Search results for: electronic health records
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10852

Search results for: electronic health records

10252 The Model Development of Caregiver Skills for the End of Life’s Cancer Patients

Authors: Chaliya Wamaloon, Malee Chaisaena, Nusara Prasertsri

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Informal caregivers providing home-based palliative and end-of-life (EOL) care to people with advanced cancer is needed, however, there has not been develop caregiver skills for the EOL in cancer patients. The aim of this research was to study the model development of caregiver skills for the EOL in cancer patients. Mixed methods research was conducted in 3 phases. All subjects were in Ubon Rathchathani Cancer Hospital including 30 EOL cancer patient caregivers, 30 EOL cancer patients, and 111 health care professionals who provided care for the EOL cancer patients and 30 EOL target participants who had been trained to be cancer patient caregivers. The research tools were questionnaires, semi structured interviews, and caregiver skills questionnaires. Data were analyzed by using percentage, mean, standard deviation, pair t-test, and content analysis. The result from this study showed the model development of caregiver skills for cancer patients consisted of 9 domains skills: 1. monitoring, 2. interpreting, 3. making decisions, 4. taking action, 5. making adjustments, 6. providing hands-on care, 7. accessing resources, 8. working together with the ill patients, and 9. navigating the healthcare system. The model composed of skills development curriculum for cancer patient caregivers, Manual of palliative care for caregivers, diary of health care records for cancer patients, and the evaluation model of development of caregiver skills for EOL cancer patients. The results of the evaluation in the development model of caregiver skills for EOL cancer patients showed that the caregivers were satisfied with the model of development for caregiver skills at a high level. The comparison of the caregiver skills before and after obtaining the development of caregivers skills revealed that it improved at a statistically significant level (p < 0.05).

Keywords: caregiver, caregiver skills, cancer patients, end of life

Procedia PDF Downloads 152
10251 Medical Waste Management in Nigeria: A Case Study

Authors: Y. Y. Babanyara, D. B. Ibrahim, T. Garba

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Proper management of medical waste is a crucial issue for maintaining human health and the environment. The waste generated in the hospitals has the potential for spreading infections and causing diseases. The study is aimed at assessing the medical waste management practices in Nigeria. Three instruments, questionnaire administration, in-depth interview and observation method for data collection were adopted in the study. The results revealed that the hospital does not quantify medical waste. Segregation of medical wastes is not conducted according to definite rules and standards. Wheeled trolleys are used for on-site transportation of waste from the points of production to the temporary storage area. Offsite transportation of the hospital waste is undertaken by a private waste management company. Small pickups are mainly used to transport waste daily to an off-site area for treatment and disposal. The main treatment method used in the final disposal of infectious waste is incineration. Non-infectious waste is disposed off using land disposal method. The study showed that the hospital does not have a policy and plan in place for managing medical waste. The study revealed number of problems the hospital faces in terms of medical waste management, including; lack of necessary rules, regulations and instructions on the different aspects of collections and disposal of waste, failure to quantify the waste generated in reliable records, lack of use of coloured bags by limiting the bags to only one colour for all waste, the absence of a dedicated waste manager, and no committee responsible for monitoring the management of medical waste. Recommendations are given with the aim of improving medical waste management in the hospital.

Keywords: medical waste, treatment, disposal, public health

Procedia PDF Downloads 297
10250 A Study of Using Different Printed Circuit Board Design Methods on Ethernet Signals

Authors: Bahattin Kanal, Nursel Akçam

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Data transmission size and frequency requirements are increasing rapidly in electronic communication protocols. Increasing data transmission speeds have made the design of printed circuit boards much more important. It is important to carefully examine the requirements and make analyses before and after the design of the digital electronic circuit board. It delves into impedance matching techniques, signal trace routing considerations, and the impact of layer stacking on signal performance. The paper extensively explores techniques for minimizing crosstalk issues and interference, presenting a holistic perspective on design strategies to optimize the quality of high-speed signals. Through a comprehensive review of these design methodologies, this study aims to provide insights into achieving reliable and high-performance printed circuit board layouts for these signals. In this study, the effect of different design methods on Ethernet signals was examined from the type of S parameters. Siemens company HyperLynx software tool was used for the analyses.

Keywords: HyperLynx, printed circuit board, s parameters, ethernet

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10249 Applying the Global Trigger Tool in German Hospitals: A Retrospective Study in Surgery and Neurosurgery

Authors: Mareen Brosterhaus, Antje Hammer, Steffen Kalina, Stefan Grau, Anjali A. Roeth, Hany Ashmawy, Thomas Gross, Marcel Binnebosel, Wolfram T. Knoefel, Tanja Manser

Abstract:

