Search results for: catchment area of healthcare

Authors: Sreejith Gopinath, Aspen Olmsted

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This paper is based on our previous work that proposed a risk-transference-based architecture for healthcare systems to store sensitive data outside the system boundary, rendering the system unattractive to would-be bad actors. This architecture also allows a compromised system to be abandoned and a new system instance spun up in place to ensure business continuity without paying a ransom or engaging with a bad actor. This paper delves into the details of various attacks we simulated against the prototype system. In the paper, we discuss at length the time and computational costs associated with storing and retrieving data in the prototype system, abandoning a compromised system, and setting up a new instance with existing data. Lastly, we simulate some analytical workloads over the data stored in our specialized data storage system and discuss the time and computational costs associated with running analytics over data in a specialized storage system outside the system boundary. In summary, this paper discusses the total costs of data storage, access, and analytics incurred with the proposed architecture.

Keywords: cybersecurity, healthcare, ransomware, resilience, risk transference

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Authors: Naziha Mokadem, Rainier Dennis, Ingrid Dennis

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In South Africa, Karst aquifers are receiving greater attention since they provide large supplies of water which is used for domestic and agricultural purposes as well as for industry. Accordingly, a better insight into the origin of water mineralization and the geochemical processes controlling the recharge of the aquifer is crucial. Analyses of geochemical and environmental isotopes could lead to relevant information regarding karstification and infiltration processes, groundwater chemistry and isotopy. A study was conducted in a typical karst landscape of Wonderfonteinspruit catchment, also known as Wonderfonteinspruit Valley in North-western -South Africa. Furthermore, fifty-two samples were collected from (35 boreholes, 5 surface waters, 4 Dams, 4 springs, 1 canal, 2 pipelines, 1 cave) within the study area for hydrochemistry and 2H and 18O analysis. The determination of the anions (Cl-, SO42-, NO2, NO3-) were performed using Metrohm ion chromatography, model: 761 compact IC, with a precision of ± 0.001 mg/l. While, the cations (Na+, Mg2+, K+, Ca2+) were determined using Metrohm ion chromatography, Model: ICP-MS 7500 series. The alkalinity (Alk) was determined by pH meter with volumetric titration using HCL to pH 4.5; 4.2; and 8.2. In addition, 18O and 2H relative to the Vienna-Standard Mean Ocean Water (RVSMOW), were determined by picarro L2130-I Isotopic H2O (Cavity Ringdown laser spectrometer, Picarro Ltd). The hydrochemical analysis of Wonderfonteinspruit groundwater showed a dominance of the cations Ca-Mg and the anion HCO3. Piper diagram shows that the groundwater sample of study area is characterized by four hydrochemical facies: Two main groups: (1) Ca–Mg–Cl–SO4; (2) Ca–Mg–HCO3 and two minor groups: (3) Ca–Mg–Cl; (4) Na–K–HCO3. The majority of boreholes of Malmani (Transvaal Supergroup) aquifer are plotted in Ca–Mg–HCO3.Oxygen-18 (18O‰SMOW) and deuterium (D‰SMOW) isotopic data indicate that the aquifer’s recharge is influenced by two phenomena; precipitation rates for most of the samples and river flow (Wonderfonteinspruit, Middelvieinspruit, Renfonteinspruit) for some samples.

Keywords: South Africa, Wonderfonteinspruit Valley, isotopic, hydrochemical, carbonate aquifers

