Search results for: long term care

Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

Procedia PDF Downloads 181

Authors: Xing Zhang

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Since the State Council of China issued the Regulations on the Conservation of Historical Cultural Towns and Villages in 2008, formulation of conservation planning has been carried out in national, provincial and municipal historical and cultural villages for protection needs, which provides a legal basis for inheritance of historical culture and protection of historical resources. Although the quantity and content of the conservation planning are continually increasing, the implementation and application are still ambiguous. To solve the aforementioned problems, this paper explores methods to enhance the implementation of conservation planning from the perspective of planning formulation. Specifically, the technical framework of "overall objectives planning - sub-objectives planning - zoning guidelines - implementation by stages" is proposed to implement the planning objectives in different classifications and stages. Then combined with details of the Qiqiao historical and cultural village conservation planning project in Ningbo, five sub-objectives are set, which are implemented through the village zoning guidelines. At the same time, the key points and specific projects in the near-term, medium-term and long-term work are clarified, and the spatial planning is transformed into the action plan with time scale. The proposed framework and method provide a reference for the implementation and management of the conservation planning of historical and cultural villages in the future.

Keywords: conservation planning, planning by stages, planning implementation, zoning guidelines

Procedia PDF Downloads 232

Authors: Areej Alosimi, Heather Wharrad, Katharine Whittingham

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Palliative care is a crucial element in nursing, especially with the steep increase in non-communicable diseases. Providing education in palliative care can help elevate the standards of care and address the growing need for it. However, palliative care has not been introduced into nursing curricula, specifically in Saudi Arabia, evidenced by students' inadequate understanding of the subject. Digital learning has been identified as a persuasive and effective method to improve education. The study aims to assess the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia by investigating the potential of delivering palliative care nurse education via distance learning. The study will utilize a sequential exploratory mixed-method approach. Phase one will entail identifying needs, developing a web-based program in phase two, and intervention implementation with a pre-post-test in phase three. Semi-structured interviews will be conducted to explore participant perceptions and thoughts regarding the intervention. Data collection will incorporate questionnaires and interviews with nursing students. Data analysis will use SPSS to analyze quantitative measurements and NVivo to analyze qualitative aspects. The study aims to provide insights into the feasibility of implementing digital learning in palliative care education. The results will serve as a foundation to investigate the effectiveness of e-learning interventions in palliative care education among nursing students. This study addresses a crucial gap in palliative care education, especially in nursing curricula, and explores the potential of digital learning to improve education. The results have broad implications for nursing education and the growing need for palliative care globally. The study assesses the feasibility and accessibility of implementing digital learning in palliative care education in Saudi Arabia. The research investigates whether palliative care nurse education can be effectively delivered through distance learning to improve students' understanding of the subject. The study's findings will lay the groundwork for a larger investigation on the efficacy of e-learning interventions in improving palliative care education among nursing students. The study can potentially contribute to the overall advancement of nursing education and the growing need for palliative care.

Keywords: undergraduate nursing students, E-Learning, Palliative care education, Knowledge

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Authors: Dogan Cetin, Omar Hamdi Jasim

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Using some additives is very common method to improve the soil properties such as shear strength, bearing capacity; and to reduce the settlement and lateral deformation. Soil reinforcement with natural materials is an attractive method to improve the soil properties because of their low cost. However, the studies conducted by using natural additive are very limited. This paper presents the results of an investigation on the immediate and long-term effects of the sawdust on the shear strength behavior of a clayey silt soil obtained in Arnavutkoy in Istanbul with sawdust. Firstly, compaction tests were conducted to be able to optimum moisture content for every percentage of sawdust. The samples were obtained from compacted soil at optimum moisture content. UU Triaxial Tests were conducted to evaluate the response of randomly distributed sawdust on the strength of low plasticity clayey silt soil. The specimens were tested with 1%, 2% and 3% content of sawdust. It was found that the undrained shear strength of clay soil with 1%, 2% and 3% sawdust were increased respectively 4.65%, 27.9% and 39.5% higher than the soil without additive. At 5%, shear strength of clay soil decreased by 3.8%. After 90 days cure period, the shear strength of the soil with 1%, 2%, 3% and %5 increased respectively 251%, 302%, 260% and 153%. It can be said that the effect of the sawdust usage has a remarkable effect on the undrained shear strength of the soil. Besides the increasing undrained shear strength, it was also found that the sawdust decreases the liquid limit, plastic limit and plasticity index by 5.5%, 2.9 and 10.9% respectively.

