Search results for: services provision

Authors: W. Rowan, Y. O’Connor, L. Lynch, C. Heavin

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Situation Awareness can offer the potential for conscious dynamic reflection. In an era of online health data sharing, it is becoming increasingly important that users of health social networks (HSNs) have the information necessary to make informed decisions as part of the registration process and in the provision of eConsent. This research aims to leverage an adapted Situation Awareness (SA) model to explore users’ decision making processes in the provision of eConsent. A HSN platform was used to investigate these behaviours. A mixed methods approach was taken. This involved the observation of registration behaviours followed by a questionnaire and focus group/s. Early results suggest that users are apt to automatically accept eConsent, and only later consider the long-term implications of sharing their personal health information. Further steps are required to continue developing knowledge and understanding of this important eConsent process. The next step in this research will be to develop a set of guidelines for the improved presentation of eConsent on the HSN platform.

Keywords: eConsent, health social network, mixed methods, situation awareness

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Authors: Yan Ding, Fei Yan, Ji Liang, Hong Jiang, Xiaoguang Yang, Xu Qian

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The health status of GonjiKolela District, Amhara Region, Ethiopia is below its national average, and a sub-project of China UK Global Health Support Programme (GHSP) is expected to increase the uptake of a suite of reproductive, maternal, newborn and child health (RMNCH) interventions there. To explore what is on the ground and what could be helpful for the uptake of RMNCH services in GonjiKolela, a qualitative study was performed as part of the baseline assessment before the implementation of the project. Nine key informants from GonjiKolela were interviewed with self-designed interview guides and they were from the district Health Office, health centers, health posts, women health development army (community volunteer groups), mothers of newborns, and also a gynecologist from the maternal and child health center which is the referral center for pregnant women for this project. The interview were transcribed into words and sorted with qualitative analysis software MAXqda. Content analysis was mainly used to analyze the data. The district health office, the health centers and the health posts all had focal persons taking care of the management and provision of RMNCH services, and RMNCH related indicators were recorded and reported at each level routinely. In addition, district government and administration at community/administrative village level kept a close eye on the reduction of maternal, neonatal and child mortality. Women Health Development Amy at household level supported health workers at community/administrative village level (called health extension workers) in tracing, recording and reporting pregnant women, newborn and under-five children,organizing events for health education, demonstrating and leading health promotion activities, and stimulating the utilization of RMNCH.

Keywords: Reproductive Maternal Newborn and Child Health, Health Care Utilization, Qualitative Study, Ethiopia

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Peninah Agaba, Monica Magadi, Bev Orton

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Uganda is one of the countries with high maternal mortality (336/100,000) where adolescents account for 24 percent of the total maternal deaths. Research shows that use of maternal health services may prevent some of these deaths and good provider attitudes attract adolescents to use the services. However, poor health provider’s attitudes discourage adolescents from seeking the services during the maternity period. This study explores the experiences of unmarried female adolescents at the health facilities during the maternity period. The study population is unmarried adolescent girls aged 10-19 years who were pregnant or had given birth within three years before the interview. This is a special interest group that requires attention throughout this period. Most of the pregnancies among unmarried adolescents are unwanted; as a result, many of them have been abused and neglected by parents and close family members including partners who deny fatherhood of the pregnancy/child. These adolescents hope to find comfort from health providers like being listened to during counseling, not abused and judged; unfortunately this is not the case always. The research was approved by the University of Hull, School of Education and Social Sciences ethics review committee, Mildmay Uganda Research Ethics Committee and Uganda National Council of Science and Technology. The study was carried out in Bushenyi and Kibale districts in Western Uganda. Fourteen in-depth interviews and seven focus group discussions were completed in the local languages and later transcribed to English language. Thematic analysis to identify the themes was done. Adolescents were aged 16-19 years, two had become pregnant before 15 years. Most had not completed secondary education; none had tertiary education and three of the 14 IDI adolescent participants wanted to get pregnant. Analysis shows varied experiences; most adolescents were abused verbally and physically by the health providers due to their young age of pregnancy, lack of essential items during this period (maternity dresses, children clothes, delivery kit) and fear of labour pains. Another cause for abuse was these adolescents coming for antenatal care with no partners yet the implementation of a policy on increasing male involvement in reproductive health in Uganda requires them to attend antenatal care with their partners and most of these unmarried adolescents have no partners to accompany them. Despite the above challenges, the study also identified the care some of these unmarried adolescents received during the maternity visits for example they were not abused, were provided with appropriate information and supported with child care. The study identified abuse and support the unmarried adolescents received during the maternity period. Efforts to provide adolescents with adequate information including what to expect during labour by providers and provision of basic needs are essential. Health providers should have trainings on client care especially how to embrace unmarried adolescents when they come to access maternity services. More so, the policy on improving male involvement in RH issues need to be considerate of unmarried adolescents who in most cases do not have the partners to go with to access maternity care.

