Search results for: primary health center

Authors: Ngabilas Salama

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Background: Indonesia has the 2nd highest number of incidents of tuberculosis (TB). It accounts for 1.020.000 new cases per year, only 30% of which has been reported. To find the lost 70%, a massive active case discovery was conducted through two programs: Ketuk Pintu Layani Dengan Hati (KPLDH) and Kader Juru Pemantau Batuk (Jumantuk cadres), who also plays a role in child TB screening. Methods: Data was collected and analyzed through Tuberculosis Integrated Online System from 2014 to 2017 involving 129 DOTS facility with 86 primary health centers in East Jakarta. Results: East Jakarta consists of 2.900.722 people. KPLDH program started in February 2016 consisting of 84 teams (310 people). Jumantuk cadres was formed 4 months later (218 orang). The number of new TB cases in East Jakarta (primary health center) from 2014 to June 2017 respectively is as follows: 6.499 (2.637), 7.438 (2.651), 8.948 (3.211), 5.701 (1.830). Meanwhile, the percentage of child TB case discovery in primary health center was 8,5%, 9,8%, 12,1% from 2014 to 2016 respectively. In 2017, child TB case discovery was 13,1% for the first 3 months and 16,5% for the next 3 months. Discussion: Increased TB incidence rate from 2014 to 2017 was 14,4%, 20,3%, and 27,4% respectively in East Jakarta, and 0,5%, 21,1%, and 14% in primary health center. This reveals the positive role of KPLDH and Jumantuk in TB detection and reporting. Likewise, these programs were responsible for the increase in child TB case discovery, especially in the first 3 months of 2017 (Ketuk Pintu TB Day program) and the next 3 months (active TB screening). Conclusion: KPLDH dan Jumantuk are actively involved in increasing TB case discovery in both adults and children.

Keywords: tuberculosis, case discovery program, primary health center, cadre

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: K. Mellou, G. Anastopoulos, T. Zakinthinos, C. Botsi, A. Terzidis

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‘PHILOS – Emergency health response to refugee crisis’ is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP). The programme is funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. With the EU Member States accepting, the last period, accelerating migration flows, Greece inevitably occupies a prominent position in the migratory map due to this geographical location. The main objectives of the programme are a) reinforcement of the capacity of the public health system and enhancement of the epidemiological surveillance in order to cover refugees/migrant population, b) provision of on-site primary health care and psychological support services, and c) strengthening of national health care system task-force. The basic methods for achieving the aforementioned goals are: a) implementation of syndromic surveillance system at camps and enhancement of public health response with the use of mobile medical units (Sub-action A), b) enhancement of health care services inside the camps via increasing human resources and implementing standard operating procedures (Sub-action B), and c) reinforcement of the national health care system (primary healthcare units, hospitals, and emergency care spots) of affected regions with personnel (Sub-action C). As a result, 58 health professionals were recruited under sub-action 2 and 10 mobile unit teams (one or two at each health region) were formed. The main actions taken so far by the mobile units are the evaluation, of syndromic surveillance, of living conditions at camps and medical services. Also, vaccination coverage of children population was assessed, and more than 600 catch-up vaccinations were performed by the end of June 2017. Mobile units supported transportation of refugees/migrants from camps to medical services reducing the load of the National Center for Emergency Care (more than 350 transportations performed). The total number of health professionals (MD, nurses, etc.) placed at camps was 104. Common practices were implemented in the recording and collection of psychological and medical history forms at the camps. Protocols regarding maternity care, gender based violence and handling of violent incidents were produced and distributed at personnel working at camps. Finally, 290 health care professionals were placed at primary healthcare units, public hospitals and the National Center for Emergency Care at affected regions. The program has, also, supported training activities inside the camps and resulted to better coordination of offered services on site.

