Search results for: health-care centers

Authors: Chiedu C. Ifekandu, Olusegun Sangowawa, Jean E. Njab

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Background: Health care providers (HCPs) in Nigeria receive little or no training of the healthcare needs of men who have sex with men (MSM) limiting the quality and effectiveness of comprehensive HIV prevention and treatment services. Consequently, most MSM disguise themselves to access services which limit the quality of care provided partly due to challenges related to stigma and discrimination, and breach of confidentiality. Objective: To assess the knowledge of healthcare providers on effective intervention for MSM. Methods: We trained 122 HIV focal persons drawn from 60 health facilities from twelve Nigerian states. , the participants were requested to complete a pre-training questionnaire to assess their level of working experience with key populations as a baseline. Participants included male and female doctors, nurses and counselors/testers. A test was administered to measure their knowledge on MSM sexual risk practices, HIV prevention and healthcare needs and also to assess their attitudes (including homophobia) and beliefs and how it affects service uptake by key populations particularly MSM prior and immediately after the training to ascertain the impact of the training. Results: The mean age of the HCP was 38 years +/- SD Of the 122 HCPs (45 % female, 55 % male; 85 % counsellor/testers; 15 % doctors and nurses; 92 % working in government facilities) from 42 health facilities were trained, of which 105 attempted the test questions. At the baseline, few HCPs reported any prior sensitivity training on MSM. Most of the HCPs had limited knowledge of MSM sexual health needs. Over 90% of the HCPs believed that homosexuality is a mental illness. 8 % do not consider MSM, FSW and PWID as key populations for HIV infection. 45 % lacked knowledge on MSM anal sexual practices. The post-test showed that homophobic attitudes had decreased significantly by the end of the training; the health care providers have acquired basic knowledge compared to the pre-test. Conclusions: Scaling up MSM sensitivity training for Nigerian HCPs is likely to be a timely and effective means to improve their understanding of MSM-related health issues, reduce homophobic sentiments and enhance their capacity to provide responsive HIV prevention, treatment and care services in a supportive and non-stigmatizing environment.

Keywords: healthcare providers, key population, men who have sex with men, HCT

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Authors: Khodijah Salimah

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Game Space Program is the program design and development game for therapy the autistic child who had problems with sensory processing and integration. This program is the basic for game space to expand treatment therapy in many areas to help autistic's ability to think through visual perception. This problem can be treated with sensory experience and integration with visual experience to learn how to think and how to learn with visual perception. This perception can be accommodated through an understanding of visual thinking received from sensory exist in game space as virtual healthcare facilities are adjusted based on the sensory needs of children with autism. This paper aims to analyze the potential of virtual visual thinking for treatment autism with the game space program.

Keywords: autism, game space program, sensory, virtual healthcare facilities, visual perception

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Authors: Soroush Pakniyat-Jahromi, Jessica Bucciarelli, Souparno Mitra, Neda Motamedi, Ralph Amazan, Samuel Rothman, Jose Tiburcio, Douglas Reich, Vicente Liz

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Violence is defined as an act of physical force that is intended to cause harm and may lead to physical and/or psychological damage. Violence toward healthcare workers (HCWs) is more common in psychiatric settings, emergency departments, and nursing homes; however, healthcare workers in medical setting are not spared from such events. Workplace violence has a huge burden in the healthcare industry and has a major impact on the physical and mental wellbeing of staff. The purpose of this study is to compare the prevalence of patient agitation and violence in medical-surgical settings in BronxCare Hospital (BCH) Bronx, New York, one year before and during the COVID-19 pandemic. Data collection occurred between June 2021 and August 2021, while the sampling time was from 2019 to 2021. The data were separated into two separate time categories: pre-COVID-19 (03/2019-03/2020) and COVID-19 (03/2020-03/2021). We created frequency tables for 19 variables. We used a chi-square test to determine a variable's statistical significance. We tested all variables against “restraint type”, determining if a patient was violent or became violent enough to restrain. The restraint types were “chemical”, “physical”, or both. This analysis was also used to determine if there was a statistical difference between the pre-COVID-19 and COVID-19 timeframes. Our data shows that there was an increase in incidents of violence in COVID-19 era (03/2020-03/2021), with total of 194 (62.8%) reported events, compared to pre COVID-19 era (03/2019-03/2020) with 115 (37.2%) events (p: 0.01). Our final analysis, completed using a chi-square test, determined the difference in violence in patients between pre-COVID-19 and COVID-19 era. We then tested the violence marker against restraint type. The result was statistically significant (p: 0.01). This is the first paper to systematically review the prevalence of violence in medical-surgical units in a hospital in New York, pre COVID-19 and during the COVID-19 era. Our data is in line with the global trend of increased prevalence of patient agitation and violence in medical settings during the COVID-19 pandemic. Violence and its management is a challenge in healthcare settings, and the COVID-19 pandemic has brought to bear a complexity of circumstances, which may have increased its incidence. It is important to identify and teach healthcare workers the best preventive approaches in dealing with patient agitation, to decrease the number of restraints in medical settings, and to create a less restrictive environment to deliver care.