Background: The identification of critical incidents in hospitals is an essential component of improving patient safety. To date, various methods have been used to measure and characterize such critical incidents. These methods are often viewed by physicians and nurses as external quality assurance, and this creates obstacles to the reporting events and the implementation of recommendations in practice. One way to overcome this problem is to use tools that directly involve staff in measuring indicators of quality and safety of care in the department. One such instrument is the global trigger tool (GTT), which helps physicians and nurses identify adverse events by systematically reviewing randomly selected patient records. Based on so-called ‘triggers’ (warning signals), indications of adverse events can be given. While the tool is already used internationally, its implementation in German hospitals has been very limited. Objectives: This study aimed to assess the feasibility and potential of the global trigger tool for identifying adverse events in German hospitals. Methods: A total of 120 patient records were randomly selected from two surgical, and one neurosurgery, departments of three university hospitals in Germany over a period of two months per department between January and July, 2017. The records were reviewed using an adaptation of the German version of the Institute for Healthcare Improvement Global Trigger Tool to identify triggers and adverse event rates per 1000 patient days and per 100 admissions. The severity of adverse events was classified using the National Coordinating Council for Medication Error Reporting and Prevention. Results: A total of 53 adverse events were detected in the three departments. This corresponded to adverse event rates of 25.5-72.1 per 1000 patient-days and from 25.0 to 60.0 per 100 admissions across the three departments. 98.1% of identified adverse events were associated with non-permanent harm without (Category E–71.7%) or with (Category F–26.4%) the need for prolonged hospitalization. One adverse event (1.9%) was associated with potentially permanent harm to the patient. We also identified practical challenges in the implementation of the tool, such as the need for adaptation of the global trigger tool to the respective department. Conclusions: The global trigger tool is feasible and an effective instrument for quality measurement when adapted to the departmental specifics. Based on our experience, we recommend a continuous use of the tool thereby directly involving clinicians in quality improvement.

Keywords: adverse events, global trigger tool, patient safety, record review

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10248 Outline of a Technique for the Recommendation of Tourism Products in Cuba Using GIS

Authors: Jesse D. Cano, Marlon J. Remedios

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Cuban tourism has developed so much in the last 30 years to the point of becoming one of the engines of the Cuban economy. With such a development, Cuban companies opting for e-tourism as a way to publicize their products and attract customers has also grown. Despite this fact, the majority of Cuban tourism-themed websites simply provide information on the different products and services they offer which results in many cases, in the user getting overwhelmed with the amount of information available which results in the user abandoning the search before he can find a product that fits his needs. Customization has been recognized as a critical factor for successful electronic tourism business and the use of recommender systems is the best approach to address the problem of personalization. This paper aims to outline a preliminary technique to obtain predictions about which products a particular user would give a better evaluation; these products would be those which the website would show in the first place. To achieve this, the theoretical elements of the Cuban tourism environment are discussed; recommendation systems and geographic information systems as tools for information representation are also discussed. Finally, for each structural component identified, we define a set of rules that allows obtaining an electronic tourism system that handles the personalization of the service provided effectively.

Keywords: geographic information system, technique, tourism products, recommendation

Procedia PDF Downloads 489
10247 Near Ambient Pressure Photoelectron Spectroscopy Studies of CO Oxidation on Spinel Co3O4 Surfaces: Electronic Structure and Mechanistic Aspects of Wet and Dry CO Oxidation

Authors: Ruchi Jain, Chinnakonda S. Gopinath

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The CO oxidation is a primary reaction in heterogeneous catalysis due to its potential to overcome the air pollution caused by various reasons. Indeed, in the study of sustainable catalysis, the role played by water is very important. The present work is focused on studying the effect of moisture on the sustainability of Co3O4 NR catalyst for CO oxidation reaction at ambient temperature. The catalytic activity, electronic structure and the mechanistic aspects of spinel Co3O4 nanorod surfaces have been explored in dry and wet atmosphere by near-ambient pressure photoelectron spectroscopic techniques (NAP-PES) with conventional x-ray (Al kα) and ultraviolet sources (He-I).Comparative NAPPES studies have been employed to understand the elucidation of the catalytic reaction pathway and the evolution of various surface species. The presence of water with CO+O2 plummet the catalytic activity due to the change in electronic nature from predominantly oxidic (without water in the feed) to few intermediates covered Co3O4 surface. However, ≥ 375 K Co3O4 surface recovers and regain oxidation activity, at least partially, even in the presence of water. Above mentioned observations are fully supported by the changes observed in the work function of Co3O4 in the presence of wet (H2O+CO+O2) compared to dry (CO+O2) conditions. Various type of surface species, such as CO(ads), carbonate, formate, are found to be on the catalyst surface depending on the reaction conditions. Under dry condition, CO couples with labile O atoms to form CO2, however under wet conditions it also interacts with surface OH groups results in the formation carbonate and formate intermediate. The carbonate acts at reaction inhibitor at room temperature, however proves as active intermediate at temperature 375 K or above. On the other hand, formate has proved to be reaction spectator due to its high stability. The intrinsic role of these species to suppress the oxidation has been demonstrated through a possible reaction mechanism under different reaction conditions.

