Search results for: healthcare regulations

Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

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Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

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Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: ecosystem, business model, personal data, preventive healthcare

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: Partha Saha, Uttam Kumar Banerjee

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Maternal and Child Healthcare (MCH) has always been regarded as one of the important issues globally. Reduction of maternal and child mortality rates and increase of healthcare service coverage were declared as one of the targets in Millennium Development Goals till 2015 and thereafter as an important component of the Sustainable Development Goals. Over the last decade, worldwide MCH indicators have improved but could not match the expected levels. Progress of both maternal and child mortality rates have been monitored by several researchers. Each of the studies has stated that only less than 26% of low-income and middle income countries (LMICs) were on track to achieve targets as prescribed by MDG4. Average worldwide annual rate of reduction of under-five mortality rate and maternal mortality rate were 2.2% and 1.9% as on 2011 respectively whereas rates should be minimum 4.4% and 5.5% annually to achieve targets. In spite of having proven healthcare interventions for both mothers and children, those could not be scaled up to the required volume due to fragmented health systems, especially in the developing and under-developed countries. In this research, a knowledge discovery based interactive Decision Support System (DSS) has been developed on web platform which would assist healthcare policy makers to develop evidence-based policies. To achieve desirable results in MCH, efficient resource planning is very much required. In maximum LMICs, resources are big constraint. Knowledge, generated through this system, would help healthcare managers to develop strategic resource planning for combatting with issues like huge inequity and less coverage in MCH. This system would help healthcare managers to accomplish following four tasks. Those are a) comprehending region wise conditions of variables related with MCH, b) identifying relationships within variables, c) segmenting regions based on variables status, and d) finding out segment wise key influential variables which have major impact on healthcare indicators. Whole system development process has been divided into three phases. Those were i) identifying contemporary issues related with MCH services and policy making; ii) development of the system; and iii) verification and validation of the system. More than 90 variables under three categories, such as a) educational, social, and economic parameters; b) MCH interventions; and c) health system building blocks have been included into this web-based DSS and five separate modules have been developed under the system. First module has been designed for analysing current healthcare scenario. Second module would help healthcare managers to understand correlations among variables. Third module would reveal frequently-occurring incidents along with different MCH interventions. Fourth module would segment regions based on previously mentioned three categories and in fifth module, segment-wise key influential interventions will be identified. India has been considered as case study area in this research. Data of 601 districts of India has been used for inspecting effectiveness of those developed modules. This system has been developed by importing different statistical and data mining techniques on Web platform. Policy makers would be able to generate different scenarios from the system before drawing any inference, aided by its interactive capability.

Keywords: maternal and child heathcare, decision support systems, data mining techniques, low and middle income countries

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Authors: Khalid Alshaikh

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In recent years, leadership, Corporate Governance (CG) and Corporate Social Responsibility (CSR) have been under scrutiny in the Libyan society. Scholars and institutions have commenced investigating the possible resolutions they can arrange to alleviate the economic, social and environmental problems the war has produced. Thus far, these constructs requisite an in-depth reinvestigation, reconceptualization, and analysis to clearly reconstruct their rules and regulations. With the demise of Qaddafi’s regime, levels, degrees, and efforts to apply CG regulations have varied in public and private commercial banks. CSR is a new organizational culture that still designs its route within these financial institutions. Detaching itself from any notion of dictatorship and autocratic traits, leadership counts on transformational and transactional styles. Therefore, this paper investigates the extent to which the Board of Directors and Chief Executive Officers (CEOs) redefine these concepts and how they entrench CSR within the framework of CG. The research methodology used both public and private banks as a case study and qualitative research to interview ten Board of Directors (BoDs) and eleven Chief executive managers to explore how leadership, CG, and CSR are defined and how leadership integrates CSR into CG structures. The findings suggest that the CG framework in Libya still requires great efforts to be developed. Full CG code implementation appears daunting. Also, the CSR is still influenced by the power of religion. Nevertheless, the Islamic perspective is more consistent with the social contract concept of the CSR. The Libyan commercial banks do not solely focus on the economic side of maximizing profits, but also concentrate on its morality. The issue is that CSR activities are not enough to achieve good charity publicly and needs strategies to address major social issues. Moreover, leadership is more transformational and transactional and endeavors to make economic, social and environmental changes, but these changes are curtailed by tradition and traditional values dominating the Libyan social life where religious and tribal practices establish the relationship between leaders and their subordinates. Finally, the findings reveal that transformational and transactional leadership styles encourage the incorporation of CSR into the CG regulations. The boardroom and executive management have such a particular role in flagging up how embedded corporate Social responsibility is in organizational culture across the commercial banks, yet it is still important that the BoDs and CEOs need to do much more to embed corporate social responsibility through their core functions. They need to boost their standing to be more influential and make sure that the right discussions about CSR happen with the right stakeholders involved.

