Search results for: national health insurance program
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 15481

Search results for: national health insurance program

12541 The Moment of Departure: Redefining Self and Space in Literacy Activism

Authors: Sofie Dewayani, Pratiwi Retnaningdyah

Abstract:

Literacy practice is situated within the identity enactment in a particular time and space. The literacy practices in public places, ranging from city parks, urban slums to city roads are meeting places of discursive practices produced by dynamic interactions, and sometimes contestations, of social powers and capitals. The present paper examines the ways the literacy activists construct their sense of space in attempts to develop possibilities for literacy programs as they are sent to work with marginalized communities far away from their hometowns in Indonesia. In particular, this paper analyzes the activists’ reflections of identity enactment - othering, familiarity, and sense of comfort - as they are trying to make meaning of the communities’ literacy capitals and practices in the process of adapting with the communities. Data collected for this paper were travel diaries - serving as literacy narratives - obtained from a literacy residency program sponsored by the Indonesian Ministry of Education and Culture. The residency program itself involved 30 youths (18 to 30 years old) to work with marginalized communities in literacy activism programs. This paper analyzes the written narratives of four focal participants using Bakhtin’s chronotopes - the configurations of time and space - that figure into the youth’s meaning-making of literacy as well as their exercise of power and identity. Follow-up interviews were added to enrich the analysis. The analysis considers the youth’s ‘moment of departure’ a critical point in their reconstructions of self and space. This paper expands the discussions of literacy discourse and spatiality while lending its supports to literacy activism in highly diverse multicultural settings.

Keywords: chronotopes, discourse, identity, literacy activism

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12540 Multicomponent Positive Psychology Intervention for Health Promotion of Retirees: A Feasibility Study

Authors: Helen Durgante, Mariana F. Sparremberger, Flavia C. Bernardes, Debora D. DellAglio

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Health promotion programmes for retirees, based on Positive Psychology perspectives for the development of strengths and virtues, demand broadened empirical investigation in Brazil. In the case of evidence-based applied research, it is suggested feasibility studies are conducted prior to efficacy trials of the intervention, in order to identify and rectify possible faults in the design and implementation of the intervention. The aim of this study was to evaluate the feasibility of a multicomponent Positive Psychology programme for health promotion of retirees, based on Cognitive Behavioural Therapy and Positive Psychology perspectives. The programme structure included six weekly group sessions (two hours each) encompassing strengths such as Values and self-care, Optimism, Empathy, Gratitude, Forgiveness, and Meaning of life and work. The feasibility criteria evaluated were: Demand, Acceptability, Satisfaction with the programme and with the moderator, Comprehension/Generalization of contents, Evaluation of the moderator (Social Skills and Integrity/Fidelity), Adherence, and programme implementation. Overall, 11 retirees (F=11), age range 54-75, from the metropolitan region of Porto Alegre-RS-Brazil took part in the study. The instruments used were: Qualitative Admission Questionnaire; Moderator Field Diary; the Programme Evaluation Form to assess participants satisfaction with the programme and with the moderator (a six-item 4-point likert scale), and Comprehension/Generalization of contents (a three-item 4-point likert scale); Observers’ Evaluation Form to assess the moderator Social Skills (a five-item 4-point likert scale), Integrity/Fidelity (a 10 item 4-point likert scale), and Adherence (a nine-item 5-point likert scale). Qualitative data were analyzed using content analysis. Descriptive statistics as well as Intraclass Correlations coefficients were used for quantitative data and inter-rater reliability analysis. The results revealed high demand (N = 55 interested people) and acceptability (n = 10 concluded the programme with overall 88.3% frequency rate), satisfaction with the program and with the moderator (X = 3.76, SD = .34), and participants self-report of Comprehension/Generalization of contents provided in the programme (X = 2.82, SD = .51). In terms of the moderator Social Skills (X = 3.93; SD = .40; ICC = .752 [IC = .429-.919]), Integrity/Fidelity (X = 3.93; SD = .31; ICC = .936 [IC = .854-.981]), and participants Adherence (X = 4.90; SD = .29; ICC = .906 [IC = .783-.969]), evaluated by two independent observers present in each session of the programme, descriptive and Intraclass Correlation results were considered adequate. Structural changes were introduced in the intervention design and implementation methods, as well as the removal of items from questionnaires and evaluation forms. The obtained results were satisfactory, allowing changes to be made for further efficacy trials of the programme. Results are discussed taking cultural and contextual demands in Brazil into account.

Keywords: feasibility study, health promotion, positive psychology intervention, programme evaluation, retirees

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12539 Relation between Tourism and Health: Case Study AIDS in Lebanon

Authors: Viana Hassan

Abstract:

Each year, 600 million tourists travelled abroad to practice several types of tourism. Nowadays, whatever is the type of tourism practiced it considered as a real public health problem which can contribute the spread of several diseases such as AIDS, H1N1, NDM1 With regard to HIV/AIDS, Lebanon is always considered as a low HIV prevalence country. However, the potential risks associated with the mobility of the population, migration and tourism. The total number of cases reported by the ministry of health since 1989 until the end of 2011 is of 1455 cases, with an average of 85 new cases per year over the last three years. The main reason of the increased number is Travel and migration which represent 50% of the risks reported by cumulative cases. Given the interest of this kind of epidemic it would be interesting to study the Evolution of HIV/ AIDS and its relation with travel and tourism The main aim of this research is to study in general the relation between tourism and health, more specific to understand the relation between Tourism and AIDS, the problem of the transmission of HIV in Lebanon, the ways of contamination and the countries in which these people are contaminated.