Keywords: COVID-19 pandemic, patient agitation, restraints, violence

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Authors: Ursula D'Almeida, Danielly Aliprandi

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A car-based development is observed in our cities, what leads to social and environmental impacts, such as air pollution, excessive noises and the substitution of public open spaces for roads and parking lots. Concerning the efforts to promote a sustainable development, a key issue is the reduction of fossil fuels consumption. An alternative to the pollutant gases emission, especially from urban transportation, is the incentive for active transport. The promoting of non-motorized travels and locomotion ways that only depend on human propulsion meets the sustainable mobility notion. Walking is one of the healthiest, cleanest, most natural and economical means to move around. Also, it integrates part of public transportation travels. Since walking demands physical effort, it is sensitive to environmental conditions. In urban space, not always we come across pedestrian friendly road structures. Based on the theory of walkability, the present paper aims to discuss the walking conditions in city centers by analyzing the distribution of urban services and uses, and this also regarding sidewalks quality. The case study presented is the urban center in the medium-sized Brazilian city Campos dos Goytacazes, in Rio de Janeiro State. The study also brings contributions to the recovering of underused public open spaces, especially by encouraging their use and appropriation through valuing non-motorized travels conditions.

Keywords: active transport, historical center, sustainable mobility, walking

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Authors: Kldiashvili Ekaterina, Burduli Archil, Ghortlishvili Gocha

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Introduction – Medical information system (MIS) is at the heart of information technology (IT) implementation policies in healthcare systems around the world. Different architecture and application models of MIS are developed. Despite of obvious advantages and benefits, application of MIS in everyday practice is slow. Objective - On the background of analysis of the existing models of MIS in Georgia has been created a multi-user web-based approach. This presentation will present the architecture of the system and its application for image based second opinion consultations. Methods – The MIS has been created with .Net technology and SQL database architecture. It realizes local (intranet) and remote (internet) access to the system and management of databases. The MIS is fully operational approach, which is successfully used for medical data registration and management as well as for creation, editing and maintenance of the electronic medical records (EMR). Five hundred Georgian language electronic medical records from the cervical screening activity illustrated by images were selected for second opinion consultations. Results – The primary goal of the MIS is patient management. However, the system can be successfully applied for image based second opinion consultations. Discussion – The ideal of healthcare in the information age must be to create a situation where healthcare professionals spend more time creating knowledge from medical information and less time managing medical information. The application of easily available and adaptable technology and improvement of the infrastructure conditions is the basis for eHealth applications. Conclusion - The MIS is perspective and actual technology solution. It can be successfully and effectively used for image based second opinion consultations.

Keywords: digital images, medical information system, second opinion consultations, electronic medical record

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Authors: Peter Yamoah, Frasia Oosthuizen

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Introduction: Reporting of Adverse Events Following Immunization continues to be a challenge. Pharmacovigilance centers throughout the world are mandated by the WHO to submit AEFI reports from various countries to a large pool of adverse drug reaction electronic database called Vigibase. Despite the relevant information of AEFI in Vigibase, it is unavailable to the general public. However, the WHO has an alternative website called VigiAccess which is an open access website serving as a repository of reported adverse drug reactions and AEFIs. The aim of the study was to ascertain the reporting pattern of a number of commonly used vaccines in VigiAccess. Methods: VigiAccess was thoroughly searched on the 5th of February 2018 for AEFI reports of measles vaccine, oral polio vaccine (OPV), yellow fever vaccine, pneumococcal vaccine, rotavirus vaccine, meningococcal vaccine, tetanus vaccine and tuberculosis (BCG) vaccine. These were reports from all pharmacovigilance centers in the world from the time they joined the WHO drug monitoring program. Results: After a thorough search in VigiAccess, there were 9,062 measles vaccine AEFIs, 185,829 OPV AEFIs, 24,577 yellow fever vaccine AEFIs, 317,208 pneumococcal vaccine AEFIs, 73,513 rotavirus vaccine AEFIs, 145,447 meningococcal vaccine AEFIs, 22,781 tetanus vaccine AEFIs and 35,556 BCG vaccine AEFIs. Conclusion: The study revealed that out of the eight vaccines studied, pneumococcal vaccines are associated with the highest number of AEFIs whilst measles vaccines were associated with the least AEFIs.

Keywords: vaccines, adverse reactions, VigiAccess, adverse event reporting

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Authors: Ashleigh Medina

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Chronic conditions account for the majority of total health care spending both in the United States and globally. Encouraging self-management to improve chronic conditions, which in turn could decrease the strain placed on hospitals, requires resources to address the patient’s social concerns in addition to their medical concerns. Transitional care has been identified as a possible bridge between acutely managing conditions at the hospital to chronically managing conditions in a community setting. The aim of this integrative review was to examine the impact of transitional care on self-management outcomes of chronic conditions in un/underinsured populations. Both transitional care, by assisting with resources such as funding sources for healthcare and medications or identifying a healthcare provider for continued care, and self-management, by increasing responsibility for one’s care through goal setting and taking action, can impact health outcomes while providing health care cost-savings.