Keywords: migrants, refugees, public health, syndromic surveillance, national health care system, primary care, emergency health response

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Authors: Dan Richard D. Fernandez

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This study determined the perspectives of community health workers’ perspectives in the sustainability of primary health care. Eight community health workers, two community officials and a rural health midwife in a rural community in the in the Philippines were enjoined to share their perspectives in the sustainability of primary health care. The study utilized the critical research method. The critical research assumes that there are ‘dominated’ or ‘marginalized’ groups whose interests are not best served by existing societal structures. Their experiences highlighted that the challenges of their role include unkind and uncooperative patients, the lack of institutional support mechanisms and conflict of their roles with their family responsibilities. Their most revealing insight is the belief that primary health care is within their grasp. Finally, they believe that the burden to sustain primary health care rests on their shoulders alone. This study establishes that Multi-stakeholder participation is and Gender-sensitivity is integral to the sustainability of Primary Health Care. It also observed that the ingrained Expert-Novice or Top-down Management Culture and the marginalisation of BHWs within the system is a threat to PHC sustainability. This study also recommends to expand the study and to involve the local government units and academe in lobbying the integration of gender-sensitivity and multi-stake participatory approaches to health workforce policies. Finally, this study recognised that the CHWs’ role is indispensable to the sustainability of primary health care.

Keywords: community health workers, multi-stakeholder participation, sustainability, gender-sensitivity

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Authors: Petcharat Kerdonfag, Supunnee Thrakul

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School health services through regular screening of school students’ health status have been the main responsibility for community or school health nurses. The purposes of these retrospective study were to assess and compare health problems between government and private primary school students in the central region of Thailand. The data were collected from the school health records in October at the end of the first semester in the academic year 2018. Two thousand and fifty primary school health records from government and private primary schools were gathered to assess health problems regarding anthropometric measurements, physical examination/personal hygiene, and clinical findings for this study. Descriptive statistics and Chi-square were used to be analyzed. The results revealed that health problems of all the school students remained high magnitude. The five top ranks for prevalence rate of health problems were dental caries (36.6%), visual acuity problem (27.7%), over-nutrition (16.8%), head lice (12.8%), and under-nutrition (6.8%), respectively. However, when compared between government and private schools among five health problems; dental caries (55.0% vs 19.9%), visual acuity problem (23.1% vs 31.9%), over-nutrition (20.2% vs 13.8%), head lice (26.5% vs 0.3%), and under-nutrition (10.6% vs 3.4%) with Chi-square analysis, there were significantly different (p < .001). The problem of visual acuity seems to be more serious in private schools while other health problems tend to be more critical in government schools. The findings have suggested that parents who have children in the private primary schools should pay more attention to visual health defects whereas parents with children in the government school should pay more vigilance regards to hygiene and health behavior problems.

Keywords: community health nursing, school health service, health status, primary school children

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Authors: Thuraya Ahmed Hamood Al Shidhani

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Sports Medicine injuries are very common in primary health care. It is not necessary related to direct trauma, but it could be because of repetitive stress and overuse injuries. Knowledge of Primary Health care providers about the common sports medicine injuries and when to refer to a specialist is essential. Common sports injuries are muscle strain, joint sprain, bone bruise, Patellofemoral pain syndrome, Anterior cruciate ligament injuries, meniscal injuries, ankle ligaments injuries, concussion, Rotator cuff tendinosis/impingement syndrome, lateral and medial epicondylitis and fractures. Systematic approach is very useful in evaluation of sports injuries. RICE is important in initial management. Physiotherapy is essential for rehabilitation. Definitive Management is dependent on patient’s condition and function.

Keywords: common, sports medicine injuries, primary health care, injuries

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Authors: David Nkurunziza, Rahman Tafahomi

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The population growth rate of the city of Kigali is increasing annually. In 1960 the population was six thousand, in 1990 it became two hundred thousand and is supposed to be 4 to 5 million incoming twenty years. With the increase in the residents living in the city of Kigali, there is also a need for an increase in social and economic infrastructures connected by the road networks to serve the residents effectively. A road network is a route that connects people to their needs and has to facilitate people to reach the social and economic facilities easily. This research analyzed the social and economic aspects of three selected roads networks passing through all three districts of the city of Kigali, whose center is the city center roundabout, thorough evaluation of the proximity of the social and economic facilities to the road network. These road networks are the city center to nyabugogo to karuruma, city center to kanogo to Rwanda to kicukiro center to Nyanza taxi park, and city center to Yamaha to kinamba to gakinjiro to kagugu health center road network. This research used a methodology of identifying and quantifying the social and economic facilities within a limited distance of 300 meters along each side of the road networks. Social facilities evaluated are the health facilities, education facilities, institution facilities, and worship facilities, while the economic facilities accessed are the commercial zones, industries, banks, and hotels. These facilities were evaluated and graded based on their distance from the road and their value. The total scores of each road network per kilometer were calculated and finally, the road networks were ranked based on their percentage score per one kilometer—this research was based on field surveys and interviews to collect data with forms and questionnaires. The analysis of the data collected declared that the road network from the city center to Yamaha to kinamba to gakinjiro to the kagugu health center is the best performer, the second is the road network from the city center to nyabugogo to karuruma, while the third is the road network from the city center to kanogo to rwandex to kicukiro center to nyaza taxi park.

