Search results for: healthcare architecture
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3271

Search results for: healthcare architecture

2821 Elimination of Mother to Child Transmission of HIV/AIDS: A Study of the Knowledge, Attitudes and Perceptions of Healthcare Workers in Abuja Nigeria

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

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

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

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2820 Beyond Inclusion: The Need for Health Equity for Women with Disabilities

Authors: Jaishree Ellis

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

Keywords: health equity, inclusion, healthcare disparities, education

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2819 Product Architecture and Production Process of Battery Modules from Prismatic Lithium-Ion-Battery Cells

Authors: Achim Kampker, Heiner Hans Heimes, Nemanja Sarovic, Jan-Philip Ganser, Saskia Wessel, Christoph Lienemann

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The electrification of the power train is a fundamental technical transition in the automotive industry and poses a major challenge for established car companies. Providing the traction energy, requiring an ever greater amount of space within the car and having a high share of value-add the lithium-ion battery is a central component of the electric power train and a completely new component to car manufacturers at the same time. Being relatively new to the automotive industry, the current design of the product architecture and production process (including manufacturing and assembling processes) of lithium-ion battery modules do not allow for an easy and cost-efficient disassembly or product design change. Yet these two requirements will increase in importance with rising sales volumes of electric cars in the near future and need to be addressed for the electric car to be competitive with conventional power train systems. This paper focuses on the current product architecture and production process of common automotive battery modules from prismatic lithium-ion battery cells to derive impacts for a remanufacturing concept. The information necessary for this purpose were gathered by literature research, patent inquiries, industry expert interviews and first-hand experiences of the authors. On the basis of these results, the underlying causes for the design´s lack of remanufacturability and flexibility with regards to product design changes are examined. In all, this paper gives an extensive and detailed overview of the state of the art of the product architecture and production process of lithium-ion battery modules from prismatic battery cells, identifies its deficiencies and derives improvement measures.

Keywords: battery module, prismatic lithium-ion battery cell, product architecture, production process, remanufacturing, flexibility

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2818 Alvaro Siza’s Design Strategy: An Insight into Critical Regionalism

Authors: Rahmatollah Amirjani

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By the emergence of the debate over the failure of Regionalism in the late 1970s, Critical Regional­ism was introduced as a different way to respond to the state of architecture in the post-war era. Critical Regionalism is most often understood as a discourse that not only mediates the language of modern architecture with the local cultures but also revives the relation between architecture and spectator as indexed by capitalism. Since the inception of Critical Regionalism, a large number of architectural practices have emerged around the globe; however, the work of the well-known Portuguese architect, Álvaro Siza, is considered as a unique case amongst works associated with the discourse of Critical Regionalism. This paper intends to respond to a number of questions, including; what are the origins of Critical Regionalism? How does Siza’s design strategy correspond to the thematic of Critical Regionalism? How does Siza recover the relation between object and subject in most of his projects? Using Siza’s housing project for the Malagueira district in Évora, Portugal, this article will attempt to answer these questions, and highlight Alvaro Siza’s design procedure which goes beyond the existing discourse of Critical Regionalism and contributes to our understanding of this practice.

Keywords: Alvaro Siza, critical regionalism, Malagueira housing, placelessness

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2817 Islamic Art and Architecture on Religious Buildings of Dagestan, Russia

Authors: Anahita Shahrokhi, Hamed Kazemzadeh

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Various issues are included in cultural relations between societies. Art styles along with architectural similarities are by far one of the most noticeable cultural-historic relations. The Dagestan Republic located in the south of Russia Federation in the North Caucasus has had cultural relations with historical Iran since long ago and is considered as a part of the Islamic world. From Sassanid era and Islamic Empire prior to Tsars’ government, such relations had been maintained largely due to Iran and Islam’s political and social dominance over the region. The presence of the Iranians, mostly for business and commerce, is evident through not only written documents but also other cultural elements including architecture and art. Southern Dagestan and northern provinces of Iran, not distant from each other by sea, have a lot of artistic and cultural aspects in common. The architecture used in some structures such as religious centers, Tekie and Saqa Nafars strongly resembles religious centers in the south of Dagestan. The majority of these similarities lie in the wooden carvings, engravings, and paintings of the interior decorations on the pillars, capitals, walls, and ceilings, as well as the similarity of the plans. Such designs were formed in Safavid dynasty first in Mazandaran and later in Dagestan so that this style is currently named Persiski, meaning Persian, in the Dagestan Republic. These similarities indicate the relationship between the artists and educated people from Iran and Dagestan and the Iranians’ role on the religious and cultural development of Dagestan from the 17th and 18th centuries.

