Search results for: health data standards

Authors: B. Sathyanarayana

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As per the report of World Health Organization, more than 80% of world population uses medicines made from herbal and natural materials. They have stood the test of time for their safety, efficacy, cultural acceptability and lesser side effects. Quality assurance and control measures, such as national quality specification and standards for herbal materials, good manufacturing practices (GMP) for herbal medicines, labelling, and licensing schemes for manufacturing, imports and marketing, should be in place in every country where herbal medicines are regulated. These measures are vital for ensuring the safety and efficacy of herbal medicines. In the case of herbal products challenge begins at the stage of designing itself except the classical products. Selection of herbal ingredients, officinal parts to be used, proportions are vital. Once the formulation is designed one should take utmost care to produce the standardized product of assured quality and safety. Quality control measures should cover the validation of quality and identity of raw materials, in process control (as per SOP and GMP norms) and at the level of final product. Quality testing, safety and efficacy studies of the final product are required to ensure the safe and effective use of the herbal products in human beings. Medicinal plants being the materials of natural resource are subjected to great variation making it really difficult to fix quality standards especially in the case of polyherbal preparations. Manufacturing also needs modification according to the type of ingredients present. Hence, it becomes essential to develop Standard operative Procedure for a specific herbal product. Present paper throws a light on the challenges that are encountered during the design and development of herbal products.

Keywords: herbal product, challenges, quality, safety, efficacy

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Authors: T. Miková

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This paper analyzes the effect of a single uniform accounting rule on reporting quality by investigating the influence of IFRS on earnings management. This paper examines whether earnings management is reduced after IFRS adoption through the use of “loss avoidance thresholds”, a method that has been verified in earlier studies. This paper concentrates on two European countries: one that represents the continental code law tradition with weak protection of investors (France) and one that represents the Anglo-American common law tradition, which typically implies a strong enforcement system (the United Kingdom). The research investigates a sample of 526 companies (6822 firm-year observations) during the years 2000 – 2013. The results are different for the two jurisdictions. This study demonstrates that a single set of accounting standards contributes to better reporting quality and reduces the pervasiveness of earnings management in France. In contrast, there is no evidence that a reduction in earnings management followed the implementation of IFRS in the United Kingdom. Due to the fact that IFRS benefit France but not the United Kingdom, other political and economic factors, such legal system or capital market strength, must play a significant role in influencing the comparability and transparency cross-border companies’ financial statements. Overall, the result suggests that IFRS moderately contribute to the accounting quality of reported financial statements and bring benefit for stakeholders, though the role played by other economic factors cannot be discounted.

Keywords: accounting standards, earnings management, international financial reporting standards, loss avoidance, reporting quality

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Authors: L. Lindsay, S. A. Coleman, D. Kerr, B. J. Taylor, A. Moorhead

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Cognitive decline and frailty is apparent in older adults leading to an increased likelihood of the risk of falling. Currently health care professionals have to make professional decisions regarding such risks, and hence make difficult decisions regarding the future welfare of the ageing population. This study uses health data from The Irish Longitudinal Study on Ageing (TILDA), focusing on adults over the age of 50 years, in order to analyse health risk factors and predict the likelihood of falls. This prediction is based on the use of machine learning algorithms whereby health risk factors are used as inputs to predict the likelihood of falling. Initial results show that health risk factors such as long-term health issues contribute to the number of falls. The identification of such health risk factors has the potential to inform health and social care professionals, older people and their family members in order to mitigate daily living risks.

Keywords: classification, falls, health risk factors, machine learning, older adults

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Authors: Anu Soikkeli

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Early 20th century functionalism aimed at generalising living and rationalising construction, thus laying the foundation for the standardisation of construction components and products. From the 1930s onwards, all measurement and quality instructions for building products, different types of building components, descriptions of working methods complying with advisable building practises, planning, measurement and calculation guidelines, terminology, etc. were called standards. Standardisation was regarded as a necessary prerequisite for the mass production of housing. This article examines the early stages of standardisation in Finland in the 1940s and 1950s, as reflected on the working history of an individual architect, Erkki Koiso-Kanttila (1914-2006). In 1950 Koiso-Kanttila was appointed the Head of Design of the Finnish Association of Architects’ Building Standards Committee, a position which he held until 1958. His main responsibilities were the development of the RT Building Information File and compiling of the files.