Keywords: board of directors, chief executive officers, corporate governance, corporate social responsibility

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Authors: Neha Joshi, Srikanth Jois, Hector J. Peughero, Poornima Jayakrishna, Moulya R., Purnima Madivanan, Kiran Kumar K. Salagame

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Transgenders are a marginalized section of the community, who are at high risk of mental health problems due to their stigmatization, abandonment by family, prejudice, discrimination by society at large, and the physical, emotional, and sexual abuse from both within and outside their community. Their mental healthcare needs remain largely unaddressed due to lack of access, discrimination by healthcare professions, and lack of resources, including time and money, to seek conventional medical and psychotherapeutic treatments. Meditation is increasingly receiving acceptance as a tool for managing stress and anxiety by the patients as well as mental healthcare professionals. “Meditation on Twin Hearts” is a no cost, self-administered intervention that a person can practice anywhere and at any time of the day. This pilot study evaluates the need for alternate traditional and ingenious interventions like “Meditation of Twin Hearts” to address the mental healthcare needs of the transgender community and acceptance of such an intervention by the community. Thirteen individuals identifying themselves as transgender were invited to participate in one (Hunsur Taluk) of the five scheduled free meditation camps in Mysore. After obtaining informed consent for participation in the study, their mental health status is captured using an anonymous survey using standard, validated, self-reported questionnaires Generalised Anxiety Disorders (GAD)-7 for anxiety, Patient Health Questionnaire (PHQ-9) for depression, and Suicidal Behavior Questionnaire-Revised for suicidality. Then, they were requested to attend a session on “Meditation on Twin Hearts.” After the session, their feedback on willingness to further explore the meditation technique for managing their mental healthcare need was assessed through another survey form. Out of the 13 participants, 92% scored for anxiety (4 mild, and 8 moderate anxiety). In the depression scale, 5 scored for mild and 5 for moderate depression, with a total of 77% (10/13) scoring positively on depression scale. Nearly 70% of participants (9/13), scored greater than the clinical cutoff for the need for clinical intervention. The proportion of individuals at risk for suicide was particularly high in this group, with 8/ 13 (61.5%) participants scoring the clinical cutoff score of ≥ 7. Surprisingly, none of the participants had ever consulted a mental healthcare professional. All the participants (13/13; 100%) responded in affirmative to the question, “Will you be willing to continue meditation for management of your anxiety?” Six out of 13 participants described their experience of meditation as “happy” and 3 described it as “peaceful”. None of the participants reported any negative beliefs or experience regarding the meditation. The study provides evidence for the urgent yet unmet mental healthcare need of the transgender community. The findings of the study also supports the rationale of conducting future systematic research to evaluate and explore ingenious and traditional practices, such as meditation, to meet the healthcare needs, especially in marginalized populations in a low income setting such as Lower and Middle Income countries. Based on these preliminary findings, the Principal Investigator (PI) is planning to cover 4 more areas of Mysore district.

Keywords: anxiety, depression, meditation on twin heart, suicidality, transgender

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Authors: Nazura Abdul Manap, Siti Nur Farah Atiqah Salleh

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For decades, the misuse of personal data has been a critical issue. Malaysia has accepted responsibility by implementing the Malaysian Personal Data Protection Act 2010 to secure personal data (PDPA 2010). After more than a decade, this legislation is set to be revised by the current PDPA 2023 Amendment Bill to align with the world's key personal data protection regulations, such as the European Union General Data Protection Regulations (GDPR). Among the other suggested adjustments is the Data User's appointment of a Data Protection Officer (DPO) to ensure the commercial entity's compliance with the PDPA 2010 criteria. The change is expected to be enacted in parliament fairly soon; nevertheless, based on the experience of the Personal Data Protection Department (PDPD) in implementing the Act, it is projected that there will be a slew of additional concerns associated with the DPO mandate. Consequently, the goal of this article is to highlight the issues that the DPO will encounter and how the Personal Data Protection Department should respond to this subject. The study result was produced using a qualitative technique based on an examination of the current literature. This research reveals that there are probable obstacles experienced by the DPO, and thus, there should be a definite, clear guideline in place to aid DPO in executing their tasks. It is argued that appointing a DPO is a wise measure in ensuring that the legal data security requirements are met.

Keywords: guideline, law, data protection officer, personal data

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Authors: Merav Ben Natan, Yaniv Steinfeld, Sara Badash, Galina Shmilov, Milena Abramov, Danny Epstein, Yaniv Yonai, Eyal Berbalek, Yaron Berkovich

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Introduction: Postoperative pain management is crucial for effective rehabilitation, with the Visual Analog Scale (VAS) being a common tool for assessing pain intensity due to its sensitivity and accuracy. However, challenges such as misunderstanding of instructions and discrepancies in pain reporting can affect its reliability. Additionally, the mandatory use of face masks during the COVID-19 pandemic may impair nonverbal and verbal communication, potentially impacting pain assessment and overall care quality. Aims: This study examines the association between the type of mask worn by health care professionals and the assessment of pain intensity in patients after orthopedic surgery using the visual analog scale (VAS). Design: A nonrandomized controlled trial was conducted among 176 patients hospitalized in an orthopedic department of a hospital located in northern-central Israel from January to March 2021. Methods: In the intervention group (n = 83), pain assessment using the VAS was performed by a healthcare professional wearing a transparent face mask, while in the control group (n = 93), pain assessment was performed by a healthcare professional wearing a standard nontransparent face mask. The initial assessment was performed by a nurse, and 15 minutes later, an additional assessment was performed by a physician. Results: Healthcare professionals wearing a standard non-transparent mask obtained higher VAS scores than healthcare professionals wearing a transparent mask. In addition, nurses obtained lower VAS scores than physicians. The discrepancy in VAS scores between nurses and physicians was found in 50% of cases. This discrepancy was more prevalent among female patients, patients after knee replacement or spinal surgery, and when health care professionals were wearing a standard nontransparent mask. Conclusions: This study supports the use of transparent face masks by healthcare professionals in an orthopedic department, particularly by nurses. In addition, this study supports the assumption of problems involving the reliability of VAS.

