors: Elias K. Maragos, Petros E. Maravelakis, Apostolos I. Linardis

Abstract:

Health2020 is a promising framework of policies provided by the World Health Organization (WHO) and aiming to diminish the health and well-being inequalities among the citizens of the European Union (EU) countries. The major demographic, social and environmental changes, in addition to the resent economic crisis prevent the unobstructed and successful implementation of this framework. The unemployment rates and the percentage of people at risk of poverty have increased among the citizens of EU countries. At the same time, the adopted fiscal, economic policies do not help governments to serve their social role and mitigate social and health inequalities. In those circumstances, there is a strong pressure to organize all health system resources efficiently and wisely. In order to provide a unified and value-based framework of valuation, we propose a valuation framework using data envelopment analysis (DEA) and dynamic DEA. We believe that the adopted methodology could provide a robust tool which can capture the degree of success with which policies have been implemented and is capable to determine which of the countries developed the requested policies efficiently and which of the countries have been lagged. Using the proposed methodology, we evaluated the performance of 28 EU member-countries in relation to the Health2020 peripheral targets. We adopted several versions of evaluation, measuring the effectiveness and the efficiency of EU countries from 2011 to 2016. Our results showed stability in technological changes and revealed a group of countries which were benchmarks in most of the years for the inefficient countries.

Keywords: DEA, Health2020, health inequalities, malmquist index, policies evaluation, well-being

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9422 Payment of Carbon Offsetting: A Case Study in Dharan, Nepal

Authors: Mana Shrestha, Dhruba Khatri, Pralhad Kunwor

Abstract:

The objective of the study was to explore the vehicle owners’ willingness to pay (WTP) for offsetting carbon that could eventually facilitate local governmental institutions to take further step in environmental conservation. Contingent valuation method was used to find out how much amount people were willing to pay for the carbon service they are getting from providers. Open ended questionnaire was carried out with 181 respondents randomly. The result shows different mean willingness to pay amount depending upon demographic variations like education, occupation, sex and residence but the occupation and the educational status significantly affected the WTP of respondent. Total WTP amount was calculated as 650 NRS.

Keywords: community forest, carbon offset, Kyoto, REDD WTP

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9421 Examining the Relationship Between Depression and Drug and Alcohol Use in Iran

Authors: Masoumeh Kazemi

Abstract:

Depression is one of the most common mental disorders that damage mental health. In addition to mental distress, mental health damage affects other dimensions of human health, including physical and social health. According to the national study of diseases and injuries in Iran, the third health problem of the country is depression. The purpose of this study was to measure the level of depression in people referred to Karaj psychiatric treatment centers, and to investigate the relationship between depression and drug and alcohol consumption. The statistical population included 5000 people. Morgan table was used to determine the sample size. The research questions sought to identify the relationship between depression and factors such as drug and alcohol use, employment and marital status, and gender. Beck standard questionnaire was used to collect complete information. Cronbach's alpha coefficient was used to confirm the reliability of the questionnaire. To test research hypotheses, non-parametric methods of correlation coefficient, Spearman's rank, Mann-Whitney and Kruskal-Wallis tests were used. The results of using SPSS statistical software showed that there is a direct relationship between depression and drug and alcohol use. Also, the rate of depression was higher in women, widows and unemployed people. Finally, by conducting the present study, it is suggested that people use the following treatments in combination for effective recovery: 1. Cognitive Behavioral Therapy (CBT) 2. Interpersonal Therapy (IPT) 3. Treatment with appropriate medication 4. Special light therapy 5. Electric shock treatment (in acute and exceptional cases) 6. Self-help

Keywords: alcohol, depression, drug, Iran

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9420 A Semantic E-Learning and E-Assessment System of Learners

Authors: Wiem Ben Khalifa, Dalila Souilem, Mahmoud Neji

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The evolutions of Social Web and Semantic Web lead us to ask ourselves about the way of supporting the personalization of learning by means of intelligent filtering of educational resources published in the digital networks. We recommend personalized courses of learning articulated around a first educational course defined upstream. Resuming the context and the stakes in the personalization, we also suggest anchoring the personalization of learning in a community of interest within a group of learners enrolled in the same training. This reflection is supported by the display of an active and semantic system of learning dedicated to the constitution of personalized to measure courses and in the due time.