Keywords: architecture, post WWII period, reconstruction, standardisation

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Authors: Khaldoon G. Albitar, Hassan Y. Kikhia, Jin P. Zhang

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Since 2007, all companies listed on both Shanghai Stock Exchange and Shenzhen Stock Exchange are required to prepare their consolidated financial statements in accordance with International Financial Reporting Standards (IFRS). This study investigates the impact of adopting IFRS on accounting quality for a sample of listed on Chinese companies during the period 2003-2013 with sample of 10846 observations over a four-year period before and a five-year period after the adoption of IFRS. This study tests whether the level of earnings management is significantly lower after the adoption of IFRS, and reported earnings is more value relevant during the IFRS period by using the Ohlson model and Jones model, as modified by Dechow. The empirical results show that accounting quality improved with lower earnings management and higher value relevant after the adoption of IFRS in China. The current study contributes to the literature on IFRS adoption and earning quality in two ways. First, As most of the existing studies on earnings quality and IFRS have been conducted on data from the U.S and European countries, this study fills a gap in the existing literature by studying the effect of adoption of IFRS on earnings quality in an emerging market. Second, the findings of our study have important implications for policymakers, auditors, multinational firms, and users of financial reports. As the rapid growth of China's economy gains global recognition, the Chinese stock market is capturing the attention of international investor.

Keywords: international financial reporting standards (ifrs), accounting quality, earnings management, value relevance, china

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Authors: James D. Beauchemin

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This study tested whether youth mental health care quality, operationalized as the extent to which youth and families experienced system-of-care principles in service interactions with providers, varied by level of youth need after adjusting for sociodemographic and treatment factors. The relationship of quality to clinical outcomes was also examined. Using administrative data and cross-sectional surveys from a stratified random sample of 1,124 caregivers of youths ages 5 to 20 within a statewide system-of-care, adjusted analyses indicated youths with the most intensive needs were significantly less likely to experience high-quality care (51% vs. 63%, p=0.016), with marked deficits on 6 of 9 items. Receipt of lower-quality care predicted less improvement in youth functioning. Despite considerable effort to develop systems-of-care for youths with the most severe mental health needs, these data suggest quality disparities remain for the most impaired youths. Policy and intervention development may be needed to improve the quality of care for this population.

Keywords: system-of-care, adherence, mental health, youth

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Authors: Walid Al-Qerem, Ruba Zumot

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Background: The rise of obesity among children and adolescents remains a primary challenge for healthcare providers globally and in the Middle East. The aim of the present study is to determine the prevalence of obesity among 5-20 years old Jordanians based on CDC criteria. Method: A total of 5722 Jordanians (37% males; 63% females) aged 5-20 years data were retrieved from the Jordanian Ministry of Health electronic database (Hakeem). As per the CDC selection criteria, the chosen data pertains exclusively to healthy Jordanian children and adolescents who are medically sound, not suffering from health conditions, and not undergoing any treatments that could hinder normal growth patterns, such as severe infection, chronic kidney disease (CKD), Down’s syndrome, attention deficit hyperactivity disorder, cancer, heart disease, lung disease, cystic fibrosis, Crohn’s disease, type 1 diabetes, hormonal disturbances, any stress-related conditions, hormonal therapy such as corticosteroids, Growth hormones (GHS) or gonadotropin-releasing hormone agonists, insulin, and amphetamines or any other stimulants. In addition, participants with missing or invalid data values for anthropometric measurements were excluded from the study. Weight for age and body mass index for age were analyzed comparatively for Jordanian children and adolescents against the international growth standards. The Z-score for each record was computed based on CDC equations. As per CDC classifications, BMI for age percentiles, values ≥85th and < 95th are classified as overweight, and value at ≥ 95th is classified as obesity. Results: The average age of the evaluated sample was 12.33 ±4.39 years (10.79 ±3.39 for males and 13.23 ± 4.66 for females). The mean weight for males and females were 33.16±14.17 Kg and 133.54±17.17 cm for males, 43.86 ±18.82 Kg, and 142.19±18.35 for females, while for BMI the mean was for boys and girls 17.81±3.88 and 20.52±5.03 respectively. The results indicated that based on CDC criteria, 8.9% of males were classified as children/adolescents with overweight, and 9.7% were classified as children/adolescents with obesity, while in females, 17.8% were classified as children/adolescents with overweight and 10.2% were classified as children/adolescents with obesity. Discussion: The high prevalence of obesity reported in the present study emphasizes the importance of applying different strategies to prevent childhood obesity, including encouraging physical activity, promoting healthier food options, and behavioral changes. Conclusion: The results presented in this study indicated the high prevalence of overweight/obesity among Jordanian adolescents and children, which must be tagged by healthcare planners and providers.