Keywords: postoperative pain management, visual analog scale, face masks, orthopedic surgery

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Authors: Dina Dahood Dabash

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Refugee camps are habitually defined as receptive sites, transient spaces of exile and nondescript depoliticized places of exception. However, such arguments form partial sides of reality, especially in countries that are geopolitically challenged and rely immensely on international aid. In Jordan, the dynamics brought with the floating population of refugees (Palestinian amongst others) have resulted in spatial after-effects that cannot be easily overlooked. For instance, Palestine refugee camps have turned by time into socioeconomic centers of gravity and cores of spatial evolution. Yet, such a position is not instantaneous. Amongst various reasons, it can be related, according to this paper, to a distinctive institutional climate that has been co-produced by the refugees, host community and the state. This paper aims to investigate the evolution of urban and spatial regulations in Jordan between 1948 and 1995, more specifically, state regulations, community regulations and refugee-self-regulation that all dynamically interacted that period. The paper aims to unpack the relations between refugee camps and their environs to further explore the agency of such floating populations in establishing rooted networks that extended the time and place boundaries. The paper’s argument stems from the fact that the spatial configuration of urban systems is not only an outcome of a historical evolutionary process but is also a result of interactions between the actors. The research operationalizes Marka camp in Jordan as a case study. Marka Camp is one of the six "emergency" camps erected in 1968 to shelter 15,000 Palestine refugees and displaced persons who left the West Bank and Gaza Strip. Nowadays, camp shelters more than 50,000 refugees in the same area of land. The camp is located in Russeifa, a city in Zarqa Governorate in Jordan. Together with Amman and Zarqa, Russeifa is part of a larger metropolitan area that acts as a home to more than half of Jordan’s businesses. The paper aspires to further understand the post-conflict strategies which were historically applied in Jordan and can be employed to handle more recent geopolitical challenges such as the Syrian refugee crisis. Methodological framework: The paper traces the evolution of the refugee-camp regulating norms in Jordan, parallel with the horizontal and vertical evolution of the Marka camp and its surroundings. Consequently, the main methods employed are historical and mental tracing, Interviews, in addition to using available Aerial and archival photos of the Marka camp and its surrounding.

Keywords: forced migration, Palestine refugee camps, spatial agency, urban regulations

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Authors: Bruce X. B. Yu, Yan Liu, Keith C. C. Chan

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We propose to record Activities of Daily Living (ADLs) of elderly people using a vision-based system so as to provide better assistive and personalization technologies. Current ADL-related research is based on data collected with help from non-elderly subjects in laboratory environments and the activities performed are predetermined for the sole purpose of data collection. To obtain more realistic datasets for the application, we recorded ADLs for the elderly with data collected from real-world environment involving real elderly subjects. Motivated by the need to collect data for more effective research related to elderly care, we chose to collect data in the room of an elderly person. Specifically, we installed Kinect, a vision-based sensor on the ceiling, to capture the activities that the elderly subject performs in the morning every day. Based on the data, we identified 12 morning activities that the elderly person performs daily. To recognize these activities, we created a HARELCARE framework to investigate into the effectiveness of existing Human Activity Recognition (HAR) algorithms and propose the use of a transfer learning algorithm for HAR. We compared the performance, in terms of accuracy, and training progress. Although the collected dataset is relatively small, the proposed algorithm has a good potential to be applied to all daily routine activities for healthcare purposes such as evidence-based diagnosis and treatment.

Keywords: daily activity recognition, healthcare, IoT sensors, transfer learning

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Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob

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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.

Keywords: technical, environmental, healthcare, characteristic of medical equipment

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Authors: Neda Safari, Jacob Petersen-Perlman

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There are more than two million dams in the United States, and a considerable portion of them are either non-operational or approaching the end of their designed lifespan. However, this emerging trend is new, and the majority of dam sites have not undergone thorough research and assessments after their removal to determine the overall effectiveness of restoration initiatives, particularly in the case of large-scale dams that may significantly impact their surrounding areas. A crucial factor to consider is the lack of specific regulations pertaining to dam removal at the federal level. Consequently, other environmental regulations that were not originally designed with dam removal considerations are used to execute these projects. This can result in delays or challenges for dam removal initiatives. The process of removing dams is usually the most important first step to restore the ecological and biological health of the river, but often there is a lack of measurable indicators to assess if it has achieved its intended objectives. In addition, the majority of studies on dam removal are only short-term and focus on a particular measure of response. Therefore, it is essential to conduct extensive and continuous monitoring to analyze the river's response throughout every aspect. Our study is divided into two sections. The first section of my research will analyze the establishment and utilization of dam removal laws and regulations in the Condit Dam removal process. We will highlight the areas where the frameworks for policy and dam removal projects remain in need of improvement in order to facilitate successful dam removals in the future. In this part, We will review the policies and plans that affected the decision-making process to remove the Condit dam while also looking at how they impacted the physical changes to the river after the dam was removed. In the second section, we will look at the effects of the dam removal over a decade later and attempt to determine how the river's physical response has been impacted by this modification. Our study aims to investigate the Condit dam removal process and its impact on the ecological response of the river. We anticipate identifying areas for improvement in policies pertaining to dam removal projects and exploring ways to enhance them to ensure improved project outcomes in the future.