Keywords: Semantic Web, semantic system, ontology, evaluation, e-learning

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9419 The Lifecycle of a Heritage Language: A Comparative Case Study of Volga German Descendants in North America

Authors: Ashleigh Dawn Moeller

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This is a comparative case study which examines the language attitudes and behaviors of descendants of Volga German immigrants in North America and how these attitudes combined with surrounding social conditions have caused their heritage language to develop differently within each community. Of particular interest for this study are the accounts of second- and third-generation descendants in Oregon, Kansas, and North Dakota regarding their parents’ and grandparents’ attitudes toward their language and how this correlates with the current sentiment as well as visibility of their heritage language and culture. This study discusses the point at which cultural identity could diverge from language identity and what elements play a role in this development, establishing the potential for environments (linguistic landscapes) which uphold their heritage yet have detached from the language itself. Emigrating from Germany in the 1700s, these families settled for over a hundred years along the Volga Region of Imperial Russia. Subsequently, many descendants of these settlers immigrated to the Americas in the 1800-1900s. Identifying neither as German nor Russian, they called themselves Wolgadeutche (Volga Germans). During their time in Russia, the German language was maintained relatively homogenously, yet the use and status of their heritage language diverged considerably upon settlement across the Americas. Data shows that specific conditions, such as community isolation, size, religion, location as well as language policy established prior to and following the Volga German immigration to North America have had a substantial impact on the maintenance of their heritage language—causing complete loss in some areas and peripheral use or even full rebirth in others. These past conditions combined with the family accounts correlate directly with the general attitudes and ideologies of the descendants toward their heritage language. Data also shows that in many locations, despite a strong presence of German within the linguistic landscape, minimal to no German is spoken nor understood; the attitude toward the language is indifferent while a staunch holding to the heritage is maintained and boasted. Data for this study was gathered from historical accounts, archived records and newspapers, and published biographies as well as from formal interviews with second- and third-generation descendants of Volga German immigrants conducted in Oregon and Kansas. Through the interviews, members of the community have shared and provided their family genealogies as well as biographies published by family members. These have helped to trace their relatives back to specific locations, thus allowing for comparisons within the same families residing in distinctly different areas of North America. This study is part of a larger ongoing project which researches the immigration of Volga and Black Sea Germans to North America and diachronically examines the over-arching sociological factors which have directly impacted the maintenance, loss, or rebirth of their heritage language. This project follows specific families who settled in areas of Colorado, Kansas, Nebraska, Illinois, Minnesota, North and South Dakota, Saskatchewan, and Manitoba, and who later had relatives move west to areas of Oregon and Washington State. Interviews for the larger project will continue into the following year.

Keywords: heritage language, immigrant language, language change, language contact, linguistic landscape, Volga Germans, Wolgadeutsche

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9418 Innovative In-Service Training Approach to Strengthen Health Care Human Resources and Scale-Up Detection of Mycobacterium tuberculosis

Authors: Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Tsegahun Manyazewal, Francesco Marinucci, Getachew Belay, Abraham Tesfaye, Gonfa Ayana, Amaha Kebede, Yewondwossen Tadesse, Susan Lehman, Zelalem Temesgen

Abstract:

In-service health trainings in Sub-Saharan Africa are mostly content-centered with higher disconnection with the real practice in the facility. This study intended to evaluate in-service training approach aimed to strengthen health care human resources. A combined web-based and face-to-face training was designed and piloted in Ethiopia with the diagnosis of tuberculosis. During the first part, which lasted 43 days, trainees accessed web-based material and read without leaving their work; while the second part comprised a one-day hands-on evaluation. Trainee’s competency was measured using multiple-choice questions, written-assignments, exercises and hands-on evaluation. Of 108 participants invited, 81 (75%) attended the course and 71 (88%) of them successfully completed. Of those completed, 73 (90%) scored a grade from A to C. The approach was effective to transfer knowledge and turn it into practical skills. In-service health training should transform from a passive one-time-event to a continuous behavioral change of participants and improvements on their actual work.