Keywords: CDC, obesity, childhood, Jordan

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Authors: Gokhan Kilic, Pelin Celik

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Structural health monitoring (SHM) is widely used in evaluating the state and health of membrane structures. In the past, in order to collect data and send it to a data collection unit on membrane structures, wire sensors had to be put as part of the SHM process. However, this study recommends using wireless sensors instead of traditional wire ones to construct an economical, useful, and easy-to-install membrane structure health monitoring system. Every wireless sensor uses a software translation program that is connected to the monitoring server. Operational neural networks (ONNs) have recently been developed to solve the shortcomings of convolutional neural networks (CNNs), such as the network's resemblance to the linear neuron model. The results of using ONNs for monitoring to evaluate the structural health of a membrane are presented in this work.

Keywords: wireless sensor network, non-destructive testing, operational neural networks, membrane structures, dynamic monitoring

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Authors: Beenish Urooj, Ubaid Ullah, Sidra Riasat

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National Testing Service-Pakistan (NTS) is an agency in Pakistan that conducts student success appraisal examinations. In this research paper, we must present a security model for the NTS organization. The security model will depict certain security countermeasures for a better defense against certain types of breaches and system malware. We will provide a security roadmap, which will help the company to execute its further goals to maintain security standards and policies. We also covered multiple aspects in securing the environment of the organization. We introduced the processes, architecture, data classification, auditing approaches, survey responses, data handling, and also training and awareness of risk for the company. The primary contribution is the Risk Survey, based on the maturity model meant to assess and examine employee training and knowledge of risks in the company's activities.

Keywords: NTS, risk assessment, threat factors, security, services

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Authors: Judith Klostermann, Miguel Segura, Wilma Jans, Dragana Bojovic, Isadora Christel Jimenez, Francisco Doblas-Reyees, Judit Snethlage

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The Climate Data Store (CDS), developed by the Copernicus Climate Change Service (C3S) implemented by the European Centre for Medium-Range Weather Forecasts (ECMWF) on behalf of the European Union, is intended to become a key instrument for exploring climate data. The CDS contains both raw and processed data to provide information to the users about the past, present and future climate of the earth. It allows for easy and free access to climate data and indicators, presenting an important asset for scientists and stakeholders on the path for achieving a more sustainable future. The C3S Evaluation and Quality Control (EQC) is assessing the quality of the CDS by undertaking a comprehensive user requirement assessment to measure the users’ satisfaction. Recommendations will be developed for the improvement and expansion of the CDS datasets and products. User requirements will be identified on the fitness of the datasets, the toolbox, and the overall CDS service. The EQC function of the CDS will help C3S to make the service more robust: integrated by validated data that follows high-quality standards while being user-friendly. This function will be closely developed with the users of the service. Through their feedback, suggestions, and contributions, the CDS can become more accessible and meet the requirements for a diverse range of users. Stakeholders and their active engagement are thus an important aspect of CDS development. This will be achieved with direct interactions with users such as meetings, interviews or workshops as well as different feedback mechanisms like surveys or helpdesk services at the CDS. The results provided by the users will be categorized as a function of CDS products so that their specific interests will be monitored and linked to the right product. Through this procedure, we will identify the requirements and criteria for data and products in order to build the correspondent recommendations for the improvement and expansion of the CDS datasets and products.

Keywords: climate data store, Copernicus, quality, user engagement

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Shaikh Farhad Hossain, Liakot Ali

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Technology advances accelerate the quality and type of services provided for health care and especially for monitoring health conditions. Sensors have turned out to be more effective to detect diverse physiological signs and can be worn on the human body utilizing remote correspondence modules. An assortment of programming devices have been created to help in preparing a difference rundown of essential signs by examining and envisioning information produced by different sensors. In this proposition, we presented a Health signs and Activity acknowledgment monitoring system. Utilizing off-the-rack sensors, we executed a movement location system for identifying five sorts of action: falling, lying down, sitting, standing, and walking. The framework collects and analyzes sensory data in real-time, and provides different feedback to the users. In addition, it can generate alerts based on the detected events and store the data collected to a medical server.

Keywords: ADL, SVM, TRIL , MEMS

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Authors: Nuray Gökçek Karaca, Berrin Gökçek

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Employers occupational safety and health training obligations are regulated in 89/391/EEC Framework Directive and also in 6331 numbered Occupational Health and Safety Law in Turkey. The main objective of this research is to determine and evaluate the employers’ occupational health and safety training obligations in Framework Directive in comparison with the 6331 numbered Occupational Health and Safety Law and to examine training principles in Turkey. For this purpose, employers’ occupational health and safety training obligations examined in Framework Directive and Occupational Health and Safety Law. This study carried out through comparative scanning model and literature model. The research data were collected through European Agency and ministry legislations. As a result, employers’ occupational health and safety training obligations in the 6331 numbered Occupational Health and Safety Law are compatible with the 89/391/EEC numbered Framework Directive and training principles are determined by in different ways like the trained workers, training issues, training period, training time, and trainers. In this study, employers’ training obligations are evaluated in detail.