Keywords: chronic conditions, self-management, transitional care, uninsured

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Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

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The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

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Authors: A. Alrasheed, I. Connerton

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Providing patients with safe meals on a daily basis is one of the challenges in the healthcare sector. In Saudi Arabia matters related to food safety and hygiene have been the heart of the Ministry of Health (MOH) and Saudi Food and Drugs Authority (SFDA). The aim of this study is to examine the causes of inadequate implementation of food safety management systems such as HACCP in Riyadh’s MOH hospitals. By the law, food safety must be managed using a documented, HACCP based approach, and food handlers must be appropriately trained in food safety. Food handlers in Saudi Arabia are not required to provide a certificate or attend a food handling training course even in healthcare sectors. Since food safety and hygiene issues are of increasing importance for Saudi Arabian health decision makers, the SFDA has been established to apply food hygiene requirements in all food operations. It should be pointed out that the implications of food outbreaks on the whole society may potentially go beyond individual health impacts but also impact on the Nation’s health and bring about economic repercussions.

Keywords: food safety, patient, hospital, HACCP

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Authors: Riina I. Bray, Yifan Wang, Nikolas Argiropoulos, Stephanie Robins, John Molot, Kelly Tragash, Lynn M. Marshall, Margaret E. Sears, Marie-Andrée Pigeon, Michel Gaudet, Pierre Auger, Emily Bélanger, Rohini Peris

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Multiple chemical sensitivity (MCS) is a chronic medical condition characterized by intolerances to chemical substances. Since the arrival of the COVID-19 pandemic and associated health measures, people experiencing MCS (PEMCS) are at a heightened risk of environmental exposures associated with cleaners, disinfectants, and sanitizers. Little attention has been paid to the well-being of PEMCS in the context of the COVID-19 pandemic. Objective: This study assesses the lived experiences of Canadian adults with MCS in relation to their living environment, access to healthcare, and levels of perceived social support before and during the pandemic. Methods: A total of 119 PEMCS completed an online questionnaire. McNemar Chi-Squared and Wilcoxon Signed Rank tests were used to evaluate if there were statistically significant changes in participants’ perception of their living environment, access to healthcare, and levels of social support before and after March 11, 2020. Results: Both positive and negative outcomes were noted. Participants reported an increase in exposure to disinfectants/sanitizers that entered their living environment (p<.001). There was a reported decrease in access to a family doctor during the pandemic (p<0.001). Although PEMCS experienced increased social isolation (p<0.001), they also reported an increase in understanding from family (p<0.029) and a decrease in stigma for wearing personal protective equipment (p<0.001). Conclusion: PEMCS reported experiencing: increased exposure to disinfectants or sanitizers, a loss of social support, and barriers in accessing healthcare during the pandemic. However, COVID-19 provided an opportunity to normalize the living conditions of PEMCS, such as wearing masks and social isolation. These findings can guide decision-makers on the importance of implementing nontoxic alternatives for cleaning and disinfection, as well as improving accommodation measures for PEMCS.

Keywords: covid-19, multiple chemical sensitivity, MCS, quality of life, social isolation, physical environment, healthcare

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Authors: Zongmin Ma, Shaowen Zhang, Yueping Fu, Jun Tang, Yunbo Shi, Jun Liu

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Solid-state quantum sensors are attracting wide interest because of their high sensitivity at room temperature. In particular, spin properties of nitrogen–vacancy (NV) color centres in diamond make them outstanding sensors of magnetic fields, electric fields and temperature under ambient conditions. Much of the work on NV magnetic sensing has been done so as to achieve the smallest volume, high sensitivity of NV ensemble-based magnetometry using micro-cavity, light-trapping diamond waveguide (LTDW), nano-cantilevers combined with MEMS (Micro-Electronic-Mechanical System) techniques. Recently, frequency-modulated microwaves with continuous optical excitation method have been proposed to achieve high sensitivity of 6 μT/√Hz using individual NV centres at nanoscale. In this research, we built-up an experiment to measure static magnetic field through continuous wave optical excitation with frequency-modulated microwaves method under continuous illumination with green pump light at 532 nm, and bulk diamond sample with a high density of NV centers (1 ppm). The output of the confocal microscopy was collected by an objective (NA = 0.7) and detected by a high sensitivity photodetector. We design uniform and efficient excitation of the micro strip antenna, which is coupled well with the spin ensembles at 2.87 GHz for zero-field splitting of the NV centers. Output of the PD signal was sent to an LIA (Lock-In Amplifier) modulated signal, generated by the microwave source by IQ mixer. The detected signal is received by the photodetector, and the reference signal enters the lock-in amplifier to realize the open-loop detection of the NV atomic magnetometer. We can plot ODMR spectra under continuous-wave (CW) microwave. Due to the high sensitivity of the lock-in amplifier, the minimum detectable value of the voltage can be measured, and the minimum detectable frequency can be made by the minimum and slope of the voltage. The magnetic field sensitivity can be derived from η = δB√T corresponds to a 10 nT minimum detectable shift in the magnetic field. Further, frequency analysis of the noise in the system indicates that at 10Hz the sensitivity less than 10 nT/√Hz.