Keywords: Ethiopia, health care, Mycobacterium tuberculosis, training

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9417 The Effect of a New Reimbursement Policy for Discharge Planning Service

Authors: Chueh Chi-An, Chan Hui-Ya

Abstract:

Background and Aim: National Health Insurance (NHI) Administration released a new reimbursement policy for hospital patients who received a superior discharge plan on April 1, 2016. Each case could be claimed 1,500 points for fee-of service with related documents. The policy is considered a solution to help reducing the crowding in the emergency department, the length of stay of hospital, unplanned readmission rate and unplanned ER visit. This study aim is to explore the effect of the new reimbursement policy for discharge planning service in a medical center. Methods: The discharge team explained to general wards the new policy and encouraged early assessment, communication and connecting to community care for patients. They stated the benefit from the policy and asked documenting for reimbursement claiming from April to May 2016. The imbursement fee of NHI declaration from June 2015 to October 2017 was collected. The indicators included hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction were analyzed after the policy implemented. Results: The results showed that the amount of service declaration was increasing from 2 cases in February 2016 to 110 cases in October 2017, the application rate was increasing from 0.029% to 1.576% of all inpatient cases, and the average payment from NHI was around 148,500 NT dollars per month in 2017. There are no significant differences in the indicators among hospital occupancy rate, hospital bed turnover rate, long-term hospitalization rate, and patients’ satisfaction. Conclusion: To provide a good discharge plan require a specialized case manager, the new reimbursement policy is too complicated and the total fee-of-service hospital could claim is too limited to hiring one. The results suggest more strategies combine with the new reimbursement policy will be needed.

Keywords: discharge planning, reimbursement, unplanned ER visit, readmission rate

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9416 Toward a Measure of Appropriateness of User Interfaces Adaptations Solutions

Authors: Abderrahim Siam, Ramdane Maamri, Zaidi Sahnoun

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The development of adaptive user interfaces (UI) presents for a long time an important research area in which researcher attempt to call upon the full resources and skills of several disciplines. The adaptive UI community holds a thorough knowledge regarding the adaptation of UIs with users and with contexts of use. Several solutions, models, formalisms, techniques, and mechanisms were proposed to develop adaptive UI. In this paper, we propose an approach based on the fuzzy set theory for modeling the concept of the appropriateness of different solutions of UI adaptation with different situations for which interactive systems have to adapt their UIs.

Keywords: adaptive user interfaces, adaptation solution’s appropriateness, fuzzy sets

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9415 Evaluating the Evolution of Public Art across the World and Exploring Its Growth in Urban India

Authors: Mitali Kedia, Parul Kapoor

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Public Art is a tool with the power to enrich and enlighten any place; it has been accepted and welcomed effortlessly by many cultures around the World. In this paper, we discuss the implications Public Art has had on the society and how it has evolved over the years, and how in India, art in this aspect is still overlooked and treated as an accessory. Urban aesthetics are still substantially limited to the installation of deities, political figures, and so on. The paper also discusses various possibilities and opportunities on how Public Art can boost a society; it also suggests a framework that can be incorporated in the legal system of the country to make it a part of the city development process.

Keywords: public art, urban fabric, placemaking, community welfare, public art program, imageability

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9414 Stakeholder-Driven Development of a One Health Platform to Prevent Non-Alimentary Zoonoses

Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

Abstract:

Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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9413 An Investigation about the Health-Promoting Lifestyle of 1389 Emergency Nurses in China

Authors: Lei Ye, Min Liu, Yong-Li Gao, Jun Zhang

Abstract:

Purpose: The aims of the study are to investigate the status of health-promoting lifestyle and to compare the healthy lifestyle of emergency nurses in different levels of hospitals in Sichuan province, China. The investigation is mainly about the health-promoting lifestyle, including spiritual growth, health responsibility, physical activity, nutrition, interpersonal relations, stress management. Then the factors were analyzed influencing the health-promoting lifestyle of emergency nurses in hospitals of Sichuan province in order to find the relevant models to provide reference evidence for intervention. Study Design: A cross-sectional research method was adopted. Stratified cluster sampling, based on geographical location, was used to select the health facilities of 1389 emergency nurses in 54 hospitals from Sichuan province in China. Method: The 52-item, six-factor structure Health-Promoting Lifestyle Profile II (HPLP- II) instrument was used to explore participants’ self-reported health-promoting behaviors and measure the dimensions of health responsibility, physical activity, nutrition, interpersonal relations, spiritual growth, and stress management. Demographic characteristics, education, work duration, emergency nursing work duration and self-rated health status were documented. Analysis: Data were analyzed through SPSS software ver. 17.0. Frequency, percentage, mean ± standard deviation were used to describe the general information, while the Nonparametric Test was used to compare the constituent ratio of general data of different hospitals. One-way ANOVA was used to compare the scores of health-promoting lifestyle in different levels hospital. A multiple linear regression model was established. P values which were less than 0.05 determined statistical significance in all analyses. Result: The survey showed that the total score of health-promoting lifestyle of nurses at emergency departments in Sichuan Province was 120.49 ± 21.280. The relevant dimensions are ranked by scores in descending order: interpersonal relations, nutrition, health responsibility, physical activity, stress management, spiritual growth. The total scores of the three-A hospital were the highest (121.63 ± 0.724), followed by the senior class hospital (119.7 ± 1.362) and three-B hospital (117.80 ± 1.255). The difference was statistically significant (P=0.024). The general data of nurses was used as the independent variable which includes age, gender, marital status, living conditions, nursing income, hospital level, Length of Service in nursing, Length of Service in emergency, Professional Title, education background, and the average number of night shifts. The total score of health-promoting lifestyle was used as dependent variable; Multiple linear regression analysis method was adopted to establish the regression model. The regression equation F = 20.728, R2 = 0.061, P < 0.05, the age, gender, nursing income, turnover intention and status of coping stress affect the health-promoting lifestyle of nurses in emergency department, the result was statistically significant (P < 0.05 ). Conclusion: The results of the investigation indicate that it will help to develop health promoting interventions for emergency nurses in all levels of hospital in Sichuan Province through further research. Managers need to pay more attention to emergency nurses’ exercise, stress management, self-realization, and conduct intervention in nurse training programs.

Keywords: emergency nurse, health-promoting lifestyle profile II, health behaviors, lifestyle

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9412 NO2 Exposure Effect on the Occurrence of Pulmonary Dysfunction the Police Traffic in Jakarta

Authors: Bambang Wispriyono, Satria Pratama, Haryoto Kusnoputranto, Faisal Yunus, Meliana Sari

Abstract:

Introduction/objective: The impact of the development of motor vehicles is increasing the number of pollutants in the air. One of the substances that cause serious health problems is NO2. The health impacts arising from exposure to NO2 include pulmonary function impairment. The purpose of this study was to determine the relationship of NO2 exposure on the incidence of pulmonary function impairment. Methods: We are using a cross-sectional study design with 110 traffic police who were divided into two groups: exposed (police officers working on the highway) and the unexposed group (police officers working in the office). Election subject convenient sampling carried out in each group to the minimum number of samples met. Results: The results showed that the average NO2 in the exposed group was 18.72 ppb and unexposed group is 4.14 ppb. Pulmonary dysfunction on exposed and unexposed groups showed that FVC (Forced Vital Capacity) value are 88.68 and 90.27. And FEV1 (Forced Expiratory Volume in One) value are 94.9 and 95.16. Some variables like waist circumference, Body Mass Index, Visceral Fat, and Fat has associated with the incidence of Pulmonary Dysfunction (p < 0.05). Conclusion: Health monitoring is needed to decreasing health risk in Policeman.