Keywords: abuse, maternity care, Uganda, unmarried, adolescents

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Authors: Nasser Marshad Alzeer

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This study examines the spatial distribution of secondary schools in Riyadh. It considers both public girls and boys sector provision and assesses the efficiency of the spatial distribution of secondary schools. Since the establishment of the Ministry of Education (MOE) in 1953 and General Presidency for Female Education, (GPFE) in 1960, there has been a great expansion of education services in Saudi Arabia, particularly during the 1980s. However, recent years have seen much slower rates of increase in the public education sector but the population continues to grow rapidly. This study investigates the spatial distribution of schools through the use of questionnaire surveys and applied GIS. Overall, the results indicate a shortage of public secondary schools, especially in the north of the city. It is clear that there is overcrowding in the majority of secondary schools. The establishment of new schools has been suggested to solve the problem of overcrowding. A number of socio-economic and demographic factors are associated with differences in the utilization of the public secondary schools. A GIS was applied in this study in order to assess the spatial distribution of secondary schools including the modification of existing catchment area boundaries and locating new schools. This modification could also reduce the pupil pressure on certain schools and further benefits could probably be gained.

Keywords: analysis, distribution, Saudi, GIS, schools

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Authors: Rashid Javed, Hardy Lehmkuehler, Franz Josef-Behr

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Web Processing Services (WPS) have up growing concern in geoinformation research. However, teaching about them is difficult because of the generally complex circumstances of their use. They limit the possibilities for hands- on- exercises on Web Processing Services. To support understanding however a Training Tools Collection was brought on the way at University of Applied Sciences Stuttgart (HFT). It is limited to the scope of Geostatistical Interpolation of sample point data where different algorithms can be used like IDW, Nearest Neighbor etc. The Tools Collection aims to support understanding of the scope, definition and deployment of Web Processing Services. For example it is necessary to characterize the input of Interpolation by the data set, the parameters for the algorithm and the interpolation results (here a grid of interpolated values is assumed). This paper reports on first experiences using a pilot installation. This was intended to find suitable software interfaces for later full implementations and conclude on potential user interface characteristics. Experiences were made with Deegree software, one of several Services Suites (Collections). Being strictly programmed in Java, Deegree offers several OGC compliant Service Implementations that also promise to be of benefit for the project. The mentioned parameters for a WPS were formalized following the paradigm that any meaningful component will be defined in terms of suitable standards. E.g. the data output can be defined as a GML file. But, the choice of meaningful information pieces and user interactions is not free but partially determined by the selected WPS Processing Suite.

Keywords: deegree, interpolation, IDW, web processing service (WPS)

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Authors: Mokhtar Azizi

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Due to heavy traffic and congested roads, it is crucial that the most popular main public transport services in Kuala Lumpur i.e. Putra LRT, Star LRT, KTM Commuter, KL Monorail and Rapid Bus must be continuously monitored and improved to fulfill the rider’s requirement and kept updated by the transit agencies. Evaluation on the current status of the services has been determined out by calculating the transit supportive area (TSA) and level of service (LOS) for each transit station. This research study has carried out the TSA and LOS mapping based on GIS techniques. The detailed census data of the region along the line of services has been collected from the Department of Statistics Malaysia for this purpose. The service coverage has been decided by 400 meters buffer zone for bus stations and 800 meters for rails station and railways in measurement the Quality of Service along the line of services. All the required information has been calculated by using the customized GIS software called Kuala Lumpur Transit Information System (KLTIS). The transit supportive area was calculated with the employment density at least 10 job/hectare or household density at 7.5 unit/hectare and total area covered by transit supportive area is 22516 hectare and the total area that is not supported by transit is 1718 hectare in Kuala Lumpur. The level of service is calculated with the percentage of transit supportive area served by transit for each station. In overall the percentage transit supportive areas served by transit for all the stations were less than 50% which falls in a very low level of service category. This research has proven its benefit by providing the current transit services operators with vital information for improvement of existing public transport services.

Keywords: service coverage, transit supportive area, level of service, transit system

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Authors: Abu Samah Abdul Khalim, Hamzah Khali Aziz