Keywords: nitrogen-vacancy (NV) centers, frequency-modulated microwaves, magnetic field sensitivity, noise density

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Authors: Nomcebo N. Mpili, Cynthia Z. Madlabana

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The South African Primary Health Care (PHC) system has undergone a number of transformations such as the introduction of National Health Insurance (NHI) to bring about easily accessible universal health coverage and to meet the health needs for all its citizens. This provides ongoing challenges to ensure that health workers are equipped with appropriate knowledge, support, and skills to meet these changes. Therefore it is crucial to understand the experiences and challenges of nurses as the backbone of PHC in providing quality healthcare services. In addition there has been a need to understand nurses’ experiences with management support, role ambiguity and role conflict amongst other challenges in light of the current reforms in healthcare. Indeed these constructs are notorious for having a detrimental impact on the outcomes of change initiatives within any organisation, this is no different in healthcare. This draws a discussion on professional nurses within the South African health care system especially since they have been labelled as the backbone of PHC, meaning any healthcare backlog falls on them. The study made use of semi-structured interviews and adopted the interpretative phenomenological approach (IPA) as the researcher aimed to explore the lived experiences of (n= 18) participants. The study discovered that professional nurses experienced a lack of management support within PHC facilities and that management mainly played an administrative and disciplinary role. Although participants mainly held positive perceptions with regards to changes happening in health care however they also expressed negative experiences in terms of how change initiatives were introduced resulting in role conflict and role ambiguity. Participants mentioned a shortage of staff, inadequate training as well as a lack of management support as some of the key challenges faced in facilities. This study offers unique findings as participants have not only experienced the various reforms within the PHC system however they have also been part of NHI pilot. The authors are not aware of any other studies published that examine management support, role conflict and role ambiguity together especially in South African PHC facilities. In conclusion understanding these challenges may provide insight and opportunities available to improve the current landscape of PHC not only in South Africa but internationally.

Keywords: management support, professional nurse, role ambiguity, role conflict

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Authors: A. Kourou, S. Kyriakopoulos, N. Anyfanti

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A lot of children under the age of five spend their daytime hours away from their home, in a kindergarten. Caring for children is a serious subject, and their safety in case of earthquake is the first priority. Being aware of earthquakes helps to prioritize the needs and take the appropriate actions to limit the effects. Earthquakes occurring anywhere at any time require emergency planning. Earthquake planning is a cooperative effort and childcare providers have unique roles and responsibilities. Greece has high seismicity and Ionian Islands Region has the highest seismic activity of the country. The last five years Earthquake Planning and Protection Organization (EPPO), which is a national organization, has analyzed the needs and requirements of kindergartens on earthquake protection issues. In this framework it has been noticed that although the State requires child care centers to hold drills, the standards for emergency preparedness in these centers are varied, and a lot of them had not written plans for emergencies. For these reasons, EPPO supports the development of emergency planning guidance and familiarizes the day care centers’ staff being prepared for earthquakes. Furthermore, the Handbook on Day Care Earthquake Planning that has been developed by EPPO helps the providers to understand that emergency planning is essential to risk reduction. Preparedness and training should be ongoing processes, thus EPPO implements every year dozens of specific seminars on children’s disaster related needs. This research presents the results of a survey that detects the level of earthquake preparedness of kindergartens in all over the country and Ionian Islands too. A closed-form questionnaire of 20 main questions was developed for the survey in order to detect the aspects of participants concerning the earthquake preparedness actions at individual, family and day care environment level. 2668 questionnaires were gathered from March 2014 to May 2019, and analyzed by EPPO’s Department of Education. Moreover, this paper presents the EPPO’s educational activities targeted to the Ionian Islands Region that implemented in the framework of “Telemachus” Project. To provide safe environment for children to learn, and staff to work is the foremost goal of any State, community and kindergarten. This project is funded under the Priority Axis "Environmental Protection and Sustainable Development" of Operational Plan "Ionian Islands 2014-2020". It is increasingly accepted that emergency preparedness should be thought of as an ongoing process rather than a one-time activity. Creating an earthquake safe daycare environment that facilitates learning is a challenging task. Training, drills, and update of emergency plan should take place throughout the year at kindergartens to identify any gaps and to ensure the emergency procedures. EPPO will continue to work closely with regional and local authorities to actively address the needs of children and kindergartens before, during and after earthquakes.

Keywords: child care centers, education on earthquake, emergency planning, kindergartens, Ionian Islands Region of Greece