Keywords: heterogeneous catalysis, surface chemistry, photoelectron spectroscopy, ambient oxidation

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10246 Integrating Geographic Information into Diabetes Disease Management

Authors: Tsu-Yun Chiu, Tsung-Hsueh Lu, Tain-Junn Cheng

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Background: Traditional chronic disease management did not pay attention to effects of geographic factors on the compliance of treatment regime, which resulted in geographic inequality in outcomes of chronic disease management. This study aims to examine the geographic distribution and clustering of quality indicators of diabetes care. Method: We first extracted address, demographic information and quality of care indicators (number of visits, complications, prescription and laboratory records) of patients with diabetes for 2014 from medical information system in a medical center in Tainan City, Taiwan, and the patients’ addresses were transformed into district- and village-level data. We then compared the differences of geographic distribution and clustering of quality of care indicators between districts and villages. Despite the descriptive results, rate ratios and 95% confidence intervals (CI) were estimated for indices of care in order to compare the quality of diabetes care among different areas. Results: A total of 23,588 patients with diabetes were extracted from the hospital data system; whereas 12,716 patients’ information and medical records were included to the following analysis. More than half of the subjects in this study were male and between 60-79 years old. Furthermore, the quality of diabetes care did indeed vary by geographical levels. Thru the smaller level, we could point out clustered areas more specifically. Fuguo Village (of Yongkang District) and Zhiyi Village (of Sinhua District) were found to be “hotspots” for nephropathy and cerebrovascular disease; while Wangliau Village and Erwang Village (of Yongkang District) would be “coldspots” for lowest proportion of ≥80% compliance to blood lipids examination. On the other hand, Yuping Village (in Anping District) was the area with the lowest proportion of ≥80% compliance to all laboratory examination. Conclusion: In spite of examining the geographic distribution, calculating rate ratios and their 95% CI could also be a useful and consistent method to test the association. This information is useful for health planners, diabetes case managers and other affiliate practitioners to organize care resources to the areas most needed.

Keywords: catchment area of healthcare, chronic disease management, Geographic information system, quality of diabetes care

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10245 Application of IED to Condition Based Maintenance of Medium Voltage GCB/VCB

Authors: Ming-Ta Yang, Jyh-Cherng Gu, Chun-Wei Huang, Jin-Lung Guan

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Time base maintenance (TBM) is conventionally applied by the power utilities to maintain circuit breakers (CBs), transformers, bus bars and cables, which may result in under maintenance or over maintenance. As information and communication technology (ICT) industry develops, the maintenance policies of many power utilities have gradually changed from TBM to condition base maintenance (CBM) to improve system operating efficiency, operation cost and power supply reliability. This paper discusses the feasibility of using intelligent electronic devices (IEDs) to construct a CB CBM management platform. CBs in power substations can be monitored using IEDs with additional logic configuration and wire connections. The CB monitoring data can be sent through intranet to a control center and be analyzed and integrated by the Elipse Power Studio software. Finally, a human-machine interface (HMI) of supervisory control and data acquisition (SCADA) system can be designed to construct a CBM management platform to provide maintenance decision information for the maintenance personnel, management personnel and CB manufacturers.

Keywords: circuit breaker, condition base maintenance, intelligent electronic device, time base maintenance, SCADA

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10244 Health Hazards of Performance Enhancing Drugs

Authors: Austin Oduor Otieno

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There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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10243 Vibrational Spectra and Nonlinear Optical Investigations of a Chalcone Derivative (2e)-3-[4-(Methylsulfanyl) Phenyl]-1-(3-Bromophenyl) Prop-2-En-1-One

Authors: Amit Kumar, Archana Gupta, Poonam Tandon, E. D. D’Silva

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Nonlinear optical (NLO) materials are the key materials for the fast processing of information and optical data storage applications. In the last decade, materials showing nonlinear optical properties have been the object of increasing attention by both experimental and computational points of view. Chalcones are one of the most important classes of cross conjugated NLO chromophores that are reported to exhibit good SHG efficiency, ultra fast optical nonlinearities and are easily crystallizable. The basic structure of chalcones is based on the π-conjugated system in which two aromatic rings are connected by a three-carbon α, β-unsaturated carbonyl system. Due to the overlap of π orbitals, delocalization of electronic charge distribution leads to a high mobility of the electron density. On a molecular scale, the extent of charge transfer across the NLO chromophore determines the level of SHG output. Hence, the functionalization of both ends of the π-bond system with appropriate electron donor and acceptor groups can enhance the asymmetric electronic distribution in either or both ground and excited states, leading to an increased optical nonlinearity. In this research, the experimental and theoretical study on the structure and vibrations of (2E)-3-[4-(methylsulfanyl) phenyl]-1-(3-bromophenyl) prop-2-en-1-one (3Br4MSP) is presented. The FT-IR and FT-Raman spectra of the NLO material in the solid phase have been recorded. Density functional theory (DFT) calculations at B3LYP with 6-311++G(d,p) basis set were carried out to study the equilibrium geometry, vibrational wavenumbers, infrared absorbance and Raman scattering activities. The interpretation of vibrational features (normal mode assignments, for instance) has an invaluable aid from DFT calculations that provide a quantum-mechanical description of the electronic energies and forces involved. Perturbation theory allows one to obtain the vibrational normal modes by estimating the derivatives of the Kohn−Sham energy with respect to atomic displacements. The molecular hyperpolarizability β plays a chief role in the NLO properties, and a systematical study on β has been carried out. Furthermore, the first order hyperpolarizability (β) and the related properties such as dipole moment (μ) and polarizability (α) of the title molecule are evaluated by Finite Field (FF) approach. The electronic α and β of the studied molecule are 41.907×10-24 and 79.035×10-24 e.s.u. respectively, indicating that 3Br4MSP can be used as a good nonlinear optical material.