Keywords: dam removal, ecolocgical change, water related regulation, water resources

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Authors: Julia Wimmers Klick

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Interprofessional Education (IPE) is widely recognized as a valuable approach in healthcare education, despite the challenges it presents. This study explores IP surface anatomy lab sessions, with a focus on fostering trust and collaboration among healthcare students. The research is conducted within the context of rural healthcare settings in British Columbia (BC), where a medical school and a physical therapy (PT) program operate under the Faculty of Medicine at the University of British Columbia (UBC). While IPE sessions addressing soft skills have been implemented, the integration of hard skills, such as Anatomy, remains limited. To address this gap, a pilot feasibility study was conducted with a positive outcome, a follow-up study involved these IPE sessions aimed at exploring the influence of bonding and trust between medical and PT students. Data were collected through focus groups comprising participating students and faculty members, and a structured SWOC (Strengths, Weaknesses, Opportunities, and Challenges) analysis was conducted. The IPE sessions, 3 in total, consisted of a 2.5-hour lab on surface anatomy, where PT students took on the teaching role, and medical students were newly exposed to surface anatomy. The focus of the study was on the relationship-building process and trust development between the two student groups, rather than assessing the acquisition of surface anatomy skills. Results indicated that the surface anatomy lab served as a suitable tool for the application and learning of soft skills. Faculty members observed positive outcomes, including productive interaction between students, reversed hierarchy with PT students teaching medical students, practicing active listening skills, and using a mutual language of anatomy. Notably, there was no grade assessment or external pressure to perform. The students also reported an overall positive experience; however, the specific impact on the development of soft skill competencies could not be definitively determined. Participants expressed a sense of feeling respected, welcomed, and included, all of which contributed to feeling safe. Within the small group environment, students experienced becoming a part of a community of healthcare providers that bonded over a shared interest in health professions education. They enjoyed sharing diverse experiences related to learning across their varied contexts, without fear of judgment and reprisal that were often intimidating in single professional contexts. During a joint Christmas party for both cohorts, faculty members observed students mingling, laughing, and forming bonds. This emphasized the importance of early bonding and trust development among healthcare colleagues, particularly in rural settings. In conclusion, the findings emphasize the potential of IPE sessions to enhance trust and collaboration among healthcare students, with implications for their future professional lives in rural settings. Early bonding and trust development are crucial in rural settings, where healthcare professionals often rely on each other. Future research should continue to explore the impact of content-concentrated IPE on the development of soft skill competencies.

Keywords: interprofessional education, rural healthcare settings, trust, surface anatomy

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Authors: Iram Malik, Mahrukh Shaukat, Abeer Malik, Hafiz Mushtaq Ahmad

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There has been a lot of research on cyberbullying but there is limited research on the topic of accidental cyberbullying on social media with a special focus on healthcare industry. This study emphasizes to uncover the factors that contribute to accidental cyberbullying on social media and how it affects individuals, professionals’ and organizations in health care sector. Nowadays social media is becoming a necessary part of our daily life; there is a need to look into how it is shaping our social life and behaviors displayed online. Instances of cyber bullying can have long-term repercussions due to over-sharing of information. The study used simple random sampling and the instrument of data collection was survey. A sample size of 250 healthcare professionals was chosen from the twin cities of Rawalpindi and Islamabad, Pakistan to examine the relationship between their attitude towards internet use, psychological distress, verbal aggression, envy, frustration, self-compassion, personality traits and accidental cyberbullying on social media. The results of the study have been encouraging. The findings show that psychological distress, aggression, envy, frustration and personality traits had direct effect on accidental cyberbullying whereas compassion, altruism lessened the effect of accidental cyberbullying behavior. It is our intent that the findings of this study could help raise awareness regarding fair use of social media, help policy makers in developing appropriate policies for avoiding cyberbullying in future.

Keywords: accidental cyberbullying, aggression, cyberbullying, frustration, social media

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Authors: Emmanuel Chinaguh, Kehinde Adeosun

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Nigerians die untimely, with 55.75 years of life expectancy, which is 17.45 below the world average of 73.2 (Worldometer, 2020). This is due, among other factors, to the country's limited access to high-quality healthcare. To increase access to good and affordable healthcare services, the National Health Insurance Authority (NHIA) Bill 2022 – which repealed the National Health Insurance Scheme Act 2004 – was passed into law. Applying Jacob Mey’s (2001) pragmatics act (pract) theory, this study explores how NHIA seeks to actualise these healthcare goals by characterising the general situational prototype or pragmemes and pragmatic acts in institutional communications. Data was sourced from the NHIA operational guidelines, which has 147 pages and four sections, and shared posters on NHIA Nigeria Twitter Handle with 14,200 followers. Digital humanities tools, like AntConc and Voyant, were engaged in the data analysis for text encoding and data visualisation. This study identifies these discourse tokens in the data: advertisement and programmes, standards and accreditation, records and information, and offences and penalties. Advertisement and programmes pract facilitating, propagating, prospecting, advising and informing; standards and accreditation, and records and information pract stating, informing and instructing; and offences and penalties pract stating and sanctioning. These practs combined to advance the goals of affordable care and universal accessibility to quality healthcare services. The pragmatic acts were marked by these pragmatic tools: shared situational knowledge (SSK), relevance (REL), reference (REF) and inference (INF). This paper adds to the understanding of health insurance discourse in Nigeria as a mediated social practice that promotes the health of Nigerians.