Keywords: compaction test, sawdust, shear strength, UU Triaxial Test

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Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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Authors: Nidhal Mgadmi, Abdelhafidh Othmani

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This article examines the causal relationship between stock indices and cryptocurrencies during the current war between Russia and Ukraine. The econometric investigation runs from February 24, 2022, to April 12, 2023, focusing on seven stock market indices (S&P500, DAX, CAC40, Nikkei, TSX, MOEX, and PFTS) and seven cryptocurrencies (Bitcoin, Ethereum, Litcoin, Dash, Ripple, DigiByte and XEM). In this article, we try to understand how investors react to fluctuations in financial assets to seek safe havens in cryptocurrencies. We used dynamic causality to detect a possible causal relationship in the short term and seven models to estimate the long-term relationship between cryptocurrencies and financial assets. The causal relationship between financial market indexes and cryptocurrency coins in the short run indicates that three famous cryptocurrencies (BITCOIN, ETHEREUM, RIPPLE) and the two digital assets with minor popularity (XEM, Digibyte) are impacted by the German, Russian, and Ukrainian stock markets. In the long run, we found a positive and significate effect of the American, Canadian, French, and Ukrainian stock market indexes on Bitcoin. Thus, the stability of the traditional financial markets during the current war period can be explained on the one hand by investors’ fears of an unstable business climate, and on the other hand, by speculators’ sentiment towards new electronic products, which are perceived as hedging instruments and a safe haven in the face of the conflict between Ukraine and Russia.

Keywords: causality, stock indices, cryptocurrency, war, Russia, Ukraine

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Authors: Mansoureh Karimollahi, Mehriar Adrmohammadi, Mohsen Mohammadi

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Introduction: Patient satisfaction with nursing care is considered as an important indicator of the quality and effectiveness of the health care system, and improving the quality of care is not possible without paying attention to the opinions and expectations of patients. Considering that the scales for assessing satisfaction with nursing care in our country are not comprehensive and measure very few areas, therefore, in this study, psychometrically, the Persian version of the Newcastle Nursing Care Satisfaction Scale was used in patients hospitalized in the wards. Internal medicine and general surgery were discussed. Methods: This cross-sectional study was conducted on 200 patients admitted to the surgery and internal departments of hospitals affiliated to Ardabil University of Medical Sciences. The Newcastle nursing care satisfaction scale was used for the first time in Iran in comparison with the good nursing care scale from the patients' point of view to evaluate the criterion validity. The Newcastle nursing care satisfaction scale was used after translation, validity, and reliability. Results: The level of satisfaction of patients and the experience of patients with nursing care was at a favorable level, respectively, with an average of 111.8 ± 14.2 and 69.07 ± 14.8. Total CVI was estimated at 0.96 for the experience section, 0.95 for the satisfaction section, and 0.96 for the whole scale. The index (CVR) was also 0.95 for the experience section, 0.95 for the satisfaction section, and 0.95 for the whole scale. Criterion validity was also estimated using 0.725 correlation. The validity of the construct was also confirmed using the goodness of fit index (X2=1932/05, p=0.013, KMO=0.913). Convergent validity was estimated at 0.99 in the experience subscale and 0.98 in the satisfaction subscale. . The overall reliability in the experience subscale and satisfaction subscale was 94%, 92%, and 98%, respectively, which indicated the acceptable reliability of the questionnaire. Conclusion: The Persian version of the Newcastle nursing care satisfaction scale as a comprehensive tool that can be easily completed by patients and is easy to interpret, has good validity and reliability and can be used in patient care centers, in departments Surgery, and internal medicine are recommended.

Keywords: psychometrics, Newcastle nursing care satisfaction scale, nursing care satisfaction, general surgery department

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Authors: Belloufi Mohammed, Sellami Badreddine

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This paper deals with a new nonlinear modified three-term conjugate gradient algorithm for solving large-scale unstrained optimization problems. The search direction of the algorithms from this class has three terms and is computed as modifications of the classical conjugate gradient algorithms to satisfy both the descent and the conjugacy conditions. An example of three-term conjugate gradient algorithm from this class, as modifications of the classical and well known Hestenes and Stiefel or of the CG_DESCENT by Hager and Zhang conjugate gradient algorithms, satisfying both the descent and the conjugacy conditions is presented. Under mild conditions, we prove that the modified three-term conjugate gradient algorithm with Wolfe type line search is globally convergent. Preliminary numerical results show the proposed method is very promising.

Keywords: unconstrained optimization, three-term conjugate gradient, sufficient descent property, line search

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Authors: M. Hakami, A. Jammaly, I. Attafi, M. Oraiby, M. Jeraiby

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We reviewed an unusual case of a 65-year-old male taking an herbal mixture containing compounds with anticholinesterase activity for a long period of time, presented with acute my myocardial infarction and multiple organ dysfunction syndrome followed by death. Clinically, there are findings correlated with anticholinesterase activity, such as bilateral miosis, diaphoresis, vomiting and fasciculation without a history of any toxic ingestion or exposure. Gas chromatography–mass spectrometry screening studies identified the presence of thymol, anethole in the herbal extract and butylated hydroxytoluene in the blood sample. Hence, with this case report, we intend to highlight the necessity of evaluating the long-term use of the herbal mixture.