Keywords: DFT, MEP, NLO, vibrational spectra

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10242 Enhanced Properties of Plasma-Induced Two-Dimensional Ga₂O₃/GaS Heterostructures on Liquid Alloy Substrate

Authors: S. Zhuiykov, M. Karbalaei Akbari

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Ultra-low-level incorporation of trace impurities and dopants into two-dimensional (2D) semiconductors is a challenging step towards the development of functional electronic instruments based on 2D materials. Herein, the incorporation of sulphur atoms into 2D Ga2O3 surface oxide film of eutectic gallium-indium alloy (EGaIn) is achieved through plasma-enhanced metal-catalyst dissociation of H2S gas on EGaIn substrate. This process led to the growth of GaS crystalline nanodomains inside amorphous 2D Ga2O3 sublayer films. Consequently, 2D lateral heterophase was developed between the amorphous Ga2O3 and crystalline GaS nanodomains. The materials characterization revealed the alteration of photoluminescence (PL) characteristics and change of valence band maximum (VBM) of functionalized 2D films. The comprehensive studies by conductive atomic force microscopy (c-AFM) showed considerable enhancement of conductivity of 2D Ga2O3/GaS materials (300 times improvement) compared with that of 2D Ga2O3 film. This technique has a great potential for the fabrication of 2D metal oxide devices with tuneable electronic characteristics similar to nano junction memristors and transistors.

Keywords: 2D semiconductors, Ga₂O₃, GaS, plasma-induced functionalization

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10241 Assessing Acceptability and Preference of Printed Posters on COVID-19 Related Stigma: A Post-Test Study Among HIV-Focused Health Workers in Greater Accra Region of Ghana

Authors: Jerry Fiave, Dacosta Aboagye, Stephen Ayisi-Addo, Mabel Kissiwah Asafo, Felix Osei-Sarpong, Ebenezer Kye-Mensah, Renee Opare-Otoo

Abstract:

Background: Acceptability and preference of social and behaviour change (SBC) materials by target audiences is an important determinant of effective health communication outcomes. In Ghana, however, pre-test and post-test studies on acceptability and preference of specific SBC materials for specific audiences are rare. The aim of this study was therefore to assess the acceptability and preference of printed posters on COVID-19 related stigma as suitable SBC materials for health workers to influence behaviours that promote uptake of HIV-focused services. Methods: A total of 218 health workers who provide HIV-focused services were purposively sampled in 16 polyclinics where the posters were distributed in the Greater Accra region of Ghana. Data was collected in March 2021 using an adapted self-administered questionnaire in Google forms deployed via WhatsApp to participants. The data were imported into SPSS version 27 where chi-square test and regression analyses were performed to establish association as well as strength of association between variables respectively. Results: A total of 142 participants (physicians, nurses, midwives, lab scientists, health promoters, diseases control officers) made up of 85(60%) females and 57(40%) males responded to the questionnaire, giving a response rate of 65.14%. Only 88 (61.97%) of the respondents were exposed to the posters. The majority of those exposed said the posters were informative [82(93.18%)], relevant [85(96.59%)] and attractive [83(94.32%)]. They [82(93.20%)] also rated the material as acceptable with no statistically significant association between category of health worker and acceptability of the posters (X =1.631, df=5, p=0.898). However, participants’ most preferred forms of material on COVID-19 related stigma were social media [38(26.76%)], television [33(23.24%)], SMS [19(13.38%)], and radio [18(12.70%)]. Clinical health workers were 4.88 times more likely to prefer online or electronic versions of SBC materials than nonclinical health workers [AOR= 4.88 (95% CI= 0.31-0.98), p=0.034]. Conclusions: Printed posters on COVID-19 related stigma are acceptable SBC materials in communicating behaviour change messages that target health workers in promoting uptake of HIV-focused services. Posters are however, not among the most preferred materials for health workers. It is therefore recommended that material assessment studies are conducted to inform the development of acceptable and preferred materials for target audiences.

Keywords: acceptability, AIDS, HIV, posters, preference, SBC, stigma, social and behaviour change communication

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10240 Political Economy of Electronic News Media in Pakistan

Authors: Asad Ullah Khalid

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This paper encompasses the application of the concept of political economy of mass media in Pakistan. The media has developed at a massive pace and now is considered as one of the vital parts in having better administration furthermore helps in conveying the issues identified with the government to the public. Albeit Pakistani media has gained much independence after 2003 but there are many social, political and economy factors which influence the content of the media. The study employs triangulation of quantitative and qualitative methods. In terms of methods, content analysis and interview method both are used. The content of Pakistani media is analyzed quantitatively and qualitatively. Moreover, interviews with various journalists are conducted, and their findings are disclosed in this paper. Pakistan's communication landscape is neither well documented nor well understood, leaving its public off guard with regards to reviewing the role and impact of news inflow, correspondence and media in political, economic and social life. It has been found out that on particular issues some media channels have strong affiliations with certain political parties, moreover reporting and coverage have also been affected by the factors like terrorism, state policies(written and verbal), advertising/economic and demographic factors like the composition of the population.