Keywords: wooden works, Mazandaran, Dagestan, Saqa Nafar, ritual and Islamic architecture

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2816 Big Data and Cardiovascular Healthcare Management: Recent Advances, Future Potential and Pitfalls

Authors: Maariyah Irfan

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

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

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2815 Planning and Design Criteria to Make Urban Transport More Sustainable: The Case of Baku

Authors: Gülnar Bayramoğlu Barman

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Since the industrial revolution, technological developments and increased population have caused environmental damages. To protect the nature and architectural environment, firstly, green architecture, ecological architecture and then sustainability occurred. This term has been proposed not to be a new term but a response to environmental disturbances caused by human activities and it is re-conceptualization of architecture. Sustainable architecture or sustainability is lot more extensive than ecological and green architecture. It contains the imbalance between environmental problems that is natural environment and consumption that occurred all around the world. An important part of sustainability debate focused on urban planning and design for more sustainable forms and patterns. In particular, it is discussed that planning and design of urban areas have a major effect on transport and therefore can help reduce car usage, emissions, global warming and climate change. There are many planning and design approaches and movement that introduce certain criteria and strategies to prevent car dependency and encourage people to use public transportation and walking. However, when review the literature, it is seen that planning movements, such as New Urbanism and Transit Oriented Development originated and were implemented mostly in West European and North American Cities. The purpose of this study is to find out whether all those criteria, principles and strategies are also relevant planning approaches for more non-western cities like Baku, which has a very different planning background and therefore possibly different urban form and transport issues. In order to answer the above mentioned question, planning and design approaches in the literature and these recent planning movements were studied and a check list was formed which indicate planning and design approaches that can help attain a more sustainable transport outcome. The checklist was then applied to the case of Baku.

Keywords: sustainability, sustainable development, sustainable transportation, transport, urban design

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2814 Exploring Key Elements of Successful Distance Learning Programs: A Case Study in Palau

Authors: Maiya Smith, Tyler Thorne

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

Keywords: distance learning, Pacific, Palau, telehealth

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2813 Educational Infrastructure a Barrier for Teaching and Learning Architecture

Authors: Alejandra Torres-Landa López

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Introduction: Can architecture students be creative in spaces conformed by an educational infrastructure build with paradigms of the past?, this question and others related are answered in this paper as it presents the PhD research: An anthropic conflict in Mexican Higher Education Institutes, problems and challenges of the educational infrastructure in teaching and learning History of Architecture. This research was finished in 2013 and is one of the first studies conducted nationwide in Mexico that analysis the educational infrastructure impact in learning architecture; its objective was to identify which elements of the educational infrastructure of Mexican Higher Education Institutes where architects are formed, hinder or contribute to the teaching and learning of History of Architecture; how and why it happens. The methodology: A mixed methodology was used combining quantitative and qualitative analysis. Different resources and strategies for data collection were used, such as questionnaires for students and teachers, interviews to architecture research experts, direct observations in Architecture classes, among others; the data collected was analyses using SPSS and MAXQDA. The veracity of the quantitative data was supported by the Cronbach’s Alpha Coefficient, obtaining a 0.86, figure that gives the data enough support. All the above enabled to certify the anthropic conflict in which Mexican Universities are. Major findings of the study: Although some of findings were probably not unknown, they haven’t been systematized and analyzed with the depth to which it’s done in this research. So, it can be said, that the educational infrastructure of most of the Higher Education Institutes studied, is a barrier to the educational process, some of the reasons are: the little morphological variation of space, the inadequate control of lighting, noise, temperature, equipment and furniture, the poor or none accessibility for disable people; as well as the absence, obsolescence and / or insufficiency of information technologies are some of the issues that generate an anthropic conflict understanding it as the trouble that teachers and students have to relate between them, in order to achieve significant learning). It is clear that most of the educational infrastructure of Mexican Higher Education Institutes is anchored to paradigms of the past; it seems that they respond to the previous era of industrialization. The results confirm that the educational infrastructure of Mexican Higher Education Institutes where architects are formed, is perceived as a "closed container" of people and data; infrastructure that becomes a barrier to teaching and learning process. Conclusion: The research results show it's time to change the paradigm in which we conceive the educational infrastructure, it’s time to stop seen it just only as classrooms, workshops, laboratories and libraries, as it must be seen from a constructive, urban, architectural and human point of view, taking into account their different dimensions: physical, technological, documental, social, among others; so the educational infrastructure can become a set of elements that organize and create spaces where ideas and thoughts can be shared; to be a social catalyst where people can interact between each other and with the space itself.