Keywords: affordable care, NHIA, Nigeria’s health insurance discourse, pragmatic acts.

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Authors: Aran Dezhban, Hooshang Dolatshahi Pirooz

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The phenomenon of corrosion, especially in the Persian Gulf region, is the main cause of the deterioration of offshore platforms, due to the high corrosion of its water. This phenomenon occurs mostly in the area of water spraying, threatening the members of the first floor of the jacket, legs, and piles in this area. In the current study, the effect of bracing arrangement on the Capacity Curve and Reserve Strength Ratio of Fixed-Type Offshore Platforms is investigated. In order to continue the operation of the platform, two modes of robust and damaged structures are considered, while checking the adequacy of the platform capacity based on the allowable values of API RP-2SIM regulations. The platform in question is located in the Persian Gulf, which is modeled on the OpenSEES software. In this research, the Nonlinear Pushover Analysis has been used. After validation, the Capacity Curve of the studied platforms is obtained and then their Reserve Strength Ratio is calculated. Results are compared with the criteria in the API-2SIM regulations.

Keywords: fixed-type jacket structure, structural integrity management, nonlinear pushover analysis, robust and damaged structure, reserve strength ration, capacity curve

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Authors: Pırıl Tekin, Rızvan Erol

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Risk management has become very important and popular in developing countries in recent years. Especially making patient and employee health and safety issues compulsory in the hospitals, raised the number of studies in Turkey. Also risk management become more important for hospital senior management from clinics to the laboratories. Because quality is really important to be chosen for both patients to consult and employees to prefer to work. And also risk management studies can lead to hospital management team about future works and methods. By this point of view, this study is the risk assessment carried out in the biggest dental hospital in the south part of Turkey. This study was conducted as a research case study, covering two different health care place; A Clinic and A Laboratory. It shows that the problems in this dental hospital and how it can solve all.

Keywords: risk management, healthcare, dental hospital, quality management

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Authors: Haroon Mahmood, Christopher Gan, Cuong Nguyen

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Maturity transformation risk is highlighted as one of the major causes of recent global financial crisis. Basel III has proposed new liquidity regulations for transformation function of banks and hence to monitor this risk. Specifically, net stable funding ratio (NSFR) is introduced to enhance medium- and long-term resilience against liquidity shocks. Islamic banking is widely accepted in many parts of the world and contributes to a significant portion of the financial sector in many countries. Using a dataset of 68 fully fledged Islamic banks from 11 different countries, over a period from 2005 – 2014, this study has attempted to analyze various factors that may significantly affect the maturity transformation risk in these banks. We utilize 2-step system GMM estimation technique on unbalanced panel and find bank capital, credit risk, financing, size and market power are most significant among the bank specific factors. Also, gross domestic product and inflation are the significant macro-economic factors influencing this risk. However, bank profitability, asset efficiency, and income diversity are found insignificant in determining the maturity transformation risk in Islamic banking model.

Keywords: Basel III, Islamic banking, maturity transformation risk, net stable funding ratio

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Authors: Juliana Brandao, Holly Gibbs, Lisa Naughton, Lisa Rausch

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The Brazilian Amazon continues to be plagued by modern day slave labor, specifically within the cattle production industry. In response to this issue, modern day anti-slavery activists have implemented additional regulations designed to combat slave labor associated with cattle. These regulations have been incorporated into existing agreements designed to control deforestation. The goal of these rules is to prevent the trade of beef contaminated with modern slave labor between supplier farms and slaughterhouses. In this study, we identify farms that make use of modern slave labor, and we use cattle transaction data to track the sale of cattle between farms and slaughterhouses. Our analysis reveals that slaughterhouses, which have signed cattle agreements that include requirements to refuse cattle associated with modern slave labor, have avoided buying cattle from suppliers that were on the dirty list. This trend is especially evident when the "dirty lists" that identify modern-day slave labor users are made publicly accessible online. We conclude that the "dirty list" of modern-day slave labor users should be maintained on publicly available websites to allow slaughterhouses, retailers, and consumers to send powerful market signals that discourage the use of modern-day slave labor.

Keywords: cattle ranchers, modern slave labor, deforestation, brazilian amazon

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Authors: Zbigniew Izdebski, Alicja Kozakiewicz, Maciej Białorudzki, Joanna Mazur