Keywords: political economy, news media, Pakistan, electronic news media, journalism, mass media

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10239 Development of an NIR Sorting Machine, an Experimental Study in Detecting Internal Disorder and Quality of Apple Fruitpple Fruit

Authors: Eid Alharbi, Yaser Miaji

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The quality level for fresh fruits is very important for the fruit industries. In presents study, an automatic online sorting system according to the internal disorder for fresh apple fruit has developed by using near infrared (NIR) spectroscopic technology. The automatic conveyer belts system along with sorting mechanism was constructed. To check the internal quality of the apple fruit, apple was exposed to the NIR radiations in the range 650-1300nm and the data were collected in form of absorption spectra. The collected data were compared to the reference (data of known sample) analyzed and an electronic signal was pass to the sorting system. The sorting system was separate the apple fruit samples according to electronic signal passed to the system. It is found that absorption of NIR radiation in the range 930-950nm was higher in the internally defected samples as compared to healthy samples. On the base of this high absorption of NIR radiation in 930-950nm region the online sorting system was constructed.

Keywords: mechatronics, NIR, fruit quality, spectroscopic technology, mechatronic design

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10238 Environmental and Health Risks Associated with Dental Waste Management: A Review

Authors: Y. Y. Babanyara, B. A. Gana, T. Garba, M. A. Batari

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Proper management of dental waste is a crucial issue for maintaining human health and the environment. The waste generated in the dental clinics has the potential for spreading infections and causing diseases, so improper disposal of these dental wastes can cause harm to the dentist, the people in immediate vicinity of the dentist, waste handlers, general public and the environment through production of toxins or as by-products of the destruction process. Staff that provide dental healthcare ought to be aware of the proper handling and the system of management of dental waste used by different dental hospitals. The method of investigation adopted in the paper involved a desk study in which documents and records relating to dental waste handling were studied to obtain background information on existing dental waste management in Nigeria other countries of the world are also mentioned as examples. Additionally, information on generation, handling, segregation, risk associated during handling and treatment of dental medical waste were sought in order to determine the best method for safe disposal. This article provides dentists with the information they need to properly dispose of mercury and amalgam waste, and provides suggestions for managing the other wastes that result from the day-to-day activities of a dental office such as: used X-ray fixers and developers; cleaners for X-ray developer systems; lead foils, shields and aprons; chemiclave/chemical sterilant solutions; disinfectants, cleaners, and other chemicals; and, general office waste. Additionally, this study may be beneficial for authorities and researchers of developing countries to work towards improving their present dental waste management system.

Keywords: clinic, dental, disposal, environment, waste management

Procedia PDF Downloads 301
10237 Culture Dimensions of Information Systems Security in Saudi Arabia National Health Services

Authors: Saleh Alumaran, Giampaolo Bella, Feng Chen

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The study of organisations’ information security cultures has attracted scholars as well as healthcare services industry to research the topic and find appropriate tools and approaches to develop a positive culture. The vast majority of studies in Saudi national health services are on the use of technology to protect and secure health services information. On the other hand, there is a lack of research on the role and impact of an organisation’s cultural dimensions on information security. This research investigated and analysed the role and impact of cultural dimensions on information security in Saudi Arabia health service. Hypotheses were tested and two surveys were carried out in order to collect data and information from three major hospitals in Saudi Arabia (SA). The first survey identified the main cultural-dimension problems in SA health services and developed an initial information security culture framework model. The second survey evaluated and tested the developed framework model to test its usefulness, reliability and applicability. The model is based on human behaviour theory, where the individual’s attitude is the key element of the individual’s intention to behave as well as of his or her actual behaviour. The research identified six cultural dimensions: Saudi national culture, Saudi health service leadership, employees’ trust, technology, multicultural interactions and employees’ job roles. The research also identified a set of cultural sub-dimensions. These include working values and norms, tribe values and norms, attitudes towards women, power sharing, vision, social interaction, respect and understanding, hospital intra-net, hospital employees’ language(s) used, multi-national culture, communication system, employees’ job satisfaction and job security. The research identified that (a) the human behaviour towards medical information in SA is one of the main threats to information security and one of the main challenges to SA health authority, (b) The current situation of SA hospitals’ IS cultures is falling short in protecting medical information due to the current value and norms towards information security, (c) Saudi national culture and employees’ job role are the main dimensions playing major roles in the employees’ attitude, and technology is the least important dimension playing a role in the employees’ attitudes.

Keywords: cultural dimension, electronic health record, information security, privacy

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10236 The Influence of E-Health Education on Professional Practice: A Qualitative Study

Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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10235 The Development of the Kamakhya Temple as a Historical Landmark in the Present State of Assam, India