Keywords: educational infrastructure, impact of space in learning architecture outcomes, learning environments, teaching architecture, learning architecture

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2812 Treatment of Healthcare Wastewater Using The Peroxi-Photoelectrocoagulation Process: Predictive Models for Chemical Oxygen Demand, Color Removal, and Electrical Energy Consumption

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

Abstract:

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

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

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2811 FLEX: A Backdoor Detection and Elimination Method in Federated Scenario

Authors: Shuqi Zhang

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Federated learning allows users to participate in collaborative model training without sending data to third-party servers, reducing the risk of user data privacy leakage, and is widely used in smart finance and smart healthcare. However, the distributed architecture design of federation learning itself and the existence of secure aggregation protocols make it inherently vulnerable to backdoor attacks. To solve this problem, the federated learning backdoor defense framework FLEX based on group aggregation, cluster analysis, and neuron pruning is proposed, and inter-compatibility with secure aggregation protocols is achieved. The good performance of FLEX is verified by building a horizontal federated learning framework on the CIFAR-10 dataset for experiments, which achieves 98% success rate of backdoor detection and reduces the success rate of backdoor tasks to 0% ~ 10%.

Keywords: federated learning, secure aggregation, backdoor attack, cluster analysis, neuron pruning

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2810 Healthcare Fire Disasters: Readiness, Response and Resilience Strategies: A Real-Time Experience of a Healthcare Organization of North India

Authors: Raman Sharma, Ashok Kumar, Vipin Koushal

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

Keywords: healthcare, fires, smoke, management, strategies

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2809 A Fuzzy Decision Making Approach for Supplier Selection in Healthcare Industry

Authors: Zeynep Sener, Mehtap Dursun

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

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

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2808 Artificial Neural Networks in Environmental Psychology: Application in Architectural Projects

Authors: Diego De Almeida Pereira, Diana Borchenko

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Artificial neural networks are used for many applications as they are able to learn complex nonlinear relationships between input and output data. As the number of neurons and layers in a neural network increases, it is possible to represent more complex behaviors. The present study proposes that artificial neural networks are a valuable tool for architecture and engineering professionals concerned with understanding how buildings influence human and social well-being based on theories of environmental psychology.

Keywords: environmental psychology, architecture, neural networks, human and social well-being

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2807 A Real Time Ultra-Wideband Location System for Smart Healthcare

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

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

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

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2806 Hybridization as a Process of Refusal of Imposed Popular Architecture

Authors: Jorge Eliseo Muñiz-Gutierrez, Daniel Olvera-García, Cristina Sotelo-Salas

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The objective of this research is to allow the understanding of the hybridization process shown in culture through the architecture of mass production for the purpose of consumption, taking as a case study the mass-built housing of the city of Mexicali, Mexico. The methodology is born from the hermeneutical study of the meta-modified architectural object, which guided the research with a qualitative focus to be carried out in two stages, the first is based on the literature review regarding cultural hybridization, and the second stage is carried out in through an ethnographic study of the cultural exploration of the contextual landscape produced by the houses located in popular neighborhoods of the city of Mexicali, Mexico. The research shows that there is an unconscious hybridization process, the birth of a mixture of impositions guided by the popular and the personal aspirations of the inhabitant. The study presents the possibilities of a home and the relationship with its inhabitant and, in turn, its effects on the context and its contribution to culture through hybridization.