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Tropical forests in Malaysia safeguard enormous biological diversity while providing crucial benefits and services for the sustainable development of human communities. They are highly significant globally, both for their diverse and threatened species and as representative unique ecosystems. In order to promote the conservation and sustainable management of forest in this country, the Forestry Department (FD) is using ITTO guidelines on managing the forest under the Sustainable Forest Management practice (SFM). The fundamental principles of SFM are the sustained provision of products, goods and services; economic viability, social acceptability and the minimization of environmental/ecological impacts. With increased awareness and recognition of the importance of tropical forests and biodiversity in the global environment, efforts have been made to classify forests and natural areas with unique values or properties in a universally accepted scale. In line with that the concept of High Conservation Value Forest (HCVF) first used by the Forest Stewardship Council (FSC) in 1999, has been adopted and included as Principle ‘9’ in the Malaysia Criteria and Indicators for Forest Management Certification (MC&I 2002). The MC&I 2002 is a standard used for assessing forest management practices of the Forest Management Unit (FMU) level for purpose of certification. The key to the concept of HCVF is identification of HCVs of the forest. This paper highlighted initiative taken by the Forestry Department Peninsular Malaysia in establishing and managing HCVF areas within the Permanent Forest Reserves (PFE). To date almost all states forestry department in Peninsular Malaysia have established HCVFs in their respective states under different categories. Among others, the establishments of HCVF in this country are related to the importance of conserving biological diversity of the flora in the natural forest in particular endemic and threatened species such as Shorea bentongensis. As such it is anticipated that by taking this important initiatives, it will promote the conservation of biological diversity in the PFE of Peninsular Malaysia in line with the Sustainable Forest Management practice.

Keywords: high conservation value forest, sustainable forest management, forest management certification, Peninsular Malaysia

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Authors: K. C. M. Wong, C. P. Y. Cheng, K. Y. Chan, G. S. C. Fung, T. F. O. Lau, K. F. C. Leung, J. P. C. Fok

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Hospital Authority (HA) is the statutory body to manage all public hospitals in Hong Kong. Occupational Care Medicine Service (OMCS) is an in-house multi-disciplinary team responsible for injury management in HA. Hospital administrative services (AS) provides essential support in hospital daily operation to facilitate the provision of quality healthcare services. An occupational health enhancement program in Tai Po Hospital (TPH) domestic service supporting unit (DSSU) was piloted in 2013 with satisfactory outcome, the keys to success were staff engagement and management support. Riding on the success, the program was rolled out to another 5 AS departments of Alice Ho Miu Ling Nethersole Hospital (AHNH) and TPH in 2015. This paper highlights the indispensable components of disability management and occupational health enhancement program in hospital settings. Objectives: 1) Facilitate workplace to support staff with health affecting work problem, 2) Enhance staff’s occupational health. Methodology: Hospital Occupational Safety and Health (OSH) team and AS departments (catering, linen services, and DSSU) of AHNH and TPH worked closely with OMCS. Focus group meetings and worksite visits were conducted with frontline staff engagement. OSH hazards were identified with corresponding OSH improvement measures introduced, e.g., invention of high dusting device to minimize working at height; tailor-made linen cart to minimize back bending at work, etc. Specific MHO trainings were offered to each AS department. A disability management workshop was provided to supervisors in order to enhance their knowledge and skills in return-to-work (RTW) facilitation. Based on injured staff's health condition, OMCS would provide work recommendation, and RTW plan was formulated with engagement of staff and their supervisors. Genuine communication among stakeholders with expectation management paved the way for realistic goals setting and success in our program. Outcome: After implementation of the program, a significant drop of 26% in musculoskeletal disorders related sickness absence day was noted in 2016 as compared to the average of 2013-2015. The improvement was postulated by innovative OSH improvement measures, teamwork, staff engagement and management support. Staff and supervisors’ feedback were very encouraging that 90% respondents rated very satisfactory in program evaluation. This program exemplified good work sharing among departments to support staff in need.

Keywords: disability management, occupational health, return to work, occupational medicine

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Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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Authors: Oluyemi Christianah Ojo

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This study seeks to investigate the quality of ICT provided in the new Caring Heart schools in Ondo State, Nigeria. The population for the study was all caring Heart Mega Schools in Ondo State, Nigeria. Research questions were generated; two instruments CCCMS and TQCUC were used to elicit information from the schools and the teachers. The study adopts descriptive survey approach. The studies revealed and concluded that ICT components were available and adequate in these schools, Charts showing ICT components and other forms of computer devices used as instructional materials were available but were not adequate; teachers teaching computer studies are competent in the delivery of instructions and in handling computer gadgets in the laboratory. The study recommended the provision of steady electricity, uninterrupted internet facilities and provision of adequate ICT components and charts for effective teaching delivery and learning.

Keywords: facilities, information communication technology, mega primary school, primary education

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Authors: Dezhi Li, Peng Cui, Bo Zhang, Tengyuan Chang

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In order to solve the housing problem for the low-income families, the construction of affordable housing is booming in China. However, due to various reasons, the service facilities and systems in the indemnificatory residential community meet many problems. This article established a Satisfaction Evaluation System of the Fundamental Public Services for Large-scale Indemnificatory Residential Community based on the national standards and local criteria and developed evaluation methods and processes. At last, in the case of Huagang project in Nanjing, the satisfaction of basic public service is calculated according to a survey of local residents.

