Search results for: healthcare policies

Authors: Sheldon McCall, Miao Yu, Liyun Gong, Shigang Yue, Stefanos Kollias

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Falls are a significant health concern for older adults globally, and prompt identification is critical to providing necessary healthcare support. Our study proposes a new fall detection method using computer vision based on modern deep learning techniques. Our approach involves training a trans- former model on a large 2D pose dataset for general action recognition, followed by transfer learning. Specifically, we freeze the first few layers of the trained transformer model and train only the last two layers for fall detection. Our experimental results demonstrate that our proposed method outperforms both classical machine learning and deep learning approaches in fall/non-fall classification. Overall, our study suggests that our proposed methodology could be a valuable tool for identifying falls.

Keywords: healthcare, fall detection, transformer, transfer learning

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Authors: Caio Fialho

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The automobile incentive policy in Brazil since the 1950s creates several problems in its cities, more visible in large centers such as São Paulo or Rio de Janeiro, but also strongly present in smaller cities, resulting in an increase in social and spatial inequality, together with a drop in the quality of life. The analyzed city, Campo Mourão, reflects these policies, a city that initially planned to be compact and walkable took other directions and currently suffers from urban mobility and social inequality in this urban environment, despite being a medium-sized city in Brazil. The research aims to understand and diagnose how these policies shaped the city and what are the results in Brazilian's inland cities. Based on historical, bibliographical, and field research in the city, the result is a diagnosis of the problem faced and how it can be reversed in search of social equality and better quality of life.

Keywords: urban mobility, quality of life, social equality, substantiable

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Authors: Gulhan Sen

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Disasters could result in many deaths and injuries. In these difficult times, accessible resources are limited, demand and supply balance is distorted, and there is a need to make urgent interventions. Disproportionateness between accessible resources and intervention capacity makes triage a necessity in every stage of disaster response. Healthcare professionals, who are in charge of triage, have to evaluate swiftly and make ethical decisions about which patients need priority and urgent intervention given the limited available resources. For such critical times in disaster triage, 'doing the greatest good for the greatest number of casualties' is adopted as a code of practice. But there is no guide for healthcare professionals about ethical decision-making during disasters, and this study is expected to use as a source in the preparation of the guide. This study aimed to examine whether the qualities healthcare professionals in Izmir related to disaster triage were adequate and whether these qualities influence their capacity to make ethical decisions. The researcher used a survey developed for data collection. The survey included two parts. In part one, 14 questions solicited information about socio-demographic characteristics and knowledge levels of the respondents on ethical principles of disaster triage and allocation of scarce resources. Part two included four disaster scenarios adopted from existing literature and respondents were asked to make ethical decisions in triage based on the provided scenarios. The survey was completed by 215 healthcare professional working in Emergency-Medical Stations, National Medical Rescue Teams and Search-Rescue-Health Teams in Izmir. The data was analyzed with SPSS software. Chi-Square Test, Mann-Whitney U Test, Kruskal-Wallis Test and Linear Regression Analysis were utilized. According to results, it was determined that 51.2% of the participants had inadequate knowledge level of ethical principles of disaster triage and allocation of scarce resources. It was also found that participants did not tend to make ethical decisions on four disaster scenarios which included ethical dilemmas. They stayed in ethical dilemmas that perform cardio-pulmonary resuscitation, manage limited resources and make decisions to die. Results also showed that participants who had more experience in disaster triage teams, were more likely to make ethical decisions on disaster triage than those with little or no experience in disaster triage teams(p < 0.01). Moreover, as their knowledge level of ethical principles of disaster triage and allocation of scarce resources increased, their tendency to make ethical decisions also increased(p < 0.001). In conclusion, having inadequate knowledge level of ethical principles and being inexperienced affect their ethical decision-making during disasters. So results of this study suggest that more training on disaster triage should be provided on the areas of the pre-impact phase of disaster. In addition, ethical dimension of disaster triage should be included in the syllabi of the ethics classes in the vocational training for healthcare professionals. Drill, simulations, and board exercises can be used to improve ethical decision making abilities of healthcare professionals. Disaster scenarios where ethical dilemmas are faced should be prepared for such applied training programs.