Keywords: directive, occupational health and safety, training, work accidences

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Yi-Jiun Chou, Ying-Hsuan Li, Yi-Jung Liu, Hsin-Yu Chiang, Hsuan-Ching Wang

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Background: Patients received therapeutic hypothermia (TH) after resuscitation from cardiac arrest are more dependent on continue and intensive nursing care. It involves many difficult steps, especially achieving target body temperature. To our best knowledge, there is no consensus or recommended standards on nursing practice of TH. Aim: The aim of this study is to increase the completion rate of nursing care at therapeutic hypothermia. Methods: We took five measures: (1) Amendment of nursing standards of therapeutic hypothermia; (2) Amendment of TH checklist items to nursing records; (3) Establishment of monitor procedure; (4) Design each period of TH care reminder cards; (5) Providing in-service training sections of TH for ICU nursing staff. Outcomes: The completion rate of nursing care at therapeutic hypothermia increased from 78.1% to 89.3%. Conclusion: The project team not only increased the completion rate but also improved patient safety and quality of care.

Keywords: therapeutic hypothermia, nursing, critical care, quality of care

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Authors: Serkan Kocapinar, Gülay Altay

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This study investigates the efficiency of two different industrial intumescent coatings which have different types of certifications, in the fire protection performance in steel beams in the case of ISO 834 fire for 2 hours. A better understanding of industrial intumescent coatings, which assure structural integrity and prevent a collapse of steel structures, is needed to minimize the fire risks in steel structures. A comparison and understanding of different fire protective intumescent coatings, which are Product A and Product B, are used as a thermal barrier between the steel components and the fire. Product A is tested according to EN 13381-8 and BS 476-20,22 and is certificated by ISO Standards. Product B is tested according to EN 13381-8 and ASTM UL-94 and is certificated by the Turkish Standards Institute (TSE). Generally, fire tests to evaluate the fire performance of steel components are done numerically with commercial software instead of experiments due to the high cost of an ISO 834 fire test in a furnace. Hence, there is a gap in the literature about the comparisons of different certificated intumescent coatings for fire protection in the case of ISO 834 fire in a furnace experiment for 2 hours. The experiment was carried out by using two 1-meter UPN 200 steel sections. Each one was coated by different industrial intumescent coatings. A furnace was used by the Turkish Standards Institute (TSE) for the experiment. The temperature of the protected steels and the inside of the furnace was measured with the help of 24 thermocouples which were applied before the intumescent coatings during the two hours for the performance of intumescent coatings by getting a temperature-time curve of steel components. FIN EC software was used to determine the critical temperatures of protected steels, and Abaqus was used for thermal analysis to get theoretical results to compare with the experimental results.

Keywords: fire safety, structural steel, ABAQUS, thermal analysis, FIN EC, intumescent coatings

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Authors: Francesco Colcerasa, Fabio Pisani

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We contribute to the subjective well-being literature testing the relationship between life satisfaction and inequality of opportunity in health, measured through the Human Opportunity Index calculated at the national level using individual socio-economic data from the cross-country European Social Survey sample. We compute several indexes of opportunity inequality in health, each obtained according to a different combination of circumstances (gender, immigrant status, parents’ education). We find a robust and significant relationship where life satisfaction is higher in correspondence with low levels of health opportunity inequality. The result is twofold. On the one hand, the importance of the well-being of other types of inequality than income inequality emerges. On the other hand, the socioeconomic roots of inequality in health are investigated, suggesting that circumstances at birth have a role in future well-being. Several rationales for the nexus between life satisfaction and inequality of opportunity in health are possible, which we investigate by splitting the sample. Among others, we find a prominent role of pro-social preferences – formalized as interest towards own offspring (which can be interpreted as intergenerational justice) – as a mediating factor of the relationship.