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Authors: Susmita Ghosh

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Catchment area of Damodar River, India experiences seasonal rains due to the south-west monsoon every year and depending upon the intensity of the storms, floods occur. During the monsoon season, the rainfall in the area is mainly due to active monsoon conditions. The upstream reach of Damodar river system has five dams store the water for utilization for various purposes viz, irrigation, hydro-power generation, municipal supplies and last but not the least flood moderation. But, in the downstream reach of Damodar River, known as Lower Damodar region, is severely and frequently suffering from flood due to heavy monsoon rainfall and also release from upstream reservoirs. Therefore, an effective flood management study is required to know in depth the nature and extent of flood, water logging, and erosion related problems, affected area, and damages in the Lower Damodar region, by conducting mathematical model study. The design flood or discharge is needed to decide to assign the respective model for getting several scenarios from the simulation runs. The ultimate aim is to achieve a sustainable flood management scheme from the several alternatives. there are various methods for estimating flood discharges to be carried through the rivers and their tributaries for quick drainage from inundated areas due to drainage congestion and excess rainfall. In the present study, the flood frequency analysis is performed to decide the design flood discharge of the study area. This, on the other hand, has limitations in respect of availability of long peak flood data record for determining long type of probability density function correctly. If sufficient past records are available, the maximum flood on a river with a given frequency can safely be determined. The floods of different frequency for the Damodar has been calculated by five candidate distributions i.e., generalized extreme value, extreme value-I, Pearson type III, Log Pearson and normal. Annual peak discharge series are available at Durgapur barrage for the period of 1979 to 2013 (35 years). The available series are subjected to frequency analysis. The primary objective of the flood frequency analysis is to relate the magnitude of extreme events to their frequencies of occurrence through the use of probability distributions. The design flood for return periods of 10, 15 and 25 years return period at Durgapur barrage are estimated by flood frequency method. It is necessary to develop flood hydrographs for the above floods to facilitate the mathematical model studies to find the depth and extent of inundation etc. Null hypothesis that the distributions fit the data at 95% confidence is checked with goodness of fit test, i.e., Chi Square Test. It is revealed from the goodness of fit test that the all five distributions do show a good fit on the sample population and is therefore accepted. However, it is seen that there is considerable variation in the estimation of frequency flood. It is therefore considered prudent to average out the results of these five distributions for required frequencies. The inundated area from past data is well matched using this flood.

Keywords: design discharge, flood frequency, goodness of fit, sustainable flood management

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Authors: Jing Jiang, Yuguang Gao, Yang Yu

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Facing increasingly challenging insurance payment pressures, the Chinese healthcare system is undergoing significant transformations, akin to the implementation of DRG payment models by the United States' Medicare. Consequently, there is a pressing need for Chinese hospitals to establish optimizations in departmental operations tailored to the ongoing healthcare payment reforms. This abstract delineates the meticulous construction of a scientifically rigorous and comprehensive index system at the departmental level in China strategically aligned with the evolving landscape of healthcare payment reforms. Methodologically, it integrates key process areas and maturity assessment theories, synthesizing relevant literature and industry standards to construct a robust framework and indicator pool. Employing the Delphi method, consultations with 21 experts were conducted, revealing a collective demonstration of high enthusiasm, authority, and coordination in designing the index system. The resulting model comprises four primary indicators -technical capabilities, cost-effectiveness, operational efficiency, and disciplinary potential- supported by 14 secondary indicators and 23 tertiary indicators with varied coefficient adjustment for department types (platform or surgical). The application of this evaluation system in a Chinese hospital within the northeastern region yielded results aligning seamlessly with the actual operational scenario. In conclusion, the index system comprehensively considers the integrity and effectiveness of structural, process, and outcome indicators and stands as a comprehensive reflection of the collective expertise of the engaged experts, manifesting in a model designed to elevate the operational management of hospital departments. Its strategic alignment with healthcare payment reforms holds practical significance in guiding departmental development positioning, brand cultivation, and talent development.

Keywords: Chinese healthcare system, Delphi method, departmental management, evaluation indicators, hospital operations, weight coefficients

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Sisira Edirippulige

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Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Mohammad Al-Mousawi

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This academic article explores the indispensable role of critical thinking in the process of diagnosing diseases. Employing a multidisciplinary approach, we delve into the cognitive skills and analytical mindset that clinicians, researchers, and healthcare professionals must employ to navigate the complexities of disease identification. By examining the integration of critical thinking within the realms of medical education, diagnostic decision-making, and technological advancements, this article aims to underscore the significance of cultivating and applying critical thinking skills in the ever-evolving landscape of healthcare.

Keywords: critical thinking, medical education, diagnostic decision-making, fostering critical thinking

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Authors: Nastja Utrosa, Matevz Juvancic

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Hospital buildings are complex public environments characterized by intricate functional arrangements and architectural layouts. Effective wayfinding is essential for patients, visitors, students, and staff. However, spatial orientation planning is often overlooked until after construction. While these environments meet functional needs, they frequently neglect the psychological aspects of user experience. This study investigates wayfinding within complex urban healthcare environments, focusing on the influences of spatial design, spatial cognition, and user experience. The inherent complexity of these environments, with extensive spatial dimensions and dispersed buildings, exacerbates the problem. Gradual expansions and additions contribute to disorientation and navigational difficulties for users. Effective route guidance in urban healthcare settings has become increasingly crucial. However, research on the environmental elements that influence wayfinding in such environments remains limited. To address this gap, we conducted a study at the University Medical Centre Ljubljana (UMCL), Slovenia's largest university hospital. Using a questionnaire, we assessed how individuals' perceptions and use of outdoor hospital spaces with a diverse sample (n=179). We evaluated the area’s usability by analyzing visit frequency, stops, modes of arrival, and parking patterns and examined the visitors' age distribution. Additionally, we investigated spatial aids and the use of color as an orientation element at three specific locations within the medical center. Our study explored the impact of color on entrance selection and the effectiveness of warm versus cool colors for wayfinding. Our findings highlight the significance of graphic adjustments in shaping perceptions of hospital outdoor spaces. Most participants preferred visually organized entrances, underscoring the importance of effective visual communication. Implementing these adaptations can substantially enhance the user experience, reducing stress and increasing satisfaction in hospital environments.