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Authors: Maria L. McLeod

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This study examines the ways in which cancer patient narratives are portrayed and framed on the websites of three leading U.S. cancer care centers –The University of Texas MD Anderson Cancer Center in Houston, Memorial Sloan Kettering Cancer Center in New York, and Seattle Cancer Care Alliance. Thirty patient stories, ten from each cancer center website blog, were analyzed using qualitative and quantitative textual analysis of unstructured data, documenting repeated use of specific metaphors and tropes while charting common themes and other elements of story structure and content. Patient narratives were coded using grounded theory as the basis for conducting emergent qualitative research. As part of a systematic, inductive approach to collecting and analyzing data, recurrent and unique themes were examined and compared in terms of positive and negative framing, patient agency, and institutional praise. All three of these cancer care centers are teaching hospitals with university affiliations, that emphasizes an evidence-based scientific approach to treatment that utilizes the latest research and cutting-edge techniques and technology. Thus, the use of anecdotal evidence presented in patient narratives could be perceived as being in conflict with this evidence-based model, as the patient stories are not an accurate representation of scientific outcomes related to developing cancer, cancer reoccurrence, or cancer outcomes. The representative patient narratives tend to exclude or downplay adverse responses to treatment, survival rates, integrative and/or complementary cancer treatments, cancer prevention and causes, and barriers to treatment, such as the limitation of insurance plans, costs of treatment, and/or other issues related to access, potentially contributing to false narratives and inaccurate notions of cancer prevention, cancer care treatment and the potential for a cure. Both quantitative and qualitative findings demonstrate that cancer patient stories featured on the blogsites of the nation’s top cancer care centers deemphasize patient agency and, instead, emphasize deference and gratitude toward the institutions where the featured patients received treatment. Along these lines, language choices reflect positive framing of the cancer experience. Accompanying portrait photos of healthy appearing subjects as well as positive-framed headlines, subheads, and pull quotes function similarly, reflecting hopeful, transformative experiences and outcomes over hardship and suffering. Although patient narratives include real, factual scientific details and descriptions of actual events, the stories lack references to more negative realities of cancer diagnosis and treatment. Instead, they emphasize the triumph of survival by which the cancer care center, in the savior/hero role, enables the patient’s success, represented as a cathartic medical journey.

Keywords: cancer framing, cancer stories, medical gaze, patient narratives

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Authors: Haripriya Chakraborty

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The healthcare system in the United States is considered to be one of the most inefficient and expensive systems when compared to other developed countries. Consequently, there are persistent concerns regarding the overall functioning of this system. For instance, the large number of uninsured individuals and high premiums are pressing issues that are shown to have a negative effect on health outcomes with possible life-threatening consequences. The Affordable Care Act (ACA), which was signed into law in 2010, was aimed at improving some of these inefficiencies. This paper aims at providing a computational mechanism to examine some of these inefficiencies and the effects that policy proposals may have on reducing these inefficiencies. Agent-based modeling is an invaluable tool that provides a flexible framework to model complex systems. It can provide an important perspective into the nature of some interactions that occur and how the benefits of these interactions are allocated. In this paper, we propose a novel and versatile agent-based model with realistic assumptions to simulate the dynamics of a health insurance marketplace that contains a mixture of private and public insurers and individuals. We use this model to analyze the characteristics, motivations, payoffs, and strategies of these agents. In addition, we examine the effects of certain policies, including some of the provisions of the ACA, aimed at reducing the uninsured rate and the cost of premiums to move closer to a system that is more equitable and improves health outcomes for the general population. Our test results confirm the usefulness of our agent-based model in studying this complicated issue and suggest some implications for public policies aimed at healthcare reform.

Keywords: agent-based modeling, healthcare reform, insurance markets, public policy

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Authors: Fatima Z. Cherhabil, Mammar Sedrati, Sonia-Sabrina Bendib‎

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In order to support the continued growth, critical latency of ‎IoT ‎applications, and ‎various obstacles of traditional data centers, ‎mobile edge ‎computing (MEC) has ‎emerged as a promising solution that extends cloud data-processing and decision-making to edge devices. ‎By adopting a MEC structure, IoT applications could be executed ‎locally, on ‎an edge server, different fog nodes, or distant cloud ‎data centers. However, we are ‎often ‎faced with wanting to optimize conflicting criteria such as ‎minimizing energy ‎consumption of limited local capabilities (in terms of CPU, RAM, storage, bandwidth) of mobile edge ‎devices and trying to ‎keep ‎high performance (reducing ‎response time, increasing throughput and service availability) ‎at the same ‎time‎. Achieving one goal may affect the other, making task offloading (TO), ‎resource allocation (RA), and service placement (SP) complex ‎processes. ‎It is a nontrivial multi-objective optimization ‎problem ‎to study the trade-off between conflicting criteria. ‎The paper provides a survey on different TO, SP, and RA recent multi-‎objective optimization (MOO) approaches used in edge computing environments, particularly artificial intelligent (AI) ones, to satisfy various objectives, constraints, and dynamic conditions related to IoT applications‎.

Keywords: mobile edge computing, multi-objective optimization, artificial ‎intelligence ‎approaches, task offloading, resource allocation, ‎ service placement

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Authors: Enido Fabiano de Ramos, Ieda Kanashiro Makiya, Francisco I. Giocondo Cesar

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This study investigates the application of Digital Twins (DT) in Smart Hospital Environments (SHE), through a bibliometric study and literature review, including comparison with the principles of Industry 4.0. It aims to analyze the current state of the implementation of digital twins in clinical and non-clinical operations in healthcare settings, identifying trends and challenges, comparing these practices with Industry 4.0 concepts and technologies, in order to present a basic framework including stages and maturity levels. The bibliometric methodology will allow mapping the existing scientific production on the theme, while the literature review will synthesize and critically analyze the relevant studies, highlighting pertinent methodologies and results, additionally the comparison with Industry 4.0 will provide insights on how the principles of automation, interconnectivity and digitalization can be applied in healthcare environments/operations, aiming at improvements in operational efficiency and quality of care. The results of this study will contribute to a deeper understanding of the potential of Digital Twins in Smart Hospitals, in addition to the future potential from the effective integration of Industry 4.0 concepts in this specific environment, presented through the practical framework, after all, the urgent need for changes addressed in this article is undeniable, as well as all their value contribution to human sustainability, designed in SDG3 – Health and well-being: ensuring that all citizens have a healthy life and well-being, at all ages and in all situations. We know that the validity of these relationships will be constantly discussed, and technology can always change the rules of the game.