Keywords: disaster triage, medical ethics, ethical principles of disaster triage, ethical decision-making

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Authors: Jin Huang

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Research shows that asset-building policies have positive financial and non-financial impacts on children and families. To promote the development of asset-building policies for children in China, it is important to understand the current status of family savings for children. We use the data from the 2016 China Family Panel Studies and show only 16% of families have savings designated for children’s future education. Families with advantaged socioeconomic backgrounds are more likely to save and also save more for their children than their counterparts with disadvantaged backgrounds. Without large-scale and progressive policy interventions, families with disadvantaged backgrounds are less likely to build assets for children. Policy and practice implications for family social workers are discussed.

Keywords: assets, asset building, child, china, education, family, savings

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Authors: Anna Paola Micheli, Carmelo Intrisano, Anna Maria Calce

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This research focused on the capability of health tourism to improve the economic and financial performance of healthcare companies. It is assumed that health tourism companies have better profitability and financial efficiency because they can also count on cross-border demand differently from no health tourism companies. A three-level gap analysis was conducted: the first concerns health tourism companies located in Italy and in the other EU28 states; in the second Italian and EU28, no health tourism companies were compared; the third level is about the Italian system with a comparison between health tourism and no health tourism companies. Findings highlighted that Italian healthcare companies have better profitability performance if compared to European ones, but they present weaknesses in the financial position given the illiquidity and excessive leverage. Furthermore, studying the Italian system, we found that health tourism companies are more profitable than no health tourism companies.

Keywords: financial performance, gap analysis, health tourism, profitability performance, value creation

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Authors: Yen-Fen Tseng

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Studying migration regimes enables one to identify clusters of countries with policy features in common. A few researchers have pointed out the origin of hardship experienced by foreign workers in Taiwan, Japan, and South Korea, stems from their exclusionary migration regime. This paper aims to understand the causes and consequences of the East Asia migration regime, exploring the common exclusionary policies features of Taiwan, Japan, and South Korea, focusing on the foreign labor policy. It will then present explanations as to factors shaping migration regime; the perspective of factors within political system is adopted, as opposed to political economy and pluralist society approach. In the minds of political elites across East Asia, there exists a powerful belief in mono-ethnicity, namely, the benefits of mono-ethnicity and the social ill of “minority problems”. Guest workers policies of various alterations become the compromise between the want for foreign labor and the desire to maintain mono-ethnicity. The paper discusses the absence of immigrant settlement and formation of ethnic communities as a result of the reluctant hosts. Migrant workers in these societies commonly suffer from irregular working conditions as well as unprotected rights out of their denied legality. The case of Taiwan will be presented with greater details, drawing on data from both first-hand and secondary sources.

Keywords: migration regime, guest worker policies, East Asia, society

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Authors: Khalid Yousuf Ahmed

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At the beginning of growth period, East Asian countries achieved impressive economic growth for the decades. They transformed from agricultural economy toward industrialization and contributed to dynamic structural transformation. The achievements were driven by government-led development policies that implemented effective innovation policy to boost technological capability of local firms. Recently, most Sub-Saharan African have been showing sustainable growth. Exceptionally, Ethiopia has been recording double-digit growth for a decade. Hence, Ethiopia has claimed to follow the footstep of East Asia development model. The study is going to examine whether Ethiopia can replicate innovation and economic growth model of East Asia by using Japan, Taiwan, South Korea and China as a case to illustrate their model of growth. This research will be based on empirical data gathering and extended theory of national innovation system and economic growth theory. Moreover, the methodology is based on Knowledge Assessment Methodology (KAM) and also employing cross-countries regression analysis. The results explained that there is a significant relationship between innovation indicators and economic growth in East Asian countries while the relationship is non-existing for Ethiopia except implementing similar policies and achieving similar growth trend. Therefore, Ethiopia needs to introduce inclusive policies that give priority to improving human capital and invest on the knowledge-based economy to replicate East Asian Model.