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Work is an extremely important part of everyone's life and affects functioning in daily life. Healthcare workers (HCW) are suffering from negative actions in and out of the workplace, such as harassment, abuse, long working hours, mental suffering, exhaustion, and professional burnout. Staff burnout is detrimental not only in terms of individual employees but also to working with patients and to the healthcare institution as a whole. The purpose of this study was to explore the level of professional burnout among HCW working in medical institutions during the COVID-19 pandemic in Poland. The extent to which selected sociodemographic factors and perceived stress increase the risk of professional burnout was assessed. In addition, the frequency of use of professional psychological help and less formal support groups by HCW in relation to the level of professional burnout was presented. The survey was conducted as part of a larger project on the humanization of medicine and clinical communication from February-April 2022. This study used a self-administered online survey (CAWI) technique and PAPI (pen and paper interview) technique. The BAT-12 scale was used to measure burnout, the PSS-4 scale was used to measure stress, and questions formulated by the research team were also used. For the purpose of analysis, the sample was limited to 2196 HCWs who worked on a daily basis with patients during the COVID-19 pandemic. Frequency distributions were analyzed, and multivariate logistic regression was performed. The mean scores (scores) of job burnout as measured by the BAT-12 scale ranged among the professional groups from 2.15(0.69) to 2.30 (0.69) and remained highest for the nurses' group. The groups differed significantly in levels of burnout (chi-sq=17.719; d.f.=8; p<0.023). In the final model, raised stress most likely increased the risk of burnout (OR=3.88; 95%CI <3.13-3.81>; p<0,001). Other significant predictors of burnout included: traumatic work-related experience (OR=1.91, p<0.001), mobbing (OR=1.83, p<0.001), and a higher workload than before the pandemic (OR=1.41, p=0.002). Only 7% of respondents decided to use various forms of psychological support during the pandemic. HCW experiences challenges in dealing with an unpredictable pandemic. Limited preparedness can lead to physical and psychological problems such as high-stress levels, anxiety, fear, helplessness, hopelessness, anger and stigma. The workload can lead to professional burnout, as well as threaten patient safety.

Keywords: burnout, work, healthcare, healthcare worker, stress

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Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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Authors: Amirreza Razzaghipour, Mahdi Khalili

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References from the World Health Organization and the Center for Disease Control for deceleration the spread of the Novel COVID-19, comprises social estrangement, frequent handwashing, and covering your mouth when around others. As hearing healthcare specialists, the influence of existenceinvoluntary to boundary social interactions on persons with hearing impairment was significant for us to understand. We found ourselves delaying cochlear implant (CI) surgeries. All children, and chiefly those with hearing loss, are susceptible to reductions in spoken communication. Hearing plans, such as cochlear implants, provide children with hearing loss access to spoken communication and provision language development. when provided early and used consistently, these supplies help children with hearing loss to engage in spoken connections. Cochlear implant (CI) is a standard medical-surgical treatment for bilateral severe to profound hearing loss with no advantage with the hearing aid. Hearing is one of the most important senses in humans. Pediatric hearing loss establishes one of the most important public health challenges. Children with hearing loss are recognized early and habilitated via hearing aids or with cochlear implants (CIs). Suitable care and maintenance as well as continuous auditory verbal therapy (AVT) are also essential in reaching for the successful attainment of language acquisition. Children with hearing loss posture important challenges to their parents, particularly when there is limited admission to their hearing care providers. The disruption in the routine of their hearing and therapy follow-up services has had substantial effects on the children as well as their parents.

Keywords: healthcare, covid-19, cochlear implants, spoken communication, hearing loss

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Authors: Pello Alfonso-Muniozguren, Madeleine Bussemaker, Devendra Saroj, Judy Lee

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Wastewater treatment is becoming a worldwide concern due to new and tighter environmental regulations, and the increasing need for fresh water for the exponentially growing population. The meat industry has one of the highest consumption of water producing up to 10 times more polluted (BOD) wastewaters in comparison to domestic sewage. Therefore, suitable wastewater treatment methods are required to ensure the wastewater quality meet regulations before discharge. In the present study, a combined lab scale activated sludge-sonication system was used to treat pre-treated abattoir wastewater. A hydraulic retention time of 24 hours and a solid retention time of 13 days were used for the activated sludge process and using ultrasound as tertiary treatment. Different ultrasonic frequencies, powers and sonication times were applied to the samples and results were analysed for chemical oxygen demand (COD), biological oxygen demand (BOD), total suspended solids, pH, total coliforms and total viable counts. Additionally, both mechanical and chemical effects of ultrasound were quantified for organic matter removal (COD and BOD) and disinfection (microorganism inactivation) using different techniques such as aluminum foil pitting, flow cytometry, and KI dosimetry.

Keywords: abattoir wastewater, ultrasound, wastewater treatment, water disinfection

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Authors: Shir Daphna-Tekoah, Nurit Eitan-Gutman, Uri Balla

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Background: Systemic documentation is essential in social work practice. Collaboration between an institution of higher education and social work health care services enabled adaptation of the medical documentation model of SOAP in the field of social work, by creating the ISOAPS model (Introduction, Subjective, Objective, Assessment, Plan, Summary) model. Aims: The article describes the ISOAPS model and its implementation in the field of social work, as a tool for standardization of documentation and the enhancement of multidisciplinary collaboration. Methods: We examined the changes in standardization using a mixed methods study, both before and after implementation of the model. A review of social workers’ documentation was carried out by medical staff and social workers in the Clalit Healthcare Services, the largest provider of public and semi-private health services in Israel. After implementation of the model, semi-structured qualitative interviews were undertaken. Main findings: The percentage of reviewers who evaluated their documentation as correct increased from 46%, prior to implementation, to 61% after implementation. After implementation, 81% of the social workers noted that their documentation had become standardized. The training process prepared them for the change in documentation and most of them (83%) started using the model on a regular basis. The qualitative data indicate that the use of the ISOAPS model creates uniform documentation, improves standards and is important to teach social work students. Conclusions: The ISOAPS model standardizes documentation and promotes communication between social workers and medical staffs. Implications for practice: In the intricate realm of healthcare, efficient documentation systems are pivotal to ensuring coherent interdisciplinary communication and patient care. The ISOAPS model emerges as a quintessential instrument, meticulously tailored to the nuances of social work documentation. While it extends its utility across the broad spectrum of social work, its specificity is most pronounced in the medical domain. This model not only exemplifies rigorous academic and professional standards but also serves as a testament to the potential of contextualized documentation systems in elevating the overall stature of social work within healthcare. Such a strategic documentation tool can not only streamline the intricate processes inherent in medical social work but also underscore the indispensable role that social workers play in the broader healthcare ecosystem.