Keywords: cholinesterase inhibitors, thymole, anethole, butylatedhydroxytoluene, cardiac toxicity, myocardial infarction

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Authors: Hyunsik Park

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Objective: To provide information of charged nursing care facility for helping to establish geriatric health care policy, and to figure out which factors would be the main determinants for the choice of it. Method: 46 males and 53 females, and the same number of their caregivers admitted into the charged nursing care facility were recruited for intensive interview including personal information, disease information, and economic, familial, marital and emotional statuses. This is a cross-sectional study and we analyzed the data qualitatively. Results: Patients had 3.2 diseases and a hospitalization for 2.3 years on average. They were consists of 46 singles (46.9%), 8 unmarried (8.2%), 5 divorced (5.1%) and 32 married (32.7%). More than two third (70.1%) were supported by their eldest son or daughter. Mostly, the family caregivers decided to admit into the facilities by the doctor’s recommendation (68.4%). When they made a choice for a facility, most of them (42.9%) considered environmental and sanitary conditions. According to their expectation for management in nursing care facility, most caregivers (59.2%) wanted simple-staying for the duration, but most patients (61.3%) expected to be home after taking comprehensive rehabilitation. Three-quarter of the caregivers would agree to use nursing care facilities in the future, if they would be the same situation. Conclusion: Life style and environment are rapidly changing. In the near future, we need lots of the charged nursing care facilities for the old, thus this study can be the good reference for the preparing upcoming aged and super-aged society.

Keywords: nursing care facility, aged society, qualitative analysis, health

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Authors: Zhen Qin, Yufei Peng, Jianbei Li, Jidong Long

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In order to study the activity of the coated aluminate barium-tungsten cathodes during activation, aging, poisoning and long-term use. Through a set of hot-cathode micro-area emission uniformity study device, we tested the micro-area emission performance of the cathode under different conditions. The change of activity of cathode micro-area was obtained. The influence of micro-area activity on the performance of the cathode was explained by the ageing model of barium-tungsten cathode. This helps to improve the design and process of the cathode and can point the way in finding the factors that affect life in the cathode operation.

Keywords: barium-tungsten cathode, ageing model, micro-area emission, emission uniformity

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Authors: Jinhoa Lee

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The relationships between environmental quality, energy use and economic output have created growing attention over the past decades among researchers and policy makers. Focusing on the empirical aspects of the role of CO2 emissions and energy use in affecting the economic output, this paper is an effort to fulfil the gap in a comprehensive case study at a country level using modern econometric techniques. To achieve the goal, this country-specific study examines the short-run and long-run relationships among energy consumption, carbon dioxide (CO2) emissions and gross domestic product (GDP) for Oman using time series analysis from the year 1980-2010. To investigate the relationships between the variables, this paper employs the Augmented Dickey Fuller (ADF) test for stationary, Johansen maximum likelihood method for co-integration and a Vector Error Correction Model (VECM) for both short- and long-run causality among the research variables for the sample. All the variables in this study show very strong significant effects on GDP in the country for the long term. The long-run equilibrium in the VECM suggests positive long-run causalities from CO2 emissions to GDP. Conversely, negative impacts of energy consumption on GDP are found to be significant in Oman during the period. In the short run, there exist negative unidirectional causalities among GDP, CO2 emissions and energy consumption running from GDP to CO2 emissions and from energy consumption to CO2 emissions. Overall, the results support arguments that there are relationships among environmental quality, energy use and economic output in Oman over of period 1980-2010.

Keywords: CO2 emissions, energy consumption, GDP, Oman, time series analysis

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Authors: Murat Erdoğdu, Murat Koçyiğit

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Brand image and brand loyalty are among the most important relational marketing elements for brand owners to be able to set up long – term relationships with their customers and to maintain these relationships. Brand owners improve their brand images with the positive perceptions remaining in the consumers’ minds. In addition, they try to find the customers that are both emotionally and behaviourally faithful to themselves in order to set up long – term relationships. Therefore, the aim of this study is to analyse the effects of the brand image that has a very important role among relational marketing elements on the brand loyalty in terms of the variables such as the perceived value, the trust in brand and the brand satisfaction. In this context, a conceptual model was created to determine the effect of the brand image on the brand loyalty thanks to the Structural Equation Model (SEM). According to this aim and this model, the study was carried out in the scope of the data collected through the questionnaires in Konya with the method of convenience sampling. The results of the research showed that the brand image has positive significant effects on the perceived value and the trust in brand and that the trust in brand has positive significant effects on the brand satisfaction, and that the brand satisfaction has positive significant effects on the brand loyalty. Thus, the hypotheses that the brand image has direct effects on the perceived value and the trust in brand and that the trust in brand has direct effects on the brand satisfaction and that the brand satisfaction has direct effects on the brand loyalty were supported. In addition, the findings about whether the perceived value has a significant effect on the brand satisfaction were also acquired.