Keywords: hospital layout design, healthcare facilities, wayfinding, navigational aids, spatial orientation, color, signage

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Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

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Authors: Atin Mukherjee, Amitabha Sinha, Debesh Choudhury

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Fast Fourier transform (FFT) of large-number of samples requires larger hardware resources of field programmable gate arrays and it asks for more area as well as power. In this paper, an area efficient architecture of FFT processor is proposed, that reuses the butterfly units more than once. The FFT processor is emulated and the results are validated on Virtex-6 FPGA. The proposed architecture outperforms the conventional architecture of a N-point FFT processor in terms of area which is reduced by a factor of log_N(2) with the negligible increase of processing time.

Keywords: FFT, FPGA, resource optimization, butterfly units

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Authors: Ezinne K. Okoro, Takahiko Katoh, Yoko Kawamura, Stanley C. Meribe

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HIV infection in children is largely as a result of vertical transmission (mother to child transmission [MTCT]). Thus, elimination of mother to child transmission of HIV/AIDS is critical in eliminating HIV infection in children. In Nigeria, drawbacks such as; limited pediatric screening, limited human capital, insufficient advocacy and poor understanding of ART guidelines, have impacted efforts at combating the disease, even as treatment services are free. Prevention of Mother to Child Transmission (PMTCT) program relies on health workers who not only counsel pregnant women on first contact but can competently provide HIV-positive pregnant women with accurate information about the PMTCT program such as feeding techniques and drug adherence. In developing regions like Nigeria where health care delivery faces a lot of drawbacks, it becomes paramount to address these issues of poor PMTCT coverage by conducting a baseline assessment of the knowledge, practices and perceptions related to HIV prevention amongst healthcare workers in Nigeria. A descriptive cross-sectional study was conducted amongst 250 health workers currently employed in health facilities in Abuja, Nigeria where PMTCT services were offered with the capacity to carry out early infant diagnosis testing (EID). Data was collected using a self-administered, pretested, structured questionnaire. This study showed that the knowledge of PMTCT of HIV was poor (30%) among healthcare workers who offer this service day-to-day to pregnant women. When PMTCT practices were analyzed in keeping with National PMTCT guidelines, over 61% of the respondents reported observing standard practices and the majority (58%) had good attitudes towards caring for patients with HIV/AIDS. Although 61% of the respondents reported being satisfied with the quality of service being rendered, 63% reported not being satisfied with their level of knowledge. Predictors of good knowledge were job designation and level of educational attainment. Health workers who were more satisfied with their working conditions and those who had worked for a longer time in the PMTCT service were more likely to observe standard PMTCT practices. With over 62% of the healthcare workers suggesting that more training would improve the quality of service being rendered, this is a strong pointer to stakeholders to consider a ‘healthcare worker-oriented approach’ when planning and conducting PMTCT training for healthcare workers. This in turn will increase pediatric ARV coverage, the knowledge and effectiveness of the healthcare workers in carrying out appropriate PMTCT interventions and culminating in the reduction/elimination of HIV transmission to newborns.

Keywords: attitudes, HIV/AIDS, healthcare workers, knowledge, mother to child transmission, Nigeria, perceptions

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Authors: Faith O. Olanrewaju