Keywords: economic growth, FDI, endogenous growth theory, East Asia model

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Authors: Junbeom Lee, Jaehyuck Cho, Wookyeong Jeong, Jonghan Won, Jungmin Hwang, Youngseok Song, Taikyeong Jeong

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This paper investigates and analyzes meta-learning technologies that use multiple-cameras to monitor and check abnormal behavior in people in real-time in the area of healthcare fields. Advances in artificial intelligence and computer vision technologies have confirmed that cameras can be useful for individual health monitoring and abnormal behavior detection. Through this, it is possible to establish a system that can respond early by automatically detecting abnormal behavior of the elderly, such as patients and the elderly. In this paper, we use a technique called meta-learning to analyze image data collected from cameras and develop a commercial product to determine abnormal behavior. Meta-learning applies machine learning algorithms to help systems learn and adapt quickly to new real data. Through this, the accuracy and reliability of the abnormal behavior discrimination system can be improved. In addition, this study proposes a meta-learning-based abnormal behavior detection system that includes steps such as data collection and preprocessing, feature extraction and selection, and classification model development. Various healthcare scenarios and experiments analyze the performance of the proposed system and demonstrate excellence compared to other existing methods. Through this study, we present the possibility that camera-based meta-learning technology can be useful for monitoring and testing abnormal behavior in the healthcare area.

Keywords: artificial intelligence, abnormal behavior, early detection, health monitoring

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Authors: Feguens Pierre

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For a long time, Latin American countries have been introduced to numerous programs and public policies focused on improving the agricultural sector in terms of sustainability, as well as in terms of the relationship between producers and consumers, aimed at improve farmers' income and allow consumers to have access to quality products, encouraging alternative agriculture. Therefore, in Brazil, among the programs, that is, the public policies that have encompassed alternative agriculture, in other words organic, we have the Community that Supports Agriculture (CSA) which ensures a relationship between producers and consumers focused on a solidarity economy, also protecting the environment. This work aims to understand the importance of the Community Supporting Agriculture (CSA), as well as the challenges it has faced over time. Particularly in the case of Brazil. A bibliographic methodology was used to theoretically analyze through several books and articles the performance of (CSA) in Brazil.

Keywords: community supporting agriculture, importance, challenges, producer, consumer

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Authors: A. V. Popa, C. Barna, V. Mihalache

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Being the largest port at the Black Sea and functioning as a civil and military nodal point between Europe and Asia, Constantza Port has become a potential target on the terrorist international agenda. The authors use qualitative research based on both face-to-face and online semi-structured interviews with relevant stakeholders (top decision-makers in the Romanian Naval Authority, Romanian Maritime Training Centre, National Company "Maritime Ports Administration" and military staff) in order to detect potential vulnerabilities which might be exploited by terrorists in the case of Constantza Port. Likewise, this will enable bringing together the experts’ opinions on potential mitigation measures. Subsequently, this paper formulates various counter-terrorism policies to enhance the robustness of Constantza Port under potential terror attacks and connects them with the attributions in the field of critical infrastructure protection conferred by the law to the lead national authority for preventing and countering terrorism, namely the Romanian Intelligence Service. Extending the national counterterrorism efforts to an international level, the authors propose the establishment – among the experts of the NATO member states of the Wider Black Sea Region – of a platform for the exchange of know-how and best practices in the field of critical infrastructure protection.

Keywords: Constantza Port, counter-terrorism policies, critical infrastructure protection, security, Wider Black Sea Region

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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The translation of healthcare technologies is an expensive, complex affair, current healthcare challenges in Asian countries and their efforts to meet Millennium Development Goals (MDGs), necessitates continuous technology advancement to save countless lives, improve the quality of life and for socio-economic development. India’s consistently improving global innovation index (57) demonstrates its innovation potential, but access to health care is asymmetric and lacks priority in India. Therefore, there is utmost need of a robust translation system for point-of-care (POC) solutions, inexpensive, low-maintenance, reliable, and easy-to-use diagnostic technologies. Few cases of POC technologies viz. Elisa based diagnostic kits for regional viral disease, a device for detection of cancerous lesions were studied to understand the process and challenges involved in their translation. Accordingly, the entire translation ecosystem was summarized proposing a nexus of various actors such as technology developer, technology transferor technology receiver, funding entities, government/regulatory bodies and their effect on translation of different medical technologies. This study highlights the role and concerns pertaining to these actors for POC such as unsystematic and unvalidated research roadmap, low profit preposition, unfocused approach of up-scaling, low market acceptability and multiple window regulatory framework, etc. This provides an opportunity to devise solutions to overcome problem areas in translation path.