Keywords: brand image, brand loyalty, perceived value, satisfaction, trust

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Authors: Li Guo, Jianhong Wang, Dian Huang, Shengzhong Feng

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Computing networks as a new network architecture has shown great promise in boosting the utilization of different resources, such as computing, caching, and communications. To maximise the efficiency of resource orchestration in computing network control systems (CNCSs), this work proposes a dynamic orchestration strategy of a different resource based on task requirements from computing power requestors (CPRs). Specifically, computing power providers (CPPs) in CNCSs could share information with each other through communication channels on the basis of blockchain technology, especially their current idle resources. This dynamic process is modeled as a cooperative game in which CPPs have the same target of maximising long-term rewards by improving the resource utilization ratio. Meanwhile, the task requirements from CPRs, including size, deadline, and calculation, are simultaneously considered in this paper. According to task requirements, the proposed orchestration strategy could schedule the best-fitting resource in CNCSs, achieving the maximum long-term rewards of CPPs and the best quality of experience (QoE) of CRRs at the same time. Based on the EdgeCloudSim simulation platform, the efficiency of the proposed strategy is achieved from both sides of CPRs and CPPs. Besides, experimental results show that the proposed strategy outperforms the other comparisons in all cases.

Keywords: computing network control systems, resource orchestration, dynamic scheduling, blockchain, cooperative game

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Authors: E. M. Vieira, C. S. Vieira, L. P. Bonifácio, L. M. de Oliveira Ciabati, A. C. A. Franzon, F. S. Zaratini, J. A. C. Sanchez, M. S. Andrade, J. P. Dias de Souza

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The quality of prenatal care is key to reduce maternal morbidity and mortality. Communication between the health service and users can stimulate prevention and care. M-health has been an important and low cost strategy to health education. The PRENACEL programme (prenatal in the cell phone) was developed. It consists of a programme of information via SMS from the 20^th week of pregnancy up to 12^th week after delivery. Messages were about prenatal care, birth, contraception and breastfeeding. Communication of the pregnant woman asking questions about their health was possible. The objective of this study was to evaluate the implementation of PRENACEL as a useful complement to the standard prenatal care. Twenty health clinics were selected and randomized by cluster, 10 as the intervention group and 10 as the control group. In the intervention group, women and their partner were invited to participate. The control group received the standard prenatal care. All women were interviewed in the immediate post-partum and in the 12^th and 24^th week post-partum. Most women were married, had more than 8 years of schooling and visit the clinic more than 6 times during prenatal care. The intervention group presented lowest percentage of higher economic participants (5.6%), less single mothers and no drug user. It also presented more prenatal care visits than the control group and it was less likely to present Severe Acute Maternal Mortality when compared to control group as well as higher percentage of partners (75.4%) was present at the birth compared to control group. Although the study is still being carried out, preliminary data are showing positive results of the compliance of women to prenatal care.

Keywords: cellphone, health technology, prenatal care, prevention

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Authors: Anna Paola Micheli, Anna Maria Calce, Loris Di Nallo

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Sustainable finance identifies the process that leads, in the adoption of investment decisions, to take into account environmental and social factors, with the aim of orienting investments towards sustainable and long-term activities. Considering that the topic is at the center of the interest of national agendas, long-term investments will no longer be analyzed only by looking at financial data, but environmental, social, and governance (ESG) factors will be increasingly important and will play a fundamental role in determining the risk and return of an investment. Although this perspective does not deny the orientation to profit, ESG mutual funds represent sustainable finance applied to the world of mutual funds. So the goal of this paper is to verify this attitude, in particular in the energy sector. The choice of the sector is not casual: ESG is the acronym for environmental, social, and governance, and energy companies are strictly related to the environmental theme. The methodology adopted leads to a comparison between a sample of ESG funds and a sample of ESG funds with similar characteristics, using the most important indicators of literature: yield, standard deviation, and Sharpe index. The analysis is focused on equity funds. Results that are partial, due to the lack of historicity, show a good performance of ESG funds, testifying how a sustainable approach does not necessarily mean lower profits. It is clear that these first findings do not involve an absolute preference for ESG funds in terms of performance because the persistence of results is requested. Furthermore, these findings are to be verified in other sectors and in bond funds.