Keywords: social economical aspect, road network functionality, urban road network, economic and social facilities

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Authors: Alexis Piedrahita, Ludi Valencia, Aura Gutierrez

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The migration crisis that is currently being experienced in the world is a continuous phenomenon that has had solutions in form but not in substance, violating the international humanitarian law of people who are in transit through countries foreign to their roots, especially women of age reproductive, this has caused different governments and organizations worldwide to meet around this problem to define concise actions to protect the rights of migrant women in the world. This research compiles the stories of migrant women who arrive in Colombia seeking better opportunities, such as accessibility to comprehensive and quality health services, including primary health care. This is the gateway to the offer of health promotion and disease prevention services.

Keywords: accessibility, primary health care, sexual and reproductive health, sustainable development goals, women migrant

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Authors: Tosaporn Mahamud

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The foundation of the Islamic center of Thailand plays a vital role in order to bring diverse Muslim communities in a common place. The center itself is a bridge between Muslims in Thailand and Islamic world. The operational task of the center runs by many organizations through the funds and funds use for different activities for empowerment of Thai society in general and Muslim community in particular. This paper aims to focus on the role of the foundation of the Islamic center of Thailand to the Thai society. This paper also finds out the historical background of the center in term of building structure and design and functions.

Keywords: design, empowerment, islamic, society

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Cheng Fang Hsu

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Call center is the core of building customer relationship management system. Under the strong competitive stress, it becomes a new profiting challenge for a successful enterprise. Call center is a department not only to provide customer service but also to bring business profit. This is the qualitative case study in Taiwan bank service industry which goes on deeper exploration, and analysis by business interviews and industrial analysis. This study starts from the establishment, development, and management after the reforming of the case call center. Through SWOT analysis, and industrial analysis, this study adopted 7S model to explain how the call center reforms from service oriented to profit oriented and from cost management to profit management. The results indicated how service innovation management promotes call center to be operated as a market profit competition center. The recommendations are indicated to support the call center on marketing profit by service innovation management.

Keywords: call center, 7S model, service innovation management, bioinformatics

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Authors: N. A. Parvin, E. B. Ferranti, L. A. Chapman, C. A. Pfrang

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This study intends to investigate the effects of the Urban Heat Island on public health in Birmingham. Birmingham is located at the center of the West Midlands and its weather is Highly variable due to geographical factors. Residential developments, road networks and infrastructure often replace open spaces and vegetation. This transformation causes the temperature of urban areas to increase and creates an "island" of higher temperatures in the urban landscape. Extreme heat in the urban area is influencing public health in the UK as well as in the world. Birmingham is a densely built-up area with skyscrapers and congested buildings in the city center, which is a barrier to air circulation. We will investigate the city regarding heat and cold-related human mortality and other impacts. We are using primary and secondary datasets to examine the effect of population shift and land-use change on the UHI in Birmingham. We will also use freely available weather data from the Birmingham Urban Observatory and will incorporate satellite data to determine urban spatial expansion and its effect on the UHI. We have produced a temperature map based on summer datasets of 2020, which has covered 25 weather stations in Birmingham to show the differences between diurnal and nocturnal summer and annual temperature trends. Some impacts of the UHI may be beneficial, such as the lengthening of the plant growing season, but most of them are highly negative. We are looking for various effects of urban heat which is impacting human health and investigating mitigation options.