Keywords: Inequality of opportunity, subjective wellbeing, health, health inequality, inequality of opportunity in health

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Authors: Agodo Mugenyi Herbert

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Background: A high prevalence of both HIV infection and mental disorders exists in Sub-Saharan Africa, however there is little integration of care for mental health disorders among HIV-infected individuals. The study aimed at determining the management of common mental disorders among HIV/AIDS clients attending Antiretroviral clinic in Hoima regional referral hospital. Significancy of the study: The information generated by this study would help mental health advocates, ministry of health, Civil society organizations in HIV programming to advocate for enhanced mental health care for PLWHA. The result will be used in policy development and lobbying for integration of mental health care in HIV/AIDS care. Methods: This study applied a cross sectional design. It involved data collection from clients with HIV/AIDS attending ART clinic in Hoima regional referral hospital at one specific point in time. It aimed at providing data on the entire population under study. Data was collected from Hoima Regional Referral Hospital at the ART clinic. Data analysis was performed using SPSS version 24. Results: 66 HIV/AIDS clients and 10 health workers in the ART clinic who participated fully completed the study. The overall prevalence of at least one form of mental disorder was 83%. Majority of the health care practitioner do not use pharmacological, psychological, and social interventions to manage such disorders. Conclusion: These results are suggestive of a significant proportion of the HIV-infected patients experiencing psychological difficulty for which they do not receive treatment Recommendations: Current care practices applied to patients with HIV/AIDS should be integrated more generally to include treatment services to identify and manage common mental disorders.

Keywords: common mental disorders, mental health, mental illness, and severe mental illness

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Authors: Diego S. Caetano, Doreen E. Kalz, Louise L. B. Lomardo, Luiz P. Rosa

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The energy consumption in non-residential buildings in Brazil has a great impact on the national infrastructure. The growth of the energy consumption has a special role over the building cooling systems, supported by the increased people's requirements on hygrothermal comfort. This paper presents how the occupants of office buildings notice and evaluate the hygrothermic comfort regarding temperature, humidity, and air movement, considering the cooling systems presented at the buildings studied, analyzed by real occupants in areas of hot and humid climate. The paper presents results collected over a long time from 3 office buildings in the cities of Rio de Janeiro and Niteroi (Brazil) in 2015 and 2016, from daily questionnaires with eight questions answered by 114 people between 3 to 5 weeks per building, twice a day (10 a.m. and 3 p.m.). The paper analyses 6 out of 8 questions, emphasizing on the perception of temperature, humidity, and air movement. Statistics analyses were made crossing participant answers and humidity and temperature data related to time high time resolution time. Analyses were made from regressions comparing: internal and external temperature, and then compared with the answers of the participants. The results were put in graphics combining statistic graphics related to temperature and air humidity with the answers of the real occupants. Analysis related to the perception of the participants to humidity and air movements were also analyzed. The hygrothermal comfort statistic model of the European standard DIN EN 15251 and that from the Brazilian standard NBR 16401 were compared taking into account the perceptions of the hygrothermal comfort of the participants, with emphasis on air humidity, taking basis on prior studies published on this same research. The studies point out a relative tolerance for higher temperatures than the ones determined by the standards, besides a variation on the participants' perception concerning air humidity. The paper presents a group of detailed information that permits to improve the quality of the buildings based on the perception of occupants of the office buildings, contributing to the energy reduction without health damages and demands of necessary hygrothermal comfort, reducing the consumption of electricity on cooling.

Keywords: thermal comfort, energy consumption, energy standards, comfort models

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Authors: Rebecca Oakes

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In the New Zealand public health system, work has been taking place to use electronic systems to convey data from the ‘floor to the board’ that makes patient needs, and therefore nursing work, visible. For nurses, these developments in health information technology puts us in a very new and exciting position of being able to articulate the work of nursing through a language understood at all levels of an organisation, the language of acuity. Nurses increasingly have a considerable stake-hold in patient acuity data. Patient acuity systems, when used well, can assist greatly in demonstrating how much work is required, the type of work, and when it will be required. The New Zealand Safe Staffing Unit is supporting New Zealand nurses to create a culture of shared governance, where nursing data is informing policies, staffing methodologies and forecasting within their organisations. Assisting organisations to understand their acuity data, strengthening user confidence in using electronic patient acuity systems, and ensuring nursing and midwifery workload is accurately reflected is critical to the success of the safe staffing programme. Nurses and midwives have the capacity via an acuity tool to become key informers of organisational planning. Quality patient care, best use of health resources and a quality work environment are essential components of a safe, resilient and well resourced organisation. Nurses are the key informers of this information. In New Zealand a national level approach is paving the way for significant changes to the understanding and use of patient acuity and nursing workload information.

