SUSTAINABLE HOSPITAL FOR URBAN RESIDENTS

2015 ◽  
Vol 77 (30) ◽  
Author(s):  
Shamzani Affendy Mohd Din ◽  
Nik Nurul Hidayah Nik Yahya ◽  
Rashidi Othman
Keyword(s):  
Urban Area ◽  
Motor Vehicles ◽  
Urban Residents ◽  
Kuala Lumpur ◽  
Middle Income ◽  
Adverse Health Effects ◽  
Environmental Performance Index ◽  
Number Of Patients ◽  
General Government ◽  
Particulates Matter

Malaysia is one of the sustainable countries in the world as it ranked at 51st over 178 countries in Environmental Performance Index (EPI). However, Malaysia as an upper-middle-income country set strong forces in Gross Domestic Production from 2009 until 2014 at 16.18 per cent (%) inclination. The urbanisation activities exposing the urban residents to the concentration of fine and ultrafine particulates matter (PM) include the urban area hospital occupants. The main aim of this research is to investigate the adverse health effects towards the patients in hospital specifically, Kuala Lumpur in general. Significantly, the outcome assist in particulate matter impact control in expenditure by general government and promotes the sustainable hospital ambient towards its occupants. The case study for this pilot study is Kuala Lumpur Hospital (HKL). The approaches used are literature review and data collections. The findings identified the motor vehicles as the main sources of Particulates Matter in Kuala Lumpur urban area. As the sources increases, the PM concentration also increases. Simultaneously, the number of patients facing respiratory related diseases also increased.  Contradict to previous researchers’ theory, Malaysian results shows that as the number of unhealthy days increase in the year 2012, yet the morbidity case reported decreases. This is for the general government had spent at an increment of 7.46% in the year 2011 during the fall of unhealthy days at 11.76 % in 2011. This shows that the general government spend effectively to mitigate the repeat cases of respiratory patients facing by high risk communities. In conclusion, the sustainable development can be achieved as the economy is being blend well with the environment.

scholarly journals An International Analysis of Dialysis Services Reimbursement

2018 ◽  
Vol 14 (1) ◽  
pp. 84-93 ◽  
Author(s):  
Arjan van der Tol ◽  
Norbert Lameire ◽  
Rachael L. Morton ◽  
Wim Van Biesen ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Peritoneal Dialysis ◽  
Replacement Therapy ◽  
Gdp Per Capita ◽  
Middle Income ◽  
Middle Income Countries ◽  
Number Of Patients ◽  
Kidney Replacement Therapy ◽  
Per Capita ◽  
Low And Middle Income

Background and objectivesThe prevalence of patients with ESKD who receive extracorporeal kidney replacement therapy is rising worldwide. We compared government reimbursement for hemodialysis and peritoneal dialysis worldwide, assessed the effect on the government health care budget, and discussed strategies to reduce the cost of kidney replacement therapy.Design, setting, participants, & measurementsCross-sectional global survey of nephrologists in 90 countries to assess reimbursement for dialysis, number of patients receiving hemodialysis and peritoneal dialysis, and measures to prevent development or progression of CKD, conducted online July to December of 2016.ResultsOf the 90 survey respondents, governments from 81 countries (90%) provided reimbursement for maintenance dialysis. The prevalence of patients per million population being treated with long-term dialysis in low- and middle-income countries increased linearly with Gross Domestic Product per capita (GDP per capita), but was substantially lower in these countries compared with high-income countries where we did not observe an higher prevalence with higher GDP per capita. The absolute expenditure for dialysis by national governments showed a positive association with GDP per capita, but the percent of total health care budget spent on dialysis showed a negative association. The percentage of patients on peritoneal dialysis was low, even in countries where peritoneal dialysis is better reimbursed than hemodialysis. The so-called peritoneal dialysis–first policy without financial incentive seems to be effective in increasing the utilization of peritoneal dialysis. Few countries actively provide CKD prevention.ConclusionsIn low- and middle-income countries, reimbursement of dialysis is insufficient to treat all patients with ESKD and has a disproportionately high effect on public health expenditure. Current reimbursement policies favor conventional in-center hemodialysis.