Keywords: NO2, pulmonary dysfunction, police traffic, Jakarta

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9411 Religious Government Interaction in Urban Settings

Authors: Rebecca Sager, Gary Adler, Damon Mayrl, Jonathan Cooley

Abstract:

The United States’ unique constitutional structure and religious roots have fostered the flourishing of local communities through the close interaction of church and state. Today, these local relationships play out in these circumstances, including increased religious diversity and changing jurisprudence to more accommodating church-state interaction. This project seeks to understand the meanings of church-state interaction among diverse religious leaders in a variety of local settings. Using data from interviews with over 200 religious leaders in six states in the US, we examine how religious groups interact with various non-elected and elected government officials. We have interviewed local religious actors in eight communities characterized by the difference in location and religious homogeneity. These include a small city within a major metropolitan area, several religiously diverse cities in various areas across the country, a small college town with religious diversity set in a religiously-homogenous rural area, and a small farming community with minimal religious diversity. We identified three types of religious actors in each of our geographic areas: congregations, religious non-profit organizations, and clergy coalitions. Given the well-known difficulties in identifying religious organizations, we used the following to construct a local population list from which to sample: the Association of Religion Data Archives ProPublica’s Nonprofit Explorer, Guidestar, and the Internal Revenue Service Exempt Business Master File. Our sample for selecting interviewees were stratified by three criteria: religious tradition (Christian v. non-Christian), sectarian orientation (Mainline/Catholic v. Evangelical Protestant), and organizational form (congregation vs. other). Each interview included the elicitation of local church-state interactions experienced by the organization and organizational members, the enumeration of information sources for navigating church-state interactions, and the personal and community background of interviewees. We coded interviews to identify the cognitive schema of “church” and “state,” the models of legitimate relations between the two, and discretion rules for managing interaction and avoiding conflict. We also enumerate arenas in which and issues for which local state officials are engaged. In this paper, we focus on Korean religious groups and examine how their interactions differ from other congregations, including other immigrant congregations. These churches were particularly common in one large metropolitan area. We find that Korean churches are much more likely to be concerned about any governmental interactions and have fewer connections than non-Korean churches leading to more disconnection from their communities. We argue that due to their status as new immigrant churches without a lot of community ties for many members and being in a large city, Korean churches were particularly concerned about too much interaction with any type of government officials, even ones that could be potentially helpful. While other immigrant churches were somewhat willing to work with government groups, such as Latino-based Catholic groups, Korean churches were the least likely to want to create these connections. Understanding these churches and how immigrant church identity varies and creates different types of interaction is crucial to understanding how church/state interaction can be more meaningful over space and place.

Keywords: religion, congregations, government, politics

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9410 The Cost of Non-Communicable Diseases in the European Union: A Projection towards the Future

Authors: Desiree Vandenberghe, Johan Albrecht

Abstract:

Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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9409 A Systematic Review on Communication and Relations between Health Care Professionals and Patients with Cancer in Outpatient Settings Matter

Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen

Abstract:

Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.

Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review

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9408 The Correlation Between Self-Talk and COVID-19

Authors: Abigail Vallance

Abstract:

Current research shows a correlation between declining mental health in the United States and the effect of COVID-19 on young adults and adolescents. Anxiety and depression are the two most common psychiatric illnesses, which are also the leading impediments to academic success. Spending six hours a day or more using computers is associated with higher risks of depression, with this time constraint pervasive even in present-day academia. Along with many hours on the computer, common issues COVID-19 had on students’ academic performance during online school included technical difficulties, poor support services, and difficulty adapting to online learning. Given the volume of requirements with unrealistic deadlines, and despite experiencing COVID-19, students showed an increase in their levels of anxiety. Besides the prevalent effect of COVID-19 on mental health, many studies show a correlation between mental health, COVID-19, academia, and sports performance. Academic research showed that negative self-talk, in relation to one’s self-efficacy, correlated with negative academic performance. Research showed that students who reported negative self-efficacy when test-taking led to negative test results. Furthermore, in sports performance, negative effects were found when athletes engage in negative self-talk. Overall, motivational self-talk, by oneself and through teammates and coaches, correlated with better performance than regular self-talk in sports. In relation to sports performance, the COVID-19 pandemic canceled complete sports seasons for millions of adolescents across the country. Many student-athletes use their sport to release emotions and escape from their mental health, but this was taken away. The purpose of this study is to address the current increase in mental health diagnoses in adolescents, including suicide rates after the COVID-19 pandemic began in 2020.This literature analysis is actively being studied.