Keywords: mutual funds, ESG, performance, energy

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Authors: Karolina Mazur, Stanislaw Kuciel

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Polylactides (PLA) and polyhydroxyalkanoates (PHA) are the two groups of biodegradable and biocompatible thermoplastic polymers most commonly utilised in medicine and rehabilitation. The aim of this work is to determine the changes in the strength properties and the microstructures taking place in biodegradable polymer composites during their long-term storage in a highly cooled environment (i.e. a freezer at -24ºC) and to initially assess the durability of such biocomposites when used as single-use elements of rehabilitation or medical equipment. It is difficult to find any information relating to the feasibility of long-term storage of technical products made of PLA or PHA, but nonetheless, when using these materials to make products such as casings of hair dryers, laptops or mobile phones, it is safe to assume that without storing in optimal conditions their degradation time might last even several years. SEM images and the assessment of the strength properties (tensile, bending and impact testing) were carried out and the density and water sorption of two polymers, PLA and PHA (NaturePlast PLE 001 and PHE 001), filled with cellulose fibres (corncob grain – Rehofix MK100, Rettenmaier&Sohne) up to 10 and 20% mass were determined. The biocomposites had been stored at a temperature of -24ºC for 4 years. In order to find out the changes in the strength properties and the microstructure taking place after such a long time of storage, the results of the assessment have been compared with the results of the same research carried out 4 years before. Results shows a significant change in the manner of fractures – from ductile with developed surface for the PHA composite with corncob grain when the tensile testing was performed directly after the injection into a more brittle state after 4 years of storage, which is confirmed by the strength tests, where a decrease of deformation is observed at point of fracture. The research showed that there is a way of storing medical devices made out of PLA or PHA for a reasonably long time, as long as the required temperature of storage is met. The decrease of mechanical properties found during tensile testing and bending for PLA was less than 10% of the tensile strength, while the modulus of elasticity and deformation at fracturing slightly rose, which may implicate the beginning of degradation processes. The strength properties of PHA are even higher after 4 years of storage, although in that case the decrease of deformation at fracturing is significant, reaching even 40%, which suggests its degradation rate is higher than that of PLA. The addition of natural particles in both cases only slightly increases the biodegradation.

Keywords: biocomposites, PLA, PHA, storage

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Authors: A. Iaaly, O. Jadayel, R. Jadayel

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This paper explores the effectiveness of approaches used for the implementation of technology within central governments specifically Geographic Information Systems (GIS). It examines the extent to which various strategies to GIS implementation and its roll out to users within an organization is crucial for its long term assimilation. Depending on the contextual requirements, various implementation strategies exist spanning from the most revolutionary to the most evolutionary, which have an influence on the success of GIS projects and the realization of resulting business benefits within the central governments. This research compares between two strategies of GIS implementation within the Lebanese Municipalities. The first strategy is the “Technological Approach” which is focused on technology acquisition, overlaid on existing governmental frameworks. This approach gives minimal attention to capability building and the long term sustainability of the implemented program. The second strategy, referred to as the “Ecological Approach”, is naturally oriented to the function of the organization. This approach stresses on fostering the evolution of the program and on building the human capabilities. The Union of the Joumeh Municipalities will be presented as a case study under the “Ecological Approach” and the role of the GIS Center at the University of Balamand will be highlighted. Thus, this research contributes to the development of knowledge on technology implementation and the vital role of academia in the specific context of the Lebanese public sector so that this experience may pave the way for further applications.

Keywords: ecological approach GIS, low income countries, technological approach

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Authors: Megan Glyde, Louise Dye, David Keane, Ed Sutherland

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Background: Typically patient education is provided either verbally, in the form of written material, or with a multimedia-based tool such as videos, CD-ROMs, DVDs, or via the internet. By providing patients with effective educational tools, this can help to meet their information needs and subsequently empower these patients and allow them to participate within medical-decision making. Video education may have some distinct advantages compared to other modalities. For instance, whilst eHealth is emerging as a promising modality of patient education, an individual’s ability to access, read, and navigate through websites or online modules varies dramatically in relation to health literacy levels. Literacy levels may also limit patients’ ability to understand written education, whereas video education can be watched passively by patients and does not require high literacy skills. Other benefits of video education include that the same information is provided consistently to each patient, it can be a cost-effective method after the initial cost of producing the video, patients can choose to watch the videos by themselves or in the presence of others, and they can pause and re-watch videos to suit their needs. Health information videos are not only viewed by patients in formal educational sessions, but are increasingly being viewed on websites such as YouTube. Whilst there is a lot of anecdotal and sometimes misleading information on YouTube, videos from government organisations and professional associations contain trustworthy and high-quality information and could enable YouTube to become a powerful information dissemination platform for patients and carers. This systematic review will examine the efficacy of video education to improve treatment or illness-related knowledge in patients with various long-term conditions, in comparison to other modalities of education. Methods: Only studies which match the following criteria will be included: participants will have a long-term physical health condition, video education will aim to improve treatment or illness related knowledge and will be tested in isolation, and the study must be a randomised controlled trial. Knowledge will be the primary outcome measure, with modality preference, anxiety, and behaviour change as secondary measures. The searches have been conducted in the following databases: OVID Medline, OVID PsycInfo, OVID Embase, CENTRAL and ProQuest, and hand searching for relevant published and unpublished studies has also been carried out. Screening and data extraction will be conducted independently by 2 researchers. Included studies will be assessed for their risk of bias in accordance with Cochrane guidelines, and heterogeneity will also be assessed before deciding whether a meta-analysis is appropriate or not. Results and Conclusions: Appropriate synthesis of the studies in relation to each outcome measure will be reported, along with the conclusions and implications.