Keywords: urban heat, public health, climate change

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Authors: Vichai Tienthavorn

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Background: Recently, the patients of non-communicable diseases (NCDs) are increasing in Thailand; especially hypertension and diabetes. Hypertension and Diabetes patients were found to be of 3.7 million in 2008. The varieties of human behaviors have been extensively changed in health. Hence, Thai Government has a policy to reduce NCDs. Generally, primary care plays an important role in treatment using medical process. However, NCDs patients have not been decreased. Objectives: This study not only reduce the patient and mortality rate but also increase the quality of life, could apply in different areas and propose to be the national policy, effectively for a long term operation. Methods: Here we report that primary health care (PHC), which is a primary process to screening, rapidly seek the person's risk. The screening tool of the study was Vichai's 7 color balls model, the medical education tool to transfer knowledge from student health team to community through health volunteers, creating community engagement in terms of social participation. It was found that people in community were realized in their health and they can evaluate the level of risk using this model. Results: Projects implementation (2015) in Nong Lom Health Center in Phayao (target group 15-65 years, 2529); screening hypertension coveraged 99.01%, risk group (light green) was decreased to normal group (white) from 1806 to 1893, significant severe patient (red) was decreased to moderate (orange) from 10 to 5. Health Program in behaving change with best practice of 3Es (Eating, Exercise, Emotion) and 3Rs (Reducing tobacco, alcohol, obesity) were applied in risk group; and encourage strictly medication, investigation in severe patient (red). Conclusion: This is the first demonstration of knowledge transfer to community engagement by student, which is the sustainable education in PHC.

Keywords: non-communicable disease, surveillance control and prevention systems, community engagement, primary health care

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Authors: R. B. Patil, B. S. Kothavale, L. Y. Waghmode

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Today, the CNC turning center becomes an important machine tool for manufacturing industry worldwide. However, as the breakdown of a single CNC turning center may result in the production of an entire plant being halted. For this reason, operations and preventive maintenance have to be minimized to ensure availability of the system. Indeed, improving the availability of the CNC turning center as a whole, objectively leads to a substantial reduction in production loss, operating, maintenance and support cost. In this paper, fault tree analysis (FTA) method is used for reliability analysis of CNC turning center. The major faults associated with the system and the causes for the faults are presented graphically. Boolean algebra is used for evaluating fault tree (FT) diagram and for deriving governing reliability model for CNC turning center. Failure data over a period of six years has been collected and used for evaluating the model. Qualitative and quantitative analysis is also carried out to identify critical sub-systems and components of CNC turning center. It is found that, at the end of the warranty period (one year), the reliability of the CNC turning center as a whole is around 0.61628.

Keywords: fault tree analysis (FTA), reliability analysis, risk assessment, hazard analysis

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Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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Authors: Pornnapat Berndt

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The purpose of this research is to explore challenge and opportunities to establish cultural learning center of Wayang Artwork for creative tourism within the house of Mr. Sa-ngat Jaiprom. To accomplish the goals and objectives, qualitative research will be applied. The research instruments used are observation, questionnaires (pretest and posttest), basic interviews, in-depth interviews and interviewed of key local informants. The study also uses both primary data and secondary data. From research result, it is revealed that the sample groups more realized valuable heritage value after learning about the history of wayang and the way to practices. The sample group indicated that it not too difficult for them to carving Wayang artwork as they have knowledge about Thai art before. However, in their opinion, they comment that it might difficult for others who have no basic knowledge to learn to carve wayang artwork.

Keywords: creative tourism, local community, cultural learning center, wayang artwork  

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Authors: Wen Liu

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With the rapid progress of modern cities, the railway construction must be developing quickly in China. As a typical high-density country, shopping center on the subway should be one important factor during the process of urban development. The paper discusses the influence of the layout of shopping center on the subway, and put it in the time and space’s axis of Shanghai urban development. We use the digital technology to establish the database of relevant information. And then get the change role about shopping center on subway in Shanghaiby the Kernel density estimate. The result shows the development of shopping center on subway has a relationship with local economic strength, population size, policy support, and city construction. And the suburbanization trend of shopping center would be increasingly significant. By this case research, we could see the Kernel density estimate is an efficient analysis method on the spatial layout. It could reveal the characters of layout form of shopping center on subway in essence. And it can also be applied to the other research of space form.