Keywords: digital twin, smart hospital, healthcare operations, industry 4.0, SDG3, technology

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Authors: Hani Malik

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Background: Clinician burnout is a growing phenomenon in current health systems worldwide. Increasing emotional exhaustion, depersonalisation, and reduced personal accomplishment threaten the effective delivery of healthcare. This can potentially be mitigated by mindfulness practice, which has shown promising results in reducing burnout, restoring compassion, and preventing moral injury in clinicians. Objectives: To conduct a scoping review and identify high-quality studies on mindfulness practice in clinician burnout, synthesize themes that emerge from these studies, and discuss the implications of the results to healthcare leadership and innovation. Methodology: A focused scoping review was carried out to investigate the effects of mindfulness practice on clinician burnout. High-ranking journals were targeted to analyse high-quality studies and synthesize common themes in the literature. Studies conducted on current, practicing physicians were included. Mindfulness practice of varying forms was the main intervention studied. Grey literature and studies conducted only on allied health personnel were excluded from this review. Analysis:31 studies were included in this scoping review. Mindfulness practice was found to decrease emotional exhaustion and depersonalisation while improving mood, responses to stress, and vigour. Self-awareness, compassion, and empathy were also increased in study participants. From this review, four themes emerged which include: innovations in mindfulness practice, mindfulness and positive psychology, the impact of mindfulness on work and patient care, and barriers and facilitators to clinician mindfulness practice. Conclusion: Mindfulness had widely been reported to benefit mental health and well-being, but the studies reviewed seemed to adopt a mono focus and omitted key considerations to healthcare leadership, systems-level culture, and practices. Mindfulness practice is a quintessential component of positive psychology and is inherently linked to effective leadership. A mindful and compassionate clinician leader will play a crucial role in addressing gaps in current practice, prioritise staff mental health, and provide a supportive platform for innovation.

Keywords: mindfulness practice, clinician burnout, healthcare leadership, COVID-19

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Authors: Ling-Lang Huang

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Research Background: Historically, the evolution of medicine has not only aimed to extend life but has also inadvertently introduced suffering in the process of maintaining life, presenting a contemporary challenge. We must carefully assess the conflict between the length of life and the quality of living. Evidence-Based Medicine (EBM) exists primarily to ensure the quality of cures. However, EBM alone does not fulfill our ultimate medical goals; we must also evaluate Value-Based Medicine (VBM) to find the best treatment for patients. Research Methodology: We can attempt to integrate EBM with VBM. Within the five steps of EBM, the first three steps (Ask—Acquire—Appraise) focus on the physical aspect of humans. However, in the fourth and fifth steps (Apply—Assess), the focus shifts from the physical to applying evidence-based treatment to the patient and assessing its effectiveness, considering a holistic approach to the individual. To consider VBM for patients, we can divide the process into three steps: The first step is "awareness," recognizing that each patient inhabits a different life-world and possesses unique differences. The second step is "integration," akin to the hermeneutic concept of the Fusion of Horizons. This means being aware of differences and also understanding the origins of these patient differences. The third step is "respect," which involves setting aside our adherence to medical objectivity and scientific rigor to respect the ultimate healthcare decisions made by individuals regarding their lives. Discussion and Conclusion: After completing these three steps of VBM, we can return to the fifth step of EBM: Assess. Our assessment can now transcend the physical treatment focus of the initial steps to align with a holistic care philosophy.

Keywords: shared decision-making, evidence-based medicine, values-based medicine, holistic healthcare

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Authors: Emily Hickmann, Peggy Richter, Maren Kaehlig, Hannes Schlieter

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Patient engagement is a cornerstone of high-quality care and essential for patients with chronic diseases to achieve improved health outcomes. Through digital transformation, possibilities to engage patients in their personal healthcare have multiplied. However, the exploitation of this potential is still lagging. To support the transmission of patient engagement theory into practice, this paper’s objective is to give a state-of-the-art overview of patient engagement tools and methods. A systematic literature review was conducted. Overall, 56 tools and methods were extracted and synthesized according to the four attributes of patient engagement, i.e., personalization, access, commitment, and therapeutic alliance. The results are discussed in terms of their potential to be implemented in digital health solutions under consideration of the “computers are social actors” (CASA) paradigm. It is concluded that digital health can catalyze patient engagement in practice, and a broad future research agenda is formulated.

Keywords: chronic diseases, digitalization, patient-centeredness, patient empowerment, patient engagement

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Authors: Alpa Mehta

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Talent acquisition, development, and retention are major issues encountered in the health care industries in any country. Recent authentic data showed that employee turnover in the field of health care is increasing day by day compare to other industrial sectors. There are many reasons behind retention issues. One of such can be the lack of involvement and engagement of health workers in day to day HRM. Health care is a noble profession and employee has to deal with the patient with the optimum level of satisfaction and productivity. So employee morale and motivation should be high. This area of concern is mostly ignored by management, and ultimately it turns into dissatisfaction and abandonment in search of other jobs. The paper analyses the HRM tools to retain healthcare employee with high moral through employee involvement. The paper includes the case study of One of the Prominent Health care institute of India has found out a way to retain talented employees in the organization with the tool of employee engagement.