Keywords: self-talk, COVID-19, mental health, adolescents

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9407 Analysis of Gender Budgeting in Healthcare Sector: A Case of Gujarat State of India

Authors: Juhi Pandya, Elekes Zsuzsanna

Abstract:

Health is related to every aspect of human being. Even a quintal change leads to ill-health of an individual. Gender plays an eminent role in determining an individual health exposure. Political implications on health have implicit effects on the individual, societal and economical. The inclusion of gender perspective into policies have plunged enormous attention globally, nationally and locally to detract inequalities and achieve economic growth. Simultaneously, there is an initiation of policies with gender perspective which are named differently but hold similar meaning or objective. They are named gender mainstreaming policies or gender sensitization policies. Gender budgeting acts as a tool for the application of gender mainstreaming policies. It incorporates gender perspective into the budgetary process by restricting the revenues and expenditures at all level of the budget. The current study takes into account the analysis of Gender Budgeting reports in terms of healthcare from the 2014-16 year of Gujarat State, India. The expenditures and literature under the heading of gender budgeting reports named “Health and Family Welfare Department” are discussed in the paper. The data analytics is done with the help of reports published by the Gujarat government on Gender Budgeting. The results discuss upon the expenditure and initiation of new policies as a roadmap for the promotion of gender equality from the path of gender budgeting. It states with the escalation of the budgetary numbers for the health expenditure. Additionally, the paper raises the questions on the hypothetical loopholes pertaining to the gender budgeting in Gujarat. The budget reports do not show a specify explanation to the expenditure use of budget for the schemes mentioned in healthcare. It also does not clarify that how many beneficiaries are benefited through gender budget. The explanation just provides an overlook of theory for healthcare Schemes/Yojana or Abhiyan.

Keywords: gender, gender budgeting, gender equality, healthcare

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9406 Mesozooplankton in the Straits of Florida: Patterns in Biomass and Distribution

Authors: Sharein El-Tourky, Sharon Smith, Gary Hitchcock

Abstract:

Effective fisheries management is necessarily dependent on the accuracy of fisheries models, which can be limited if they omit critical elements. One critical element in the formulation of these models is the trophic interactions at the larval stage of fish development. At this stage, fish mortality rates are at their peak and survival is often determined by resource limitation. Thus it is crucial to identify and quantify essential prey resources and determine how they vary in abundance and availability. The main resources larval fish consume are mesozooplankton. In the Straits of Florida, little is known about temporal and spatial variability of the mesozooplankton community despite its importance as a spawning ground for fish such as the Blue Marlin. To investigate mesozooplankton distribution patterns in the Straits of Florida, a transect of 16 stations from Miami to the Bahamas was sampled once a month in 2003 and 2004 at four depths. We found marked temporal and spatial variability in mesozooplankton biomass, diversity, and depth distribution. Mesozooplankton biomass peaked on the western boundary of the SOF and decreased gradually across the straits to a minimum at eastern stations. Midcurrent stations appeared to be a region of enhanced year-round variability, but limited seasonality. Examination of dominant zooplankton groups revealed groups could be parsed into 6 clusters based on abundance. Of these zooplankton groups, copepods were the most abundant zooplankton group, with the 20 most abundant species making up 86% of the copepod community. Copepod diversity was lowest at midcurrent stations and highest in the Eastern SOF. Interestingly, one copepods species, previously identified to compose up to 90% of larval blue marlin and sailfish diets in the SOF, had a mean abundance of less than 7%. However, the unique spatial and vertical distribution patterns of this copepod coincide with peak larval fish spawning periods and larval distribution, suggesting an important relationship requiring further investigation.

Keywords: mesozooplankton biodiversity, larval fish diet, food web, Straits of Florida, vertical distribution, spatiotemporal variability, cross-current comparisons, Gulf Stream

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9405 Poz and Play: Exploring the Effectiveness of the Online Teleserye 'Mga Batang Poz' in Influencing the Reproductive Health Practices of Filipino Teenagers

Authors: Arlan Jay Jondonero

Abstract:

The study explores the potential of teleseryes in improving the reproductive health practices of its Filipino teenage viewers. This includes the identification of the elements of teleseryes and the conditions that make it suitable for teleseryes to influence the practices of its viewers, as well as the assessment of how the Sabido methodology was applied in other countries to see if it can be applied in the Philippine context. It discusses the historical context of teleseryes in the Philippines, which are now in the online digital media platform. The study recognizes the role of the social cognitive theory and dramatic theory in a viewer’s acquisition of better reproductive health practices and evaluates if these theories can be applied in the Philippine context. Using the quasi-experimental approach, the study aims to determine if there is a causal relationship between how the online teleserye “Mga Batang Poz” is perceived by the Filipino teenage audience through its characters and storylines and the development of the audience’s knowledge, perceptions, and behaviors surrounding HIV/AIDS. The study looked into the components of the teleserye that made it relatable to the Filipino youth, as well as factors that should be taken into consideration to significantly influence the reproductive health practices of the Filipino youth.

Keywords: entertainment-education, HIV, quasi-experimental, Sabido methodology, teleserye

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9404 Pressures of a Pandemic on the Perinatal Women: Experiences of Welsh Women

Authors: Filiz Celik, Rachel Harrad, Rob Keasley, Paul Bennett

Abstract:

The COVID-19 pandemic has posed a significant challenge to many, with some groups with particular vulnerability to adverse psychological impacts. These include those disadvantaged by mental ill health, either pre-existing or occurring during pregnancy or post-partum. Using a qualitative approach, the research aimed to identify the challenges posed by COVID-19 to women, their infants and families during the perinatal period and to suggest what further support can help alleviate the adverse mental health impact of COVID-19. 21 expectant and new mothers who were currently receiving support via a peri-natal mental health service participated in semi-structured interviews. In these interviews, participants explored the impact of changes in social circumstances and healthcare providers as a result of COVID-19 restrictions, with the resultant audio recordings transcribed and analyzed using Reflexive Thematic Analysis (RTA). Based on these accounts, it was concluded that women, their partners and potentially their infants experienced heightened peri-natal distress, and their experience at this time increased their risk for future mental health problems. Women described emerging as more vulnerable, owing to their role as primary caregivers during the perinatal period and also explained how social isolation and limited access to services meant protective buffers against mental health deterioration were reduced and the resources they needed in order to develop resilience were weakened. Although partners were invited to take part in the research, a sizeable volume of data could not be generated to fully assess the impact of the pandemic on a partner’s mental well-being. However, women expressed concerns about the paternal mental health of partners and husbands which invites us to be further vigilant to paternal mental health and associated experiences. Overall, these interviews serve to highlight and provide a voice to these women and their families who describe experiencing disadvantage at an already vulnerable time in their lives, as well as illustrating the need for services to prioritize the needs of this population when acute events strike, be those future pandemics or other disasters.

Keywords: patient experience, perinatal mental health, covid-19 pandemic, heightened anxiety, birth trauma, post-natal well-being

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9403 Factors Influencing the General Public Intention to Be Vaccinated: A Case of Botswana

Authors: Meng Qing Feng, Otsile Morake

Abstract:

Background: Successful implementation of the COVID-19 vaccination ensures the prevention of virus infection. Postponement and refusal of the vaccination will threaten public health, which is now common among the general public across the world. In addition, an acceptance of the COVID-19 vaccine appears as a decisive factor in controlling the COVID-19 pandemic. Purpose: This study's objective is to explore the factors influencing the public intention to be vaccinated (ITBV). Design/methodology/approach: The web-based survey included socio-demographics and questions related to the theory of planned behavior (TPB) and the health belief model (HBM). An online survey was administered using Google Form to collect data from participants of Botswana. The sample included 339 participants, half-half of the participants were female. Data analysis was run using the Statistical Package for the Social Sciences (SPSS). Findings: The study results highlight that perceived severity, perceived barriers, health motivation, and attitude have a positive and significant effect on ITBV, while perceived susceptibility, benefits, subjective norms, and perceived behavior control do not affect ITBV. Among all of the predictors, perceived barriers have the most significant influence on ITBV. Conclusion: Theoretically, this research stated that both HBM and TPB are effective in predicting and explaining the general public ITBV. Practically, this study offers insights to the government and health departments to arrange and launch health awareness programs and provide a better guide to vaccination so that doubts about vaccine confidence and the level of uncertainty can be decreased.