Keywords: nursing workload, patient acuity, safe staffing, New Zealand

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Authors: Dina Siniora, Jasia Baig

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During the past few decades, the healthcare system has undergone profound changes in their healthcare decision-making competencies and moral aptitudes due to the vast advancement in technology, clinical skills, and scientific knowledge. Healthcare decision-making deals with morally contentious dilemmas ranging from illness, life and death judgments that require sensitivity and awareness towards the patient’s preferences while taking into consideration medicine’s abilities and boundaries. As the ever-evolving field of medicine continues to become more scientifically and morally multifarious; physicians and the hospital administrators increasingly rely on ethics committees to resolve problems that arise in everyday patient care. The role and latitude of responsibilities of ethics committees which includes being dispute intermediaries, moral analysts, policy educators, counselors, advocates, and reviewers; suggest the importance and effectiveness of a fully integrated committee. Despite achievements on Integrated Ethics and progress in standards and competencies, there is an imminent necessity for further improvement in quality within ethics consultation services in areas of credentialing, professionalism and standards of quality, as well as the quality of healthcare throughout the system. These concerns can be resolved first by collecting data about particular quality gaps and comprehend the level to which ethics committees are consistent with newly published ASBH quality standards. Policymakers should pursue improvement strategies that target both academic bioethics community and major stakeholders at hospitals, who directly influence ethics committees. This broader approach oriented towards education and intervention outcome in conjunction with preventive ethics to address disparities in quality on a systematic level. Adopting tools for improving competencies and processes within ethics consultation by implementing a credentialing process, upholding normative significance for the ASBH core competencies, advocating for professional Code of Ethics, and further clarifying the internal structures will improve productivity, patient satisfaction, and institutional integrity. This cannot be systemically achieved without a written certification exam for HCEC practitioners, credentialing and privileging HCEC practitioners at the hospital level, and accrediting HCEC services at the institutional level.

Keywords: ethics consultation, hospital, medical ethics, quality

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Authors: Zoltan Abram

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Background: In the last time it was hardly increased the prevalence of psychical diseases and disorders which reduce work capacity, life quality and life expectancy. Objectives: The aim of our research is to study the psychical health state of the Romanian adults living in the middle part of the country and the role of some economical, psychological and social factors, especially in relationship with depression. Methods: The study is based on a complex anonymous questionnaire, including Beck depressive scale, which was completed by a representative sample among adult population. The applied method was a combination between stratification and more-steps sampling. Results: After our results depression is the most common psychical illness with 9,1% diagnosis, but the tendency to depression, the existence of depressive symptoms is much higher than the treated illness. The percentage of suicide attempt among the studied population was 2,9%. It is analysed how gender, age, professional and social status, living and working conditions and different social factors are influencing the health state. According to Beck score, it was established a significant difference in the favour of female, elderly people, lower educational level, urban population. Conclusions: In our study it is underlined the importance of health promotion and education. It is concluded that improving living standards, modifying in a proper way the lifestyle of the population, we can positively influence the physical and mental health state of the Romanian adult population.

Keywords: Beck scale, depression, psychological aspects, suicide attempt

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Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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Authors: Alireza Vafaei Sadr, Vida Abedi, Jiang Li, Ramin Zand

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Missing data is a common challenge in medical research and can lead to biased or incomplete results. When the data bias leaks into models, it further exacerbates health disparities; biased algorithms can lead to misclassification and reduced resource allocation and monitoring as part of prevention strategies for certain minorities and vulnerable segments of patient populations, which in turn further reduce data footprint from the same population – thus, a vicious cycle. This study compares the performance of six imputation techniques grouped into Linear and Non-Linear models on two different realworld electronic health records (EHRs) datasets, representing 17864 patient records. The mean absolute percentage error (MAPE) and root mean squared error (RMSE) are used as performance metrics, and the results show that the Linear models outperformed the Non-Linear models in terms of both metrics. These results suggest that sometimes Linear models might be an optimal choice for imputation in laboratory variables in terms of imputation efficiency and uncertainty of predicted values.

Keywords: EHR, machine learning, imputation, laboratory variables, algorithmic bias

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Authors: Eyob Seife, Molla Alemayaehu, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew

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Globally, immunization averts between 2 and 3 million deaths yearly, but Vaccine-Preventable Diseases still account for more in Sub-Saharan African countries and takes the majority of under-five deaths yearly, which indicates the need for consistent and on-time information to have evidence-based decision so as to save lives of these vulnerable groups. However, ensuring data of sufficient quality and promoting an information-use culture at the point of collection remains critical and challenging, especially in remote areas where the Ararso district is selected based on a hypothesis of there is a difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Ararso district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers and reporting documents were reviewed at 4 health facilities (1 health center and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio, availability and timeliness of reports. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and at the district health office. A quality index (QI), availability and timeliness of reports were assessed. Accuracy ratios formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), TT2+ and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed poor timeliness at all levels and both over-reporting and under-reporting were observed at all levels when computing the accuracy ratio of registration to health post reports found at health centers for almost all antigens verified. A quality index (QI) of all facilities also showed poor results. Most of the verified immunization data accuracy ratios were found to be relatively better than that of quality index and timeliness of reports. So attention should be given to improving the capacity of staff, timeliness of reports and quality of monitoring system components, namely recording, reporting, archiving, data analysis and using information for decisions at all levels, especially in remote and areas.