Keywords: AIDS, tourism, health, Lebanon

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12538 The Influence of Cultural Perceptions in the Preference and Choice of STEM Programs

Authors: Priscilla Adoley Moffat

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This study explored perceptions rooted in and acquired from the cultures of many developing countries and how they impact applicants’ preferences and choices of STEM programs. The context of developing countries was chosen for this study because gender role socialization continues to maintain an important place in most of these cultures. This study’s relevance rests in the fact that, as the world takes steps to encourage and promote the choice and study of STEM programs, especially among females, there is a need for efforts towards understanding various cultural perceptions towards some programs of study, particularly STEM programs, which have diverse gender attributions in many developing cultures. Also, as the world strives to achieve gender equity in education, such a study comes in handy, as it provides a useful understanding of the underlying cultural factors that affect study program preferences of applicants, particularly in developing countries like Ghana as well as others in Africa. The study analyzed the admission application data of five public universities in Ghana. 1600 randomly-sampled final-year students of 32 randomly-selected senior high schools from the 16 regions of Ghana were interviewed. Since parents and teachers often guide and influence the study program choices of applicants, the study examined the perceptions of 180 teachers and 360 parents. The study found, among other things, that STEM programs are commonly perceived to pose much more difficulty to females than they do to males. As a result, many female applicants are discouraged from choosing these programs. While nursing programs are perceived more as programs for females, with the justification that females are better caregivers, males are perceived to be better medical doctors, engineers, and computer technicians. Thus, many females are less encouraged to choose Technology and Engineering programs.

Keywords: culture, perceptions, STEM, choice, preference

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12537 Heavy Metals in the Water of Lakes in the 'Bory Tucholskie' National Park of Biosphere Reserve

Authors: Krzysztof Gwozdzinski, Janusz Mazur

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Bory Tucholskie (Tucholskie Forest) is one of the largest pine forest complexes in Poland. It occupies approx. 3,000 square kilometers of Sandr in the Brda and Wda basin and the Tuchola Plain and the Charzykowskie Plain. Since 2010 it has transformed into The Bory Tucholskie Biosphere Reserve, according to the UNESCO decision. The area of the Bory Tucholskie National Park (BTNP), the park area, has been designated in 1996. There is little data on the presence of heavy metals in the Park's lakes. Concentration of heavy metals in the water of 19 lakes in the BTNP was examined. The lakes were divided into two groups: subglacial channel lakes of Struga Siedmiu Jezior (the Seven Lakes Stream) and other lakes. Heavy metals (transition metals) belong to d-block of elements. The part of these metals plays an important role in the function of living organisms as metalloproteins (enzymes, hemoproteins, vitamins, etc.). However, heavy metals are also typical; heavy metals are typical anthropogenic pollutants. Water samples were collected at the deepest points of lakes during spring and during summer stagnation. The analysis of metals was performed in an atomic absorption spectrophotometer Varian Spectra A300/400 in electric atomizer (GTA 96) in graphite cuvette. In the waters of the Seven Lakes Stream (Ostrowite, Zielone, Jelen, Belczak, Glowka, Plesno, Skrzynka, Mielnica) the increase in the concentration of the manganese and iron from outflow to inflow of Charzykowskie lake was found, while the concentration of copper (approx. 4 μg dm⁻³) and cadmium ( < 0.5 μg dm⁻³) was similar in all lakes. The concentration of the lead also varied within 2.1-3.6 μg dm⁻³. The concentration of nickel was approx. 3-fold higher in Ostrowite lake than other lakes of Struga. In turn the waters of the lakes Ostrowite, Jelen and Belczak were rich in zinc. The lowest level of heavy metals was observed in Zielone lake. In the second group of lakes, i.e., Krzywce Wielkie and Krzywce Male the heavy metal concentrations were lower than in the waters of Struga but higher than in oligotrophic lakes, i.e., Nierybno, Gluche, Kociol, Gacno Wielkie, Gacno Mae, Dlugie, Zabionek, and Sosnowek. The concentration of cadmium was below 0.5 μg dm⁻³ in all the studied lakes from this group. In the group of oligotrophic lakes the highest concentrations of metals such as manganese, iron, zinc and nickel in Gacno Male and Gacno Wielkie were observed. The high level of manganese in Sosnowek and Gacno Wielkie lakes was found. The lead level was also high in Nierybno lake and nickel in Gacno Wielkie lake. The lower level of heavy metals was in oligotrophic lakes such as Kociol, Dlugie, Zabionek and α-mesotrophic lake, Krzywce Wielkie. Generally, the level of heavy metals in studied lakes situated in Bory Tucholskie National Park was lower than in other lakes of Bory Tucholskie Biosphere Reserve.

Keywords: Bory Tucholskie Biosphere Reserve, Bory Tucholskie National Park, heavy metals, lakes

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12536 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

Abstract:

Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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12535 Learning from the Positive to Encourage Compliance with Workplace Health and Safety

Authors: Amy Williamson, Kerry Armstrong, Jason Edwards, Patricia Obst

Abstract:

Australian national policy endorses a responsive approach to work health and safety (WHS) regulation, combining positive motivators (education and guidance), with compliance monitoring and enforcement to encourage and secure compliance with legislation. Despite theoretical support for responsive regulation, there is limited evidence regarding how to achieve best results in practice. Using positive psychology as a novel paradigm, this study aims to investigate how non-punitive regulatory interactions can be improved to further encourage regulatory compliance in the construction industry. As part of a larger project, semi-structured interviews were conducted with 35 inspectorate staff and 11 managers in the Australian (Queensland) construction industry. Using an inductive, grounded approach, an in-depth qualitative investigation was conducted to identify the positive psychological principles which underpin effective use of the non-punitive aspects of responsive regulation. Results highlighted the importance of effective engagement between inspectors and industry managers. This involved the need to interact cooperatively and encourage compliance with WHS legislation. Several strategies were identified that assisted regulatory interactions and the ability of inspectors to engage. The importance of communication and interpersonal skills was reported to be critical to any interaction, regardless of the nature of the visit and regulatory tools used. In particular, the use of clear and open communication fostered trust and rapport which facilitated more positive interactions. The importance of respect and empathy was also highlighted. The need for provision of guidance and direction on how to achieve compliance was also reported. This related to ensuring companies understand their WHS obligations, providing specific advice regarding how to rectify a breach and meet compliance requirements, and ensuring sufficient follow up to confirm that compliance is successfully achieved. In the absence of imminent risk, allowing companies the opportunity to comply before further action is taken was also highlighted. Increased proactive engagement with industry to educate and promote the vision of safety at work was also reported. Finally, provision of praise and positive feedback was reported to assist interactions and encourage the continuation of good practices. Evidence from positive psychology and organisational psychology was obtained to support the use of each strategy in practice. In particular, the area of positive leadership provided a useful framework to consider the factors and conditions that drive positive interactions within the context of work health and safety and the specific relationship between inspectors and industry managers. This study provides fresh insight into key psychological principles which support non-punitive regulatory interactions in the area of workplace health and safety. The findings of this research contribute to a better understanding of how inspectors can enhance the efficacy of their regulatory interactions to improve compliance with legislation. Encouraging and assisting compliance through effective non-punitive activity offers a sustainable pathway for promoting safety and preventing fatalities and injuries in the construction industry.

Keywords: engagement, non-punitive approaches to compliance, positive interactions in the workplace, work health and safety compliance

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12534 Effects of Cell Phone Usage on Psychological Health of Students

Authors: Avadhesh Kumar

Abstract:

Background: The cell phone has rapidly become an integral, and, for some, an essential communication tool that is being used worldwide. Their use without any knowledge of their harmful effects like cancers and other health effects is not ‘quite’ safe. Studies on cancers due to electromagnetic radiations from cell phones are available, but there is a need to research on the detrimental physical and psychological effects on users like students. This study focused on certain psychological or mental health effects of cell phone usage amongst students. Materials and methods: The present study will be carried out on all the students of Banaras Hindu University. Students of both sexes from urban and rural backgrounds were selected at random and administered a pre- tested questionnaire which included aspects related to few common adverse psychological health signs and symptoms attributed to cell phone over-usage. Results: Stress was found to be the commonest symptom (51.47%) followed by irritability/anger (43.79%). Other common mental symptoms included lack of concentration and academic performance, insomnia, anxiety etc. Suggestions: This study confirms that the younger generation, who are the most frequent cell phone users, needs to be aware of the adverse health effects of cell phone usage especially the mental aspects and take preventive measures to minimize and control the same. Less dependence on the device, a curtailing time period spent on talking, communicating more by texting, etc. are some of the practical measures suggested.

Keywords: cell phones, psychological health effects, students, mental health

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12533 Organizational Commitment and Job Satisfaction among Health Professionals of a Maternity Ward in Lubango, Angola

Authors: Maria Vueba, Tchilissila A. Simoes

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Angola has a deficient health system characterized by reduced human and material resources. Nurses are the main actors combating different types of diseases simultaneously dealing with a lack of essentials tools and means. In this study, we aimed to assess the organizational commitment and job satisfaction of 51 health professionals from a maternity ward in Lubango, Angola. Participants completed the Organizational Commitment Questionnaire and the Job Satisfaction Scale and demonstrated a strong commitment towards the maternal facility, despite the majority of them were not satisfied with their work. Moreover, the gender and years of service seemed to not influence the level of commitment and satisfaction among the professionals. These results show the need for organizational restructuration (i.e., wages, career progression, supervision) to increase job satisfaction in this institution.

Keywords: Africa, health professionals, organizational commitment, work satisfaction

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12532 Health Risk Assessment According to Exposure with Heavy Metals and Physicochemical Parameters; Water Quality Index and Contamination Degree Evaluation in Bottled Water

Authors: Samaneh Abolli, Mahmood Alimohammadi

Abstract:

The survey analyzed 71 bottled water brands in Tehran, Iran, examining 10 physicochemical parameters and 16 heavy metals. The water quality index (WQI) approach was used to assess water quality, and methods such as carcinogen risk (CR) and hazard index (HI) were employed to evaluate health risks. The results indicated that the bottled water had good quality overall, but some brands were of poor or very poor quality. The study also revealed significant human health risks, especially for children, due to the presence of minerals and heavy metals in bottled water. Correlation analyses and risk assessments for various substances were conducted, providing valuable insights into the potential health impacts of the analyzed bottled water.

Keywords: bottled wate, rwater quality index, health risk assessment, contamination degree, heavy metal evaluation index

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12531 Development of Mobile Application for Internship Program Management Using the Concept of Model View Controller (MVC) Pattern

Authors: Shutchapol Chopvitayakun

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Nowadays, especially for the last 5 years, mobile devices, mobile applications and mobile users, through the deployment of wireless communication and mobile phone cellular network, all these components are growing significantly bigger and stronger. They are being integrated into each other to create multiple purposes and pervasive deployments into every business and non-business sector such as education, medicine, traveling, finance, real estate and many more. Objective of this study was to develop a mobile application for seniors or last-year students who enroll the internship program at each tertiary school (undergraduate school) and do onsite practice at real field sties, real organizations and real workspaces. During the internship session, all students as the interns are required to exercise, drilling and training onsite with specific locations and specific tasks or may be some assignments from their supervisor. Their work spaces are both private and government corporates and enterprises. This mobile application is developed under schema of a transactional processing system that enables users to keep daily work or practice log, monitor true working locations and ability to follow daily tasks of each trainee. Moreover, it provides useful guidance from each intern’s advisor, in case of emergency. Finally, it can summarize all transactional data then calculate each internship cumulated hours from the field practice session for each individual intern.