scholarly journals Water Woes in Zimbabwe’s Urban Areas in the Middist Of Plenty: 2000 -Present

2012 ◽  
Vol 1 (2) ◽  
pp. 151 ◽  
Author(s):  
Enock C. Makwara
Keyword(s):  
Waste Management ◽  
Water Supply ◽  
Urban Area ◽  
Urban Areas ◽  
Service Failure ◽  
Urban Residents ◽  
Contaminated Water ◽  
Recent Outbreak

Zimbabwe’s urban areas are choking under the weight of over-crowdedness amidstdilapidated infrastructure that is characterised by constant service failure. The water andsewer systems of the country’s major urban centres are on the verge of collapse, thusputting millions of people in danger of consuming contaminated water, including thatfrom underground sources. Waste management and water supply problems manifestthemselves as challenges bedevilling many an urban area in the country. The quality andquantity of water supplied in Zimbabwe’s urban centres has plummeted in recent yearsand has assumed crisis proportions owing to the difficult economic situation and otherchallenges faced by the country. The situation is desperate and dire, as is evidenced by thepoor quality of delivered water, severe water rationing and the outbreak of water-bornediseases in the urban areas dotted across the country. The situation demands and dictatesthat solutions be proffered as a matter of urgency.The recent outbreak of epidemics hasbeen blamed on lack of access to safe water and poor sanitation, two crucial factors incontrolling the spread of diseases. An overly bureaucratic environment, where decisionsand processes take longer, makes life complicated for poor urban residents. Such ascenario motivated the researchers to examine the problem with a view to suggest waysand means of intervening to mitigate and resolve the problem. It emerged from thefindings that the problem is multifaceted in nature, hence a whole range of measures needto be adopted if a long-term solution is to be provided.

scholarly journals The effects of educational media on children’s language development: A case study

2016 ◽  
Vol 6 (1) ◽  
pp. 433-443
Author(s):  
Malini Ganapathy ◽  
Amareena Jayabalam
Keyword(s):  
Data Collection ◽  
Language Development ◽  
Urban Area ◽  
Educational Media ◽  
Negative Part ◽  
Middle Income ◽  
Face To Face ◽  
Descriptive Research ◽  
One Year

The descriptive  research examines the effects of educational media on children’s language development . It aims to answer the following questions; a) To what extend does the educational media influences the children’s language development? b)  Do parents interact with their children during co-viewing ? Since many of the children in this era are exposed to educational media programs/apps/ games at a very young age, it is important for the researcher to find out the extend educational media influences children’s language development and  do parents co-view and interact with the children.  Five parents with children from age one year of age to pre-school were interviewed face to face. The research is carried out at Seberang Perai Urban Area targeting parents who send their children to middle income kindergartens. Face to face interviews were carried out to find out to what extend educational media  influences on children’s language development and to find out whether parents co-view and interact with their children. Upon completion of the data collection , the results will be used to determine the positive and negative part of educational media on children’s language development and how parents co-view and interactions can  benefit them.

scholarly journals Facilitators and barriers to child restraint use in motor vehicles: a qualitative evidence synthesis

2020 ◽  
Vol 26 (5) ◽  
pp. 478-493 ◽  
Author(s):  
Soumyadeep Bhaumik ◽  
Kate Hunter ◽  
Richard Matzopoulos ◽  
Megan Prinsloo ◽  
Rebecca Q Ivers ◽  
...  
Keyword(s):  
Linguistically Diverse ◽  
Motor Vehicles ◽  
Culturally And Linguistically Diverse ◽  
Child Safety ◽  
Qualitative Evidence Synthesis ◽  
Middle Income ◽  
Qualitative Evidence ◽  
Restraint Use ◽  
Child Restraint ◽  
Facilitators And Barriers