Keywords: healthcare technologies, point-of-care solutions, public health, translation

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Authors: Hengameh Hosseini

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Design of large healthcare facilities – such as hospitals, multi-service line clinics, and nursing facilities - that can accommodate patients with wide-ranging disabilities is a challenging endeavor and one that is poorly understood among healthcare facility managers, administrators, and executives. An even less-understood extension of this problem is the implications of weakly or insufficiently accommodative design of facilities for healthcare workers in physically-intensive jobs who may also suffer from a range of disabilities and who are therefore at increased risk of workplace accident and injury. Combine this reality with the vast range of facility types, ages, and designs, and the problem of universal accommodation becomes even more daunting and complex. In this study, we focus on the implication of facility design for healthcare workers suffering with low vision who also have physically active jobs. The points of difficulty are myriad and could span health service infrastructure, the equipment used in health facilities, and transport to and from appointments and other services can all pose a barrier to health care if they are inaccessible, less accessible, or even simply less comfortable for people with various disabilities. We conduct a series of surveys and interviews with employees and administrators of 7 facilities of a range of sizes and ownership models in the Northeastern United States and combine that corpus with in-facility observations and data collection to identify five major points of failure common to all the facilities that we concluded could pose safety threats to employees with vision impairments, ranging from very minor to severe. We determine that lack of design empathy is a major commonality among facility management and ownership. We subsequently propose three methods for remedying this lack of empathy-informed design, to remedy the dangers posed to employees: the use of an existing open-sourced Augmented Reality application to simulate the low-vision experience for designers and managers; the use of a machine learning model we develop to automatically infer facility shortcomings from large datasets of recorded patient and employee reviews and feedback; and the use of a computer vision model fine tuned on images of each facility to infer and predict facility features, locations, and workflows, that could again pose meaningful dangers to visually impaired employees of each facility. After conducting a series of real-world comparative experiments with each of these approaches, we conclude that each of these are viable solutions under particular sets of conditions, and finally characterize the range of facility types, workforce composition profiles, and work conditions under which each of these methods would be most apt and successful.

Keywords: artificial intelligence, healthcare workers, facility design, disability, visually impaired, workplace safety

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Authors: Sarah Al-Lumai, Fatima Al-Attar, Nour Jamal, Badria Al-Dabbous, Manal Abdulla

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Today, many commonly used Industrial Engineering tools and techniques are being used in hospitals around the world for the goal of producing a more efficient and effective healthcare system. A common quality improvement methodology known as Lean Six-Sigma has been successful in manufacturing industries and recently in healthcare. The objective of our project is to use the Lean Six-Sigma methodology to reduce waiting time in the Emergency Department (ED), in a local private hospital. Furthermore, a comprehensive literature review was conducted to evaluate the success of Lean Six-Sigma in the ED. According to the study conducted by Ibn Sina Hospital, in Morocco, the most common problem that patients complain about is waiting time. To ensure patient satisfaction many hospitals such as North Shore University Hospital were able to reduce waiting time up to 37% by using Lean Six-Sigma. Other hospitals, such as John Hopkins’s medical center used Lean Six-Sigma successfully to enhance the overall patient flow that ultimately decreased waiting time. Furthermore, it was found that capacity constraints, such as staff shortages and lack of beds were one of the main reasons behind long waiting time. With the use of Lean Six-Sigma and bed management, hospitals like Memorial Hermann Southwest Hospital were able to reduce patient delays. Moreover, in order to successfully implement Lean Six-Sigma in our project, two common methodologies were considered, DMAIC and DMADV. After the assessment of both methodologies, it was found that DMAIC was a more suitable approach to our project because it is more concerned with improving an already existing process. With many of its successes, Lean Six-Sigma has its limitation especially in healthcare; but limitations can be minimized if properly approached.

Keywords: lean six sigma, DMAIC, hospital, methodology

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Authors: Francisco M. Silva

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Technology is evolving, creating an impact on our everyday lives and the telehealth industry. Telehealth encapsulates the provision of healthcare services and information via a technological approach. There are several benefits of using web-based methods to provide healthcare help. Nonetheless, few health and psychological help approaches combine this method with wearable sensors. This paper aims to create an online platform for users to receive self-care help and information using wearable sensors. In addition, researchers developing a similar project obtain a solid foundation as a reference. This study provides descriptions and analyses of the software and hardware architecture. Exhibits and explains a heart rate dynamic and efficient algorithm that continuously calculates the desired sensors' values. Presents diagrams that illustrate the website deployment process and the webserver means of handling the sensors' data. The goal is to create a working project using Arduino compatible hardware. Heart rate sensors send their data values to an online platform. A microcontroller board uses an algorithm to calculate the sensor heart rate values and outputs it to a web server. The platform visualizes the sensor's data, summarizes it in a report, and creates alerts for the user. Results showed a solid project structure and communication from the hardware and software. The web server displays the conveyed heart rate sensor's data on the online platform, presenting observations and evaluations.