Keywords: indemnificatory residential community, public services, satisfaction evaluation, structural equation modeling

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Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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Authors: Samson Obiene, Khamati Shilabukha, Geoffrey Muga, James Kairo

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Mangroves play a vital role in the achievement of multiple goals of global sustainable development (SDG’s), particularly SDG SDG 14 (life under water). Their management, however, is faced with several shortcomings arising from inadequate knowledge on the perceptions of their ecosystem services, hence a need to map mangrove goods and services within SDGs while interrogating the disaggregated perceptions. This study therefore aimed at exploring the parities and disparities in attitudes and perceptions of mangrove ecosystem services among community members of Vanga and the link of the ecosystem services (ESs) to specific SDG targets. The study was based at the Kenya-Tanzania transboundary area in Vanga; where a carbon-offset project on mangroves is being up scaled. Mixed methods approach employing surveys, focus group discussions (FGDs) and reviews of secondary data were used in the study. A two stage cluster samplings was used to select the study population and the sample size. FGDs were conducted purposively selecting active participants in mangrove related activities with distinct socio-demographic characteristics. Sampled respondents comprised of males and females of different occupations and age groups. Secondary data review was used to select specific SDG targets against which mangrove ecosystem services identified through a value chain analysis were mapped. In Vanga, 20 ecosystem services were identified and categorized under supporting, cultural and aesthetic, provisioning and regulating services. According to the findings of this study, 63.9% (95% ci 56.6-69.3) perceived of the ESs as very important for economic development, 10.3% (95% ci 0-21.3) viewed them as important for environmental and ecological development while 25.8% (95% ci 2.2-32.8) were not sure of any role they play in development. In the social-economic disaggregation, ecosystem service values were found to vary with the level of interaction with the ecosystem which depended on gender and other social-economic classes within the study area. The youths, low income earners, women and those with low education levels were also identified as the primary beneficiaries of mangrove ecosystem services. The study also found that of the 17 SDGs, mangroves have a potential of influencing the achievement 12, including, SDGs 1, 2, 3, 4, 6, 8 10, 12, 13, 14, 15 and 17 either directly or indirectly. Generally therefore, the local community is aware of the critical importance mangroves for enhanced livelihood and ecological services but challenges in sustainability still occur as a result the diverse values and of the services and the contradicting interests of the different actors around the ecosystem. It is therefore important to consider parities in values and perception to avoid a ‘tragedy of the commons’ while striving to enhance sustainability of the Mangrove ecosystem.

Keywords: sustainable development, community values, socio-demographics, Vanga, mangrove ecosystem services

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Authors: Mark Linden, Trisha Forbes, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes

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Background The COVID-19 pandemic resulted in a reduction of health care services for many family carers of people with profound and multiple intellectual disabilities (PMID). Due to lack of services, family carers turned to charities for support during the pandemic. We explored the views of charity workers across the UK and Ireland who supported family carers during the COVID-19 pandemic and explored their views on effective online support programmes for family carers. Methods This was a qualitative study using online focus groups with participants (n = 24) from five charities across the UK and Ireland. Questions focused on challenges, supports, coping and resources which helped during lockdown restrictions. Focus groups were audio recorded, transcribed verbatim, and analysed through thematic analysis. Findings Four themes were identified (i) ‘mental and emotional health’, (ii) ‘they who shout the loudest’ (fighting for services), (iii) ‘lack of trust in statutory services’ and (iv) ‘creating an online support programme’. Mental and emotional health emerged as the most prominent theme and included three subthemes named as ‘isolation’, ‘fear of COVID-19’ and ‘the exhaustion of caring’. Conclusions The withdrawal of many services during the COVID-19 pandemic further isolated and placed strain on family carers. Even after the end of the pandemic family cares continue to report on the struggle to receive adequate support. There is a critical need to design services, including online support programmes, in partnership with family carers which adequately address their needs.

Keywords: intellectual disability, family carers, COVID-19, charities

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Authors: Rhiannon Barker, Gregory Hartwell, Matt Egan, Karen Lock