Keywords: employee involvement, health care industry, human resources management, talent retention

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Everdeanne Javier, Kelvin Louie Abat, Alodia Rizzalynn Cabaya, Chynna Allyson Manzano, Vlasta Sai Espiritu, Raniah May Puzon, Michelle Tobler

Abstract:

Teledermatology is becoming a more popular form of providing dermatologic healthcare worldwide, and it will almost certainly play a larger role in the future. As the current pandemic continues to worsen, Teledermatology is seen as the primary alternative to face-to-face dermatology consultation; therefore, it needs to be enhanced and developed to become as convenient and reliable as it can be for both patients and doctors. This research paper seeks to know the processes used in teledermatology regarding delivery modalities and proper consultation. This study's research design is a Qualitative Descriptive approach to describe further the processes used by teledermatologists. An online survey questionnaire was used to collect data from Teledermatology Clinics in San Fernando City, La Union. Research showed that patients tend to embrace and be pleased with teledermatology as a way of accessing healthcare. On the other hand, clinicians have usually reported positive outcomes from teledermatology. Furthermore, it is not intended to be used instead of a face-to-face appointment with a dermatologist.

Keywords: teledermatology, online dermatology consultation, dermatology, dermatologist

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Authors: Arshad Alfoqaha, Seth Bard, Dustin Demetriou

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A new multi-physics acoustic modeling approach using ANSYS Mechanical FEA and FLUENT CFD methods is developed for modeling servers mounted to racks, such as IBM Z and IBM Power Systems, in data centers. This new approach allows users to determine the thermal and acoustic conditions that people are exposed to within the data center. The sound pressure level (SPL) exposure for a human working inside a hot aisle containment system inside the data center is studied. The SPL is analyzed at the noise source, at the human body, on the rack walls, on the containment walls, and on the ceiling and flooring plenum walls. In the acoustic CFD simulation, it is assumed that a four-inch diameter sphere with monopole acoustic radiation, placed in the middle of each rack, provides a single-source representation of all noise sources within the rack. Ffowcs Williams & Hawkings (FWH) acoustic model is employed. The target frequency is 1000 Hz, and the total simulation time for the transient analysis is 1.4 seconds, with a very small time step of 3e-5 seconds and 10 iterations to ensure convergence and accuracy. A User Defined Function (UDF) is developed to accurately simulate the acoustic noise source, and a Dynamic Mesh is applied to ensure acoustic wave propagation. Initial validation of the acoustic CFD simulation using a closed-form solution for the spherical propagation of an acoustic point source is performed.

Keywords: data centers, FLUENT, acoustics, sound pressure level, SPL, hot aisle containment, IBM

Procedia PDF Downloads 170

Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Liu Szu Yin

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The center of urban development lies in commercial transactions and folk religious activities. In Taipei City, temples serve as crucial urban spaces and centers for civic activities and religious beliefs. The appearance of local temples can be influenced by the prosperity of the surrounding communities. Apart from being centers of religious worship, Taipei's temples also host festival celebrations, allowing people to gather in front of the temples and form collective urban memories. The spatial attributes for hosting festival activities include streets, squares, parks, and buildings. In Taipei, many traditional festivals take place on the streets, either as round-trip routes or linear routes with a single starting and ending point. Given the processions and parades involving palanquins and other ceremonial objects during traditional festival activities, street spaces are frequently utilized. Therefore, this study analyzes the historical context and street spaces of three traditional festivals in Taipei City, including Qingshan Temple in Monga, Xiahai City God Temple in Dadaocheng, and Baoan Temple in Dalongdong, through on-site research. Most urban festival planners need to understand the characteristics of the city's streets in order to effectively utilize street spaces for festival planning. Taipei's traditional festivals not only preserve Chinese traditional culture but also incorporate modern elements, ensuring the transmission of culture and faith and allowing the city to become characterized by sustainable culture and unique urban memories.

Keywords: festival space, urban festival, taipei, urban memory

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Authors: Mukondi Esther Nethavhakone