Keywords: Arduino, heart rate BPM, microcontroller board, telehealth, wearable sensors, web-based healthcare

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Authors: Amadou Darboe, Kuo Hsien-Wen

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Background/Objective: The Effort-Reward Imbalance (ERI) model by Siegrist et al (1986) have been widely used to examine the relationship between psychosocial factors at work and health. It claimed that failed reciprocity in terms of high efforts and low rewards elicits strong negative emotions in combination with sustained autonomic activation and is hazardous to health. The aim of this study is to identify the association between Self-rated Health and Effort-reward Imbalance (ERI) among Nurses and Environmental Health officers in the Gambia. Method: a cross-sectional study was conducted using a multi-stage random sampling of 296 healthcare professionals (206 nurses and 90 environmental health officers) working in public health facilities. The 22 items Effort-reward imbalance questionnaire (ERI-L version 22.11.2012) will be used to collect data on the psychosocial factors defined by the model. In addition, self-rated health will be assessed by using structured questionnaires containing Likert scale items. Results: We found that self-rated health among environmental health officers has a significant negative correlation with extrinsic effort and a positive significant correlations with occupational reward and job satisfaction. However, among the nurses only job satisfaction was significantly correlated with self-rated health and was positive. Overall, Extrinsic effort has a significant negative correlation with reward and job satisfaction but a positive correlation with over-commitment. Conclusion: Because low reward and high over-commitment among the nursing group, It is necessary to modify working conditions through improving psychosocial factors, such as reasonable allocation of resources to increase pay or rewards from government.

Keywords: effort-reward imbalance model, healthcare professionals, self-rated health

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Authors: De Castro-Pardo M., Cabello J. M., Martin J. M., Ruiz F.

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In this paper, we propose a new Water Sustainability Indicator based on a Multi-Reference methodology that permits modeling compensation between the analysed criteria and provides a participative approach. The proposed indicator provides results based on 19 variables grouped into 5 dimensions: availability, access, resilience, good governance and economic capacity. The indicator was applied to assess water sustainability in 27 European countries. The results showed that Finland, the Netherlands, Sweden and the United Kingdom obtained the best global results in terms of weak water (compensatory) sustainability. In terms of strong water (non-compensatory) sustainability, no country gained acceptable results in terms of strong sustainability. Climate change and the state of freshwater resources were detected as especially vulnerable in all the analysed countries. The results identified some eastern European countries with low GDP and good performance of availability and cost of water, with bad results in terms of governance and water productivity. These results could jeopardize water sustainability in the event of a potential economic development if these limitations are not addressed. In a context of economic and political instability due to the current armed conflict in nearby countries such as Ukraine, it is especially important to pay attention to these countries, whose good governance indicators could worsen even more. The proposed indicator allowed to the identification of warning signs and could contribute to the improvement in decision-making processes. Moreover, it could improve the monitoring of international water policies.

Keywords: water sustainability, composite indicators, compensatory approach, sustainability European policies

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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: M. D. Antoine

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When a child is diagnosed with an illness, condition, or developmental disorder, the process involved in understanding and accepting this diagnosis can be a very stressful and isolating experience for parents and families. The healthcare providers’ ability to effectively communicate in such situations represents a vital lifeline for parents. In this context, communication becomes a crucial element not only for getting through the period of grief but also for the future. We mobilized the five stages of grief model to summarize existing literature regarding the ways in which the experience ofan autism spectrum disorder diagnosis disclosurealigns with the experience of grief to explore how this can inform best practices for effective communication with parents through the diagnosis disclosure. Fifteen publications met inclusion criteria. Findings from the scoping review of empirical studies show that parents/families experience grief-like emotions during the diagnosis disclosure. However, grief is not an outcome of the encounter itself. In fact, the experience of the encounter can help mitigate the grief experience. The way parents/families receive and react to the ‘news’ depends on their preparedness, knowledge, and the support received through the experience. Individual communication skills, as well as policies and regulations, should be examined to alleviate adverse reactions in this context. These findings highlight the importance of further research into effective parent-provider communication strategies and their place in supporting quality autism care.