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Internal displacement and the vulnerability of women are two critical aspects of forced migration that have dominated both global and local discourses. Statistics show that in November 2021, there were over 2.1 million internally displaced persons (IDPs) in Nigeria. Literature also states that displaced women and girls are more vulnerable than displaced men. They are susceptible to adversative experiences, including various forms of sexual violence and rape. As a result, the displaced women and girls are faced with psychological and physical traumas, including HIV/AIDS as well as unexpected or poorly spaced pregnancies. In addition, the poor condition of living of internally displaced women in IDP camps affects their reproductive health, pregnancy outcomes, and maternal mortality levels. Incontrovertibly, internally displaced women constitute an imperative contributor to the ills of Nigeria's maternal health status, which is the second worse globally and the worst in Africa. World Health Organisation statistics showed that approximately 536,000 girls and women die from pregnancy-related causes globally, and Nigeria accounts for 14% of the global maternal deaths. Undeniably, this supports the claims that maternal mortality remains a challenge in Nigeria and can be exacerbated by internal displacement crises. Therefore, maternal mortality remains a critical impediment to the actualisation of the 3.1 SDG target. Owing to this, concerns arise about the quality of the policy in Nigeria’s health sector. More specifically, this study is concerned with the maternal health care services displaced women receive in IDP camps in the three states affected by internal displacement in north-central Nigeria, an understudied area. The novelty of the study also lies in its comparative investigation of maternal healthcare service delivery in three different camp structures (faith-based, government, and informal IDP camps), a pattern that is absent in literature. Therefore, this study will investigate how the camp structures affect access to maternal health services in the study areas; analyse the successes and challenges in the delivery of maternal health care services to displaced women in the various camps; and recommendation and strategies for reducing maternal healthcare disparities/gaps across IDP camps in Nigeria (should they exist). It will adopt a mixed-method approach and multi-stage sampling technique. A total of 1,152 copies of the study questionnaire will be distributed to displaced pregnant and nursing mothers (PNM); nine focus group discussions will also be held with the displaced PNM; in-depth interviews will be conducted with humanitarian actors, policymakers, and health professionals. The quantitative and qualitative data will be analysed using Statistical Package for Social Science (SPSS) 21.0 and thematic analysis, respectively. The findings of the study will be used to develop a model of care that will address the fragmentations in Nigeria's healthcare system. The findings will also inform the development of best policies and practices in the maternal health of displaced women.

Keywords: forced displacement, internally displaced women, maternal healthcare, maternal mortality

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Sanpachai Huvanandana, Settapong Malisuwan, Soparwan Tongyuak, Prust Pannachet, Anong Phoepueak, Navneet Madan

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Many regions of Thailand are prone to flooding due to tropical climate. A commonly increasing precipitation in this continent results in risk of flooding. Many efforts have been implemented such as drainage control system, multiple dams, and irrigation canals. In order to decide where the drainages, dams, and canal should be appropriately located, the flooding risk area should be determined. This paper is aimed to identify the appropriate features that can be used to classify the flooding risk area in Thailand. Several features have been analyzed and used to classify the area. Non-supervised clustering techniques have been used and the results have been compared with ten years average actual flooding area.

Keywords: flood area clustering, geographical information system, flood features

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Authors: Ema Septaria, Muhammad Yamani, N. S. B. Ambarini

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The problem begins with the imposition of fine penalties by Ipuh small fishermen for customary fishing vessels encroaching catchment area in the Ipuh, a village in Muko-Muko, Bengkulu, Indonesia. Two main reasons for that are fishermen from out of Ipuh came and fished in Ipuh water using trawl as the gear and the number of fish decrease time by time as a result of irresponsible fishing practice. Such conflict has lasted since long ago. Indonesia Governing laws do not rule the utilization of sea territory by small fishermen that when the conflict appears there is a rechtvacuum on how to solve the conflict and this leads to a chaos in society. In Ipuh itself, there has been a local law in fisheries which they still adhere up to present because they believe holding to the law will keep the fish sustain. This is an empirical legal research with socio legal approach. The results of this study show even though laws do not regulate in detail about the utilization of sea territory by small fishermen, there is an article in Fisheries Act stating fisheries activity has to put attention to local law and community participation. Furthermore, constitution governs that the land, the waters and the natural resources within shall be under the powers of the State and shall be used to the greatest benefit of the people. With the power, Government has to make a policy that reinforces what has been ruled in Ipuh local law. Besides, Bengkulu Governor has to involve Ipuh community directly in managing their fisheries to ensure the fisheries sustainability therein.