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Background: Evidence suggests that mental health (MH) issues in children and young people (CYP) in the UK are on the rise. Of particular concern is data that indicates that the pandemic, together with the impact of school closures, have accentuated already pronounced inequalities; children from families on low incomes or from black and minority ethnic groups are reportedly more likely to have been adversely impacted. This study aimed to help identify specific support which may facilitate the building of a positive school climate and protect student mental health, particularly in the wake of school closures following the pandemic. It has important implications for integrated working between schools and statutory health services. Methods: The research comprised of three parts; scoping, case studies, and a stakeholder workshop to explore and consolidate results. The scoping phase included a literature review alongside interviews with a range of stakeholders from government, academia, and the third sector. Case studies were then conducted in two London state schools. Results: Our research identified how student MH was being impacted by a range of factors located at different system levels, both internal to the school and in the wider community. School climate, relating both to a shared system of beliefs and values, as well as broader factors including style of leadership, teaching, discipline, safety, and relationships -all played a role in the experience of school life and, consequently, the MH of both students and staff. Participants highlighted the importance of a whole school approach and ensuring that support for student MH was not separated from academic achievement, as well as the importance of identifying and applying universal measuring systems to establish levels of MH need. Our findings suggest that a school’s climate is influenced by the style and strength of its leadership, while this school climate - together with mechanisms put in place to respond to MH needs (both statutory and non-statutory) - plays a key role in supporting student MH. Implications: Schools in England have a responsibility to decide on the nature of MH support provided for their students, and there is no requirement for them to report centrally on the form this provision takes. The reality on the ground, as our study suggests, is that MH provision varies significantly between schools, particularly in relation to ‘lower’ levels of need which are not covered by statutory requirements. A valid concern may be that in the huge raft of possible options schools have to support CYP wellbeing, too much is left to chance. Work to support schools in rebuilding their cultures post-lockdowns must include the means to identify and promote appropriate tools and techniques to facilitate regular measurement of student MH. This will help establish both the scale of the problem and monitor the effectiveness of the response. A strong vision from a school’s leadership team that emphasises the importance of student wellbeing, running alongside (but not overshadowed by) academic attainment, should help shape a school climate to promote beneficial MH outcomes. The sector should also be provided with support to improve the consistency and efficacy of MH provision in schools across the country.

Keywords: mental health, schools, young people, whole-school culture

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Authors: Haitam Emhemad, Brian Agnew, David Greenwood

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Amongst the many priorities facing Libya following the 2011 uprising is the provision of a transport infrastructure that will meet the nation’s needs and not undermine its prospects for economic prosperity as with many developing economies non-technical issues such as management, planning and financing are the major barriers to the efficient and effective provision of transport infrastructure. This is particularly true in the case of the effective incorporation of sustainability criteria, and the research upon which this paper is based involves the examination of alternative ways of approaching this problem. It is probably fair to say that criteria that relate to sustainability have not, historically, featured strongly in Libya’s approach to the development of its transport infrastructure. However, the current reappraisal of how best to redevelop the country’s transport infrastructure that has been afforded by recent events may offer the opportunity to alter this. The research examines recent case studies from a number of countries to explore ways in which sustainability has been included as a criterion for planning and procurement decisions. There will also be an in-depth investigation into the Libyan planning and legislative context to examine the feasibility of the introduction of such sustainability criteria into the process of planning and procurement of Libya’s transport infrastructure.

Keywords: Libya reconstruction, sustainability criteria, transport infrastructure, public transport

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Authors: Wesam Darawsheh

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Purpose: There is an absence of studies directed to evaluate the effectiveness of Community Based Rehabilitation (CBR) programs in Jordan. This research study is aimed at investigating the effectiveness of the services of CBR programmes in Jordan. Method: A questionnaire anonymized survey was carried out with forty-seven participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised eighteen questions that collected both qualitative and quantitative data with both closed- and open-ended questions. The survey assessed participants’ knowledge of CBR and perception of the effectiveness of services provided. The quantitative data were analyzed using SPSS Version 22.0 (2016, IBM Corporation New York). Qualitative data were analyzed through thematic content and analysis and open coding to identify emergent themes. Results: The ROC curve revealed that the AUC for questions of the survey to be (AUC=0.846) which indicated a good specificity and sensitivity of the questions of the survey. The MANOVA revealed insignificant results in the effect of the CBR site (p= 0.157), and the level of education of participants (p=0.549), on the perception of the effectiveness of CBR services. There were insignificant differences between the scores of PWDs and volunteers (p=0.781). 40.4% evaluated the effectiveness of CBR services to be low. This mainly stemmed out from the lack of efforts of the CBR programmes to raise the knowledge of the local community about CBR, disability and the role toward PWDs. Conclusions: A speculation for priorities of CBR programmes in Jordan was offered where efforts need to be directed at promoting livelihood and the empowerment components, in order to actualize the main three principles of CBR mainly by promoting multispectral collaboration as a way of operation.

Keywords: community based rehabilitation (CBR), people with disabilities (PWDS), CBR centres, rehabilitation services, Jordan, mixed-methods, evaluative study

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Authors: Karina Guimaraes, Lilian Santos

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This study has the purpose of planning and instituting monitoring actions as a way of knowing the scenario of assistance to the patient with stoma, treated in the public health network in Brazil, from January to November of the year 2016, from the elaboration of a technical document containing the survey of the number of procedures offered and the value of the ostomy services, accredited in the Unified Health System-SUS. The purpose of this document is to improve the quality of these services in the efficient management of available financial resources, making it indispensable for the creation of strategies for the implementation and implementation of care services for people with stomata as a strategic tool in the promotion, prevention, qualification and efficiency in health care.