BackgroundRoad traffic collisions contribute a significant burden of mortality and morbidity to children globally. The improper or non-use of child restraints can result in children sustaining significant injuries in the event of a collision. Systematic reviews on the effectiveness of various interventions to increase the use of child restraints already exist but to the best of our knowledge, there has been no qualitative evidence syntheses on the facilitators and barriers to child restraint usage. This review aims to fill that gap.MethodsWe searched for qualitative studies, which focused on perceptions, values and experiences of children, parents/caregivers or any other relevant stakeholders on the use of restraints for children travelling in motor vehicles in PubMed, EMBASE and Global Health and screened reference lists of all included studies. We assessed the quality of included studies with the Critical Appraisal Skills Programme (CASP) checklist and used the PROGRESS Plus lens for an equity focused analysis.ResultsWe identified a total of 335 records from searching the databases and five records from other sources. After screening, we identified 17 studies that met our inclusion criteria. All but one study (which had children as participants) focused on the perceptions, attitudes and barriers of parents or caregivers. The included studies were from three high-income (n=14) and one upper-middle income (n=3) country. In addition, although many focused exclusively on participants from culturally and linguistically diverse minorities, the issue of equity was not well addressed. Five major themes emerged from the analysis. (1) perceived risk for injuries and perceived safety benefits of child restraint usage varies in different settings and between different types of caregivers; (2) practical issues around the use of child restraints is a major barrier to its uptake as a child safety measure; (3) restraint use is considered as a mechanism to discipline children rather than as a safety device by parents and as children became older they actively seek opportunities to negotiate the non-usage of restraints; (4) adoption and enforcement of laws shape perceptions and usage in all settings and (5) perceptions and norms of child safety differ among culturally and linguistically diverse groups.ConclusionThe results of this systematic review should be considered when designing interventions to promote the uptake of child restraints. However, there is a need to conduct qualitative research around the facilitators and barriers to child restraint usage in low-income and middle-income countries. Furthermore, there is a need for more evidence conducted in semiurban and rural areas and to involve fathers, policy-makers, implementers and enforcement agencies in such studies.

scholarly journals Traffic-Related Airborne VOC Profiles Variation on Road Sites and Residential Area within a Microscale in Urban Area in Southern Taiwan

Atmosphere ◽  
2020 ◽  
Vol 11 (9) ◽  
pp. 1015
Author(s):  
Jiun-Horng Tsai ◽  
Yen-Ting Lu ◽  
I-I Chung ◽  
Hung-Lung Chiang
Keyword(s):  
Urban Area ◽  
Ambient Air ◽  
Abundant Species ◽  
Residential Area ◽  
Motor Vehicles ◽  
Strategy Development ◽  
Residential Areas ◽  
Volatile Organic ◽  
Methyl Cyclopentane ◽  
Set Up

The sampling sites, including roadsides and residential areas, were set up to collect ambient air and determine the volatile organic species it contained. For the roadside air, the average VOCs (volatile organic compounds) abundant at rush hour periods was two times that at non-rush hour periods. In the residential area, the VOC concentrationswere106 and 129 ppb during rush hour periods. The VOC concentration ratios of roadside and residential areas were in the range of 1.08–1.75 and the traffic emissions were related to the VOCs abundant in air. The highest VOC concentration was 168 ppb at midnight at residential sites and the VOC abundance could be two times that of roadside sites. This level of concentration could be attributed to the application of solvents and to human activity in a nearby motorcycle/vehicle maintenance plant, laundry rooms, etc. High abundant species were similar in both the roadside and residential air samples. These highly abundant species included toluene, acetone, acetonitrile, m,p-xylene and n-pentane, all of which can be emitted from traffic exhaust. Benzene, acrolein, formaldehyde, vinyl chloride and 1,3-butadiene were the main species with health impacts collected at both sites. In the micro-scale environment, the residential ambient air was affected by traffic flow from morning to night. In the midnight period, some local activities (a motorcycle/vehicle maintenance shop and laundry shops) affected the concentrations of certain VOCs (acetonitrile, toluene, hexane, 2-methylpentane, methyl cyclopentane and 3-methylpentane). The traffic and motor vehicles’ effects were determined, which could be useful for air quality management and strategy development in an urban area.

