Search results for: service
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3528

Search results for: service

798 Completion of the Modified World Health Organization (WHO) Partograph during Labour in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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797 Reality Shock Affecting the Motivation to Work of New Flight Attendants: An Exploratory Qualitative Study of Flight Attendants Who Left Their Jobs Early

Authors: Hiromi Takafuji

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Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.

Keywords: reality shock, flight attendant, early turnover, qualitative study

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796 A Needs-Based Top-Down Approach for a Tailor-Made Smart City Roadmap

Authors: Mustafa Eruyar, Ersoy Pehlivan, Fatih Kafalı, Fatih Gundogan

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All megacities are not only under the pressure of common urbanization and growth problems but also dealing with different challenges according to their specific circumstances. However, the majority of cities focuses mainly on popular smart city projects, which are usually driven by strong private sector, regardless of their characteristics, each city needs to develop customized projects within a tailor-made smart city roadmap to be able to solve its own challenges. Smart city manifest, helps citizens to feel the action better than good reading smart city vision statements, which consists of five elements; namely purpose, values, mission, vision, and strategy. This study designs a methodology for smart city roadmap based on a top-down approach, breaking down of smart city manifest to feasible projects for a systematic smart city transformation. This methodology was implemented in Istanbul smart city transformation program which includes smart city literature review, current state analysis, roadmap, and architecture projects, respectively. Istanbul smart city roadmap project followed an extensive literature review of certain leading smart cities around the world and benchmarking of the city’s current state using well known smart city indices. In the project, needs of citizens and service providers of the city were identified via stakeholder, persona and social media analysis. The project aimed to develop smart city projects targeting fulfilling related needs by implementing a gap analysis between current state and foreseen plans. As a result, in 11 smart city domains and enablers; 24 strategic objectives, 50 programs, and 101 projects were developed with the support of 183 smart city stakeholder entities and based on 125 citizen persona profiles and last one-year social media analysis. In conclusion, the followed methodology helps cities to identify and prioritize their needs and plan for long-term sustainable development, despite limited resources.

Keywords: needs-based, manifest, roadmap, smart city, top-down approach

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795 People Vote with Their Feet: The 'Parallel Polis' in South Africa as a Reaction to the Neo-Patrimonial State

Authors: A. Kok

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The South African experience of the general upsurge in protest movements internationally is characterised by a tension between a neo-patrimonial state on the one hand, and a society with growing middle-class needs and interests on the other. This tension translates into local community service delivery protests – often violent in nature – that have been steadily increasing in number since 2008, student uprisings that have reached their height in October 2015, and various continuing local social #MustFall movements that are geared towards addressing government corruption and transforming neo-liberal structures. As a result, growing citizen (and non-citizen) revolt in South Africa has seen the (i) creeping securitization of the neo-patrimonial state and (ii) the 'top-down' misuse of a current 'bottom-up' people’s ideology, decoloniality, in an attempt by a faction in the ruling party (representing the neo-patrimonial state) to legitimize its actions and consolidate its power. The neo-patrimonial state’s creeping securitization and ideological positioning lead to a further mistrust of public institutions, people’s disengagement with traditional politics, and the creation of a 'parallel polis' by citizens and non-citizens that bypasses the official and oftentimes corrupt structures of the state. By applying the concept 'parallel polis' – originally developed by Václav Benda in connection with the movement Charter 77 in former Czechoslovakia – to a South African case study, it is illustrated that, even in the absence of overt oppression and the use of terror by a ruling elite, entrenched neo-patrimonialism can be potent enough to fuel the creation of various independent parallel public spheres (or, as a whole, understood as a 'parallel polis') to bypass dysfunctional state channels. A flourishing parallel polis offers possibilities for political, social and economic renewal. This is especially relevant in the consolidation of South Africa’s relatively young democracy.

Keywords: decoloniality, neo-patrimonialism, 'parallel polis', protest movements, South Africa, state securitization

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794 Female Sex Workers and Their Association with Self-Help Groups in Thane, Maharashtra, India: A Comparative Analysis in the Context of HIV Program Outcome

Authors: Awdhesh Yadav, P. S. Saravanamurthy, Shaikh Tayyaba, Uma Shah, Ashok Agarwal

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Objectives: HIV interventions in India has leveraged Self-Help Group (SHG) as one of the key strategies under structural intervention to empower female sex workers (FSW) to reduce their risk exposure and vulnerability to STI/HIV. Understanding the role of SHGs in light of the evolving dynamics of sex work needs to be delved into to strategize HIV interventions among FSWs in India. This paper aims to study the HIV program outcome among the FSWs associated with SHGs and FSWs not associated with SHGs in Thane, Maharashtra. Study Design: This cross-sectional study, was undertaken from the Behavioral Tracking Survey (BTS) conducted among 503 FSWs in Thane in 2015. Two-stage probability based conventional sampling was done for selection of brothel and bar based FSWs, while Time Location Cluster (TLC) sampling was done for home, lodge and street-based sex workers. Methods: Bivariate and multivariate logistic regression were performed to compare and contrast between FSWs associated with SHG and those not associated with SHG with respect to the utilization of HIV related services by them. ‘Condom use’, ‘consistent condom use’, ‘contact with peer-educators’, ‘counseling sessions’ and ‘HIV testing’ were chosen as indicators on HIV service utilization. Results: 8% (38) of FSWs are registered with SHG; 92% aged ≥ 25 years, 47% illiterate, and 71% are currently married. The likelihood of utilizing HIV services including, knowledge on HIV/AIDS and its mode of transmission (OR:5.54; CI: 1.87-16.60; p < 0.05),accessed drop-in Centre (OR: 6.53; CI: 2.15-19.88; p < 0.10), heard about joint health camps (OR: 4.71; CI:2.12-10.46); p < 0.05), negotiated or stood up against police/broker/local goonda/clients (OR: 2.26; CI: 1.08-4.73; p < 0.05), turned away clients when they refused to use condom during sex (OR: 3.76; CI: 1.27-11.15; p < 0.05) and heard of ART (OR; 4.55; CI: 2.18-9.48; p < 0.01) were higher among FSWs associated with SHG in comparison to FSWs not associated with SHG. Conclusions: Considering the improved HIV program outcomes among FSWs associated with SHG; HIV interventions among FSWs could consider facilitating the formation of SHGs with FSWs as one of the key strategies to empower the community for ensuring better program outcomes.