Keywords: local law, reinforcement, conflict, sea utilization, small fishermen

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Authors: Maariyah Irfan

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Intro: Current cardiovascular (CV) care faces challenges such as low budgets and high hospital admission rates. This review aims to evaluate Big Data in CV healthcare management through the use of wearable devices in atrial fibrillation (AF) detection. AF may present intermittently, thus it is difficult for a healthcare professional to capture and diagnose a symptomatic rhythm. Methods: The iRhythm ZioPatch, AliveCor portable electrocardiogram (ECG), and Apple Watch were chosen for review due to their involvement in controlled clinical trials, and their integration with smartphones. The cost-effectiveness and AF detection of these devices were compared against the 12-lead ambulatory ECG (Holter monitor) that the NHS currently employs for the detection of AF. Results: The Zio patch was found to detect more arrhythmic events than the Holter monitor over a 2-week period. When patients presented to the emergency department with palpitations, AliveCor portable ECGs detected 6-fold more symptomatic events compared to the standard care group over 3-months. Based off preliminary results from the Apple Heart Study, only 0.5% of participants received irregular pulse notifications from the Apple Watch. Discussion: The Zio Patch and AliveCor devices have promising potential to be implemented into the standard duty of care offered by the NHS as they compare well to current routine measures. Nonetheless, companies must address the discrepancy between their target population and current consumers as those that could benefit the most from the innovation may be left out due to cost and access.

Keywords: atrial fibrillation, big data, cardiovascular healthcare management, wearable devices

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Authors: Maiya Smith, Tyler Thorne

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Background: The Pacific faces multiple healthcare crises, including high rates of noncommunicable diseases, infectious disease outbreaks, and susceptibility to natural disasters. These issues are expected to worsen in the coming decades, increasing the burden on an already understaffed healthcare system. Telehealth is not new to the Pacific, but improvements in technology and accessibility have increased its utility and have already proven to reduce costs and increase access to care in remote areas. Telehealth includes distance learning; a form of education that can help alleviate many healthcare issues by providing continuing education to healthcare professionals and upskilling staff, while decreasing costs. This study examined distance learning programs at the Ministry of Health in the Pacific nation of Palau and identified key elements to their successful distance learning programs. Methods: Staff at the Belau National Hospital in Koror, Palau as well as private practitioners were interviewed to assess distance learning programs utilized. This included physicians, IT personnel, public health members, and department managers of allied health. In total, 36 people were interviewed. Standardized questions and surveys were conducted in person throughout the month of July 2019. Results: Two examples of successful distance learning programs were identified. Looking at the factors that made these programs successful, as well as consulting with staff who undertook other distance learning programs, four factors for success were determined: having a cohort, having a facilitator, dedicated study time off from work, and motivation. Discussion: In countries as geographically isolated as the Pacific, with poor access to specialists and resources, telehealth has the potential to radically change how healthcare is delivered. Palau shares similar resources and issues as other countries in the Pacific and the lessons learned from their successful programs can be adapted to help other Pacific nations develop their own distance learning programs.

Keywords: distance learning, Pacific, Palau, telehealth

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Authors: Samuel Fekadu A., Esayas Alemayehu B., Bultum Oljira D., Seid Tiku D., Dessalegn Dadi D., Bart Van Der Bruggen A.

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The peroxi-photoelectrocoagulation process was evaluated for the removal of chemical oxygen demand (COD) and color from healthcare wastewater. A 2-level full factorial design with center points was created to investigate the effect of the process parameters, i.e., initial COD, H₂O₂, pH, reaction time and current density. Furthermore, the total energy consumption and average current efficiency in the system were evaluated. Predictive models for % COD, % color removal and energy consumption were obtained. The initial COD and pH were found to be the most significant variables in the reduction of COD and color in peroxi-photoelectrocoagulation process. Hydrogen peroxide only has a significant effect on the treated wastewater when combined with other input variables in the process like pH, reaction time and current density. In the peroxi-photoelectrocoagulation process, current density appears not as a single effect but rather as an interaction effect with H₂O₂ in reducing COD and color. Lower energy expenditure was observed at higher initial COD, shorter reaction time and lower current density. The average current efficiency was found as low as 13 % and as high as 777 %. Overall, the study showed that hybrid electrochemical oxidation can be applied effectively and efficiently for the removal of pollutants from healthcare wastewater.

Keywords: electrochemical oxidation, UV, healthcare pollutants removals, factorial design

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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Authors: Omer Al-Kaabi, Ahmed Nasr, Abdullah Al-Ghafri, Mohammed Abdelfattah