scholarly journals The changing patterns of access overtime to the renal replacement therapy programme in Thailand

2019 ◽  
Author(s):  
Noppakun Thammatacharee ◽  
Anne Mills ◽  
Dorothea Nitsch ◽  
Adisorn Lumpaopong
Keyword(s):  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Transplant ◽  
Cohort Analysis ◽  
Universal Coverage ◽  
Programme Implementation ◽  
Health Security ◽  
Middle Income ◽  
Number Of Patients ◽  
Over Time

Abstract Based on projected numbers, approximately only 50% of those requiring renal replacement therapy (RRT) receive it. Many patients who require RRT live in low- and middle-income countries. The objective of this study was to examine the changing pattern over time of entry into the RRT programme in Thailand following RRT’s inclusion in the Universal Coverage Scheme. This study was an ecological study using the age-period-cohort analysis to look at dialysis registration and kidney transplant trends during RRT programme implementation. Data from 2008 to 2016 of patients diagnosed with end-stage renal disease (ESRD) were obtained from the National Health Security Office. The study found that the numbers of new patients with ESRD, aged 20–69, registered with the dialysis programme increased over time. For patients aged 20–40 years, the dialysis programme took up to 400 new patients for every 1000 new ESRD diagnoses. For kidney transplant, the rates increased slowly. The kidney transplant programme could at best treat only around 50 cases for every 1000 new ESRD diagnoses in patients aged 20–30 years. Findings of this study highlighted the importance of promoting strategies to reduce the increasing number of patients with kidney disease, to consider conservative therapy for older/frail patients, and to improve access to kidney transplantation and live-donation.

scholarly journals Cardiac Involvement of Hepatitis B and C Virus Infection

2013 ◽  
Vol 8 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Mohammad Saifullah Patwary ◽  
KMHS Sirajul Haque ◽  
Nusrat Shoaib ◽  
Khondaker Syedus Salehin ◽  
ATM Iqbal Hosan
Keyword(s):  
Heart Disease ◽  
Hepatitis C ◽  
Hepatitis B ◽  
Heart Diseases ◽  
Hepatocellular Cancer ◽  
Japanese Patients ◽  
Hcv Infection ◽  
Global Network ◽  
Middle Income ◽  
Number Of Patients

Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are the cause of many different forms of heart disease worldwide and yet few cardiologists are aware of it as an etiology of heart disease, or its treatment. The burden of HBV and HCV derived heart diseases are global, with a higher prevalence in Asia, Africa, and low- and middle-income countries. The study showed that in more than 10% of Japanese patients, their cardiomyopathies are associated with HCV infection. More recently, it is found in the USA that up to 15% of patients with heart failure with myocarditis have been associated HCV infection. In contrast, in China 79% of patients with hepatocellular cancer and 37% of hepatitis C patients have heart disease, as detected by measuring a proven and sensitive biomarker of heart disease, NT-proBNP. In Pakistan, 17% of hepatitis C patients have heart diseases, as measured by this metric (NT-proBNP). Based on these data, 3% of 6.6 billion (198 million) persons worldwide are infected with HCV and 17–37% (34–73 million) persons are suffering from HCV-derived heart diseases. These figures may be comparable to the number of patients with hepatitis C. HCV infection causes only hepatitis in some patients, only heart diseases in some patients, and both hepatitis and heart diseases in other patients. A global network is required to establish methods to detect heart diseases caused by infectious agents. Other goals for the network are the expansion of preventive and therapeutic programs in under privileged countries. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16084 University Heart Journal Vol. 8, No. 2, July 2012

Contribution of older urban residents

2018 ◽  
Vol 3 (1) ◽  
pp. 187-192
Author(s):  
Katherine Kline
Keyword(s):  
Civil Society ◽  
Older People ◽  
Urban Areas ◽  
Older Persons ◽  
Population Group ◽  
Population Ageing ◽  
Urban Residents ◽  
Ageing Population ◽  
Middle Income ◽  
Persons With Disabilities