Keywords: long-term condition, patient education, systematic review, video

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Authors: Michael Joseph Passmore

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Euthanasia, or assisted suicide (EAS), refers to the provision of medical assistance to individuals seeking to end their own lives. In Canada, the issue of EAS has been the subject of debate and legislative action for many years. In 2016, the Canadian government passed the Medical Assistance in Dying (MAID) Act. This legalized EAS in Canada is subject to certain eligibility criteria. In 2023, debate in Canada continues regarding the scope of MAID practice and associated legislation. Dementia is an illness that causes suffering at the end of life. Persons suffering due to dementia deserve timely and effective palliative care.

Keywords: palliative care, neurocognitive disorder, dementia, Alzheimer’s disease, euthanasia, assisted suicide, medical ethics, bioethics

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Authors: Andrzej Wałęga, Marta Cebulska, Agnieszka Ziernicka-Wojtaszek, Wojciech Młocek, Agnieszka Wałęga, Tommaso Caloiero

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Drought is one of the natural phenomena influencing many aspects of human activities like food production, agriculture, industry, and the ecological conditions of the environment. In the area of the Polish Carpathians, there are periods with a deficit of rainwater and an increasing frequency in dry months, especially in the cold half of the year. The aim of this work is a spatial and temporal analysis of drought, expressed as SPI in a heterogenous area of the Polish Carpathian and of the highland Region in the Central part of Europe based on long-term precipitation data. Also, to our best knowledge, for the first time in this work, drought characteristics analyzed via the SPI were discussed based on the atmospheric circulation calendar. The study region is the Upper Vistula Basin, located in the southern and south-eastern part of Poland. In this work, monthly precipitation from 56 rainfall stations was analysed from 1961 to 2022. The 3-, 6-, 9-, and 12-month Standardized Precipitation Index (SPI) were used as indicators of meteorological drought. For the 3-month SPI, the main climatic mechanisms determining extreme droughts were defined based on the calendar of synoptic circulations. The Mann-Kendall test was used to detect the trend of extreme droughts. Statistically significant trends of SPI were observed on 52.7% of all analyzed stations, and in most cases, a positive trend was observed. Statistically significant trends were more frequently observed in stations located in the western part of the analyzed region. Long-term droughts, represented by the 12-month SPI, occurred in all stations but not in all years. Short-term droughts (3-month SPI) were most frequent in the winter season, 6 and 9-month SPI in winter and spring, and 12-month SPI in winter and autumn, respectively. The spatial distribution of drought was highly diverse. The most intensive drought occurred in 1984, with the 6-month SPI covering 98% of the analyzed region and the 9 and 12-month SPI covering 90% of the entire region. Droughts exhibit a seasonal pattern, with a dominant 10-year periodicity for all analyzed variants of SPI. Additionally, Fourier analysis revealed a 2-year periodicity for the 3-, 6-, and 9-month SPI and a 31-year periodicity for the 12-month SPI. The results provide insights into the typical climatic conditions in Poland, with strong seasonality in precipitation. The study highlighted that short-term extreme droughts, represented by the 3-month SPI, are often caused by anticyclonic situations with high-pressure wedges Ka and Wa, and anticyclonic West as observed in 52.3% of cases. These findings are crucial for understanding the spatial and temporal variability of short and long-term extreme droughts in Central Europe, particularly for the agriculture sector dominant in the northern part of the analyzed region, where drought frequency is highest.