Keywords: hybridization, architectural landscape, architecture, mass housing

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2805 Modal Analysis for Study of Minor Historical Architecture

Authors: Milorad Pavlovic, Anna Manzato, Antonella Cecchi

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Cultural heritage conservation is a challenge for contemporary society. In recent decades, significant resources have been allocated for the conservation and restoration of architectural heritage. Historical buildings were restored, protected and reinforced with the intent to limit the risks of degradation or loss, due to phenomena of structural damage and to external factors such as differential settlements, earthquake effects, etc. The wide diffusion of historic masonry constructions in Italy, Europe and the Mediterranean area requires reliable tools for the evaluation of their structural safety. In this paper is presented a free modal analysis performed on a minor historical architecture located in the village of Bagno Grande, near the city of L’Aquila in Italy. The location is characterized by a complex urban context, seriously damaged by the earthquake of 2009. The aim of this work is to check the structural behavior of a masonry building characterized by several boundary conditions imposed by adjacent buildings and infrastructural facilities.

Keywords: FEM, masonry, minor historical architecture, modal analysis

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2804 Disparate Use of Chemical and Physical Restraints in the Emergency Department by Race/Ethnicity

Authors: Etta Conteh, Tracy Macintosh

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

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

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2803 Modern Architecture and the Scientific World Conception

Authors: Sean Griffiths

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Introduction: This paper examines the expression of ‘objectivity’ in architecture in the context of the post-war rejection of this concept. It aims to re-examine the question in light of the assault on truth characterizing contemporary culture and of the unassailable truth of the climate emergency. The paper analyses the search for objective truth as it was prosecuted in the Modern Movement in the early 20th century, looking at the extent to which this quest was successful in contributing to the development of a radically new, politically-informed architecture and the extent to which its particular interpretation of objectivity, limited that development. The paper studies the influence of the Vienna Circle philosophers Rudolph Carnap and Otto Neurath on the pedagogy of the Bauhaus and the architecture of the Neue Sachlichkeit in Germany. Their logical positivism sought to determine objective truths through empirical analysis, expressed in an austere formal language as part of a ‘scientific world conception’ which would overcome metaphysics and unverifiable mystification. These ideas, and the concurrent prioritizing of measurement as the determinant of environmental quality, became key influences in the socially-driven architecture constructed in the 1920s and 30s by Bauhaus architects in numerous German Cities. Methodology: The paper reviews the history of the early Modern Movement and summarizes accounts of the relationship between the Vienna Circle and the Bauhaus. It looks at key differences in the approaches Neurath and Carnap took to the achievement of their shared philosophical and political aims. It analyses how the adoption of Carnap’s foundationalism influenced the architectural language of modern architecture and compares, through a close reading of the structure of Neurath’s ‘protocol sentences,’ the latter’s alternative approach, speculating on the possibility that its adoption offered a different direction of travel for Modern Architecture. Findings: The paper finds that the adoption of Carnap’s foundationalism, while helping Modern Architecture forge a new visual language, ultimately limited its development and is implicated in its failure to escape the very metaphysics against which it had set itself. It speculates that Neurath’s relational language-based approach to the issue of establishing objectivity has its architectural corollary in the process of revision and renovation that offers new ways an ‘objective’ language of architecture might be developed in a manner that is more responsive to our present-day crisis. Conclusion: The philosophical principles of the Vienna Circle and the architects of the Modern Movement had much in common. Both contributed to radical historical departures which sought to instantiate a world scientific conception in their respective fields, which would attempt to banish mystification and metaphysics and would align itself with socialism. However, in adopting Carnap’s foundationalism as the theoretical basis for the new architecture, Modern Architecture not only failed to escape metaphysics but arguably closed off new avenues of development to itself. The adoption of Neurath’s more open-ended and interactive approach to objectivity offers possibilities for new conceptions of the expression of objectivity in architecture that might be more tailored to the multiple crises we face today.