Authors: Priyanka Tamta, Sukanya Sharma

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The Kamakhya Temple in Assam plays a very important role in the development of Assam as not only a historical place but also as an archaeologically important site. Temple building activity on the site began in 5th century AD when a cave temple dedicated to Lord Balabhadraswami was constructed here by King Maharajadhiraja Sri Surendra Varman. In the history of Assam, the name of this king is not found and neither the name of this form of Vishnu is known in this region. But this inscription sanctified the place as it recorded the first ever temple building activity in this region. The fifteen hundred years habitation history of the Kamakhya temple sites shows a gradual progression of the site from a religious site to an archaeological site and finally as a historical landmark. Here, in this paper, our main objective is to understand the evolution of Kamakhya temple site as a historical landscape and as an important landmark in the history of Assam. The central theme of the paper is the gradual development of the religious site to a historical landmark. From epigraphical records, it is known that the site received patronage from all ruling dynasties of Assam and its adjoining regions. Royal households of Kashmir, Nepal, Bengal, Orissa, Bihar, etc. have left their footprints on the site. According to records they donated wealth, constructed or renovated temples and participated in the overall maintenance of the deity. This made Kamakhya temple a ground of interaction of faiths, communities, and royalties of the region. Since the 5th century AD, there was a continuous struggle between different beliefs, faiths, and power on the site to become the dominant authority of the site. In the process, powerful beliefs system subsumed minor ones into a larger doctrine of beliefs. This can be seen in the case of the evolution of the Kamakhya temple site as one of the important Shakta temples in India. Today, it is cultural identity marker of the state of Assam within which it is located. Its diverse faiths and beliefs have been appropriated by powerful legends to the dominant faith of the land. The temple has evolved from a cave temple to a complex of seventeen temples. The faith has evolved from the worship of water, an element of nature to the worship of the ten different forms of the goddess with their five male consorts or Bhairavas. Today, it represents and symbolizes the relationship of power and control out of which it has emerged. During different periods of occupation certain architectural and iconographical characters developed which indicated diffusion and cultural adaptation. Using this as sources and the epigraphical records this paper will analyze the interactive and dynamic processes which operated in the building of this cultural marker, the archaeological site of Kamakhya.

Keywords: cultural adaptation and diffusion, cultural and historical landscape, Kamakhya, Saktism, temple art and architecture, historiography

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10234 The Pressure Effect and First-Principles Study of Strontium Chalcogenides SrS

Authors: Benallou Yassine, Amara Kadda, Bouazza Boubakar, Soudini Belabbes, Arbouche Omar, M. Zemouli

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The study of the pressure effect on the materials, their functionality and their properties is very important, insofar as it provides the opportunity to identify others applications such the optical properties in the alkaline earth chalcogenides, as like the SrS. Here we present the first-principles calculations which have been performed using the full potential linearized augmented plane wave method (FP-LAPW) within the Generalized Gradient Approximation developed by Perdew–Burke–Ernzerhor for solids (PBEsol). The calculated structural parameters like the lattice parameters, the bulk modulus B and their pressure derivative B' are in reasonable agreement with the available experimental and theoretical data. In addition, the elastic properties such as elastic constants (C11, C12, and C44), the shear modulus G, the Young modulus E, the Poisson’s ratio ν and the B/G ratio are also given. The treatments of exchange and correlation effects were done by the Tran-Blaha modified Becke-Johnson (TB-mBJ) potential for the electronic. The pressure effect on the electronic properties was visualized by calculating the variations of the gap as a function of pressure. The obtained results are compared to available experimental data and to other theoretical calculations

Keywords: SrS, GGA-PBEsol+TB-MBJ, density functional, Perdew–Burke–Ernzerhor, FP-LAPW, pressure effect

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10233 Performance Evaluation of Fingerprint, Auto-Pin and Password-Based Security Systems in Cloud Computing Environment

Authors: Emmanuel Ogala

Abstract:

Cloud computing has been envisioned as the next-generation architecture of Information Technology (IT) enterprise. In contrast to traditional solutions where IT services are under physical, logical and personnel controls, cloud computing moves the application software and databases to the large data centres, where the management of the data and services may not be fully trustworthy. This is due to the fact that the systems are opened to the whole world and as people tries to have access into the system, many people also are there trying day-in day-out on having unauthorized access into the system. This research contributes to the improvement of cloud computing security for better operation. The work is motivated by two problems: first, the observed easy access to cloud computing resources and complexity of attacks to vital cloud computing data system NIC requires that dynamic security mechanism evolves to stay capable of preventing illegitimate access. Second; lack of good methodology for performance test and evaluation of biometric security algorithms for securing records in cloud computing environment. The aim of this research was to evaluate the performance of an integrated security system (ISS) for securing exams records in cloud computing environment. In this research, we designed and implemented an ISS consisting of three security mechanisms of biometric (fingerprint), auto-PIN and password into one stream of access control and used for securing examination records in Kogi State University, Anyigba. Conclusively, the system we built has been able to overcome guessing abilities of hackers who guesses people password or pin. We are certain about this because the added security system (fingerprint) needs the presence of the user of the software before a login access can be granted. This is based on the placement of his finger on the fingerprint biometrics scanner for capturing and verification purpose for user’s authenticity confirmation. The study adopted the conceptual of quantitative design. Object oriented and design methodology was adopted. In the analysis and design, PHP, HTML5, CSS, Visual Studio Java Script, and web 2.0 technologies were used to implement the model of ISS for cloud computing environment. Note; PHP, HTML5, CSS were used in conjunction with visual Studio front end engine design tools and MySQL + Access 7.0 were used for the backend engine and Java Script was used for object arrangement and also validation of user input for security check. Finally, the performance of the developed framework was evaluated by comparing with two other existing security systems (Auto-PIN and password) within the school and the results showed that the developed approach (fingerprint) allows overcoming the two main weaknesses of the existing systems and will work perfectly well if fully implemented.