Keywords: autism spectrum disorder, autism spectrum disorder diagnosis, diagnosis disclosure, parent-provider communication, parental grief

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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: Corinne Kowalski, Lea de Jong, Rainer Sauerborn, Niamh Herlihy, Anneliese Depoux, Jale Tosun

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Climate change is considered one of the biggest threats to human health of the 21st century. The link between climate change and health has received relatively little attention in the media, in research and in policy-making. A long term and broad overview of how health is represented in the legislation on climate change is missing in the legislative literature. It is unknown if or how the argument for health is referred in legal clauses addressing climate change, in national and European legislation. Integrating scientific based evidence into policies regarding the impacts of climate change on health could be a key step to inciting the political and societal changes necessary to decelerate global warming. This may also drive the implementation of new strategies to mitigate the consequences on health systems. To provide an overview of this issue, we are analyzing the Global Climate Legislation Database provided by the Grantham Research Institute on Climate Change and the Environment. This institution was established in 2008 at the London School of Economics and Political Science. The database consists of (updated as of 1st January 2015) legislations on climate change in 99 countries around the world. This tool offers relevant information about the state of climate related policies. We will use the database to systematically analyze the 829 identified legislations to identify how health is represented as a relevant aspect of climate change legislation. We are conducting explorative research of national and supranational legislations and anticipate health to be addressed in various forms. The goal is to highlight how often, in what specific terms, which aspects of health or health risks of climate change are mentioned in various legislations. The position and recurrence of the mention of health is also of importance. Data will be extracted with complete quotation of the sentence which mentions health, which will allow for second qualitative stage to analyze which aspects of health are represented and in what context. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, explorative research, health, policies

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Authors: Antigoni Parmaxi, Anna Nicolaou, Salomi Papadima-Sophocleous, Dimitrios Boglou

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This study provides an overview of the socio linguistic situation of an under-researched city, Limassol, Cyprus, with regard to multilingualism and plurilingualism. More specifically, it explores issues pertaining to multilingualism and plurilingualism in education, the public sphere, economic life, the private sphere, and urban spaces. Through an examination of Limassol’s history of language diversity, as well as through an analysis of the city from a contemporary point of view, the study attempts to portray the multilingual Limassol of yesterday and of today. Findings demonstrate several aspects of multilingualism, such as how communication is achieved among the citizens, how the city encourages multilingualism, as well as what policies and practices are implemented in the various spheres in order to promote intercultural dialogue and mutual understanding. As a result of the findings, suggestions for best practices, introduction or improvement of policies and visions of the city are put forward.

Keywords: language diversity, social inclusion, multilingualism, language visibility, language policy

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Authors: Saad Saeed Althiabi

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There is great progress in formulating and executing legislative policies in GCC, however, the public participation in formulating and in major decision making still remains weak. Drawing attention on the international law of public participation in construction and natural resource management, this paper aims in creating a feasible legislative framework for extensive public participation in the industries such as construction and oil and gas decision-making that GCC can implement. This paper would address the conflicts associated with the management and creation of legislation and ensuring public participation for the creation of a practical framework. A feasible legislative framework must take into account the various factors that shape the effectiveness of participation and the elements that promote the objectives of participation. It is premised on the ground that viewing to international prescriptions might help to reveal gaps in domestic laws, as well as alternatives to overcome them.

Keywords: legislative policies, public participation, planning legislation, GCC countries, international law

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Authors: A. G. Back

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In the context of global climate change, extreme weather events are increasingly intense and frequent, challenging the adaptability of urban space. In this sense, urban planning is a relevant instrument for addressing, in a systemic manner, various sectoral policies capable of linking the urban agenda to the reduction of social and environmental risks. The Master Plan of the Municipality of Sao Paulo, 2014, presents innovations capable of promoting the transition to sustainability in the urban space. Among such innovations, the following stand out: i) promotion of density in the axes of mass transport involving mixture of commercial, residential, services, and leisure uses (principles related to the compact city); ii) vulnerabilities reduction based on housing policies, including regular sources of funds for social housing and land reservation in urbanized areas; iii) reserve of green areas in the city to create parks and environmental regulations for new buildings focused on reducing the effects of heat island and improving urban drainage. However, long-term implementation involves distributive conflicts and may change in different political, economic, and social contexts over time. Thus, the central objective of this paper is to identify which factors limit or support the implementation of these policies. That is, to map the challenges and interests of converging and/or divergent urban actors in the sustainable urban development agenda and what resources they mobilize to support or limit these actions in the city of Sao Paulo. Recent proposals to amend the urban zoning law undermine the implementation of the Master Plan guidelines. In this context, three interest groups with different views of the city come into dispute: the real estate market, upper middle class neighborhood associations ('not in my backyard' movements), and social housing rights movements. This paper surveys the different interests and visions of these groups taking into account their convergences, or not, with the principles of sustainable urban development. This approach seeks to fill a gap in the international literature on the causes that underpin or hinder the continued implementation of policies aimed at the transition to urban sustainability in the medium and long term.