Keywords: atmospheric circulation, drought, precipitation, SPI, the Upper Vistula Basin

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Authors: Kianoosh Samimi, Siham Kamali-Bernard, Ali Akbar Maghsoudi

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Due to the difficult placement and vibration between reinforcements of reinforced concrete and the defects that it may cause, the use of self-compacting concrete (SCC) is becoming more widespread. Ordinary Portland Cement (OPC) is the most widely used binder in the construction industry. However, the manufacture of this cement results in a significant amount of CO₂ being released, which is detrimental to the environment. Thus, an alternative to reduce the cost of SCC is the use of more economical and environmental mineral additives in partial or total substitution of Portland cement. Our study is in this context and aims to develop SCCs both economic and ecological. Two natural pozzolans such as pumice and zeolite are chosen in this research. This research tries to answer questions including the microstructure of the two types of natural pozzolan and their influence on the mechanical properties as well as on the transport property of SCC. Based on the findings of this study, the studied zeolite is a clinoptilolite that presents higher pozzolan activity compared to pumice. However, the use of zeolite decreases the compressive strength of SCC composites. On the contrary, the compressive strength in SCC containing of pumice increases at both early and long term ages with a remarkable increase at long term. A correlation is obtained between the compressive strength with permeable pore and capillary absorption. Also, the results concerning compressive strength and transport property are well justified by evaporable and non-evaporable water content measurement. This paper shows that the substitution of Portland cement by 15% of pumice or 10% of zeolite in HSSCC is suitable in all aspects. 

Keywords: concrete, durability, pumice, SCC, transport, zeolite

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Hong Wu, Naiji Lu, Chenguang Wang, Xinming Tu

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This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g. traffic accidents) among elderly people. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. By using longitudinal data from a representative national China Health and retirement longitudinal study of people aged 45 and older in China, our findings indicate that informal care decreases while poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care to elders into account. Second, ease of birth policy and postponed retirement policy are urgent to meet the demand of informal care. Third, medical policies should attach great importance to not only physical health but also mental health of elderly parents especially for older people with accident history.

Keywords: accident, China, fall, informal care, mental health, physical health

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Authors: Diana Flores Galindo, Richard Gil Herrera

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Nowadays, Lean Manufacturing and Industry 4.0 are very important in every country. One of the main benefits is continued market presence. It has been identified that there is a need to change existing educational programs, as well as update the knowledge and skills of existing employees. It should be borne in mind that behind each technological improvement, there is a human being. Human talent cannot be neglected. The main objectives of this article are to review the link between Lean Manufacturing, the incorporation of Industry 4.0 and the steps to follow to implement it; analyze the current situation and study the implications and benefits of this new trend, with a particular focus on Mexico. Lean Manufacturing and Industry 4.0 implementation waves must always take care of the most important capital – intellectual capital. The methodology used in this article comprised the following steps: reviewing the reality of the fourth industrial revolution, reviewing employees’ skills on the journey to become world-class, and analyzing the situation in Mexico. Lean Manufacturing and Industry 4.0 were studied not as exclusive concepts, but as complementary ones. The methodological framework used is focused on motivating companies’ collaborators to guarantee common results, innovate, and remain in the market in the face of new requirements from company stakeholders. The key findings were that both trends emphasize the need to improve communication across the entire company and incorporate new technologies into everyday work, from the shop floor to administrative staff, to help improve processes. Taking care of people, activities and processes will bring a company success. In the specific case of Mexico, companies in all sectors need to be aware of and implement technological improvements according to their specific needs. Low-cost labor represents one of the most typical barriers. In conclusion, companies must build a roadmap according to their strategy and needs to achieve their short, medium- and long-term goals.

Keywords: lean management, lean manufacturing, industry 4.0, motivation, SWOT analysis, Hoshin Kanri

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Authors: Lucile Richard

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Contemporary thinkers studying biopolitics and its lethal logic find little interest in Foucault's "vague sketch of the pastorate.” Despite pastoral power being depicted as the matrix of governmentality in the genealogy of biopower, most post-Foucauldian theorists disregard its study. Sovereign power takes precedence in the examination of the governmental connection between care, violence, and death. Questioning this recurring motif, this article advocates for a feminist exploration of pastoral power. It argues that giving attention to the genealogy of the pastorate is essential to account for the carelessness that runs today's politics. Examining Foucault's understanding of this "power to care" uncovers the link between care work and politics, a facet of governmentality often overlooked in sovereignty-centered perspectives. His description of “pastoral insurrections”, in so far as it highlights that caring, far from being excluded from politics, is the object of competing problematizations, also calls for a more nuanced and complex comprehension of the politicization of care and care work than the ones developed by feminist theorists. As such, it provides an opportunity to delve into under-theorized dimensions of the "care crisis" in feminist accounts. On one hand, it reveals how populations are disciplined and controlled, not only through caregiving obligations, but also through being assigned or excluded from receiving care. On the other, it stresses that the organization of the public sphere is just as important as the organization of the private sphere, which is the main focus for most feminists, in preventing marginalized perspectives on caring from gaining political momentum.