Keywords: accuracy ratio, ararso district, quality of monitoring system, regular immunization program, timeliness of reports, Somali region-Ethiopia

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Authors: Khlood F. Salman, Richard Zoucha, Hani Nawafleh

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Introduction: Jordan ranks the fourth highest breast cancer prevalence after Lebanon, Bahrain, and Kuwait. Considerable evidence showed that cultural, ethnic, and economic differences influence a woman’s practice to early detection and prevention of breast cancer. Objectives: To understand women’s health beliefs and values in relation to early detection of breast cancer; and to explore the impact of these beliefs on their decisions regarding reluctance or acceptance of early detection measures such as mammogram screening. Design: A qualitative focused ethnography was used to collect data for this study. Settings: The study was conducted in the second largest city surrounded by a large rural area in Ma’an- Jordan. Participants: A total of twenty seven women, with no history of breast cancer, between the ages of 18 and older, who had prior health experience with health providers, and were willing to share elements of personal health beliefs related to breast health within the larger cultural context. The participants were recruited using the snowball method and words of mouth. Data collection and analysis: A short questionnaire was designed to collect data related to socio demographic status (SDQ) from all participants. A Semi-structured interviews guide was used to elicit data through interviews with the informants. Nvivo10 a data manager was utilized to assist with data analysis. Leininger’s four phases of qualitative data analysis was used as a guide for the data analysis. The phases used to analyze the data included: 1) Collecting and documenting raw data, 2) Identifying of descriptors and categories according to the domains of inquiry and research questions. Emic and etic data is coded for similarities and differences, 3) Identifying patterns and contextual analysis, discover saturation of ideas and recurrent patterns, and 4) Identifying themes and theoretical formulations and recommendations. Findings: Three major themes were emerged within the cultural and religious context; 1. Fear, denial, embarrassment and lack of knowledge were common perceptions of Ma’anis’ women regarding breast health and screening mammography, 2. Health care professionals in Jordan were not quick to offer information and education about breast cancer and screening, and 3. Willingness to learn about breast health and cancer prevention. Conclusion: The study indicated the disparities between the infrastructure and resourcing in rural and urban areas of Jordan, knowledge deficit related to breast cancer, and lack of education about breast health may impact women’s decision to go for a mammogram screening. Cultural beliefs, fear, embarrassments as well as providers lack of focus on breast health were significant contributors against practicing breast health. Health providers and policy makers should provide resources for the establishment health education programs regarding breast cancer early detection and mammography screening. Nurses should play a major role in delivering health education about breast health in general and breast cancer in particular. A culturally appropriate health awareness messages can be used in creating educational programs which can be employed at the national levels.

Keywords: breast health, beliefs, cultural context, ethnography, mammogram screening

Procedia PDF Downloads 279

Authors: Edna Roseline Dede Tetteh

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Reproductive health research and discussions have, over the years, placed a special focus on Africa. This is partly due to the significant relationship between African cultures and reproductive health. Several studies have also acknowledged the economic impact of reproductive health in Africa, because of which reproductive health, particularly family planning, has featured prominently in many economic discussions about Africa. Gender, which is a major element of most African cultures, inspired this study. Given that gender has a significant cultural influence in Africa, the study examined the effect of gender inequality on reproductive health in Africa, with a special focus on Ghana. Specifically, the study examined whether there exists any relationship between gender inequality and reproductive health and, if there is, what the nature and the effect of the relationship are. The study's findings were based on data gathered from 2304 respondents, randomly selected from Ghana's different tribes and ethnic groups. Given that the study was focused on the influence of gender in sexual relationships, the study’s population was people 16 years and above since 16 is the legal age of sexual consent in Ghana. Data was collected through questionnaires and interviews. It was found that the beliefs and practices of the traditional Ghanaian society, like most African societies, have direct and significant impacts on reproductive health. Males in these cultures have more control over reproductive health decisions and choices than females. The study found that it was culturally condemnable for a wife to refuse her husband’s request for sex, even when she is not in the mood for sex, or she is unwell. It was further found that, when it comes to the decision of birth control, males have more power. Consequently, females with reproductive health conditions have no control over choices that support their reproductive health conditions; they must always satisfy their husbands’ sexual needs. Most of the female respondents indicated they had less or no control over protecting themselves from reproductive health risks unless they had the understanding and support of their sexual partners.