Keywords: empowerment, female sex workers, HIV, Thane, self-help group

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793 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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792 Recreation and Environmental Quality of Tropical Wetlands: A Social Media Based Spatial Analysis

Authors: Michael Sinclair, Andrea Ghermandi, Sheela A. Moses, Joseph Sabu

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Passively crowdsourced data, such as geotagged photographs from social media, represent an opportunistic source of location-based and time-specific behavioral data for ecosystem services analysis. Such data have innovative applications for environmental management and protection, which are replicable at wide spatial scales and in the context of both developed and developing countries. Here we test one such innovation, based on the analysis of the metadata of online geotagged photographs, to investigate the provision of recreational services by the entire network of wetland ecosystems in the state of Kerala, India. We estimate visitation to individual wetlands state-wide and extend, for the first time to a developing region, the emerging application of cultural ecosystem services modelling using data from social media. The impacts of restoration of wetland areal extension and water quality improvement are explored as a means to inform more sustainable management strategies. Findings show that improving water quality to a level suitable for the preservation of wildlife and fisheries could increase annual visits by 350,000, an increase of 13% in wetland visits state-wide, while restoring previously encroached wetland area could result in a 7% increase in annual visits, corresponding to 49,000 visitors, in the Ashtamudi and Vembanad lakes alone, two large coastal Ramsar wetlands in Kerala. We discuss how passive crowdsourcing of social media data has the potential to improve current ecosystem service analyses and environmental management practices also in the context of developing countries.

Keywords: coastal wetlands, cultural ecosystem services, India, passive crowdsourcing, social media, wetland restoration

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791 Motivation in Online Instruction

Authors: David Whitehouse

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Some of the strengths of online teaching include flexibility, creativity, and comprehensiveness. A challenge can be motivation. How can an instructor repeating the same lessons over and over, day in and day out, year after year, maintain motivation? Enthusiasm? Does motivating the student and creating enthusiasm in class build the same things inside the instructor? The answers lie in the adoption of what I label EUQ—The Empathy and Understanding Quotient. In the online environment, students who are adults have many demands on their time: civilian careers, families (spouse, children, older parents), and sometimes even military service. Empathetic responses on the part of the instructor will lead to open and honest communication on the part of the student, which will lead to understanding on the part of the instructor and a rise in motivation in both parties. Understanding the demands can inform an instructor’s relationship with the student throughout the temporal parameters of classwork. In practicing EUQ, instructors can build motivation in their students and find internal motivation in an enhanced classroom dynamic. The presentation will look at what motivates a student to accomplish more than the minimum required and how that can lead to excellent results for an instructor’s own motivation. Through direct experience of having students give high marks on post-class surveys and via direct messaging, the presentation will focus on how applying EUQ in granting extra time, searching for intent while grading, communicating with students via Quick Notes, responses in Forums, comments in Assignments, and comments in grading areas - - - how applying these things infuses enthusiasm and energy in the instructor which drive creativity in teaching. Three primary ways of communicating with students will be given as examples. The positive response and negative response each for a Forum, an Assignment, and a Message will be explored. If there is time, participants will be invited to craft their own EUQ responses in a role playing exercise involving two common classroom scenarios—late work and plagiarism.

Keywords: education, instruction, motivation, online, teaching

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790 Measuring the Unmeasurable: A Project of High Risk Families Prediction and Management

Authors: Peifang Hsieh

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The prevention of child abuse has aroused serious concerns in Taiwan because of the disparity between the increasing amount of reported child abuse cases that doubled over the past decade and the scarcity of social workers. New Taipei city, with the most population in Taiwan and over 70% of its 4 million citizens are migrant families in which the needs of children can be easily neglected due to insufficient support from relatives and communities, sees urgency for a social support system, by preemptively identifying and outreaching high-risk families of child abuse, so as to offer timely assistance and preventive measure to safeguard the welfare of the children. Big data analysis is the inspiration. As it was clear that high-risk families of child abuse have certain characteristics in common, New Taipei city decides to consolidate detailed background information data from departments of social affairs, education, labor, and health (for example considering status of parents’ employment, health, and if they are imprisoned, fugitives or under substance abuse), to cross-reference for accurate and prompt identification of the high-risk families in need. 'The Service Center for High-Risk Families' (SCHF) was established to integrate data cross-departmentally. By utilizing the machine learning 'random forest method' to build a risk prediction model which can early detect families that may very likely to have child abuse occurrence, the SCHF marks high-risk families red, yellow, or green to indicate the urgency for intervention, so as to those families concerned can be provided timely services. The accuracy and recall rates of the above model were 80% and 65%. This prediction model can not only improve the child abuse prevention process by helping social workers differentiate the risk level of newly reported cases, which may further reduce their major workload significantly but also can be referenced for future policy-making.