Keywords: Foucault, feminist theory, resistance, pastoral power, crisis of care, biopolitics

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Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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Authors: Hong Wu, Naiji Lu

Abstract:

Improvement of health behavior among people with chronic diseases is vital for increasing longevity and enhancing quality of life. This paper researched the causal effects of informal care on the compliance with doctor’s health advices – smoking control, dietetic regulation, weight control and keep exercising – among older people with chronic diseases in China, which is facing the challenge of aging. We addressed the selection bias by using propensity score matching in the estimation process. We used the 2011-2012 national baseline data of the China Health and Retirement Longitudinal Study. Our results showed informal care can help improve health behavior of older people. First, informal care improved the compliance of smoking controls: whether smoke, frequency of smoking, and the time lag between wake up and the first cigarette was all lower for these older people with informal care; Second, for dietetic regulation, older people with informal care had more meals every day than older people without informal care; Third, three variables: BMI, whether gain weight and whether lose weight were used to measure the outcome of weight control. There were no significant difference between group with informal care and that without for BMI and the possibility of losing weight. Older people with informal care had lower possibility of gain weight than that without; Last, for the advice of keeping exercising, informal care increased the probability of walking exercise, however, the difference between groups for moderate and vigorous exercise were not significant. Our results indicate policy makers who aim to decrease accidents should take informal care to elders into account and provide an appropriate policy to meet the demand of informal care. Our birth policy and postponed retirement policy may decrease the informal caregiving hours, so adjustments of these policies are important and urgent to meet the current situation of aged tendency of population. In addition, government could give more support to develop organizations to provide formal care, such as nursing home. We infer that formal care is also useful for health behavior improvements.

Keywords: chronic diseases, compliance, CHARLS, health advice, informal care, older people, propensity score matching

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Authors: Florian Monetti, Brett Beamsley, Peter McComb, Simon Weppe

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Land reclamation from the ocean has considerably increased over past decades to support worldwide rapid urban growth. Reshaping the coastline, however, inevitably affects coastal systems. One of the main challenges for coastal oceanographers is to predict the physical and morphological responses for nearshore systems to man-made changes over multiple time-scales. Fully-coupled numerical models are powerful tools for simulating the wide range of interactions between flow field and bedform morphology. Restricted and inconsistent measurements, combined with limited computational resources, typically make this exercise complex and uncertain. In the present study, we investigate the impact of proposed land reclamation within a wave-dominated bay in New Zealand. For this purpose, we first calibrated our morphological model based on the long-term evolution of the bay resulting from land reclamation carried out in the 1950s. This included the application of sedimentological spin-up and reduction techniques based on historical bathymetry datasets. The updated bathymetry, including the proposed modifications of the bay, was then used to predict the effect of the proposed land reclamation on the wave climate and morphology of the bay after one decade. We show that reshaping the bay induces a distinct symmetrical response of the shoreline which likely will modify the nearshore wave patterns and consequently recreational activities in the area.

Keywords: coastal waves, impact of land reclamation, long-term coastal evolution, morphodynamic modeling

Procedia PDF Downloads 164

Authors: W. L. Tsang, H. Y. Li, S. L. Wong, T. Y. Kwok, S. C. Yuen, S. S. Kwok, P. S. Ko, S. Y. Lau

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Introduction: Palliative care is no doubt necessary in surgery. When one looks at studies of what patients with life-threatening illness want and compares to what they experience in surgical units, the gap is huge. Surgical nurses, being patient advocates, should engage with patients and families sooner rather than later in their illness trajectories to consider how to manage the illness, not just their capacity to survive. Objective: This clinical practice guide aims to fill the service gap of palliative care in surgery by producing a quality-driven, evidence-based yet straightforward clinical practice guide based on a focus strategy. Methodology: In line with Guide to Good Nursing Practice: End-of-Life Care recommended by Nursing Council of Hong Kong and the strategic goal of improving quality of palliative care proposed in HA Strategic Plan 2017-2022, multiple phases of work were undertaken from July 2015 to December 2017. A pragmatic clinical practice guide for surgical patients facing life-threatening conditions was developed based on assessments on knowledge of and attitudes towards end-of-life care of surgical nurses. Key domains, including preparation for bereavement, nursing care for imminently dying patients and at the dying scene were crystallized according to the results of the assessments and the palliative care checklist formulated by UCH Palliative Care Team. After a year of rollout, its content was refined through analyses of implementation in routine practice and consensus opinions from frontline nurses. Results and Outcomes: This clinical practice guide inspires surgical nurses with the art of care to provide for patients’ comfort, function, and longevity. It provides practical directions and assists nurses to master the skills on advance care planning and learn how to be clear with patients, families and themselves about the realities of the disease pictures. Through the implementation, patients and families are included in the decision process, and their wishes are honored. The delivery of explicit and high-quality palliative care maintains good nurse-to-patient relations and enhances satisfaction of hospital care of patients and families. Conclusion: Surgical nursing has always been up to the unique challenges of the era. This clinical practice guide has become an island of credibility for our nurses as they traverse the often stormy waters of life-limiting illness.

Keywords: palliative care delivery, palliative care in surgery, hospice care, end-of-life care

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