Keywords: internship, mobile application, Android OS, smart phone devices, mobile transactional processing system, guidance and monitoring, tertiary education, senior students, model view controller (MVC)

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12530 Effectiveness of Myofascial Release Technique in Treatment of Sacroiliac Joint Hypo-Mobility in Postnatal Women

Authors: Ahmed A. Abd El Rahim, Mohamed M. M. Essa, Magdy M. A. Shabana, Said A. Mohamed, Mohamed Ibrahim Mabrouk

Abstract:

Background: Sacroiliac joint (SIJ) dysfunction is considered the main cause of pregnancy-related back pain, which may continue to persist postnatally. Myofascial release technique (MFR) is an application of low-intensity, prolonged stretch to myofascial structures to improve function by increasing the sliding properties of restricted myofascial tissues. Purpose: This study was designed to investigate the effect of MFR on postnatal SIJ hypo-mobility. Materials and Methods: Fifty postnatal women complaining of SIJ hypo-mobility participated in this study. Their ages ranged from 26 to 35 yrs., and their body mass index (BMI) didn`t exceed 30 kg/m2. They were randomly assigned to two equal groups, group A (Gr. A) and group B (Gr. B). Both groups received three sessions per week for eight successive weeks. Gr. A received a traditional physical therapy program, while Gr. B received a traditional physical therapy program in addition to MFR. Doppler imaging of vibration was utilized to measure SIJ mobility pre- and post-intervention, and an electronic digital goniometer was used to measure back flexion and extension Range of motion. Results: Findings revealed a statistical improvement in post-intervention values of SIJ mobility in addition to trunk flexion and extension ROM in Gr. B compared to Gr. A (P<0.001). Conclusion: Adding MFR to traditional physical therapy programs is highly recommended in the treatment of SIJ hypo-mobility in postnatal women.

Keywords: sacroiliac hypo-mobility, sacroiliac dysfunction, myofascial release technique, traditional physical therapy, postnatal

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12529 Social Movements of Central-Eastern Europe: Examining Trends of Cooperation and Antagonism by Using Big Data

Authors: Reka Zsuzsanna Mathe

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The globalization and the Europeanization have significantly contributed to a change in the role of the nation-states. The global economic crisis, the climate changes, and the recent refugee crisis, are just a few among many challenges that cannot be effectively addressed by the traditional role of the nation-states. One of the main roles of the states is to solve collective action problems, however due to their changing roles; apparently this is getting more and more difficult. Depending on political culture, collective action problems are solved either through cooperation or conflict. The political culture of Central and Eastern European (CEE) countries is marked by low civic participation and by a weak civil society. In this type of culture collective action problems are likely to be induced through conflict, rather than the democratic process of dialogue and any type of social change is probably to be introduced by social movements. Several studies have been conducted on the social movements of the CEE countries, yet, it is still not clear if the most significant social movements of the region tend to choose rather the cooperative or the conflictual way as action strategy. This study differentiates between a national and a European action field, having different social orders. The actors of the two fields are the broadly understood civil society members, conceptualized as social movements. This research tries to answer the following questions: a) What are the norms that best characterize the CEE countries’ social order? b) What type of actors would prefer a change and in which areas? c) Is there a significant difference between the main actors active in the national versus the European field? The main hypotheses are that there are conflicting norms defining the national and the European action field, and there is a significant difference between the action strategies adopted by social movements acting in the two different fields. In mapping the social order, the study uses data provided by the European Social Survey. Big data of the Global Data on Events, Location and Tone (GDELT) database offers information regarding the main social movements and their preferred type of action. The unit of the analysis is the so called ‘Visegrad 4’ countries: Poland, Czech Republic, Slovakia and Hungary and the research uses data starting from 2005 (after the European accession of these four countries) until May, 2017. According to the data, the main hypotheses were confirmed.

Keywords: big data, Central and Eastern Europe, civil society, GDELT, social movements

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12528 Optimization of Palm Oil Plantation Revitalization in North Sumatera

Authors: Juliza Hidayati, Sukardi, Ani Suryani, Sugiharto, Anas M. Fauzi

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The idea of making North Sumatera as a barometer of national oil palm industry requires efforts commodities and agro-industry development of oil palm. One effort that can be done is by successful execution plantation revitalization. The plantation Revitalization is an effort to accelerate the development of smallholder plantations, through expansion and replanting by help of palm Estate Company as business partner and bank financed plantation revitalization fund. Business partner agreement obliged and bound to make at least the same smallholder plantation productivity with business partners, so that the refund rate to banks become larger and prosperous people as a plantation owner. Generally low productivity of smallholder plantations under normal potential caused a lot of old and damaged plants with plant material at random. The purpose of revitalizing oil palm plantations is which are to increase their competitiveness through increased farm productivity. The research aims to identify potential criteria in influencing plantation productivity improvement priorities to be observed and followed up in order to improve the competitiveness of destinations and make North Sumatera barometer of national palm oil can be achieved. Research conducted with Analytical Network Process (ANP), to find the effect of dependency relationships between factors or criteria with the knowledge of the experts in order to produce an objective opinion and relevant depict the actual situation.