Keywords: performance evaluation, fingerprint, auto-pin, password-based, security systems, cloud computing environment

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10232 Ilizarov's External Fixator. A Bone Regeneration Method Little Used in Africa. Our Experience of 20 Years in Cameroon.

Authors: Ibrahima Farikou, Kolontchang Gatchou Alberic Lionel, Tsiagadgui Jean Gustave, Ngo Yamben Marie-Ange, Handy Eone Daniel

Abstract:

Introduction: It was in 1956 that Ilizarov pioneered the concept of osteogenesis in distraction by the device that bears his name to help produce bone and soft tissue regeneration and bone consolidation. This technique is not widely used in Africa where, however, its applications are numerous (loss of bone substances, congenital or acquired malformations). Our goal is to bring the indications of Ilizarov's device back to our practice conditions. Methods: Our study was conducted in 2 hospitals over a period of 20 years. For the retrospective phase, this study included all complete usable records of patients operated on in the Ilizarov external fixator department, and for the prospective phase, all patients operated on in the departments with complete usable records. Our sample was consecutive and not exhaustive. Data were analyzed by SPSS software version 23.0. Results: A total of 52 patients were reviewed. The average age of our patients was 14.7 years. The sex ratio was 1.6 in favor of men. The lower limb was the most affected (49), with a predominance of the tibia (62.4%). The average elongation was 6.4 cm. Traumatic acquired pathologies (delayed union, malunion) represented 60.6%. The mean time to union was seven months. Correction of the limb length discrepancy or filling of loss of bone substance was obtained in 75% of cases. Functionally, 80.8% of the patients treated had regained autonomy at the end of treatment, but in 17.3% of the patients, pain and limping persisted. Conclusion: This technique should be popularized in Africa because the benefit that would accrue to patients is invaluable and would be an attractive alternative to many amputations sometimes carried out in Africa by despair.

Keywords: ilizarov, external fixator, limb lengthening, bone regeneration, africa

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10231 Ecological Risk Assessment of Informal E-Waste Processing in Alaba International Market, Lagos, Nigeria

Authors: A. A. Adebayo, O. Osibanjo

Abstract:

Informal electronic waste (e-waste) processing is a crude method of recycling, which is on the increase in Nigeria. The release of hazardous substances such as heavy metals (HMs) into the environment during informal e-waste processing has been a major concern. However, there is insufficient information on environmental contamination from e-waste recycling, associated ecological risk in Alaba International Market, a major electronic market in Lagos, Nigeria. The aims of this study were to determine the levels of HMs in soil, resulting from the e-waste recycling; and also assess associated ecological risks in Alaba international market. Samples of soils (334) were randomly collected seasonally for three years from fourteen selected e-waste activity points and two control sites. The samples were digested using standard methods and HMs analysed by inductive coupled plasma optical emission. Ecological risk was estimated using Ecological Risk index (ER), Potential Ecological Risk index (RI), Index of geoaccumulation (Igeo), Contamination factor (Cf) and degree of contamination factor (Cdeg). The concentrations range of HMs (mg/kg) in soil were: 16.7-11200.0 (Pb); 14.3-22600.0 (Cu); 1.90-6280.0 (Ni), 39.5-4570.0 (Zn); 0.79-12300.0 (Sn); 0.02-138.0 (Cd); 12.7-1710.0 (Ba); 0.18-131.0 (Cr); 0.07-28.0 (V), while As was below detection limit. Concentrations range in control soils were 1.36-9.70 (Pb), 2.06-7.60 (Cu), 1.25-5.11 (Ni), 3.62-15.9 (Zn), BDL-0.56 (Sn), BDL-0.01 (Cd), 14.6-47.6 (Ba), 0.21–12.2 (Cr) and 0.22-22.2 (V). The trend in ecological risk index was in the order Cu > Pb > Ni > Zn > Cr > Cd > Ba > V. The potential ecological risk index with respect to informal e-waste activities were: burning > dismantling > disposal > stockpiling. The index of geo accumulation indices revealed that soils were extremely polluted with Cd, Cu, Pb, Zn and Ni. The contamination factor indicated that 93% of the studied areas have very high contamination status for Pb, Cu, Ba, Sn and Co while Cr and Cd were in the moderately contaminated status. The degree of contamination decreased in the order of Sn > Cu > Pb >> Zn > Ba > Co > Ni > V > Cr > Cd. Heavy metal contamination of Alaba international market environment resulting from informal e-waste processing was established. Proper management of e-waste and remediation of the market environment are recommended to minimize the ecological risks.