UN-Habitat’s biennial World Urban Forum (WUF9) took place in Kuala Lumpur, Malaysia this year from 7-13 February.  Following 18 months after Habitat III, its theme appropriately focused on “Cities 2030, Cities for All”.I participated as the co-chair of the General Assembly of Partners (GAP) official civil society group for older persons. Given very limited resources, we organized several panels with others: an official 2 hour Older Persons Roundtable; one with GAP Persons with Disabilities on accessibility and universal design; another representing older women as part of the Women’s Assembly; a fourth contributing the civil society perspective to one by Business & Industry; and a fifth organized by City Space Architecture focusing on the importance of safe and accessible public spaces which can reduce isolation faced by many older urban residents.Urbanisation and population ageing are century defining demographic trends. Over 500 million urban residents are older people. Yet cities everywhere are failing to address the changes brought about by global population ageing with increasing inequality and insecurity. Physical, social and economic barriers prevent older people in particular from fully enjoying their rights and living in dignity and safety in cities. By 2030, older persons are expected to account for over 25 percent of the population in Europe and northern America, 17 percent in Asia, Latin America and the Caribbean, and six percent in Africa. Over half the ageing population, 289 million, currently lives in low- and middle-income countries, and is increasingly concentrated in urban areas. Older persons are the fastest growing population group globally, expected to reach 22% by 2050 (UNDESA 2017). In 2015, 58% of the world’s people aged 60 and over resided in urban areas, up from 50% in 2000.

Comparative benefit of interstitial needles in addition to intracavitary applicators in the treatment of locally advanced cervical cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5528-5528
Author(s):  
Dorothy Chilambe Lombe ◽  
Juanita M. Crook ◽  
Francois Bachand ◽  
Deidre Batchelar ◽  
Jocelyn Moore ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Locally Advanced ◽  
Tumour Volume ◽  
Median Number ◽  
Intracavitary Brachytherapy ◽  
Advanced Cervical Cancer ◽  
Median Percentage ◽  
Middle Income ◽  
Locally Advanced Cervical Cancer ◽  
Number Of Patients

5528 Background: Cervical cancer is the leading cause of cancer mortality of women in Low and Middle Income Countries (LMIC). Interstitial needles (IN) have improved outcomes but the resources required in comparison to intracavitary brachytherapy (IC) alone has impeded uptake in endemic regions. We conducted a retrospective review of the utilisation of IN in the management of locally advanced cervical cancer and simulated 2D planning by loading the applicators using standard Manchester loading (ML) to explore the magnitude of benefit that interstitial needles provide. Methods: 72 brachytherapy plans of 18 patients who had undergone treatment using tandem and ring and had interstitial brachytherapy between 04/2016 and 10/2018 were reviewed. ML plans prescribed to point A were generated to represent a 2D scenario but the known HR-CTV was taken into consideration and its dosimetric outcomes were compared to those of the 3D based plans. Results: The median tumour volume was 23 cm3. IN was used in 82 % of the insertions. The median number of IN was 2 (range 0 – 6) with median percentage of IN dwell time 6.6 % (range 0.68 – 38.5). V100 was excellent 98.2% for ML 97.3% for 3D IN and 98.7% for 3D non-IN plans. The median HRCTV D90 was 8.5 Gy/fraction (cumulative EQD210101.4 Gy) for ML plans and 8.0 Gy/fraction (cumulative EQD210 91.4 Gy) for 3D plans. The ML plans failed to meet the OAR goals except for the rectum, which was optimally distanced by the rectal paddle. The median bladder, sigmoid and small bowel doses were 24% above the recommended constraint in the individual plans and 15% cumulative EQD2. A statistically significant relationship was found between the number of needles utilised, tumour volume (p < 0.001) and coverage (p = 0.006) but not delivered dose (p < 0.068). Conclusions: 2D brachytherapy can provide adequate dose coverage for most tumours but IN provide a benefit in reducing the doses to OARs in a significant number of patients. This justifies investment in resources for uptake of interstitial needles to increase access to optimal treatment of cervical cancer for women in LMIC. This research was made possible an ASCO Conquer Cancer Foundation grant.

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