Keywords: palm barometer, acceleration of plantation development, productivity, revitalization

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12527 Epidemiological Profile of Hospital Acquired Infections Caused by Acinetobacter baumannii in Intensive Care Unit

Authors: A. Dali-Ali, F. Agag, H. Beldjilali, A. Oukebdane, K. Meddeber, R. Dali-Yahia, N. Midoun

Abstract:

The ability of Acinetobacter baumannii to develop multiple resistances towards to the majority of antibiotics explains the therapeutic difficulties encountered in severe infections. Furthermore, its persistence in the humid or dry environment promotes cross-contamination in intensive care units. The aim of our study was to describe the epidemiological and bacterial resistance profiles of hospital-acquired infections caused by Acinetobacter baumannii in the intensive care unit of our teaching hospital. During the study period (June 3, 2012 to December 31, 2013), 305 patients having duration of hospitalization equal or more than 48 hours were included in the study. Among these, 36 had developed, at least, one health-care associated infection caused by Acinetobacter baumannii. The rate of infected patients was equal to 11.8% (36/305). The rate of cumulative incidence of hospital-acquired pneumonia was the highest (9.2%) followed by central venous catheter infection (1.3%). Analysis of the various antibiotic resistance profile shows that 93.8% of the strains were resistant to imipenem. The nosocomial infection control committee set up a special program not only to reduce the high rates of incidence of these infections but also to descrease the rate of imipenem resistance.

Keywords: Acinetobacer baumannii, epidemiological profile, hospital acquired infections, intensive care unit

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12526 Prevalence Of High-Risk Obstructive Sleep Apnoea by Berlin Questionnaire in Patients with Type 2 Diabetes Mellitus: A Study from Tertiary Care Hospital

Authors: Leela Lakshmi Sai Srinivas Parasa, Pushpavalli Naidu, Bhaskar Kambhampati

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Background: Obstructive Sleep Apnea (OSA) is a common but underdiagnosed sleep disorder characterized by repeated upper airway collapse during sleep. It frequently coexists with Type 2 Diabetes Mellitus (T2DM), a chronic metabolic condition with significant global and national health implications. The interplay between these conditions increases the risk of severe complications such as stroke, hypertension, and cardiovascular diseases. Understanding the prevalence of high-risk OSA in T2DM patients is essential for improving clinical outcomes and guiding public health interventions. Objective: This study aimed to assess the prevalence of high-risk OSA among T2DM patients using the Berlin questionnaire and to identify demographic and clinical predictors of risk. Methodology: This cross-sectional study of 100 patients with Type2 diabetes was undertaken at a tertiary care hospital in India for a period of 2 months. OSA was evaluated using the Berlin questionnaire. Diabetes mellitus was diagnosed according to WHO criteria as fasting blood sugar level > 7 mmol/L or random blood sugar >126 mg/dl on 2 separate occasions. Particulars of patients were recorded following which detailed history and physical examination were done. Data was analyzed using spss version 21. Results: The prevalence of high-risk OSA was 72% among the study population. The mean age was 54.9 +- 12.47 years. Age groups were divided into 3 groups (less than 50, 50-65, and greater than 65) The highest prevalence was observed in the 50-65 age group, accounting for 59.7% of high-risk cases. Gender distribution revealed a higher proportion of high-risk females (88.46%) compared to males (66.21%). Normal-weight individuals (BMI 18.5–24.9 kg/m²) represented 74.02% of high-risk OSA cases, while overweight individuals (BMI 25–29.9 kg/m²) accounted for 65.21%. Additionally, 90.9% of hypertensive patients were identified as high-risk for OSA. Conclusion: The study highlights a high prevalence of OSA risk among T2DM patients, especially those with hypertension and those in the middle-aged group. These findings emphasize the importance of routine OSA screening and tailored interventions for diabetic patients to reduce associated health risks. Proactive management can help mitigate the compounded effects of these two conditions, improving overall patient outcomes and reducing the burden on healthcare systems.

Keywords: obstructive sleep apnea, type 2 diabetes mellitus, berlin questionnaire, prevalence, hypertension

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12525 An Assessment of the Writing Skills of Reflective Essay of Grade 10 Students in Selected Secondary Schools in Valenzuela City

Authors: Reynald Contreras, Shaina Marie Bho, Kate Roan Dela Cruz, Marvin Dela Cruz

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This study was conducted with the aim of determining the skill level of grade ten (Grade 10) students in writing a reflective essay in selected secondary schools of Valenzuela. This research used descriptive and qualitative-quantitative research methods to systematically and accurately describe the level of writing skills of students and used a convenient sampling technique in selecting forty (40) students in grade ten. (Grade 10) at Polo, Wawang Pulo, and Arkong Batong high schools with a total of one hundred and twenty (120) students to assess the written reflective essay using modified rubrics developed based on 6+1 writing traits by Ruth Culham. According to the findings of the study, students at Polo and Wawang Pulo National high schools have low levels of writing skills that need to be developed or are not proficient. Meanwhile, Arkong Bato National High School has achieved a high degree of writing proficiency. Based on the study's findings, the researchers devised a suggested curriculum mapping for the suggested activity or intervention activity that would aid in the development and cultivation of the writing skills of children in grade ten (Grade 10).