Keywords: health economic, management, ostomy, unified health system

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Authors: Samaneh Pouyanfar, Michael Oliff

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Nowadays, customer satisfaction and discovering the superior services, are counted as vital issues in most manufacturing and services companies. In these terms, gaining the competitive advantage by a business depends on products and services which are able to cause the customer satisfaction. Given the importance of this subject, this paper tries to investigate the correlation between components of customer satisfaction and gaining the competitive advantage by the business. For this purpose, after reviewing the research literature and doing deep interviews with authors and active people in the industry, based on the variables affecting the customer satisfaction and determinant components of business competitive advantage, research questionnaire was prepared. In sum, 96 executives of PARS-KHAZAR Company were asked in a survey. The results of P.L.S. Test for the research structure analysis showed that the measuring tools in terms of technical features, like convergent and divergent validity and compound reliability were very appropriate. Moreover the results showed that, the structure of products and factors related to foundation, has affected the competitive advantage performance positively and significantly; but the influence of structure of services and business environment on competitive advantage was not confirmed.

Keywords: customer satisfaction, competitive advantage, products, foundation, home appliances

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Authors: Jessica Raven Gates, Gemma Wilson-Menzfeld, Professor Alison Steven

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In 2019, the Primary Care system in the UK National Health Service (NHS) was subject to reform and restructuring. Primary Care Networks (PCNs) were established, which aligned with a trend towards integrated care both within the NHS and internationally. The introduction of PCNs brought groups of GP practices in a locality together, to operate as a network, build on existing services and collaborate at a larger scale. PCNs were expected to bring a range of benefits to patients and address some of the workforce pressures in the NHS, through an expanded and collaborative workforce. The early establishment of PCNs was disrupted by the emerging COVID-19 pandemic. This study, set in the context of the pandemic, aimed to explore experiences of the PCN workforce, and their perceptions of the establishment of PCNs. Specific objectives focussed on examining factors perceived as enabling or hindering the success of a PCN, the impact on day-to-day work, the approach to implementing change, and the influence of the COVID-19 pandemic upon PCN development. This study is part of a three-phase PhD project that utilized qualitative approaches and was underpinned by social constructionist philosophy. Phase 1: a systematic narrative review explored the provision of preventative healthcare services in UK primary settings and examined facilitators and barriers to delivery as experienced by the workforce. Phase 2: informed by the findings of phase 1, semi-structured interviews were conducted with fifteen participants (PCN workforce). Phase 3: follow-up interviews were conducted with original participants to examine any changes to their experiences and perceptions of PCNs. Three main themes span across phases 2 and 3 and were generated through a Framework Analysis approach: 1) working together at scale, 2) network infrastructure, and 3) PCN leadership. Findings suggest that through efforts to work together at scale and collaborate as a network, participants have broadly accepted the concept of PCNs. However, the workforce has been hampered by system design and system complexity. Operating against such barriers has led to a negative psychological impact on some PCN leaders and others in the PCN workforce. While the pandemic undeniably increased pressure on healthcare systems around the world, it also acted as a disruptor, offering a glimpse into how collaboration in primary care can work well. Through the integration of findings from all phases, a new theoretical model has been developed, which conceptualises the findings from this Ph.D. study and demonstrates how the workforce has experienced change associated with the establishment of PCNs. The model includes a contextual component of the COVID-19 pandemic and has been informed by concepts from Complex Adaptive Systems theory. This model is the original contribution to knowledge of the PhD project, alongside recommendations for practice, policy and future research. This study is significant in the realm of health services research, and while the setting for this study is the UK NHS, the findings will be of interest to an international audience as the research provides insight into how the healthcare workforce may experience imposed policy and service changes.

Keywords: health services research, qualitative research, NHS workforce, primary care

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Authors: Meenakshi

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Background: The complications during pregnancy are the major cause of morbidity and deaths among women in the reproductive age group. Childbearing is the most important phase in women’s lives that occur mainly in the adolescent and adult years. Maternal health, thus is an important issue as this as this is important phase is also productive time for women as they strive fulfill their capabilities as an individual, mothers, family members and also as a citizen. The objective of the study is to document the coverage of ANC and its determinants among domestic workers. Method: A survey of 300 domestic workers were carried in Delhi. Only respondents in the age group (15-49) and whose recent birth was of 5 years preceding the survey were included. Socio-demographic data and information on maternal health was collected from these respondents Information on ANC was collected from total 300 respondents. Standard of living index were composed based on households assists and similarly autonomy index was computed based on women decision making power in the households taking certain key variables. Cross tabulations were performed to obtain frequency and percentages. Potential socio-economic determinants of utilization of ANC among domestic workers were examined using binary logistic regressions. Results: Out of 300 domestic workers survey, only 70.7 per cent per cent received ANC. Domestic workers who married at age 18 years and above are 4 times more likely to utilize antenatal services during their last birth (***p< 0.01). Comparison to domestic workers with number of living children two or less, domestic workers with number of living children more than two are less likely to utilize antenatal care services (**p< 0.05). Domestic workers belonging to Other Backward Castes are more likely to utilize antenatal care services than domestic workers belonging to scheduled tribes ((**p< 0.05). Conclusion: The level of utilization of maternal health services are less among domestic workers is less, as they spend most of their time at the employers household. Though demonstration effect do have impact on their life styles but utilization of maternal health services is poor. Strategies and action are needed to improve the utilization of maternal health services among this section of workers as they are vulnerable because of no proper labour legislations.