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The Falaj system, derived from natural water sources, is a man-made canal system designed to supply communities of farmers with water for domestic and agricultural purposes. For thousands of years, Falaj has served communities by harnessing the force of gravity; it persists as a vital water management system in numerous regions across the Sultanate of Oman. Remarkably, predates the establishment of many fundamental hydraulic principles used today. Al-Khatmain Falaj, with its accessibility and historical significance spanning over 2000 years, was chosen as the focal point of this study. The research aimed to investigate the efficiency of Al-Khatmain Falaj in meeting specific water demands. The HEC-RAS model was utilized to visualize water flow dynamics within the Falaj channels, accompanied by graphical representations of pertinent variables. The application of HEC-RAS helped to measure different water flow scenarios within the channel, enabling a clear comparison with the demand area catchment. The cultivated land of Al-Khatmain is 723,124 m² and consists of 16,873 palm trees representing 91% of the total area and the remaining 9% is mixed types of trees counted 3,920 trees. The study revealed a total demand of 8,244 m³ is required to irrigate the cultivated land. Through rigorous analysis, the study has proven that the Falaj system in Al-Khatmain operates with high efficiency, as the average annual water supply is 9676.8 m3/day. Additionally, the channel designed at 0.6m width x 0.3m height efficiently holds the optimal water supply, with an average flow depth of 0.21m. Also, the system includes an overflow drainage channel to mitigate floods and prevent crop damage based on seasonal requirements. This research holds promise for examining diverse hydrological conditions and devising effective strategies to manage scenarios of both high and low flow rates.

Keywords: Al-Khatmain, sustainability, Falaj, HEC-RAS, water management system

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Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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Healthcare facilities are always seen as places of haven and protection for managing the external incidents, but the situation becomes more difficult and challenging when such facilities themselves are affected from internal hazards. Such internal hazards are arguably more disruptive than external incidents affecting vulnerable ones, as patients are always dependent on supportive measures and are neither in a position to respond to such crisis situation nor do they know how to respond. The situation becomes more arduous and exigent to manage if, in case critical care areas like Intensive Care Units (ICUs) and Operating Rooms (OR) are convoluted. And, due to these complexities of patients’ in-housed there, it becomes difficult to move such critically ill patients on immediate basis. Healthcare organisations use different types of electrical equipment, inflammable liquids, and medical gases often at a single point of use, hence, any sort of error can spark the fire. Even though healthcare facilities face many fire hazards, damage caused by smoke rather than flames is often more severe. Besides burns, smoke inhalation is primary cause of fatality in fire-related incidents. The greatest cause of illness and mortality in fire victims, particularly in enclosed places, appears to be the inhalation of fire smoke, which contains a complex mixture of gases in addition to carbon monoxide. Therefore, healthcare organizations are required to have a well-planned disaster mitigation strategy, proactive and well prepared manpower to cater all types of exigencies resulting from internal as well as external hazards. This case report delineates a true OR fire incident in Emergency Operation Theatre (OT) of a tertiary care multispecialty hospital and details the real life evidence of the challenges encountered by OR staff in preserving both life and property. No adverse event was reported during or after this fire commotion, yet, this case report aimed to congregate the lessons identified of the incident in a sequential and logical manner. Also, timely smoke evacuation and preventing the spread of smoke to adjoining patient care areas by opting appropriate measures, viz. compartmentation, pressurisation, dilution, ventilation, buoyancy, and airflow, helped to reduce smoke-related fatalities. Henceforth, precautionary measures may be implemented to mitigate such incidents. Careful coordination, continuous training, and fire drill exercises can improve the overall outcomes and minimize the possibility of these potentially fatal problems, thereby making a safer healthcare environment for every worker and patient.

Keywords: healthcare, fires, smoke, management, strategies

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Authors: Zeynep Sener, Mehtap Dursun

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Supplier evaluation and selection is one of the most important components of an effective supply chain management system. Due to the expanding competition in healthcare, selecting the right medical device suppliers offers great potential for increasing quality while decreasing costs. This paper proposes a fuzzy decision making approach for medical supplier selection. A real-world medical device supplier selection problem is presented to illustrate the application of the proposed decision methodology.

Keywords: fuzzy decision making, fuzzy multiple objective programming, medical supply chain, supplier selection

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Authors: N. S. A. Rahim, N. N. Abu Mansor, M. I. Saidi, N. R. A. Rahim, K. F. Adrutdin

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The use of coaching as one of organizational culture with the contribution of the involvement of line manager roles is an important to update employees’ knowledge and skills continuously. In healthcare sector, it is dynamic that nurse must update their knowledge and skills to keep pace with change. This paper attempts to discuss the involvement of line manager roles towards creating a coaching culture who give their support and innovation towards motivate nurses to give their best performance either in public or private hospitals.