Keywords: Shanghai, shopping center on the subway, layout form, Kernel density estimate

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: Avasha Rambiritch, Adelia Carstens

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In especially the context of a writing center, learning takes place during, and as part of, the conversations between the writing center tutor and the student. This interaction or dialogue is an integral part of writing center research and is the focus of this largely qualitative study, employing a politeness lens. While there is some research on positive politeness strategies employed by writing center tutors, there is very little research on specifically praising as a positive politeness strategy. This study attempts to fill this gap by analyzing a corpus of 10 video-recorded consultations to determine how tutors in a writing center utilize the positive politeness strategy of praise. Findings indicate that while tutors exploit a range of politeness strategies, praise is used more often than any other strategy. The research indicates that praise as a politeness strategy is utilized significantly more when commenting on higher-order concerns, as in line with the writing center literature. The benefits of this study include insights into how such analyses can be used to better prepare and equip the tutors (usually postgraduate students appointed as part-time tutors in the writing center) for the work they do on a daily basis.

Keywords: writing center, academic writing, positive politeness, tutor

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Dilsad Akal

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Aim: Companies communicate with each other and with their costumers via call centers. Call centers are defined as stressful because of their uncertain working hours, inadequate relief time, performance based system and heavy workload. In literature, this sector is defined as risky as mining sector by means of health and safety. The aim of this research is to enlight the relatively dark area. Subject and Methods: The collection of data for this study completed during April-May 2015 for the two selected call centers in different parts of Turkey. The applied question mostly investigated the health conditions of call center workers. Electromagnetic field measurements were completed at the same time with applying the question poll. The ratio of employee accessibility noted as 73% for the first call center and 87% for the second. Results: The results of electromagnetic field measurements were as between 371 V/m-32 V/m for the first location and between 370 V/m-61 V/m for the second. The general complaints of the employees for both workplaces can be counted as; inadequate relief time, inadequate air conditioning, disturbance, poor thermal conditions, inadequate or extreme lighting. Furthermore, musculoskeletal discomfort, stress, ear and eye discomfort are main health problems of employees. Conclusion: The measured values and the responses to the question poll were found parallel with the other similar research results in literature. At the end of this survey, a risk map of workplace was prepared in terms of safety and health at work in general and some suggestions for resolution were provided.

Keywords: call center, health and safety, electromagnetic field, risk map

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Authors: S. J. Sirima, C. Thirawan, R.Puntharikorn, K. Ungsumalin, J. Kaemwich

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Acinetobacter spp. is a gram negative bacterium causing the high incidence of multi-drug resistance in patients admitted to an intensive care unit. A hundred isolates of Imipenem-resistant Acinetobacter spp. isolated from patients admitted at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand, were subjected to modified Hodge test and combined disc test in order to evaluate the production of carbapenemases. The results revealed that about 35% of isolates were found to be carbapenemases producers. In addition, multiplex polymerase chain reactions were performed to detect blaOXA-like genes. It showed that 92% of isolates possess blaOXA-51-like and blaOXA-23-like genes. However, blaOXA-58-like gene was detected in only 8 isolates. No detection of blaOXA-24-like gene was observed in all isolates. In conclusion, an ability to produce carbepenemases would be an important mechanism of multi-drug resistance among clinical isolates of Acinetobacter spp. at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand. Furthermore, it was likely that the class D carbapenemases genes, blaOXA-51-like and blaOXA-23-like, might contribute to imipenem-resistance exhibiting among isolates.

Keywords: Acinetobacter spp., blaOXA-like genes, carbapenemases, tertiary health care center

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Authors: Hilal Al Shamsi, Abdullah Almutairi

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Introduction: As primary healthcare centres play an important role in implementing Saudi Arabia’s health strategy, this paper offers a review of publications on the quality of the country’s primary health care. With the aim of deciding on solutions for improvement, it provides an overview of healthcare quality in this context and indicates barriers to quality. Method: Using two databases, ProQuest and Scopus, data extracted from published articles were systematically analysed for determining the care quality in Saudi primary health centres and obstacles to achieving higher quality. Results: Twenty-six articles met the criteria for inclusion in this review. The components of healthcare quality were examined in terms of the access to and effectiveness of interpersonal and clinical care. Good access and effective care were identified in such areas as maternal health care and the control of epidemic diseases, whereas poor access and effectiveness of care were shown for chronic disease management programmes, referral patterns (in terms of referral letters and feedback reports), health education and interpersonal care (in terms of language barriers). Several factors were identified as barriers to high-quality care. These included problems with evidence-based practice implementation, professional development, the use of referrals to secondary care and organisational culture. Successful improvements have been implemented by other systems, such as mobile medical units, electronic referrals, online translation tools and mobile devices and their applications; these can be implemented in Saudi Arabia for improving the quality of the primary healthcare system in this country. Conclusion: The quality of primary health care in Saudi Arabia varies among the different services. To improve quality, management programmes and organisational culture must be promoted in primary health care. Professional development strategies are also needed for improving the skills and knowledge of healthcare professionals. Potential improvements can be implemented to improve the quality of the primary health system.