Keywords: child abuse, high-risk families, big data analysis, risk prediction model

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789 The Optimization of Sexual Health Resource Information and Services for Persons with Spinal Cord Injury

Authors: Nasrin Nejatbakhsh, Anita Kaiser, Sander Hitzig, Colleen McGillivray

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Following spinal cord injury (SCI), many individuals experience anxiety in adjusting to their lives, and its impacts on their sexuality. Research has demonstrated that regaining sexual function is a very high priority for individuals with SCI. Despite this, sexual health is one of the least likely areas of focus in rehabilitating individuals with SCI. There is currently a considerable gap in appropriate education and resources that address sexual health concerns and needs of people with spinal cord injury. Furthermore, the determinants of sexual health in individuals with SCI are poorly understood and thus poorly addressed. The purpose of this study was to improve current practices by informing a service delivery model that rehabilitation centers can adopt for appropriate delivery of their services. Methodology: We utilized qualitative methods in the form of a semi-structured interview containing open-ended questions to assess 1) sexual health concerns, 2) helpful strategies in current resources, 3) unhelpful strategies in current resources, and 4) Barriers to obtaining sexual health information. In addition to the interviews, participants completed surveys to identify socio-demographic factors. Data gathered was coded and evaluated for emerging themes and subthemes through a ‘code-recode’ technique. Results: We have identified several robust themes that are important for SCI sexual health resource development. Through analysis of these themes and their subthemes, several important concepts have emerged that could provide agencies with helpful strategies for providing sexual health resources. Some of the important considerations are that services be; anonymous, accessible, frequent, affordable, mandatory, casual and supported by peers. Implications: By incorporating the perspectives of individuals with SCI, the finding from this study can be used to develop appropriate sexual health services and improve access to information through tailored needs based program development.

Keywords: spinal cord injury, sexual health, determinants of health, resource development

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788 An Experience of HIV Testing and Counseling Services at a Tertiary Care Center of Bangladesh

Authors: S. M. Rashed Ul Islam, Shahina Tabassum, Afsana Anwar Miti

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Objective: HIV testing and counseling center (HTC) is an important component of the HIV/AIDS detection, prevention and control interventions. The service was first initiated at the Department of Virology, Bangabandhu Sheikh Mujib Medical University (BSMMU) since the first case detection in 1989. The present study aimed to describe the demographic profile among the attendees tested HIV positive. Methods: The present study was carried out among 219 HIV positive cases detected through screening at the Department of Virology of BSMMU during the year of 2012-2016. Data were collected through pre-structured written questionnaire during the counseling session. Data were expressed as frequency and percentages and analyzed using SPSS v20.0 program. Results: Out of 219 HIV cases detected, 77.6% were males, and 22.4% were females with a mean age (mean±SD) of 35.46±9.46 years. Among them, 70.7% belonged to the 26-45 age groups representing the sexually active age. The majority of the cases were married (86.3%) and 49.8% had primary level of education whereas, 8.7% were illiterate. Nearly 42% of cases were referred from Chittagong division (south-east part of the country) followed by Dhaka division (35.6%). The bulk of study population admitted to involvement in high-risk behaviour (90%) in the past and 42% of them had worked overseas. The Pearson Chi-square (χ2) analysis revealed significant relationship of gender with marital (χ2=7.88 at 2% level) and occupation status (χ2=120.48 at 6% level); however, no association was observed with risk behaviour and educational status. Recommendations: HIV risk behavior was found to be a prime source for HIV infection among the study population. So, there is need for health education and awareness program to bring about behavioral changes to halt the yearly increase of new cases in the country with special attention to our overseas workers on HIV/AIDS risk and safety.

Keywords: Bangladesh, health education, HIV testing and counseling (HTC), HIV/AIDS, risk behavior

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787 Regulation, Evaluation and Incentives: An Analysis of Management Characteristics of Nonprofit Organizations in China

Authors: Wuqi Yang, Sufeng Li, Linda Zhai, Zhizhong Yuan, Shengli Wang

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How to assess and evaluate a not-for-profit (NFP) organisation’s performance should be of concern to all stakeholders because, amongst other things, without correctly evaluating its performance might affect an NFP being not able to continue to meet its service objectives. Given the growing importance of this sector in China, more and more existing and potential donors, governments and others are starting to take an increased interest in the financial conditions and performance of NFPs. However, when these various groups look for ways (methods) to assess the performance of NFPs, they find there has been relatively little research conducted into methods for assessing the performance of NFPs in China. Furthermore, there does not appear to have been any research to date into the performance evaluation of Chinese NFPs. The focus of this paper is to investigate how the Chinese government manages and evaluates not-for-profit (NFP) organisations' performances in China. Through examining and evaluating the NFPs in China from different aspects such as business development, mission fulfillment, financial position and other status, this paper finds some institutional constraints currently facing by the NFPs in China. At the end of this paper, a new regulatory framework is proposed for regulators’ considerations. The research methods are based on a combination of a literature review; using Balanced Scorecard to assess NFPs in China; Case Study method is employed to analyse a charity foundation’s performance in Hebei Province and proposing solutions to resolve the current issues and challenges facing by the NFPs. These solutions include: formulating laws and regulations on NFPs; simplifying management procedures, introducing tax incentives, providing financial support and other incentives to support the development of non-profit organizations in China. This study provides the first step towards a greater understanding of the NFP performance evaluation in China. It is expected that the findings and solutions from this study will be useful to anyone involved with the China NFP sector; particularly CEOs, managers, bankers, independent auditors and government agencies.