Keywords: nursing, line managers’ roles, coaching, coaching culture

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Authors: Seyed Ali Hossein Zahraei, Iman Dianat

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The role of midwives and healthcare providers in applying pain relief methods to female patients is very important. different therapies like hydropathy, flavorer remedies, and respiratory techniques for pain relief do not work properly as what we expected. Lack of recognition of the physiological property of birth, despite findings that coming will attenuate the consequences of hurting, suggests the necessity for bigger awareness among expectant oldsters, educators, and health professionals of the potential of coming as a way of pain relief. Method: In our method we have 5 steps to achieve activation of oxytocin and dopamine pathways in order to reduce pain in all possible fields and reasons instead of using other treatments such as chemical painkillers. Step 1: First of all the patient should start by rubbing the clitoris up and down till occurring first clitoral orgasm. Step 2: Without stop rubing clitoris the patient must continue stimulate the clitoris in different way like circular motion in clock pathway until occurring second clitoral orgasm. Step 3: Immedietly the patient can change the position from clitoris to urethral opening where vestibular glands located. In this step the patient nock the urethral area very slowly without pressure and just like touching the area till feeling want to pee. But because of activation of sympathic nerves the gi tract is inactive. Step 4: In this step the patient should apply more pressure and change the motion to circular on urethral area in which the pee sensation increase but actually it is vestibular gland fluid. The patient should release it in small amount in this step. Step 5: The last step is combination of clitoral and urethral stimulation in up and down motion that cause more pee feeling and after clitoral orgasm occurred the amount of released fluid can be about 400ml.

Keywords: female, natural, method, pain

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Authors: Mahmud Gungor, Ali Aydin, Erdal Akyol, Suat Tasdelen

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The understanding of geotechnical characteristics of near-surface material and the effects of the groundwater is very important problem in such as site studies. For showing the relations between seismic data and groundwater we selected about 25 km2 as the study area. It has been presented which is a detailed work of seismic data and groundwater depths of Gokpinar Damp area. Seismic waves velocity (Vp and Vs) are very important parameters showing the soil properties. The seismic records were used the method of the multichannel analysis of surface waves near area of Gokpinar Damp area. Sixty sites in this area have been investigated with survey lines about 60 m in length. MASW (Multichannel analysis of surface wave) method has been used to generate one-dimensional shear wave velocity profile at locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 2 and 5 m intervals up to a depth of 45 m. Levels of equivalent shear wave velocity of soil are used the classified of the study area. After the results of the study, it must be considered as components of urban planning and building design of Gokpinar Damp area, Denizli and the application and use of these results should be required and enforced by municipal authorities.

Keywords: seismic data, Gokpinar Damp, urban planning, Denizli

Procedia PDF Downloads 271

Authors: Mingyang Sun, Guozheng Yan, Dasheng Liu, Lei Yang

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Driven by the demand of intelligent monitoring in rehabilitation centers or hospitals, a high accuracy real-time location system based on UWB (ultra-wideband) technology was proposed. The system measures precise location of a specific person, traces his movement and visualizes his trajectory on the screen for doctors or administrators. Therefore, doctors could view the position of the patient at any time and find them immediately and exactly when something emergent happens. In our design process, different algorithms were discussed, and their errors were analyzed. In addition, we discussed about a , simple but effective way of correcting the antenna delay error, which turned out to be effective. By choosing the best algorithm and correcting errors with corresponding methods, the system attained a good accuracy. Experiments indicated that the ranging error of the system is lower than 7 cm, the locating error is lower than 20 cm, and the refresh rate exceeds 5 times per second. In future works, by embedding the system in wearable IoT (Internet of Things) devices, it could provide not only physical parameters, but also the activity status of the patient, which would help doctors a lot in performing healthcare.

Keywords: intelligent monitoring, ultra-wideband technology, real-time location, IoT devices, smart healthcare

Procedia PDF Downloads 116

Authors: Etta Conteh, Tracy Macintosh

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Introduction: Restraints are often used in the Emergency Department when it is necessary for a patient to be restrained in order to decrease their agitation and better treat them. Chemical and physical restraints may be used on these patients at the discretion of the medical provider. Racism and injustice are rampant within our country, and medicine and healthcare are not spared. While racism and racial bias in medicine and healthcare have been studied, information on the differences in the use of restraints by race are scarce. Objective: The objective of this study is to determine if African Americans and Hispanic-American patients are restrained at higher rates compared to their White counterparts. Methods: This study will be carried out through a retrospective analysis utilizing the Hospital Corporation of America (HCA) national Emergency Department (ED) and inpatient database with patient visits from 2016-2019. All patient visits, with patients aged 18 years or older, will be reviewed, looking specifically for the race and the use and type of restraints. Other factors, such a pre-existing psychiatric condition, will be used for sub-analysis. Rationale: The outcome of this project will demonstrate the absence or presence of a racial disparity in the use of restraints in the Emergency Department. These results can be used as a foundation for improving racial equity in healthcare treatment.