Keywords: writing skills, reflective essay, intervention activity, 6+1 writing traits, modified rubrics

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12524 Organisational Culture and the Role of the Mental Health Nurse: An Ethnography of the New Graduate Nurse Experience

Authors: Mary-Ellen Hooper, Graeme Browne, Anthony Paul O'Brien

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Background: It has been reported that the experience of the organisational workplace culture for new graduate mental health nurses plays an important role in their attraction and retention to the discipline. Additionally, other research indicates that a negative workplace culture contributes to their dissatisfaction and attrition rate. Method: An ethnographic research design was applied to explore the subcultural experiences of new graduate nurses as they encounter mental health nursing. Data was collected between April and September 2017 across 6 separate Australian, NSW, mental health units. Data comprised of semi-structured interviews (n=24) and 31 episodes of field observation (62 hours). A total number of 26 new graduate and recent graduate nurses participated in the study – 14 new graduate nurses and 12 recently graduated nurses. Results: A key finding from this study was the New Graduate difficulty in articulating the role the of mental health nurse. Participants described a dichotomy between their ideological view of the mental health nurse and the reality of clinical practice. The participants’ ideological view of the mental health nurse involved providing holistic and individualised care within a flexible framework. Participants, however, described feeling powerless to change the recovery practices within the mental health service(s) because of their low status within the hierarchy. Resulting in participants choosing to fit into the existing culture, or considering leaving the field altogether. Conclusion: An incongruence between the values and ideals of an organisational culture and the reality shock of practice are shown to contribute to role ambiguity within its members. New graduate nurses entering the culture of mental health nursing describe role ambiguity resulting in dissatisfaction with practice. The culture and philosophy inherent to a service are posited to be crucial in creating positive experiences for graduate nurses.

Keywords: culture, mental health nurse, mental health nursing role, new graduate nurse

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12523 The Influence of Activity Selection and Travel Distance on Forest Recreation Policies

Authors: Mark Morgan, Christine Li, Shuangyu Xu, Jenny McCarty

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The National Wild and Scenic Rivers System was created by the U.S. Congress in 1968 (Public Law 90-542; 16 U.S.C. 1271 et seq.) to preserve outstanding natural, cultural, and recreational values of some U.S. rivers in a free-flowing condition for the enjoyment of present and future generations. This Act is notable for safeguarding the special character of these rivers while supporting management action that encourages public participation for co-creating river protection goals and strategies. This is not an easy task. To meet the challenges of modern ecosystem management, federal resource agencies must address many legal, environmental, economic, political, and social issues. The U.S. Forest Service manages a 44-mile section of the Eleven Point National Scenic River (EPR) in southern Missouri, mainly for outdoor recreation purposes. About half of the acreage is in private lands, while the remainder flows through the Mark Twain National Forest. Private land along the river is managed by scenic easements to ensure protection of scenic values and natural resources, without public access. A portion of the EPR lies adjacent to a 16,500-acre tract known as the Irish Wilderness. The spring-fed river has steep bluffs, deep pools, clear water, and a slow current, making it an ideal setting for outdoor enthusiasts. A 10-month visitor study was conducted at five access points along the EPR during 2019 so the US Forest Service could update their river management plan. A mail-back survey was administered to 560 on-site visitors, yielding a response rate of 53%. Although different types of visitors use the EPR, boating and fishing were the predominant forms of outdoor recreation. Some river use was from locals, but other visitors came from farther away. Formulating unbiased policies for outdoor recreation is difficult because managers must assign relative values to recreational activities and travel distance. Because policymaking is a subjective process, management decisions can affect user groups in different ways (i.e., boaters vs. fishers; proximate vs. distal visitors), as seen through a GIS analysis.

Keywords: activity selection, forest recreation, policy, travel distance

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12522 Integration of “FAIR” Data Principles in Longitudinal Mental Health Research in Africa: Lessons from a Landscape Analysis

Authors: Bylhah Mugotitsa, Jim Todd, Agnes Kiragga, Jay Greenfield, Evans Omondi, Lukoye Atwoli, Reinpeter Momanyi

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The INSPIRE network aims to build an open, ethical, sustainable, and FAIR (Findable, Accessible, Interoperable, Reusable) data science platform, particularly for longitudinal mental health (MH) data. While studies have been done at the clinical and population level, there still exists limitations in data and research in LMICs, which pose a risk of underrepresentation of mental disorders. It is vital to examine the existing longitudinal MH data, focusing on how FAIR datasets are. This landscape analysis aimed to provide both overall level of evidence of availability of longitudinal datasets and degree of consistency in longitudinal studies conducted. Utilizing prompters proved instrumental in streamlining the analysis process, facilitating access, crafting code snippets, categorization, and analysis of extensive data repositories related to depression, anxiety, and psychosis in Africa. While leveraging artificial intelligence (AI), we filtered through over 18,000 scientific papers spanning from 1970 to 2023. This AI-driven approach enabled the identification of 228 longitudinal research papers meeting inclusion criteria. Quality assurance revealed 10% incorrectly identified articles and 2 duplicates, underscoring the prevalence of longitudinal MH research in South Africa, focusing on depression. From the analysis, evaluating data and metadata adherence to FAIR principles remains crucial for enhancing accessibility and quality of MH research in Africa. While AI has the potential to enhance research processes, challenges such as privacy concerns and data security risks must be addressed. Ethical and equity considerations in data sharing and reuse are also vital. There’s need for collaborative efforts across disciplinary and national boundaries to improve the Findability and Accessibility of data. Current efforts should also focus on creating integrated data resources and tools to improve Interoperability and Reusability of MH data. Practical steps for researchers include careful study planning, data preservation, machine-actionable metadata, and promoting data reuse to advance science and improve equity. Metrics and recognition should be established to incentivize adherence to FAIR principles in MH research

Keywords: longitudinal mental health research, data sharing, fair data principles, Africa, landscape analysis

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12521 The Lopsided Burden of Non-Communicable Diseases in India: Evidences from the Decade 2004-2014