Keywords: Chinese non-profit organizations, evaluation, management, supervision

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786 Developing a Complete Profile: Vocational Assessment, Rehabilitation, and Management for Adults with Intellectual Disability in India

Authors: Virakti Dhaval Shah

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Advances in technology and the changes in lifestyle and work expectations amid the COVID-19 pandemic are requiring changes to vocational assessment, provision of vocational training, and identification of job matches for individuals with intellectual disability. Vocational assessment involves the assessment of interests, skills, abilities, and strengths/weaknesses, as well as a detailed understanding of healthcare, familial, social, community, workplace-related and policy-level protective and risk factors impacting the individual. In India, vocational assessment procedures such as interviews play a major role in vocational placement today. Unfortunately, many of the most widely used vocational assessment instruments in India were developed in the 1970s to 2000s and have not been revised since. Hence, there is a dire need to update existing tools and prepare a structured approach for vocational service providers to meet the unique employment needs of individuals with intellectual disabilities. To address this need, this project designed a multi-domain assessment toolkit for a structured approach to vocational assessment, training, and job placement for individuals with intellectual disabilities in India. Methods included conducting an empirical review of the available tools currently in use in India for the vocational assessment of persons with intellectual disabilities. Domains addressed in the instrument review were organized into a structured system, and additional items related to contemporary technology, pandemic-related experiences of persons with disabilities, and changes in lifestyle and work expectations due to the pandemic were added. Items assessing behaviors, provision of vocational training, and identification of job matches for individuals with intellectual disabilities were developed. The proposed tool has the potential to benefit organizations working with and preparing individuals with intellectual disabilities to find successful employment by undertaking a structured approach to vocational assessment, rehabilitation, training, and placement. It can be particularly useful for guiding new professionals doing vocational rehabilitation in India.

Keywords: intellectual disability, rehabilitation, vocational assessment, vocational rehabilitation

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785 Factors Affecting Women's Participation in Social, Political and Economic Decision-Making Positions at Kelemwollega Zone, Western Ethiopia

Authors: T. Aragaw, P. Gari

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In spite of social, political, and economic marginalization, women are still considered as the backbone of Ethiopia, one of the least developed countries in the world. The general purpose of this study was to assess factors that affect participation of women in politics, social and economic decisions at Kelem-Wollega Administrative Zone of Oromia Regional State, Ethiopia. Data used in this paper is mainly primary, and a few secondary data were incorporated. Respondents were selected using a systematic random sampling method and were placed questionnaires containing open-ended and closed-ended. Focus group discussion was also used for the study subjects in two offices. According to the information collected from the KWAZ Development and Social Service Office, a total of 18,473 tax-paying employees are present in the Zone, which is 14% of the total population of the Zone. Among the total number of employees in the Zone, 2,617 have been recruited for this study based on the criteria stated. This showed 1.8% of them were comprised of several churches and religious owned integrated development projects in the KWAZ. The 2,103 (80.34%) study participants responded personally, and they completed and returned the questionnaire to the researchers. The study revealed that in public institutions existed in KWAZ, the majority of women were having an educational status of diploma and lower, practicing lower non-decision making and leadership positions. Conclusion: Major barriers hindering women include: Socio-cultural attitudes, lack of necessary experience, education, the burden of domestic responsibilities, and lack of role models of women leaders in the Zone. Empowerment of women via social organizations, critical involvement of the government, and Affirmative action for women is critical. Further research is needed on the scope and challenges in implementing the strategies.

Keywords: women, affirmative action, leadership, empowerment, Ethiopia

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784 An Educational Program Based on Health Belief Model to Prevent Non-Alcoholic Fatty Liver Disease among Iranian Women

Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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783 Geospatial Assessment of Waste Disposal System in Akure, Ondo State, Nigeria

Authors: Babawale Akin Adeyemi, Esan Temitayo, Adeyemi Olabisi Omowumi

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The paper analyzed waste disposal system in Akure, Ondo State using GIS techniques. Specifically, the study identified the spatial distribution of collection points and existing dumpsite; evaluated the accessibility of waste collection points and their proximity to each other with the view of enhancing better performance of the waste disposal system. Data for the study were obtained from both primary and secondary sources. Primary data were obtained through the administration of questionnaire. From field survey, 35 collection points were identified in the study area. 10 questionnaires were administered around each collection point making a total of 350 questionnaires for the study. Also, co-ordinates of each collection point were captured using a hand-held Global Positioning System (GPS) receiver which was used to analyze the spatial distribution of collection points. Secondary data used include administrative map collected from Akure South Local Government Secretariat. Data collected was analyzed using the GIS analytical tools which is neighborhood function. The result revealed that collection points were found in all parts of Akure with the highest concentration around the central business district. The study also showed that 80% of the collection points enjoyed efficient waste service while the remaining 20% does not. The study further revealed that most collection points in the core of the city were in close proximity to each other. In conclusion, the paper revealed the capability of Geographic Information System (GIS) as a technique in management of waste collection and disposal technique. The application of Geographic Information System (GIS) in the evaluation of the solid waste management in Akure is highly invaluable for the state waste management board which could also be beneficial to other states in developing a modern day solid waste management system. Further study on solid waste management is also recommended especially for updating of information on both spatial and non-spatial data.