Keywords: emergency medicine, public health, racism, restraint use

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Authors: Esther M. Folarin, Evans Osabuohien, Ademola Onabote

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Agriculture constitutes an important part of development and poverty mitigation in lower-middle-income countries, like Nigeria. The level of agricultural productivity in the Nigerian economy in line with the level of demand necessary to meet the desired expectation of the Nigerian populace is threatening to meeting the standard of the United Nations (UN) Sustainable Development Goals (SDGs); This includes the SDG-2 (achieve food security through agricultural productivity). The overall objective of the study is to reveal the performance of the interaction variable in the model among other factors that help in the achievement of greater Nigerian agricultural productivity. The study makes use of Wave 4 (2018/2019) of the Living Standard Measurement Studies, Integrated Survey on Agriculture (LSMS-ISA). Qualitative analysis of the information was also used to provide complimentary answers to the quantitative analysis done in the study. The study employed human capital theory and Grossman’s theory of health Demand in explaining the relationships that exist between the variables within the model of the study. The study engages the Instrumental Variable Regression technique in achieving the broad objectives among other techniques for the other specific objectives. The estimation results show that there exists a positive relationship between female healthcare and the level of female agricultural productivity in Nigeria. In conclusion, the study emphasises the need for more provision and empowerment for greater female access to healthcare and educational attainment levels that aids higher female agricultural productivity and consequently an improvement in the total agricultural productivity of the Nigerian economy.

Keywords: agricultural productivity, education, female, healthcare, investment

Procedia PDF Downloads 61

Authors: Sulaiman D. Al Sabei, Amy M. Ross, Christopher S. Lee

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Nurse leaders play a fundamental role in transforming healthcare system and improving quality of patient care. Several healthcare organizations have called to increase the number of nurse leaders across all levels and in every practice setting. Identification of factors influencing nurses’ willingness to lead can inform healthcare leaders and policy makers of potentially illuminating strategies for establishing favorable work environments that motivate nurses to engage in leadership roles. The aim of this study was to investigate determinants of nurses’ willingness to engage in future leadership roles. The study was conducted at a public hospital in the Sultanate of Oman. A total of 171 registered nurses participated. A multilevel modeling was conducted. Findings revealed that 80% of nurses were likely to seek out opportunities to engage in leadership roles. The quality of the nurse-physician collegial relationships was a significant predictor of nurses’ willingness to lead. Establishing a work environment’s culture of positive nurse-physician relationships is critical to enhance nurses’ work attitude and engage them in leadership roles.

Keywords: interprofessional relationship, leadership, motivation, nurses

Procedia PDF Downloads 168

Authors: Ezman Fitriansyah, Lestari Diah Restu, Wawan

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Adaro coal mine in South Kalimantan-Indonesia maintains catchment area of approximately 15,000 Ha for its mine operation. As an open pit surface coal mine with high erosion rate, the mine water in Adaro coal mine contains high TSS that needs to be treated before being released to rivers. For the treatment process, Adaro operates 21 Settling Ponds equipped with combination of physical and chemical system to separate solids and water to ensure the discharged water complied with regional environmental quality standards. However, the sludge created from the sedimentation process reduces the settling ponds capacity gradually. Therefore regular maintenance activities are required to recover and maintain the ponds' capacity. Trucking system and direct dredging had been the most common method to handle sludge in Adaro. But the main problem in applying these two methods is excessive area required for drying pond construction. To solve this problem, Adaro implements an alternative method called Geotube®. The principle of Geotube® method is the sludge contained in the Settling Ponds is pumped into Geotube® containers which have been designed to release water and retain mud flocks. During the pumping process, an amount of flocculants chemicals are injected into the sludge to form bigger mud flocks. Due to the difference in particle size, the mud flocks are settled in the container whilst the water continues to flow out through the container’s pores. Compared to the trucking system and direct dredging method, this method provides three advantages: space required to operate, increasing of overburden waste dump volume, and increasing of water treatment process speed and quality. Based on the evaluation result, Geotube® method only needs 1:8 of space required by the other methods. From the geotechnical assessment result conducted by Adaro, the potential loss of waste dump volume capacity prior to implementation of the Geotube® method was 26.7%. The water treatment process of TSS in well maintained ponds is 16% more optimum.

Keywords: geotube, mine water, settling pond, sludge handling, wastewater treatment

Procedia PDF Downloads 178