Keywords: Bauhaus, logical positivism, Neue Sachlichkeit, rationalism, Vienna Circle

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2802 The Effect of Female Access to Healthcare and Educational Attainment on Nigerian Agricultural Productivity Level

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

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

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

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2801 The Impact of Nurse-Physician Interprofessional Relationship on Nurses' Willingness to Engage in Leadership Roles: A Multilevel Modelling Approach

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

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

Keywords: interprofessional relationship, leadership, motivation, nurses

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2800 A Comprehensive Study of Camouflaged Object Detection Using Deep Learning

Authors: Khalak Bin Khair, Saqib Jahir, Mohammed Ibrahim, Fahad Bin, Debajyoti Karmaker

Abstract:

Object detection is a computer technology that deals with searching through digital images and videos for occurrences of semantic elements of a particular class. It is associated with image processing and computer vision. On top of object detection, we detect camouflage objects within an image using Deep Learning techniques. Deep learning may be a subset of machine learning that's essentially a three-layer neural network Over 6500 images that possess camouflage properties are gathered from various internet sources and divided into 4 categories to compare the result. Those images are labeled and then trained and tested using vgg16 architecture on the jupyter notebook using the TensorFlow platform. The architecture is further customized using Transfer Learning. Methods for transferring information from one or more of these source tasks to increase learning in a related target task are created through transfer learning. The purpose of this transfer of learning methodologies is to aid in the evolution of machine learning to the point where it is as efficient as human learning.

Keywords: deep learning, transfer learning, TensorFlow, camouflage, object detection, architecture, accuracy, model, VGG16

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2799 Mining Diagnostic Investigation Process

Authors: Sohail Imran, Tariq Mahmood

Abstract:

In complex healthcare diagnostic investigation process, medical practitioners have to focus on ways to standardize their processes to perform high quality care and optimize the time and costs. Process mining techniques can be applied to extract process related knowledge from data without considering causal and dynamic dependencies in business domain and processes. The application of process mining is effective in diagnostic investigation. It is very helpful where a treatment gives no dispositive evidence favoring it. In this paper, we applied process mining to discover important process flow of diagnostic investigation for hepatitis patients. This approach has some benefits which can enhance the quality and efficiency of diagnostic investigation processes.

Keywords: process mining, healthcare, diagnostic investigation process, process flow

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2798 Nimbus Radiance Gate Project: Media Architecture in Sacred Space

Authors: Jorge Duarte de Sá

Abstract:

The project presented in this investigation is part of the multidisciplinary field of Architecture and explores an experience in media architecture, integrated in Arts, Science and Technology. The objective of this work is to create a visual experience comprehending Architecture, Media and Art. It is intended to specifically explore the sacred spaces that are losing social, cultural or religious dynamics and insert new Media technologies to create a new generate momentum, testing tools, techniques and methods of implementation. Given an architectural project methodology, it seems essential that 'the location' should be the starting point for the development of this technological apparatus: the church of Santa Clara in Santarém, Portugal emerged as an experimental space for apparatus, presenting itself as both temple and museum. We also aim to address the concept of rehabilitation through media technologies, directed at interventions that may have an impact on energizing spaces. The idea is emphasized on the rehabilitation of spaces that, one way or another, may gain new dynamics after a media intervention. Thus, we intend to affect the play with a sensitive and spiritual character which endemically, sacred spaces have, by exploring a sensitive aspect of the subject and drawing up new ideas for meditation and spiritual reflection. The work is designed primarily as a visual experience that encompasses the space, the object and the subject. It is a media project supported by a dual structure with two transparent screens operating in a holographic screen which will be projecting two images that complement the translucent overlay film, thus making the merger of two projections. The digitally created content reacts to the presence of observers through infrared cameras, placed strategically. The object revives the memory of the altarpiece as an architectural surface, promoting the expansion of messages through the media technologies.