Keywords: assessment, geospatial, system, waste disposal

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782 Investigate the Current Performance of Burger King Ho Chi Minh City in Terms of the Controllable Variables of the Overall Retail Strategy

Authors: Nhi Ngoc Thien

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Franchising is a popular trend in Vietnam retail industry, especially in fast food industry. Several famous foreign fast food brands such as KFC, Lotteria, Jollibee or Pizza Hut invested on this potential market since the 1990s. Following this trend, in 2011, Burger King - the second largest fast food hamburger chain all over the world - entered Vietnam with its first store located in Tan Son Nhat International Airport, with the expectation to become the leading brand in the country. However, the business performance of Burger King was not going well in the first few years making it questioned about its strategy. The given assumption was that its business performance was affected negatively by its store location selection strategy. This research aims to investigate the current performance of Burger King Vietnam in terms of the controllable variables like store location as well as to explore the key factors influencing customer decision to choose Burger King. Therefore, a case study research method was conducted to approach deeply on the opinions and evaluations of 10 Burger King’s customers, Burger King's staffs and other fast food experts on Burger King’s performance through in-depth interview, direct observation and documentary analysis. Findings show that there are 8 determinants affecting the decision-making of Burger King’s customers, which are store location, quality of food, service quality, store atmosphere, price, promotion, menu and brand reputation. Moreover, findings present that Burger King’s staffs and fast food experts also mentioned the main problems of Burger King, which are about store location and food quality. As a result, there are some recommendations for Burger King Vietnam to improve its performance in the market and attract more Vietnamese target customers by giving suitable promotional activities among its customers and being differentiated itself from other fast food brands.

Keywords: overall retail strategy, controllable variables, store location, quality of food

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781 Hospital Acquired Bloodstream Infections Among Patients With Hematological and Solid Malignancies: Epidemiology, Causative Pathogens and Mortality

Authors: Marah El-Beeli, Abdullah Balkhair, Zakaryia Al Muharmi, Samir Al Adawi, Mansoor Al-Jabri, Abdullah Al Rawahi, Hazaa Al Yahyae, Eman Al Balushi, Yahya M. Al-Farsi

Abstract:

The health care service and the anticancer chemotherapeutics has changed the natural history of cancer into manageable chronic disease and improve the cancer patient’s lifestyle and increase the survival time. Despite that, still, infection is the major dilemma opposing the cancer patient either because of the clinical presentation of the cancer type and impaired immune system or as a consequence of anticancer therapy. This study has been conducted to1) track changes in the epidemiology of hospital-acquired bloodstream infections among patients with malignancies in the last five years. 2) To explore the causative pathogens and 3) the outcome of HA-BSIs in patients with a different types of malignancies. An ampi-directional study (retrospective and prospective follow up) of patients with malignancies admitted at Sultan Qaboos University hospital (570-bed tertiary hospital) during the study period (from January 2015 to December 2019). The cumulative frequency and prevalence rates of HA-BSIs by patients and isolates were calculated. In addition, the cumulative frequency of participants with single versus mixed infections and types of causative micro-organisms of HA-BSIs were obtained. A total of 1246 event of HA-BSIs has occurred during the study period. Nearly the third (30.25%) of the HA-BSI events was identified among 288 patients with malignancies. About 20% of cases were mixed infections (more than one isolate). Staphylococcus spp were the predominant isolated pathogen (24.7%), followed by Klebsiella spp (15.8%), Escherichia spp (13%), and Pseudomonas spp (9.3%). About half (51%) of cases died in the same year, and (64%) of the deaths occur within two weeks after the infection. According to the observations, no changes in the trends of epidemiology, causative pathogens, morbidity, and mortality rates in the last five years.

Keywords: epidemiology, haematological malignancies, hospital acquired bloodstream infections, solid malignancies

Procedia PDF Downloads 113
780 Giving Right-of-Way to Emergency Ambulances: Attitude and Behavior of Road Users in Developing Countries

Authors: Mahmoud T. Alwidyan, Ahmad Alrawashdeh, Alaa O. Oteir

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Background: Emergency medical service (EMS) providers, oftentimes, use the lights and sirens (L&S) of their ambulances to warn road users, navigate through traffic, and expedite transport to save lives of ill and injured patients. Despite the contribution of road users in the effectiveness of reducing transport time of EMS ambulances using L&S, there is a lack of empirical assessments exploring the road user’s attitude and behavior in such situations. This study, therefore, aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey developed and distributed to adult road users in Northern Jordan. The questionnaire included 20 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were complete and appropriate for analysis. The mean age was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) in our sample would perform inappropriate action in response to EMS ambulances with L&S in use. The multivariate logistic regression model show that being female (OR, 0.63; 95% CI = 0.48-0.81), more educated (OR, 0.68; 95% CI = 0.53-0.86), or public transport driver (OR, 0.55; 95% CI = 0.34-0.90) is significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as crossing red traffic lights or following the passing by EMS ambulances, which would, in turn, increase the risk on ambulances and other road users. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances, and many engage in risky driving behaviors due perhaps to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior, which, in turn, improves the efficiency of ambulance services.