Authors: Kajori Banerjee, Laxmi Kant Dwivedi

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India is a part of the ongoing globalization, contemporary convergence, industrialization and technical advancement that is taking place world-wide. Some of the manifestations of this evolution is rapid demographic, socio-economic, epidemiological and health transition. There has been a considerable increase in non-communicable diseases due to change in lifestyle. This study aims to assess the direction of burden of disease and compare the pressure of infectious diseases against cardio-vascular, endocrine, metabolic and nutritional diseases. The change in prevalence in a ten-year period (2004-2014) is further decomposed to determine the net contribution of various socio-economic and demographic covariates. The present study uses the recent 71st (2014) and 60th (2004) rounds of National Sample Survey. The pressure of infectious diseases against cardio-vascular (CVD), endocrine, metabolic and nutritional (EMN) diseases during 2004-2014 is calculated by Prevalence Rates (PR), Hospitalization Rates (HR) and Case Fatality Rates (CFR). The prevalence of non-communicable diseases are further used as a dependent variable in a logit regression to find the effect of various social, economic and demographic factors on the chances of suffering from the particular disease. Multivariate decomposition technique further assists in determining the net contribution of socio-economic and demographic covariates. This paper upholds evidences of stagnation of the burden of communicable diseases (CD) and rapid increase in the burden of non-communicable diseases (NCD) uniformly for all population sub-groups in India. CFR for CVD has increased drastically in 2004-2014. Logit regression indicates the chances of suffering from CVD and EMN is significantly higher among the urban residents, older ages, females, widowed/ divorced and separated individuals. Decomposition displays ample proof that improvement in quality of life markers like education, urbanization, longevity of life has positively contributed in increasing the NCD prevalence rate. In India’s current epidemiological phase, compression theory of morbidity is in action as a significant rise in the probability of contracting the NCDs over the time period among older ages is observed. Age is found to play a vital contributor in increasing the probability of having CVD and EMN over the study decade 2004-2014 in the nationally representative sample of National Sample Survey.

Keywords: cardio-vascular disease, case-fatality rate, communicable diseases, hospitalization rate, multivariate decomposition, non-communicable diseases, prevalence rate

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12520 Maximizing the Role of Companion Teachers for the Achievement of Professional Competencies and Pedagogics Workshop Activities of Teacher Professional Participants in the Faculty of Teaching and Education of Mulawarman University

Authors: Makrina Tindangen

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The problems faced by participants of teacher profession program in Faculty of teaching and education Mulawarman University is professional and pedagogic competence. Professional competence related to the mastery of teaching materials, while pedagogic competence related with the ability to plan and to implement learning. Based on the problems, the purpose of the research is to maximize the role of companion teacher for the achievement of professional and pedagogic competencies in the workshop of the participants of teacher professional education in the Faculty of Teaching and Education of Mulawarman University. Qualitative research method with interview guidance and document to get in-depth data on how to maximize the role of companion teachers in the achievement of professional and pedagogic competencies in the workshop participants of professional education participants. Location of this research is on the Faculty of Teaching and Education of Mulawarman University, Samarinda City, East Kalimantan Province. Research respondents were 12 teachers of workshop facilitator. Descriptive data analysis is through interpretation of interview data. The conclusion of the research result, how to maximize the role of assistant teachers in workshop activities for the professional competence and pedagogic competence of professional teacher training program participants, through facilitation activities conducted by teachers of companion related to real problems faced by students in school, so that the workshop participants have professional competence and pedagogic as an initial competence before carrying out practical activities of field experience in school.

Keywords: companion teacher, professional and pedagogical competence, activities, workshop participants

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12519 Possibilities and Limits for the Development of Care in Primary Health Care in Brazil

Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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12518 The Appropriateness of Antibiotic Prescribing within Dundee Dental Hospital

Authors: Salma Ainine, Colin Ritchie, Tracey McFee

Abstract:

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

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

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12517 The Socio-Demographics of HIV-Infected Persons with Psychological Morbidity in Zaria, Nigeria

Authors: Obiageli Helen Ezeh, Chuks Clement Ezeh

Abstract:

Background: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompany chronic illnesses and may be associated with substance abuse, poor health seeking behavior and adherence to treatment program; it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is a cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geo-political zone of Nigeria. The study would help to identify high risk groups and prevent the progression and spread of the infection. Aim: To identify HIV-infected persons with psychological morbidity, accessing HIV- clinic at Shika Hospital, Zaria, Kaduna State; and analyze their socio-demographic profile. Methods: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires, the General Health Questionnaire (GHQ-12)measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalent rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7percent were mildly distressed. More females (65 percent of those with psychological morbidity) were found to be distressed than their male (55 percent) counterparts. It was (44 percent) for patients whose HIV-infection was of relatively shorter duration(2-4 years) than those of longer duration(5-9 years; and 10 years/above). The age group (21-30 years) was the most affected (35 percent). The rate was also 55 percent for Christians and 45 percent for Muslims. For married patients with partners it was 20 percent and for singles 30 percent; for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 33 percent for all the other minority tribes put together. Conclusion/Recommendation: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.

Keywords: socio-demographics, psychological morbidities, HIV-Infection, HAART

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12516 Comparative Analysis of Patent Protection between Health System and Enterprises in Shanghai, China

Authors: Na Li, Yunwei Zhang, Yuhong Niu

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The study discussed the patent protections of health system and enterprises in Shanghai. The comparisons of technical distribution and scopes of patent protections between Shanghai health system and enterprises were used by the methods of IPC classification, co-words analysis and visual social network. Results reflected a decreasing order within IPC A61 area, namely A61B, A61K, A61M, and A61F. A61B required to be further investigated. The highest authorized patents A61B17 of A61B of IPC A61 area was found. Within A61B17, fracture fixation, ligament reconstruction, cardiac surgery, and biopsy detection were regarded as common concerned fields by Shanghai health system and enterprises. However, compared with cardiac closure which Shanghai enterprises paid attention to, Shanghai health system was more inclined to blockages and hemostatic tools. The results also revealed that the scopes of patent protections of Shanghai enterprises were relatively centralized. Shanghai enterprises had a series of comprehensive strategies for protecting core patents. In contrast, Shanghai health system was considered to be lack of strategic patent protections for core patents.