Keywords: architecture, media, sacred, technology

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2797 Modified Fuzzy Delphi Method to Incorporate Healthcare Stakeholders’ Perspectives in Selecting Quality Improvement Projects’ Criteria

Authors: Alia Aldarmaki, Ahmad Elshennawy

Abstract:

There is a global shift in healthcare systems’ emphasizing engaging different stakeholders in selecting quality improvement initiatives and incorporating their preferences to improve the healthcare efficiency and outcomes. Although experts bring scientific knowledge based on the scientific model and their personal experience, other stakeholders can bring new insights and information into the decision-making process. This study attempts to explore the impact of incorporating different stakeholders’ preference in identifying the most significant criteria that should be considered in healthcare for electing the improvement projects. A Framework based on a modified Fuzzy Delphi Method (FDM) was built. In addition to, the subject matter experts, doctors/physicians, nurses, administrators, and managers groups contribute to the selection process. The research identifies potential criteria for evaluating projects in healthcare, then utilizes FDM to capture expertise knowledge. The first round in FDM is intended to validate the identified list of criteria from experts; which includes collecting additional criteria from experts that the literature might have overlooked. When an acceptable level of consensus has been reached, a second round is conducted to obtain experts’ and other related stakeholders’ opinions on the appropriate weight of each criterion’s importance using linguistic variables. FDM analyses eliminate or retain the criteria to produce a final list of the critical criteria to select improvement projects in healthcare. Finally, reliability and validity were investigated using Cronbach’s alpha and factor analysis, respectively. Two case studies were carried out in a public hospital in the United Arab Emirates to test the framework. Both cases demonstrate that even though there were common criteria between the experts and the stakeholders, still stakeholders’ perceptions bring additional critical criteria into the evaluation process, which can impact the outcomes. Experts selected criteria related to strategical and managerial aspects, while the other participants preferred criteria related to social aspects such as health and safety and patients’ satisfaction. The health and safety criterion had the highest important weight in both cases. The analysis showed that Cronbach’s alpha value is 0.977 and all criteria have factor loading greater than 0.3. In conclusion, the inclusion of stakeholders’ perspectives is intended to enhance stakeholders’ engagement, improve transparency throughout the decision process, and take robust decisions.

Keywords: Fuzzy Delphi Method, fuzzy number, healthcare, stakeholders

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2796 Examples from a Traditional Sismo-Resistant Architecture

Authors: Amira Zatir, Abderahmane Mokhtari, Amina Foufa, Sara Zatir

Abstract:

It exists in several regions in the world, of numerous historic monuments, buildings and housing environment, built in traditional ways which survive for earthquakes, even in zones where the seismic risk is particularly raised. These constructions, stemming from vernacular architecture, allow, through their resistances in the time earthquakes, to identify the various sismo-resistant "local" techniques. Through the examples and the experiences presented, the remark which can be made, is that in the traditional built, two major principles in a way opposite, govern the constructions in earthquake-resistant. It is about the very big flexibility, whom answer very light constructions, like the Japanese wooden constructions, Turkish and even Chinese; that of the very big rigidity to which correspond constructions in masonry in particular stone, more or less heavy and massive, which we meet in particular in the Mediterranean Basin, and in the historic sanctuary of Machu Pacchu. In it sensible and well-reflected techniques of construction are added, of which the use of the humble materials such as the earth and the adobe. The ancient communities were able to face the seismic risks, thanks to them know-how reflected in their intelligently designed constructions, testifying of a local seismic culture.