Keywords: adaptation, ecosystem-based adaptation, interest groups, urban planning, urban transition to sustainability

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Authors: Aaron Zhang, Alimire Kahaer, Gerald Weber, Nalin Arachchilage

Abstract:

Access control is an essential safeguard for the security of enterprise data, which controls users’ access to information resources and ensures the confidentiality and integrity of information resources [1]. Research shows that the more common types of access control now have shortcomings [2]. In this direction, to improve the existing access control, we have studied the current technologies in the field of data security, deeply investigated the previous data access control policies and their problems, identified the existing deficiencies, and proposed a new extension structure of SPBAC. SPBAC extension proposed in this paper aims to combine Policy-Based Access Control (PBAC) with semantics to provide logically connected, real-time data access functionality by establishing associations between enterprise data through semantics. Our design combines policies with linked data through semantics to create a "Semantic link" so that access control is no longer per-database and determines that users in each role should be granted access based on the instance policy, and improves the SPBAC implementation by constructing policies and defined attributes through the XACML specification, which is designed to extend on the original XACML model. While providing relevant design solutions, this paper hopes to continue to study the feasibility and subsequent implementation of related work at a later stage.

Keywords: access control, semantic policy-based access control, semantic link, access control model, instance policy, XACML

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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

Abstract:

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

Abstract:

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: Nadhir Al-Ansari, Ammar A. Ali, Sven Knutsson

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Iraq is located in the Middle East. It covers an area of 433,970 square kilometres populated by about 32 million inhabitants. Iraq greatly relies in its water resources on the Tigris and Euphrates Rivers. Recently, Iraq is suffering from water shortage problems. This is due to external and internal factors. The former includes global warming and water resources policies of neighbouring countries while the latter includes mismanagement of its water resources. The supply and demand are predicted to be 43 and 66.8 Billion Cubic Meters (BCM) respectively in 2015, while in 2025 it will be 17.61 and 77 BCM respectively. In addition, future prediction suggests that Tigris and Euphrates Rivers will be completely dry in 2040. To overcome this problem, prudent water management policies are to be adopted. This includes Strategic Water Management Vision, development of irrigation techniques, reduction of water losses, use of non-conventional water resources and research and development planning.

Keywords: Iraq, Tigris River, Euphrates River, water scarcity, water resources management

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Authors: Funmilayo L. Amao, Amos O. Amao

Abstract:

It has been observed that majority of the people are living in poor housing quality or totally homeless in urban center despite all governmental policies to provide housing to the public. On the supply side, various government policies in the past have been formulated towards overcoming the huge shortage through several Housing Reform Programmes. Despite these past efforts, housing continues to be a mirage to ordinary Nigerian. Currently, there are various mass housing delivery programmes such as the affordable housing scheme that utilize the Public Private Partnership effort and several Private Finance Initiative models could only provide for about 3% of the required stock. This suggests the need for a holistic solution in approaching the problem. The aim of this research is to find out the problems hindering the delivery of housing in Nigeria and its effects on housing affordability. The specific objectives are to identify the causes of housing delivery problems, to examine different housing policies over years and to suggest a way out for sustainable housing delivery. This paper also reviews the past and current housing delivery programmes in Nigeria and analyses the demand and supply side issues. It identifies the various housing delivery mechanisms in current practice. The objective of this paper, therefore, is to give you an insight into the delivery option for the sustainability of housing in Nigeria, given the existing delivery structures and the framework specified in the New National Housing Policy. The secondary data were obtained from books, journals and seminar papers. The conclusion is that we cannot copy models from other nations, but should rather evolve workable models based on our socio-cultural background to address the huge housing shortage in Nigeria. Recommendations are made in this regard.

Keywords: housing, sustainability, housing delivery, housing policy, housing affordability

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