Keywords: quality, primary health care, Saudi Arabia, health centres, general medical

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Authors: Hsin-Jen Chen

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Primary schooling in Taiwan is in a process of radical restructuring during the decade. At the center of these restructuring is the position of the principal and questions to do with how principals, as school leaders, respond to radical change. Adopting a case-study approach, the study chose a middle Taiwanese primary school to investigate how the principal learned to be political. Using micropolitical leadership, the principal at the researched site successfully coped with internal change and external demands. On the whole, judging from the principal’s leadership style on the mediation between parents and teachers, as well as school-based curriculum development, it could be argued that the principal was on the stance of being a leader of the cultural transformation instead of cultural reproduction. In doing so, the qualitative evidence has indicated that the principal seemed to be successful in coping with the demands of rapid change. Continuing learning for leadership is the core of working as a principal.

Keywords: micropolitics, leadership, micropolitical leadership, learning for leadership

Procedia PDF Downloads 193

Authors: Lito M. Amit, Venecio U. Ultra, Young-Woong Song

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The business process outsourcing (BPO) in the Philippines is expanding rapidly attracting more than 2% of total employment. Currently, the BPO industry is confronted with several issues pertaining to sustainable productivity such as meeting the staffing gap, high rate of employees’ turnover and workforce retention, and the occupational health and safety (OHS) of call center agents. We conducted a survey of OHS programs and health concerns among call center agents in the Philippines and determined the sociocultural factors that affect the vulnerability of call center agents to occupational health risks and hazards. The majority of the agents affirmed that OHS are implemented and OHS orientation and emergency procedures were conducted at employment initiations, perceived favorable and convenient working environment except for occasional noise disturbances and acoustic shock, visual, and voice fatigues. Male agents can easily adjust to the demands and changes in their work environment and flexible work schedules than female agents. Female agents have a higher tendency to be pressured and humiliated by low work performance, experience a higher incidence of emotional abuse, psychological abuse, and experience more physical stress than male agents. The majority of the call center agents had a night-shift schedule and regardless of other factors, night shift work brings higher stress to agents. While working in a call center, higher incidence of headaches and insomnia, burnout, suppressed anger, anxiety, and depressions were experienced by female, younger (21-25 years old) and those at night shift than their counterpart. Most common musculoskeletal disorders include body pain in the neck, shoulders and back; and hand and wrist disorders and these are commonly experienced by female and younger workers. About 30% experienced symptoms of cardiovascular and gastrointestinal disorders and weakened immune systems. Overall, these findings have shown the variable vulnerability by a different subpopulation of call center agents and are important in the occupational health risk prevention and management towards a sustainable human resource for BPO industry in the Philippines.

Keywords: business process outsourcing industry, health risk of call center agents, socio-cultural determinants, Philippines

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Authors: Chen Wang, Qiuxiao Chen

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With the advent of the information age and the era of big data, urban planning research is no longer satisfied with the analysis and application of traditional data. Because of the limitations of traditional urban commercial center system research, big data provides new opportunities for urban research. Therefore, based on the quantitative evaluation method of big data, the commercial center system of the main city of Hangzhou is analyzed and evaluated, and the scale and hierarchical structure characteristics of the urban commercial center system are studied. In order to make up for the shortcomings of the existing POI extraction method, it proposes a POI extraction method based on adaptive adjustment of search window, which can accurately and efficiently extract the POI data of commercial business in the main city of Hangzhou. Through the visualization and nuclear density analysis of the extracted Point of Interest (POI) data, the current situation of the commercial center system in the main city of Hangzhou is evaluated. Then it compares with the commercial center system structure of 'Hangzhou City Master Plan (2001-2020)', analyzes the problems existing in the planned urban commercial center system, and provides corresponding suggestions and optimization strategy for the optimization of the planning of Hangzhou commercial center system. Then get the following conclusions: The status quo of the commercial center system in the main city of Hangzhou presents a first-level main center, a two-level main center, three third-level sub-centers, and multiple community-level business centers. Generally speaking, the construction of the main center in the commercial center system is basically up to standard, and there is still a big gap in the construction of the sub-center and the regional-level commercial center, further construction is needed. Therefore, it proposes an optimized hierarchical functional system, organizes commercial centers in an orderly manner; strengthens the central radiation to drive surrounding areas; implements the construction guidance of the center, effectively promotes the development of group formation and further improves the commercial center system structure of the main city of Hangzhou.