Keywords: EMS ambulances, lights and sirens, road users, attitude and behavior

Procedia PDF Downloads 52
779 Dutch Disease and Industrial Development: An Investigation of the Determinants of Manufacturing Sector Performance in Nigeria

Authors: Kayode Ilesanmi Ebenezer Bowale, Dominic Azuh, Busayo Aderounmu, Alfred Ilesanmi

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There has been a debate among scholars and policymakers about the effects of oil exploration and production on industrial development. In Nigeria, there were many reforms resulting in an increase in crude oil production in the recent past. There is a controversy on the importance of oil production in the development of the manufacturing sector in Nigeria. Some scholars claim that oil has been a blessing to the development of the manufacturing sector, while others regard it as a curse. The objective of the study is to determine if empirical analysis supports the presence of Dutch Disease and de-industrialisation in the Nigerian manufacturing sector between 2019- 2022. The study employed data that were sourced from World Development Indicators, Nigeria Bureau of Statistics, and the Central Bank of Nigeria Statistical Bulletin on manufactured exports, manufacturing employment, agricultural employment, and service employment in line with the theory of Dutch Disease using the unit root test to establish their level of stationarity, Engel and Granger cointegration test to check their long-run relationship. Autoregressive. Distributed Lagged bound test was also used. The Vector Error Correction Model will be carried out to determine the speed of adjustment of the manufacturing export and resource movement effect. The results showed that the Nigerian manufacturing industry suffered from both direct and indirect de-industrialisation over the period. The findings also revealed that there was resource movement as labour moved away from the manufacturing sector to both the oil sector and the services sector. The study concluded that there was the presence of Dutch Disease in the manufacturing industry, and the problem of de-industrialisation led to the crowding out of manufacturing output. The study recommends that efforts should be made to diversify the Nigerian economy. Furthermore, a conducive business environment should be provided to encourage more involvement of the private sector in the agriculture and manufacturing sectors of the economy.

Keywords: Dutch disease, resource movement, manufacturing sector performance, Nigeria

Procedia PDF Downloads 43
778 An Investigation into the Decision-Making Process of Choosing Long-Term Care Services in Taiwan

Authors: Yu-Ching Liu

Abstract:

Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.

Keywords: family caregiver, Long-term care, work-life balance, decision-making

Procedia PDF Downloads 156
777 Vulnerability Assessment of Healthcare Interdependent Critical Infrastructure Coloured Petri Net Model

Authors: N. Nivedita, S. Durbha

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Critical Infrastructure (CI) consists of services and technological networks such as healthcare, transport, water supply, electricity supply, information technology etc. These systems are necessary for the well-being and to maintain effective functioning of society. Critical Infrastructures can be represented as nodes in a network where they are connected through a set of links depicting the logical relationship among them; these nodes are interdependent on each other and interact with each at other at various levels, such that the state of each infrastructure influences or is correlated to the state of another. Disruption in the service of one infrastructure nodes of the network during a disaster would lead to cascading and escalating disruptions across other infrastructures nodes in the network. The operation of Healthcare Infrastructure is one such Critical Infrastructure that depends upon a complex interdependent network of other Critical Infrastructure, and during disasters it is very vital for the Healthcare Infrastructure to be protected, accessible and prepared for a mass casualty. To reduce the consequences of a disaster on the Critical Infrastructure and to ensure a resilient Critical Health Infrastructure network, knowledge, understanding, modeling, and analyzing the inter-dependencies between the infrastructures is required. The paper would present inter-dependencies related to Healthcare Critical Infrastructure based on Hierarchical Coloured Petri Nets modeling approach, given a flood scenario as the disaster which would disrupt the infrastructure nodes. The model properties are being analyzed for the various state changes which occur when there is a disruption or damage to any of the Critical Infrastructure. The failure probabilities for the failure risk of interconnected systems are calculated by deriving a reachability graph, which is later mapped to a Markov chain. By analytically solving and analyzing the Markov chain, the overall vulnerability of the Healthcare CI HCPN model is demonstrated. The entire model would be integrated with Geographic information-based decision support system to visualize the dynamic behavior of the interdependency of the Healthcare and related CI network in a geographically based environment.

Keywords: critical infrastructure interdependency, hierarchical coloured petrinet, healthcare critical infrastructure, Petri Nets, Markov chain

Procedia PDF Downloads 493
776 Effect of Agricultural Extension Services on Technical Efficiency of Smallholder Cassava Farmers in Ghana: A Stochastic Meta-Frontier Analysis

Authors: Arnold Missiame

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In Ghana, rural dwellers who depend primarily on agriculture for their livelihood constitute about 60% of the country’s population. This shows the critical role and potentials of the agricultural sector in helping to achieve Ghana’s vision 2030. With the current threat of climate change and advancements in technology, agricultural extension is not just about technology transfer and improvements in productivity, but it is also about improving the managerial and technical skills of farmers. In Ghana, the government of Ghana as well as other players in the sector like; non-governmental organizations, NGOs, local and international funding agencies, for decades now, have made capacity-building-investments in smallholder farmers by way of extension services delivery. This study sought to compare the technical efficiency of farmers who have access to agricultural extension and farmers who do not in Ghana. The study employed the stochastic meta-frontier model to analyze household survey data comprising 300 smallholder cassava farmers from the Fanteakwa district of Ghana. The farmers were selected through a two-stage sampling technique where 5 communities were purposively selected in the first stage and then 60 smallholder cassava farmers were randomly selected from each of the 5 communities. Semi-structured questionnaires were used to collect data on farmers’ socioeconomic and farm-level characteristics. The results showed that farmers who have access to agricultural extensions services have higher technical efficiencies (TE) and produce much closer to their meta-production frontiers (higher technology gap ratios (TGR) than farmers who do not have access to such extension services. Furthermore, experience in cassava cultivation and formal education significantly improves the technical efficiencies of farmers. The study recommends that the mode and scope of agricultural extension service delivery in the country should be enhanced to ensure that smallholder farmers have easy access to extension agents.