Keywords: COVID-19, Omicron, intention to be COVID-19 vaccine, health behavior model, theory of planned behavior, Botswana

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9402 TeleEmergency Medicine: Transforming Acute Care through Virtual Technology

Authors: Ashley L. Freeman, Jessica D. Watkins

Abstract:

TeleEmergency Medicine (TeleEM) is an innovative approach leveraging virtual technology to deliver specialized emergency medical care across diverse healthcare settings, including internal acute care and critical access hospitals, remote patient monitoring, and nurse triage escalation, in addition to external emergency departments, skilled nursing facilities, and community health centers. TeleEM represents a significant advancement in the delivery of emergency medical care, providing healthcare professionals the capability to deliver expertise that closely mirrors in-person emergency medicine, exceeding geographical boundaries. Through qualitative research, the extension of timely, high-quality care has proven to address the critical needs of patients in remote and underserved areas. TeleEM’s service design allows for the expansion of existing services and the establishment of new ones in diverse geographic locations. This ensures that healthcare institutions can readily scale and adapt services to evolving community requirements by leveraging on-demand (non-scheduled) telemedicine visits through the deployment of multiple video solutions. In terms of financial management, TeleEM currently employs billing suppression and subscription models to enhance accessibility for a wide range of healthcare facilities. Plans are in motion to transition to a billing system routing charges through a third-party vendor, further enhancing financial management flexibility. To address state licensure concerns, a patient location verification process has been integrated through legal counsel and compliance authorities' guidance. The TeleEM workflow is designed to terminate if the patient is not physically located within licensed regions at the time of the virtual connection, alleviating legal uncertainties. A distinctive and pivotal feature of TeleEM is the introduction of the TeleEmergency Medicine Care Team Assistant (TeleCTA) role. TeleCTAs collaborate closely with TeleEM Physicians, leading to enhanced service activation, streamlined coordination, and workflow and data efficiencies. In the last year, more than 800 TeleEM sessions have been conducted, of which 680 were initiated by internal acute care and critical access hospitals, as evidenced by quantitative research. Without this service, many of these cases would have necessitated patient transfers. Barriers to success were examined through thorough medical record review and data analysis, which identified inaccuracies in documentation leading to activation delays, limitations in billing capabilities, and data distortion, as well as the intricacies of managing varying workflows and device setups. TeleEM represents a transformative advancement in emergency medical care that nurtures collaboration and innovation. Not only has advanced the delivery of emergency medicine care virtual technology through focus group participation with key stakeholders, rigorous attention to legal and financial considerations, and the implementation of robust documentation tools and the TeleCTA role, but it’s also set the stage for overcoming geographic limitations. TeleEM assumes a notable position in the field of telemedicine by enhancing patient outcomes and expanding access to emergency medical care while mitigating licensure risks and ensuring compliant billing.

Keywords: emergency medicine, TeleEM, rural healthcare, telemedicine

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9401 Application of Probiotics in the Management of Food Allergies: A Review

Authors: Amir Hosseinvand

Abstract:

Probiotics have health-giving effects on the human body, so by stimulating the immune system, they prevent many occurrences they are diseases and food allergies in humans. There are various bacteria in the human digestive system; some are useful, some are harmless, and other groups of bacteria are harmful to human health. These bacteria should be in balance in the body of people in a normal state. In certain conditions, such as a person's high stress, aging, continuous use of antibiotics, or improper diet, the intestinal microbial flora has changed, and these changes cause some diseases in people. Probiotics have health benefits for the human body and are often found in the digestive system of healthy people. Nevertheless, fermented foods such as fermented dairy products such as yogurt, cheese, buttermilk or fermented pickles contain some species of these bacteria that are useful. But the important point that should be noted is that due to modern and industrial life, high fat and high protein diets, and excessive use of antibiotics, the number of these bacteria in people's bodies has decreased, and it is necessary to consume probiotics either in the form of probiotic foods or in the form of supplements. Probiotics with mild stimulation of the immune system increase the immunity level of the body and prevent the occurrence of food allergies in people.

Keywords: human health, dairy products, food allergies, probiotic

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