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In 2020 World Health Organization announced the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19) pandemic. To curb or contain the spread of the novel coronavirus (COVID 19), global governments implemented social distancing and lockdown regulations. Subsequently, it was no longer business as per usual, life as we knew it had changed, and so many aspects of people's lives were negatively affected, including financial and employment stability. Mainly, because companies/businesses had to put their operations on hold, some had to shut down completely, resulting in the loss of income for many people globally. Finances and employment insecurities are some of the issues that exacerbated many social issues that the world was already faced with, such as school drop-outs, teenage pregnancies, sexual assaults, gender-based violence, crime, child abuse, elderly abuse, to name a few. Expectedly the majority of the population's mental health state was threatened. This resulted in an increased number of people seeking mental healthcare services. The increasing need for mental healthcare services in Low and Middle-income countries proves to be a challenge because it is a well-known fact due to financial constraints and not well-established healthcare systems, mental healthcare provision is not as prioritised as the primary healthcare in these countries. It is against this backdrop that the researcher seeks to find viable, cost-effective, and accessible mental health solutions for low and middle-income countries amid the pressures of any pandemic. The researcher will undertake a systematic review of the technology-based mental health solutions that have been implemented/adopted by developed countries during COVID 19 lockdown and social distancing periods. This systematic review study aims to determine if low and middle-income countries can adopt the cost-effective version of digital mental health solutions for the healthcare system to adequately provide mental healthcare services during critical times such as pandemics (when there's an overwhelming diminish in mental health globally). The researcher will undertake a systematic review study through mixed methods. It will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mixed-methods uses findings from both qualitative and quantitative studies in one review study. It will be beneficial to conduct this kind of study using mixed methods because it is a public health topic that involves social interventions and it is not purely based on medical interventions. Therefore, the meta-ethnographic (qualitative data) analysis will be crucial in understanding why and which digital methods work and for whom does it work, rather than only the meta-analysis (quantitative data) providing what digital mental health methods works. The data collection process will be extensive, involving the development of a database, table of summary of evidence/findings, and quality assessment process lastly, The researcher will ensure that ethical procedures are followed and adhered to, ensuring that sensitive data is protected and the study doesn't pose any harm to the participants.

Keywords: digital, mental health, covid, low and middle-income countries

Procedia PDF Downloads 91

Authors: Ines Cherif, Ghassen Kharroubi, Leila Bouabid, Adel Gharbi, Aicha Boukthir, Margaret Mccarron, Nissaf Ben Alaya, Afif Ben Salah, Jihene Bettaieb

Abstract:

Healthcare workers' flu vaccination prevents influenza disease among both patients and caregivers. We aimed in this study to assess influenza vaccine (IV) coverage in 2018-2019 among Tunisian physicians and to determine factors associated with IV receipt. A cross sectional study was carried out in Tunisian primary and secondary health care facilities in the 2018-2019 influenza season. Physicians with direct patient contact were recruited according to a self-weighted multistage sampling. Data were collected through a face to face questionnaire containing questions on knowledge, attitudes, and practices regarding IV. Bivariate analysis was used in order to determine factors associated with IV receipt. A total of 167 physicians were included in the study with a mean age of 48.2 ± 7.7 years and a sex-ratio (M: F) of 0.37. Among participants, 15.1% (95% CI: [9.7%-20.3%]) were vaccinated against influenza in the 2018-2019 influenza season. Bivariate analysis revealed that previous flu immunization in the four years preceding the 2018-2019 influenza season (OR=32.3; p < 10-3), belief that vaccinating healthcare workers may reduce work absenteeism (OR=4.7, p=0.028), belief that flu vaccine should be mandatory to healthcare workers (OR=3.3, p=0.01) and high confidence towards IV efficacy in preventing influenza among caregivers (OR= 4.5, p=0.01) were associated with a higher IV receipt in 2018-2019 among physicians. Less than one fifth of Tunisian physicians were vaccinated against influenza in 2018-2019. Higher vaccine uptake was related to a higher belief in vaccine efficacy in preventing influenza disease among both patients and caregivers. This underscores the need for periodic educational campaigns to raise physicians' awareness about IV efficacy. The switch to an IV mandatory policy should also be considered.

Keywords: influenza vaccine, physicians, Tunisia, vaccination uptake

Procedia PDF Downloads 130

Authors: Frank Fan

Abstract:

PharmD (Doctor of Pharmacy) education has confronted an increasing challenge — curricular overload, a phenomenon resulting from the expansion of curricular requirements, as PharmD education strives to produce graduates who are practice-ready. The aftermath of the global pandemic has amplified the need for healthcare professionals, leading to a growing trend of assigning more responsibilities to them to address the global healthcare shortage. For instance, the pharmacist’s role has expanded to include not only compounding and distributing medication but also providing clinical services, including minor ailments management, patient counselling and vaccination. Consequently, PharmD programs have responded by continually expanding their curricula adding more requirements. While these changes aim to enhance the education and training of future professionals, they have also led to unintended consequences, including curricular overload, student burnout, and a potential decrease in program quality. To address the issue and ensure program quality, there is a growing need for evidence-based curriculum reforms. My research seeks to integrate Cognitive Load Theory, emerging machine learning algorithms within artificial intelligence (AI), and statistical approaches to develop a quantitative framework for optimizing curriculum design within the PharmD program at the University of Toronto, the largest PharmD program within Canada, to provide quantification and measurement of issues that currently are only discussed in terms of anecdote rather than data. This research will serve as a guide for curriculum planners, administrators, and educators, aiding in the comprehension of how the pharmacy degree program compares to others within and beyond the field of pharmacy. It will also shed light on opportunities to reduce the curricular load while maintaining its quality and rigor. Given that pharmacists constitute the third-largest healthcare workforce, their education shares similarities and challenges with other health education programs. Therefore, my evidence-based, data-driven curriculum analysis framework holds significant potential for training programs in other healthcare professions, including medicine, nursing, and physiotherapy.

Keywords: curriculum, curriculum analysis, health professions education, reflective writing, machine learning

Procedia PDF Downloads 57

Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro

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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.

Keywords: stroke, personalized health care, functional recovery, quality of life, health policies

Procedia PDF Downloads 15