Keywords: antenatal care, domestic workers, health services, maternal health, women’s health

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Authors: Carmen Cantuarias-Villessuzanne, Jeffrey Blain, Radmila Pineau

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Our research project aims at analyzing the sensitiveness of French households to urban biodiversity and urban ecosystem services (UES). Opinion surveys show that the French population is sensitive to biodiversity and ecosystem services loss, but the value given to these issues within urban fabric and real estate market lacks evidence. Using GIS data and economic evaluation, by hedonic price methods, weassess the isolated contribution of the explanatory variables of biodiversityand UES on the price of residential real estate. We analyze the variation of the valuefor three urban ecosystem services - flood control, proximity to green spaces, and refreshment - on the price of real estate whena property changes ownership. Our modeling and mapping focus on the price at theIRIS scale (statistical information unit) from 2014 to 2019. The main variables are internal characteristics of housing (area, kind of housing, heating), external characteristics(accessibility and infrastructure, economic, social, and physical environmentsuch as air pollution, noise), and biodiversity indicators and urban ecosystemservices for the Ile-de-France region. Moreover, we compare environmental values on the enhancement of greenspaces and their impact on residential choices. These studies are very useful for real estate developers because they enable them to promote green spaces, and municipalities to become more attractive.

Keywords: urban ecosystem services, sustainable real estate, urban biodiversity perception, hedonic price, environmental values

Procedia PDF Downloads 111

Authors: Sekkal Nawel

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The Web of Things (WoT), integration of smart technologies from the Internet or network to Web architecture or application, is becoming more complex, larger, and dynamic. The WoT is associated with various elements such as sensors, devices, networks, protocols, data, functionalities, and architectures to perform services for stakeholders. These services operate in the context of the interaction of stakeholders and the WoT elements. Such context is becoming a key information source from which data are of various nature and uncertain, thus leading to complex situations. In this paper, we take interest in the development of intelligent Web services. The key ingredients of this “intelligent” notion are the context diversity, the necessity of a semantic representation to manage complex situations and the capacity to reason with uncertain data. In this perspective, we introduce a multi-layered architecture based on a generic intelligent Web service model dealing with various contexts, which proactively predict future situations and reactively respond to real-time situations in order to support decision-making. For semantic context data representation, we use PR-OWL, which is a probabilistic ontology based on Multi-Entity Bayesian Networks (MEBN). PR-OWL is flexible enough to represent complex, dynamic, and uncertain contexts, the key requirements of the development for the intelligent Web services. A case study was carried out using the proposed architecture for intelligent plant watering to show the role of proactive and reactive contextual reasoning in terms of WoT.

Keywords: smart web service, the web of things, context reasoning, proactive, reactive, multi-entity bayesian networks, PR-OWL

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Authors: Mohsen Maraoui

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In the face of the growth in the quantity of data produced, several methods and techniques appear to remedy the problems of processing and analyzing large amounts of information mainly in the field of teaching. In this paper, we propose an intelligent cloud-based teaching system for E-learning content services. This system makes easy the manipulation of various educational content forms, including text, images, videos, 3 dimensions objects and scenes of virtual reality and augmented reality. We discuss the integration of institutional and external services to provide personalized assistance to university members in their daily activities. The proposed system provides an intelligent solution for media services that can be accessed from smart devices cloud-based intelligent service environment with a fully integrated system.

Keywords: cloud computing, e-learning, indexation, IoT, learning in Arabic language, smart tools

Procedia PDF Downloads 108

Authors: Cam-Duc Au, Philippe Krahnhof, Lars Klingenberger

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German banks are experiencing harsh times due to rising costs and declining profits. On the one hand, acquisition costs for new customers are increasing because of the rise of innovative FinTechs, which entered the market with one specific goal: disrupting the whole financial services industry by occupying parts of the value chain. On the other hand, the COVID-19 pandemic, as well as an overall low level of interest rates, cause the traditional source of bank income to still drain. Consequently, traditional banks must rethink their strategies or their identity, so to speak, because they go beyond their traditional offering of products and services. Having said that, banks may create new sources of income to stabilize their economic situation and replenish profits. The given paper aims to research the opportunities of establishing an ecosystem model. In doing so, the paper contributes to the current literature debate and provide reference points for traditional banks to start. Firstly, a systematic literature review introduces a selection of research works the author regards as significant. In the following step, quantitative data from an online survey with bank clients are analysed by means of descriptive statistics to show the perspective of Germans with regards to an ecosystem offering. The final research findings indicate that the surveyed retail banking clients express interest in the new offer, whereas non-financial products and services are of lower interest than their financial pendants.