Keywords: culture, gender, Ghana, inequality, reproductive health

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Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

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Aims: To summarize and critically review involved articles for the purpose of investigating the research ethics in them. It also tests the hypothesis, identifying causal relationship, association between variables and differences between/ among groups of participants Design: This is quasi experimental study wherein scientific models were included. It starts from the ideas before the researchers draw the questions, formulate the hypothesis and seek for the solutions. Hypothesis was brief and to the point. A data collection form was constructed. The researchers made use of speculative, presumptive, stipulated and conclusive propositions. Data are statistically analyzed and visualized and are treated objectively in light of the characteristics of a good research. Outcomes: Results and discussion are relevant to the statement of the problem and research objectives. Principles of ethical research were met where the researchers ensured high ethical standards. Variables’ types are scientifically analyzed.

Keywords: research, method, analysis, speech, text

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Authors: Sharifirad M., Poursaeed A., Lashgarara F., Mirdamadi S. M.

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Introduction: Paddy farming has been reported as one of the most important causes of non-fatal injuries and occupational accidents among farmers. The ignorance of the health of farmers can cause harm to farmers and lead to disability. As a result, these health consequences can result in less exploitation and economic growth in households. Therefore, this study aimed to determine the general health status of paddy field workers in Mazandaran province, Iran. Materials & Methods: This cross-sectional descriptive study evaluated 384 paddy farmers in Mazandaran province, Iran, who were selected using stratified random sampling. The required data were collected using the standard questionnaire of GHQ-28 with four domains of somaticsymptoms, anxiety and insomnia, social dysfunction, and symptoms of depression. The obtained data were then analyzed using SPSS software (version 25) through Spearman, Kendall, Mann-Whitney, and Kruskal-Wallis tests. Findings: The highest number of participants in this study was in the age group of 50-59 years, with a mean age of 46.9 years. According to the results, the total general health score was obtained at 64.3% for the subjects. Moreover, the scores of four areas of general health were determined at 91.1% (depression symptoms), 73.4% (social dysfunction), 48.7% (anxiety symptoms and insomnia), and 47.1% (somatic symptoms) in descending order. Discussions& Conclusions: The general health of the studied population was not in a good range. In addition, the most observed disorder in the general health of paddy farmers was related to the symptoms of depression, followed by somatic symptoms.

Keywords: general-health, mazandaran, paddyfield

Procedia PDF Downloads 158

Authors: M. Aljumaan, F. Alkhadra, A. Aldajani, M. Alarfaj, A. Alawami, Y. Aljamaan

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Introduction: The internet has been widely available with 18 million users in Saudi Arabia alone. It was shown that 58% of Saudis are using the internet as a source of health-related information which may contribute to overcrowding of the Emergency Room (ER). Not many studies have been conducted to show the effect of online searching for health related information (HRI) and its role in influencing internet users to visit various health care facilities. So the main objective is to determine a correlation between HRI website use and health care facility visits in Saudi Arabia. Methodology: By conducting a cross sectional study and distributing a questionnaire, a total number of 1095 people were included in the study. Demographic data was collected as well as questions including the use of HRI websites, type of websites used, the reason behind the internet search, which health care facility it lead them to visit and whether seeking health information on the internet influenced their attitude towards visiting health care facilities. The survey was distributed using an internet survey applications. The data was then put on an excel sheet and analyzed with the help of a biostatician for making a correlation. Results: We found 91.4% of our population have used the internet for medical information using mainly General medical websites (77.8%), Forums (34.2%), Social Media (21.6%), and government websites (21.6%). We also found that 66.9% have used the internet for medical information to diagnose and treat their medical conditions on their own while 34.7% did so due to the inability to have a close referral and 29.5% due to their lack of time. Searching for health related information online caused 62.5% of people to visit health care facilities. Outpatient clinics were most visited at 77.9% followed by the ER (27.9%). The remaining 37.5% do not visit because using HRI websites reassure them of their condition. Conclusion: In conclusion, there may be a correlation between health information website use and health care facility visits. However, to avoid potentially inaccurate medical information, we believe doctors have an important role in educating their patients and the public on where to obtain the correct information & advertise the sites that are regulated by health care officials.

Keywords: ER visits, health related information, internet, medical websites

Procedia PDF Downloads 176