Keywords: co-words analysis, IPC classification, patent protection, technical distribution

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12515 A Multiple Case Study of How Bilingual-Bicultural Teachers' Language Shame and Loss Affects Teaching English Language Learners

Authors: Lisa Winstead, Penny Congcong Wang

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This two-year multiple case study of eight Spanish-English speaking teachers explores bilingual-bicultural Latino teachers’ lived experiences as English Language Learners and, more recently, as adult teachers who work with English Language Learners in mainstream schools. Research questions explored include: How do bilingual-bicultural teachers perceive their native language use and sense of self within society from childhood to adulthood? Correspondingly, what are bilingual teachers’ perceptions of how their own language learning experience might affect teaching students of similar linguistic and cultural backgrounds? This study took place in an urban area in the Pacific Southwest of the United States. Participants were K-8 teachers and enrolled in a Spanish-English bilingual authorization program. Data were collected from journals, focus group interviews, field notes, and class artifacts. Within case and cross-case analysis revealed that the participants were shamed about their language use as children which contributed to their primary language loss. They similarly reported how experiences of mainstream educator and administrator language shaming invalidated their ability to provide support for Latino heritage ELLs, despite their bilingual-bicultural expertise. However, participants reported that counter-narratives from the bilingual authorization program, parents, community and church organizations, and cultural responsive teachers were effective in promoting their language retention, pride, and feelings of well-being.

Keywords: teacher education, bilingual education, English language learners, emergent bilinguals, social justice, language shame, language loss, translanguaging

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12514 Preliminary Evaluation of Decommissioning Wastes for the First Commercial Nuclear Power Reactor in South Korea

Authors: Kyomin Lee, Joohee Kim, Sangho Kang

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The commercial nuclear power reactor in South Korea, Kori Unit 1, which was a 587 MWe pressurized water reactor that started operation since 1978, was permanently shut down in June 2017 without an additional operating license extension. The Kori 1 Unit is scheduled to become the nuclear power unit to enter the decommissioning phase. In this study, the preliminary evaluation of the decommissioning wastes for the Kori Unit 1 was performed based on the following series of process: firstly, the plant inventory is investigated based on various documents (i.e., equipment/ component list, construction records, general arrangement drawings). Secondly, the radiological conditions of systems, structures and components (SSCs) are established to estimate the amount of radioactive waste by waste classification. Third, the waste management strategies for Kori Unit 1 including waste packaging are established. Forth, selection of the proper decontamination and dismantling (D&D) technologies is made considering the various factors. Finally, the amount of decommissioning waste by classification for Kori 1 is estimated using the DeCAT program, which was developed by KEPCO-E&C for a decommissioning cost estimation. The preliminary evaluation results have shown that the expected amounts of decommissioning wastes were less than about 2% and 8% of the total wastes generated (i.e., sum of clean wastes and radwastes) before/after waste processing, respectively, and it was found that the majority of contaminated material was carbon or alloy steel and stainless steel. In addition, within the range of availability of information, the results of the evaluation were compared with the results from the various decommissioning experiences data or international/national decommissioning study. The comparison results have shown that the radioactive waste amount from Kori Unit 1 decommissioning were much less than those from the plants decommissioned in U.S. and were comparable to those from the plants in Europe. This result comes from the difference of disposal cost and clearance criteria (i.e., free release level) between U.S. and non-U.S. The preliminary evaluation performed using the methodology established in this study will be useful as a important information in establishing the decommissioning planning for the decommissioning schedule and waste management strategy establishment including the transportation, packaging, handling, and disposal of radioactive wastes.

Keywords: characterization, classification, decommissioning, decontamination and dismantling, Kori 1, radioactive waste

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12513 Human Trafficking in Your Backyard: Know the Signs and How to Help

Authors: Jessie Fazel, Kristen Smith

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Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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12512 How Sustainable is Tourism Architecture in Uganda

Authors: Goodman Conrad Kazoroa

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Among the most remarkable socioeconomic phenomena of the post-World War II era has been the expansion of the global tourism industry. Intensifying tourism activity is continuing to affect more and more places and there can no longer be any doubt as to the potential of this sector to affect fundamental economic, social-cultural and environmental change. A phenomenon with far reaching effects like this needs to be carefully controlled and planned so as not to compromise the chances for the future generations to enjoy this resource, therefore the issue of tourism sustainability, as a result, is unveiled. The concept of sustainable tourism remains vague in Uganda as the country has seen an increase in resorts, hotels and lodges especially in most of Uganda’s ecologically vulnerable areas National Parks. To many, sustainable tourism it is merely the application of the sustainable development idea to the sector of tourism. To others, it is the conservation of the environment and its natural resources, realising and appropriately using them to achieve sustainable built environments that promote tourism. Architecture and the built environment can be the first means to link the global dimension of this phenomenon of sustainable tourism to its local implications. The aim of this paper was to critically analyse the extent to which sustainability related considerations have been pursued in the built environments for Uganda’s national parks as means to achieving sustainable tourism. This was achieved by use of a sustainable architecture rating tool that was modified to fit Uganda’s context. The results of this are presented as the final results of the study. There are many examples of sustainable tourism resorts, or what tourism managers and developers claim are sustainable tourism resorts throughout the country. This paper reveals the truth, that is, true sustainable tourism resorts are very few and far between.

Keywords: sustainable tourism, tourism architecture, sustainable architecture, sustainable tourism resorts

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