Keywords: agricultural extension, Ghana, smallholder farmers, stochastic meta-frontier model, technical efficiency

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775 Variability of Energy Efficiency with the Application of Technologies Embedded in Locomotives of a Heavy Haul Railway: Case Study of Vitoria Minas Railway, Brazil

Authors: Eric Wilson Santos Cabral, Marta Monteiro Da Costa Cruz, Rodrigo Pirola Pestana, Vivian Andréa Parreira

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In the transportation sector in Brazil, there is a great challenge that is the maintenance of profit in the face of the great variation in the price of diesel. This directly affects the variable cost of transport companies. Within the railways, part of the great challenges is to overcome the annual budget, cargo and ore transported, thus reducing costs compared to previous years, becoming more efficient each year. Within this scenario, the railway companies are looking for effective measures, aiming at reducing the ratio of liter of diesel consumed by KTKB (Kilometer Gross Ton multiplied by thousand). This ratio represents the indicator of energy efficiency of some railroads in Brazil and in other countries. In this study, we sought to analyze the behavior of the energy efficiency indicator on two parts: The first, with the application of technologies used in locomotives, such as the start-stop system of the diesel engine and the system of tracking and monitoring of fuel. The second, evaluation of the behavior of the variation of the type of cargo transported (loading mix). The study focused on locomotive technology will be carried out using statistical analysis, behavioral evaluation in different operating conditions, such as maneuvers for trains, service trains and freight trains. The analysis will also cover the evaluation of the loading mix made using statistical analysis of the existing railroad database, comparing the energy efficiency per loading mine and type of product. With the completion of this study, the railway undertakings should be able to better target decision-making in order to achieve substantial reductions in transport costs.

Keywords: railway transport, energy efficiency, railway technology, fuel consumption

Procedia PDF Downloads 273
774 GIS Based Spatial Modeling for Selecting New Hospital Sites Using APH, Entropy-MAUT and CRITIC-MAUT: A Study in Rural West Bengal, India

Authors: Alokananda Ghosh, Shraban Sarkar

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The study aims to identify suitable sites for new hospitals with critical obstetric care facilities in Birbhum, one of the vulnerable and underserved districts of Eastern India, considering six main and 14 sub-criteria, using GIS-based Analytic Hierarchy Process (AHP) and Multi-Attribute Utility Theory (MAUT) approach. The criteria were identified through field surveys and previous literature. After collecting expert decisions, a pairwise comparison matrix was prepared using the Saaty scale to calculate the weights through AHP. On the contrary, objective weighting methods, i.e., Entropy and Criteria Importance through Interaction Correlation (CRITIC), were used to perform the MAUT. Finally, suitability maps were prepared by weighted sum analysis. Sensitivity analyses of AHP were performed to explore the effect of dominant criteria. Results from AHP reveal that ‘maternal death in transit’ followed by ‘accessibility and connectivity’, ‘maternal health care service (MHCS) coverage gap’ were three important criteria with comparatively higher weighted values. Whereas ‘accessibility and connectivity’ and ‘maternal death in transit’ were observed to have more imprint in entropy and CRITIC, respectively. While comparing the predictive suitable classes of these three models with the layer of existing hospitals, except Entropy-MAUT, the other two are pointing towards the left-over underserved areas of existing facilities. Only 43%-67% of existing hospitals were in the moderate to lower suitable class. Therefore, the results of the predictive models might bring valuable input in future planning.

Keywords: hospital site suitability, analytic hierarchy process, multi-attribute utility theory, entropy, criteria importance through interaction correlation, multi-criteria decision analysis

Procedia PDF Downloads 26
773 Prevalence of Down Syndrome: A Single-Center Study in Bandung, Indonesia

Authors: Bremmy Laksono, Riksa Parikrama, Nur A. Rosyada, Willyanti Soewondo, Dadang S. H. Effendi, Eriska Rianti, Arlette S. Setiawan, Ine Sasmita, Risti S. Primanti, Erna Kurnikasari, Yunia Sribudiani

Abstract:

Down syndrome (DS) is a chromosomal abnormality characterised by complete 21 chromosome trisomy (classical or non-disjunction), or partial 21 chromosome trisomy (mosaicism), or chromosome rearrangement involving chromosome 21 (translocation). This study was carried out to describe the frequency of DS patients in a research institution in the city of Bandung, Indonesia. This descriptive study also provides a picture of the residential location and surrounding area of their dwellings. This study involved people with DS in various age whose chromosome were evaluated by conventional karyotyping method and FISH. Data were collected from 60 patients with DS from a total 150 patients during the period of September 2015 to August 2016 who were referred to Cell Culture and Cytogenetics Laboratory, Faculty of Medicine Universitas Padjadjaran, Indonesia. Results showed that the most common type of DS was non-disjunction (93%), followed by mosaicism (5%), no patient with translocation DS (0%), and a very rare type of tetrasomy 21 (2%). There were 39 males (65%) and 21 females (35%) of DS patient. Most of them live in suburban area beyond Bandung city (55%) while the rest live inside urban area of Bandung city (45%). They live mostly in dense area of greater Bandung area (65%) and only a few live in mid-density area (25%) and the least live in sparse populated area (10%). Their houses are mostly located in residential estate area (55%), nearby industrial area (37%), and around agricultural area (8%). Based on the study, it could be concluded that non-disjunction DS is the most common type. DS patients referred to the laboratory mostly came from dense residential zone in suburban area outside Bandung city. The low number of DS patients referred to the laboratory for chromosome analysis was the highlight to improve health service for people with genetic disorder. This study offered several information regarding area of DS patients’ residence and the condition of neighbourhood in Bandung city where they live as well.