Keywords: ISOAPS, professional documentation, medial social-work, social work

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Authors: María Dolores Caro, Eugenio M. Fedriani, Ángel F. Tenorio

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When lorries transport dangerous goods, there exist some legal stipulations in the European Union for assuring the security of the rest of road users as well as of those goods being transported. At this respect, lorry drivers cannot park in usual parking areas, because they must use parking areas with special conditions, including permanent supervision of security personnel. Moreover, drivers are compelled to satisfy additional regulations about resting and driving times, which involve in the practical possibility of reaching the suitable parking areas under these time parameters. The “European Agreement concerning the International Carriage of Dangerous Goods by Road” (ADR) is the basic regulation on transportation of dangerous goods imposed under the recommendations of the United Nations Economic Commission for Europe. Indeed, nowadays there are no enough parking areas adapted for dangerous goods and no complete study have suggested the best locations to build new areas or to adapt others already existing to provide the areas being necessary so that lorry drivers can follow all the regulations. The goal of this paper is to show how many additional parking areas should be built in the Iberian Peninsula to allow that lorry drivers may park in such areas under their restrictions in resting and driving time. To do so, we have modeled the problem via graph theory and we have applied a new efficient algorithm which determines an optimal solution for the problem of locating new parking areas to complement those already existing in the ADR for the Iberian Peninsula. The solution can be considered minimal since the number of additional parking areas returned by the algorithm is minimal in quantity. Obviously, graph theory is a natural way to model and solve the problem here proposed because we have considered as nodes: the already-existing parking areas, the loading-and-unloading locations and the bifurcations of roads; while each edge between two nodes represents the existence of a road between both nodes (the distance between nodes is the edge's weight). Except for bifurcations, all the nodes correspond to parking areas already existing and, hence, the problem corresponds to determining the additional nodes in the graph such that there are less up to 100 km between two nodes representing parking areas. (maximal distance allowed by the European regulations).

Keywords: dangerous goods, parking areas, Iberian peninsula, graph-based modeling

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Authors: Ibrahim Arslan

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Since 1984, Turkey has experienced a significant transformation in legal and economic matters. The most consequential examples of this transformation in recent years are the renewal of the Commercial Code and the Check Act. Nowadays, the commercial activity is not limited within the boundaries of the country; on the contrary, as required by the global economy, it has an international dimension. For this reason, unlike some other legal principles, the rules regulating the commercial life should be compatible with the international standards as much as possible. Otherwise the development possibility in the global markets will be limited. The Check Act has been adopted in 2009 and the Commercial Code has been adopted in 2011. The Commercial Code has been entered into force on 1 July 2012. The international dimension of check is in-disputable for it is based on the Geneva Convention. However, the Turkish business life has created a unique application of this legal tool. This application is called “post-date” checks. Indeed the majority of the checks being used in the market are post-dated checks. The holders of these checks have waited the date written on the check for presentation and collection. Thus, the actual situation has occurred. This actual situation has been legitimized via Check Act No. 5941 and post dated checks have gained a legal status. In the preparation of the new the Turkish Commercial Code one of the goals is "to ensure that the Turkish commercial law becomes a part of the international market". To achieve this goal, significant changes have been made especially concerning the independent external audition of the corporations, the board structure and public disclosure regulations. These changes aim to facilitate the internationalization of Turkish corporations as well as intensification of foreign direct investments through foreign capital. Although the target has been determined this way, after the adoption but five days before the entry into force of the Turkish Commercial Code No. 6102, a law made backward going alterations concerning independent external audition and public disclosure regulations. Turkish Commercial Code has been currently in force with its altered status. Both the regulations in the Check Act as well as the changes in the Commercial Code are not compatible with the goals introduced by rationale “to ensure Turkish commercial law to be a part of the international market” as such.

Keywords: Turkish Commercial Code No. 6102, Turkish Check Act, “post-date” checks, legal changes

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Authors: Xuan Hua Huang, Shu Fen Wu, Yi Ting Huang, Pi Yueh Lee