Keywords: earthquake, architecture, traditional, construction, resistance

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2795 Intrusion Detection System Based on Peer to Peer

Authors: Alireza Pour Ebrahimi, Vahid Abasi

Abstract:

Recently by the extension of internet usage, Research on the intrusion detection system takes a significant importance. Many of improvement systems prevent internal and external network attacks by providing security through firewalls and antivirus. In recently years, intrusion detection systems gradually turn from host-based systems and depend on O.S to the distributed systems which are running on multiple O.S. In this work, by considering the diversity of computer networks whit respect to structure, architecture, resource, services, users and also security goals requirement a fully distributed collaborative intrusion detection system based on peer to peer architecture is suggested. in this platform each partner device (matched device) considered as a peer-to-peer network. All transmitted information to network are visible only for device that use security scanning of a source. Experimental results show that the distributed architecture is significantly upgradeable in respect to centralized approach.

Keywords: network, intrusion detection system, peer to peer, internal and external network

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2794 The Design of Safe Spaces in Healthcare Facilities Vulnerable to Tornado Impact in Central US

Authors: Lucy Ampaw-Asiedu, Terri R. Norton

Abstract:

In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: disaster management, safe spaces, structural design, tornado, vulnerability

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2793 Humanising Digital Healthcare to Build Capacity by Harnessing the Power of Patient Data

Authors: Durhane Wong-Rieger, Kawaldip Sehmi, Nicola Bedlington, Nicole Boice, Tamás Bereczky

Abstract:

Patient-generated health data should be seen as the expression of the experience of patients, including the outcomes reflecting the impact a treatment or service had on their physical health and wellness. We discuss how the healthcare system can reach a place where digital is a determinant of health - where data is generated by patients and is respected and which acknowledges their contribution to science. We explore the biggest barriers facing this. The International Experience Exchange with Patient Organisation’s Position Paper is based on a global patient survey conducted in Q3 2021 that received 304 responses. Results were discussed and validated by the 15 patient experts and supplemented with literature research. Results are a subset of this. Our research showed patient communities want to influence how their data is generated, shared, and used. Our study concludes that a reasonable framework is needed to protect the integrity of patient data and minimise abuse, and build trust. Results also demonstrated a need for patient communities to have more influence and control over how health data is generated, shared, and used. The results clearly highlight that the community feels there is a lack of clear policies on sharing data.

Keywords: digital health, equitable access, humanise healthcare, patient data

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2792 Analyses of Adverse Drug Reactions Reported of Hospital in Taiwan

Authors: Yu-Hong Lin

Abstract:

Background: An adverse drug reaction (ADR) reported is an injury which caused by taking medicines. Sometimes the severity of ADR reported may be minor, but sometimes it could be a life-threatening situation. In order to provide healthcare professionals as a better reference in clinical practice, we do data collection and analysis from our hospital. Methods: This was a retrospective study of ADRs reported performed from 2014 to 2015 in our hospital in Taiwan. We collected assessment items of ADRs reported, which contain gender and age, occurring sources, Anatomical Therapeutic Chemical (ATC) classification of suspected drugs, types of adverse reactions, Naranjo score calculating by Naranjo Adverse Drug Reaction Probability Scale and so on. Results: The investigation included two hundred and seven ADRs reported. Most of ADRs reported were occurring in outpatient department (92%). The average age of ADRs reported was 65.3 years. Less than 65 years of age were in the majority in this study (54%). Majority of all ADRs reported were males (51%). According to ATC classification system, the major classification of suspected drugs was cardiovascular system (19%) and antiinfectives for systemic use (18%) respectively. Among the adverse reactions, Dermatologic Effects (35%) were the major type of ADRs. Also, the major Naranjo scores of all ADRs reported ranged from 1 to 4 points (91%), which represents a possible correlation between ADRs reported and suspected drugs. Conclusions: Definitely, ADRs reported is still an extremely important information for healthcare professionals. For that reason, we put all information of ADRs reported into our hospital's computer system, and it will improve the safety of medication use. By hospital's computer system, it can remind prescribers to think of information about patient's ADRs reported. No drugs are administered without risk. Therefore, all healthcare professionals should have a responsibility to their patients, who themselves are becoming more aware of problems associated with drug therapy.

Keywords: adverse drug reaction, Taiwan, healthcare professionals, safe use of medicines

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