Keywords: chromosome, descriptive, Down syndrome, prevalence

Procedia PDF Downloads 243
772 Students’ Academic and Personal Needs: Basis for a Guidance Program

Authors: Susan Marie R. De La Cruz, Bernadette F. De La Cruz, Georgia D. Demavibas

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This study determined the top 10 perceived students’ academic needs, personal needs, personal obstacles in achieving their academic goals, are as they need assistance, and their perceived feelings in math, reading and writing. The North Carolina State College, Student Support Services needs assessment survey was used. The respondents were the randomly chosen122Graduate school students. The top 10 academic needs are as follows: need to improve memory, communication skills, study habits, time management skills, career decisions, vocabulary, math skills, test taking skills, reading comprehension, and the need to reduce math anxiety. Top 10 personal needs are as follows: difficulty meeting deadline, difficulty managing money, inadequate computer skills, afraid of failing graduate school, difficulty participating in class/group discussions, absence from school, anxiety during exams, little or no experience with internet, personal counseling needs, and unsure of university academic procedures. Students’ top 10 perceived personal obstacles were as follows: issues surrounding sickness in family, lack of time management, lack of money, feeling tired, fears to speak in class, poor study habits, problems at home, late in class, too shy, and always feeling sick and easily distracted. Students felt need assistance in areas surrounding personal budget, stress management, motivation, anxiety, depressions, leadership development and goals/decision making. It is recommended that enrichment activities be provided to respond to students’ academic and personal needs. Also, Graduate School Guidance Counselor collaborates with other licensed Guidance Counselors in other colleges to have a well-coordinated and effective delivery of services responsive to students’ needs.

Keywords: academic needs, guidance counsellors, guidance service, needs assessment survey, personal needs, student services

Procedia PDF Downloads 302
771 Effect of Facilitation in a Problem-Based Environment on the Metacognition, Motivation and Self-Directed Learning in Nursing: A Quasi-Experimental Study among Nurse Students in Tanzania

Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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770 Two Dimensional Numerical Analysis for the Seismic Response of the Geosynthetic-Reinforced Soil Integral Abutments

Authors: Dawei Shen, Ming Xu, Pengfei Liu

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The joints between simply supported bridge decks and abutments need to be regularly repaired, which would greatly increase the cost during the service life of the bridge. Simply supported girder bridges suffered the most severe damage during earthquakes. Another type of bridge, the integral bridge, of which the superstructure and abutment are rigidly connected, was also used in some European countries. Because no bearings or joints exit in the integral bridge, this type of bridge could significantly reduce maintenance requirements and costs. However, conventional integral bridge usually result in high earth pressure on the abutment and surface settlement in the backfill. To solve these problems, a new type of integral bridge, geosynthetic-reinforced soil (GRS) integral bridge, was come up in recent years. This newly invented bridge has not been used in engineering practices. There was a lack of research on the seismic behavior of the conventional and new type of integral abutments. In addition, no common design code could be found for the calculation of seismic pressure of soil behind the abutment. This paper developed a dynamic constitutive model, which can consider the soil behaviors under cyclic loading. Numerical analyses of the seismic response of a full height integral bridge and GRS integral bridge were carried out using the two-dimensional numerical code, FLAC. A parametric study was also performed to investigate the soil-structure interaction. The results are presented below. The seismic responses of GRS integral bridge together with conventional simply supported bridge, GRS conventional bridge and conventional integral bridge were investigated. The results show that the GRS integral bridge holds the highest seismic stability, followed by conventional integral bridge, GRS simply supported bridge and conventional simply supported bridge. Compared with the integral bridge with 1 m thick abutments, the GRS integral bridge with 0.4 m thick abutments is subjected to a smaller bending moment, and the natural frequency and horizontal displacement remains almost the same. Geosynthetic-reinforcement will be more effective when the abutment becomes thinner or the abutment is higher.

Keywords: geosynthetic-reinforced soil integral bridge, nonlinear hysteretic model, numerical analysis, seismic response

Procedia PDF Downloads 435
769 Quality of Life among Female Sex Workers of Selected Organization of Pokhara: A Methodological Triangulation

Authors: Sharmila Dahal Paudel

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Background: There are around twenty-four thousand to twenty-eight thousand Female Sex Workers in Nepal. FSWs are the vulnerable groups for sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) infections which directly and indirectly ease to reduce the quality of life of such groups. Due to their highly marginalized status, FSWs in Nepal have limited access to information about reproductive health and safe sex practices. The objectives of the study are to assess the quality of life of female sex workers and the factors affecting them. Materials and Methods: A descriptive cross-sectional study with methodological triangulation was conducted among 108 FSWs on the basis of service record of selected organization of Pokhara valley. The complete enumerative sampling was used to select FSWs. Structured interview schedule, WHOQOL-BREF and in-depth questionnaire were used to collect the data. The descriptive and inferential statistics were used to interpret the result. Results: The mean age of participants were 23.44 years and the mean quality of life score was 174.06 ranging from 56.54 to 370.78. Among the domain scores, the mean score is highest in social domain (55.89) followed by physical (45.42), psychological (39.27) and the environmental (34.23). Regarding the association of QOL with socio-demographic, occupation and health-related variables, the multi-linear regression suggests that the satisfaction with occupation was highly significant with the total QOL score (B=-50.50, SE=10.46; p= <0.001) and there is negative relation between QOL and feeling of exploitation and facing STI problems. This means those who feels exploited have significantly less QOL comparing with those who did not feel the same. In correlation analysis, all the domains are positively co-related with each domain which is found to be significant at 1% level of significance. Conclusion: The highest mean score was in social domain, and the lowest is in environmental domain which suggests that the items included in environmental domains could not be utilized or hindrance were there.

Keywords: FSWs, HIV, QOL, WHOQOL-BREF

Procedia PDF Downloads 139