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Background: In Taiwan, the Taiwan healthcare care Indicator Series regards the rate of hospital readmission as an important indicator of healthcare quality. Unplanned readmission not only effects patient’s condition but also increase healthcare utilization rate and healthcare costs. Purpose: The purpose of this study was explored the effects of adult unplanned readmission within 14 days of discharge at a regional teaching hospital in South Taiwan. Methods: The retrospectively review design was used. A total 495 participants of unplanned readmissions and 878 of non-readmissions within 14 days recruited from a regional teaching hospital in Southern Taiwan. The instruments used included the Charlson Comorbidity Index, and demographic characteristics, and disease-related variables. Statistical analyses were performed with SPSS version 22.0. The descriptive statistics were used (means, standard deviations, and percentage) and the inferential statistics were used T-test, Chi-square test and Logistic regression. Results: The unplanned readmissions within 14 days rate was 36%. The majorities were 268 males (54.1%), aged >65 were 318 (64.2%), and mean age was 68.8±14.65 years (23-98years). The mean score for the comorbidities was 3.77±2.73. The top three diagnosed of the readmission were digestive diseases (32.7%), respiratory diseases (15.2%), and genitourinary diseases (10.5%). There were significant relationships among the gender, age, marriage, comorbidity status, and discharge planning services (χ2: 3.816-16.474, p: 0.051~0.000). Logistic regression analysis showed that old age (OR = 1.012, 95% CI: 1.003, 1.021), had the multi-morbidity (OR = 0.712~4.040, 95% CI: 0.559~8.522), had been consult with discharge planning services (OR = 1.696, 95% CI: 1.105, 2.061) have a higher risk of readmission. Conclusions: This study finds that multi-morbidity was independent risk factor for unplanned readmissions at 14 days, recommended that the interventional treatment of the medical team be provided to provide integrated care for multi-morbidity to improve the patient's self-care ability and reduce the 14-day unplanned readmission rate.

Keywords: unplanned readmission, comorbidities, Charlson comorbidity index, logistic regression

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Authors: William Mahony, L. Jacqueline Hirth, Richard Rupp, Sandra Gonzalez, Roger Zoorob

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Background: The impact of the COVID-19 pandemic on physicians has been considered by many researchers, but less is known about non-physician healthcare workers. The aim of this study is to examine the association of COVID-19 safety training and communication with stress. Methods: A 91-item online survey was distributed, starting January 2, 2021, to non-physician healthcare workers, including physician assistants, nurse practitioners, and medical assistants (MAs) in the United States through email and social media. A $1 donation was made to the Red Cross for each completed survey. The survey consisted of demographics, occupational questions, and perceived stress (perceived stress scale, PSS). Items on the PSS were combined for an overall score and categorized according to the severity of perceived stress. Chi-square tests were performed for bivariate analyses of categorical variables. Results: Of the 284 participants consenting to complete the survey, 197 participants completed the full survey. MAs made up most of the sample at 79%. Among all respondents, 47% had moderate PSS scores (scored between 14 and 26), and 51% had severe PSS scores (scored between 27 and 40). Unvaccinated participants reported statistically significantly lower levels of perceived stress (p = 0.002). Performing tasks outside of typical job responsibilities was not associated with PSS scores (p = .667). Discussion: Non-physician healthcare workers demonstrated a high level of perceived stress overall. The association between vaccination status and perceived stress should be examined in order to evaluate whether vaccination levels could be improved with further education about the virus and associated risks.

Keywords: COVID-19, SARS-Cov-2, nursing, public health

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Authors: Cletus Agbowo

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Standard principles, rules, regulations, norms and guides are necessities in practice especially in the Economics and management information system Institute of management of and technology (IMT) Enugu a case sturdy as presented by the presenter. Without mincing words, the fundamental bottle neck of management is economics, how to select to engage merger productivity resources to achieve uncountable objectives without tears. Management information system inevitably become bound up in organizational politics because the influence access to a key resource – namely information. Economics and management information can effect who does what to whom, when, where and how in an organization. In great institutions like the Institute of Management and Technology (IMT) Enugu a case study many new information systems require changes in personnel, individual routines that can be painful for those involved and require retraining and additional effort may or may not be compensated. In a nut shell, because management information system potentially change an organization’s structure, culture, business processes, and strategy, there is often considerable resistance to them when they are introduced. The case study have many schools, departments, divisions and units which needs research on economics and management information systems. A system can be defined as a set of interrelated components and / or elements, which reacts with input to produce output. A department in an organization is a system. The researcher is faced to itemize the practical challenges encountered and solution adopted by the Institute Management and Enugu state government.

Keywords: economics, information, management, productivity, regulations

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Authors: Emanuela Zilli, Suana Tikvina, Davide Bonaldo, Monica Varotto, Scilla Rizzardi, Barbara Ruzzante, Raffaele Napolitano, Stefano Bevilacqua, Antonella Ruffatto

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A healthy workplace increases productivity, creativity and decreases absenteeism and turnover. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work-related stress that are often unsustainable. The Hospital of Cittadella (in the province of Padua) has 400 beds and serves a territory of 300,000 inhabitants. The hospital itself counts 1.250 healthcare employees (healthcare professionals). This year, the Medical Board of Directors has requested additional staff; however, the economic situation of Italy can not sustain additional hires. At the same time, we have initiated projects that aim to increase well-being, decrease stress and encourage activities that promote self-care. One of the projects that the hospital has organized is the psychomotor practice. It is held by therapists and trainers who operate according to the traditional method. According to the literature, the psychomotor practice is specifically intended for the staff operating in the Intensive Care Unit, Emergency Department and Pneumology Ward. The project consisted of one session of 45 minutes a week for 3 months. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue, creating a more mindful and sustainable lifestyle. In addition, a Qigong course was held every two weeks for 5 months. It is an ancient Chinese practice designed to optimize the energy within the body, reducing stress levels and increasing general well-being. Finally, Tibetan singing crystal bowls sessions, held by a music therapist, consisted of monthly guided meditation sessions using the sounds of the crystal bowls. Sound therapy uses the vibrations created from the crystal bowls to balance the vibrations within the body to promote relaxation. In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and, consequently, user satisfaction of the services provided.

Keywords: health promotion, healthcare workers management, Weel being and organizational performance, Psychomotor practice

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