Keywords: banking, ecosystem, disruptive innovation, digital offering, open-banking-strategy, financial services industry

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Authors: Yosia Mulumba, Klaus Schmidt

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Financial Inclusion is considered a key pillar for development in most countries around the world. Access to affordable financial services in a country’s economy can be a driver to overcome poverty and reduce income inequalities, and thus increase economic growth. Nevertheless, the number of financially excluded populations in developing countries continues to be very high. This paper explores the role of Financial Technology (Fintech) as a key driver for achieving financial inclusion in developing countries post the COVID-19 pandemic with an emphasis on four East African countries: Kenya, Tanzania, Uganda, and Rwanda. The research paper is inspired by the positive disruption caused by the pandemic, which has compelled societies in East Africa to adapt and embrace the use of financial technology innovations, specifically Mobile Money Services (MMS), to access financial services. MMS has been further migrated and integrated with other financial technology innovations such as Mobile Banking, Micro Savings, and Loans, and Insurance, to mention but a few. These innovations have been adopted across key sectors such as commerce, health care, or agriculture. The research paper will highlight the Mobile Network Operators (MNOs) that are behind MMS, along with numerous innovative products and services being offered to the customers. It will also highlight the regulatory framework under which these innovations are being governed to ensure the safety of the customers' funds.

Keywords: financial inclusion, financial technology, regulatory framework, mobile money services

Procedia PDF Downloads 125

Authors: S. O. Ayansina, O. A. Adekunle

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There is an increasing demand for a functional extension delivery services in Nigeria with a view to meet up with the food and fiber needs of the ever growing population of human and animal respectively. The study was therefore designed to examine the farmers’ preference for public and private extension services in Southwestern Nigeria, specifically to determine the farmers’ level of participation in the two types of organizations involved and also to evaluate the Performance level of personnel in the two organizations in order to ascertain the beneficiaries’ satisfaction. A multi-stage random sampling technique was used to samples 30 respondents from each of the three selected organizations in each of the three states sampled in Southwestern Nigeria. Hence, 270 respondents were sampled for the study. Data collected were analyzed with Kruskal Wallis one-way Analysis of variance to test the difference between the participation of beneficiaries in the public and private extension services and the level of benefit accrued from the two organizations involved in the study. Results generally revealed that private organizations were performing better and were more preferred by the beneficiaries. Results of the tested hypotheses as shown by Kruskal Wallis test of difference (x2=0.709) indicates no significant difference between farmers’ participation in the extension services of public and private organizations but however shows significant difference (X2=12.074) in the benefits achieved by respondents in the two organizations, such benefits include: increased quantity of Crop produced, farm income, skill acquisition, and improved Education in private extension organizations. Based on this result, it could be inferred that beneficiaries generally preferred private extension organizations because of their effectiveness and vibrancy in programme administration. Public extension is therefore recommended for general overhauling and possibly “merging” of public and private sectors in order to cater for teeming population of farmers demanding for efficient and functional extension services to better their lots both in production and processing.

Keywords: public and private involvement, extension services, farmers’ preferences, Kruskal Wallis Test

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Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

Procedia PDF Downloads 153

Authors: Brenda R. Berca, Jessica S. Vieira, Lucas G. Candido, Matheus C. Ferreira, Paulo S. A. Lopes Filho, Rafaella O. Baracho

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This study aims to estimate the economic value environmental services sustained by Flamboyant Lourival Louza Municipal Park in Goiânia, Goiás, Brazil. The Flamboyant Park is one of the most relevant urban parks, and it is located near a stadium, a shopping center, and two supercenters. In order to define the methods used for the valuation of Flamboyant Park, the first step was carrying out bibliographical research with the view to better understand which method is most feasible to valuate the Park. Thus, the following direct methods were selected: travel cost, hedonic pricing, and contingent valuation. In addition, an indirect method (replacement cost) was applied at Flamboyant Park. The second step was creating and applying two surveys. The first survey aimed at the visitors of the park, addressing socio-economic issues, the use of the Park, as well as its importance and the willingness the visitors, had to pay for its existence. The second survey was destined to the existing trade in the Park, in order to collect data regarding the profits obtained by them. In the end, the characterization of the profile of the visitors and the application of the methods of contingent valuation, travel cost, replacement cost and hedonic pricing were obtained, thus monetarily valuing the various ecosystem services sustained by the park. Some services were not valued due to difficulties encountered during the process.

Keywords: contingent valuation, ecosystem services, economic environmental valuation, hedonic pricing, travel cost

Procedia PDF Downloads 198