Keywords: business center system, business format, main city of Hangzhou, POI extraction method

Procedia PDF Downloads 109

Authors: Lina Feng

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The study aimed at establishing quality evaluation indicators of an early education center for 0~3 years old, and defining the weight system of it. Expert questionnaire and Fuzzy Delphi method were applied. Firstly, in order to ensure the indicators in accordance with the practice of early education, 16 experts were invited as respondents to a preliminary Expert Questionnaire about Quality Evaluation Indicators of Early Education Center for 0~3 Years Old. The indicators were based on relevant studies on quality evaluation indicators of early education centers in China and abroad. Secondly, 20 scholars, kindergarten principals, and educational administrators were invited to form a fuzzy Delphi expert team. The experts’ opinions on the importance of indicators were calculated through triangle fuzzy numbers in order to select appropriate indicators and calculate indicator weights. This procedure resulted in the final Quality Evaluation Indicators of Early education Center for 0~3 Years Old. The Indicators contained three major levels, including 6 first-level indicators, 30 second-level indicators, and 147 third-level indicators. The 6 first-level indicators were health and safety; educational and cultivating activities; development of babies; conditions of the center; management of the center; and collaboration between family and the community. The indicators established by this study could provide suggestions for the high-quality environment for promoting the development of early year children.

Keywords: early education center for 0~3 years old, educational management, fuzzy delphi method, quality evaluation indicator

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Authors: N. R. N. Mendis, S. N. Silva

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Introduction: Patient satisfaction of services provided by primary care health services depends on many factors. One key factor in this depends on is the nursing services received in primary care. Since majority of the primary care in Sri Lanka is provided by the private sector, it is important to assess patient satisfaction on this. Objective: To assess the satisfaction among the public on nurses working in dispensaries in Sri Lanka. Methods: A descriptive study was done on 200 individual selected using convenient sampling among dispensaries in Gampaha district, Sri Lanka. Results: 59.3% of the sample had long term illnesses or disabilities and all of them preferred speaking to a nurse. 70.9% of the sample used to make appointments with nurses while 57.8% out of them were comfortable in discussing their health concerns. 98.9 % agreed that they get individual attention by the nurses. Majority of the sample that is 34.2% spends around 20 minutes with the nurse without even making any pay. Significantly, the whole sample believes that the nurses are professional and admits that the care given is of high quality. All 100% of the sample said that the nurses could understand their concerns while 93.5% admitted that it was very useful in their recovery. Conclusions: Majority of the public were very much satisfied with the nurses and their practice at the dispensaries.

Keywords: health education, nurses practices, patient satisfaction, primary care

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Authors: Joseph Reylan Viray, Kriztine R. Viray

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Call center conversations, more than the business dimensions that they normally manifest, are interactions between human beings. These are communication exchanges that are packed with psychological, cultural and social dimensions that affect the specific experience of the parties. The increasing development of information and communication technology over the past decades brought about important advantages and corresponding disadvantages in the process of communicational transactions in call center industry. It has been established that the technology is so powerful that it strongly affects, among others, call center business. In the present study, the author explores the interplay between the technology being utilized by the industry and the cultural orientations of both the call center agents and their customers in the process of communication exchanges. Specifically, the paper seeks to (1) describe the interplay between culture and technology in inbound call center industry as it affects the communication exchange of the agents and customers; (2) understand the nature and the dynamics of the call center industry as regards the cultural dimensions of Hofstede; and (3) come up with a simple study where the cross-cultural aspect of the call center industry could be highlighted and could provide necessary knowledge to the stakeholders. Cognizant of the complexity of the topic, the researchers employed Hofstede's cultural dimensions. Likewise, another theory that was used in this study is the Computer Mediated Communication Theory.

Keywords: call center industry, culture, Hofstede, CMT, technology

Procedia PDF Downloads 316