Keywords: Alaba international market, ecological risk, electronic waste, heavy metal contamination

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10230 Anxiety Treatment: Comparing Outcomes by Different Types of Providers

Authors: Melissa K. Hord, Stephen P. Whiteside

Abstract:

With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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10229 Influence of Sports Participation on Academic Performance among Afe Babalola University Student-Athletes

Authors: B. O. Diyaolu

Abstract:

The web created by sport in academics has made it difficult for it to be separated from adolescent educational development. The enthusiasm expressed towards sport by students in higher institutions is quite enormous. Primarily, academic performance should be the pride of all students but whether sports affect the academic performance of student-athletes remain an unknown fact. This study investigated the influence of sports participation on academic performance among Afe Babalola University student-athletes. Ex post facto research design was used. Two groups of students were used for the study; Student-athlete (SA) and Regular Students (RS). Purposive sampling technique was used to select 224 student-athletes, only those that are regular in the university sports team training were considered and their records (i.e. name, department, level, matriculation number, and phone number) were collected through the assistance of their coaches. For the regular students, purposive sampling technique was used to select 224 participants, only those that have no interest in sports were considered and their records were retrieved from the college registration officer. The first and second semester examination results of the two groups were compared in 10 general study courses without their knowledge, using descriptive statistics of frequency counts, mean, and standard deviation. Out of the 10 compared courses, 7 courses result showed no significant difference between students-athlete and regular students while student-athletes perform better in 3 practically oriented courses. Sports role in academics is quite significant. Exposure to sports can help build the confidence that athletes need especially when it comes to practical courses. Student-athletes can perform better in academics if the environment is friendly and not intimidating. Lecturers and coaches need to work together in order to build a well cultured and intelligent graduate.

Keywords: academic performance, regular students, sports participation, student-athlete, university sports team

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10228 Radio Frequency Identification System and Its Effect on Retailing Sector

Authors: Ayşe Çoban, Orhan Çoban, Murat Birekul

Abstract:

In this study, the effects of radio frequency identification system on the retailing sector were theoretically analysed. The technology of Radio Frequency Identification (RFID) is a method enabling to identify the objects individually and automatically, using radio frequency. RFID generally consists of a tag and reader. RFID tags can be programmed to receive, store, and send the information of object such as Electronic Product Code (EPC). Having read the tags placed on product by the reader, the information associated with the management of supply chain can be automatically recorded and replaced. Recently, RFID technology used in many areas has particularly important effects on the businesses that are active in the retailing sector. The most important disadvantage of this technology is that the cost of installation and operation is higher compared to its alternatives. However, it provides important advantages to the business enterprises in the application process. At present, it is especially adopted by the large sized enterprises and with chain stores in the international areas. The application results point out that RFID technology provides business enterprises with the important competitive advantage.

Keywords: RFID, retailing sector, RFID technologies, electronic product code

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10227 Governance in the Age of Artificial intelligence and E- Government

Authors: Mernoosh Abouzari, Shahrokh Sahraei

Abstract:

Electronic government is a way for governments to use new technology that provides people with the necessary facilities for proper access to government information and services, improving the quality of services and providing broad opportunities to participate in democratic processes and institutions. That leads to providing the possibility of easy use of information technology in order to distribute government services to the customer without holidays, which increases people's satisfaction and participation in political and economic activities. The expansion of e-government services and its movement towards intelligentization has the ability to re-establish the relationship between the government and citizens and the elements and components of the government. Electronic government is the result of the use of information and communication technology (ICT), which by implementing it at the government level, in terms of the efficiency and effectiveness of government systems and the way of providing services, tremendous commercial changes are created, which brings people's satisfaction at the wide level will follow. The main level of electronic government services has become objectified today with the presence of artificial intelligence systems, which recent advances in artificial intelligence represent a revolution in the use of machines to support predictive decision-making and Classification of data. With the use of deep learning tools, artificial intelligence can mean a significant improvement in the delivery of services to citizens and uplift the work of public service professionals while also inspiring a new generation of technocrats to enter government. This smart revolution may put aside some functions of the government, change its components, and concepts such as governance, policymaking or democracy will change in front of artificial intelligence technology, and the top-down position in governance may face serious changes, and If governments delay in using artificial intelligence, the balance of power will change and private companies will monopolize everything with their pioneering in this field, and the world order will also depend on rich multinational companies and in fact, Algorithmic systems will become the ruling systems of the world. It can be said that currently, the revolution in information technology and biotechnology has been started by engineers, large economic companies, and scientists who are rarely aware of the political complexities of their decisions and certainly do not represent anyone. Therefore, it seems that if liberalism, nationalism, or any other religion wants to organize the world of 2050, it should not only rationalize the concept of artificial intelligence and complex data algorithm but also mix them in a new and meaningful narrative. Therefore, the changes caused by artificial intelligence in the political and economic order will lead to a major change in the way all countries deal with the phenomenon of digital globalization. In this paper, while debating the role and performance of e-government, we will discuss the efficiency and application of artificial intelligence in e-government, and we will consider the developments resulting from it in the new world and the concepts of governance.

Keywords: electronic government, artificial intelligence, information and communication technology., system

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10226 GGA-PBEsol+TB-MBJ Studies of SrxPb1-xS Ternary Semiconductor Alloys

Authors: Y. Benallou, K. Amara, O. Arbouche

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In this paper, we report a density functional study of the structural, electronic and elastic properties of the ordered phases of SrxPb1-xS ternary semiconductor alloys namely rocksalt compounds: PbS and SrS and the rocksalt-based compounds: SrPb3S4, SrPbS2, and Sr3PbS4. These First-principles calculations have been performed using the full potential linearized augmented plane wave method (FP-LAPW) within the Generalized Gradient Approximation developed by Perdew–Burke–Ernzerhor for solids (PBEsol). The calculated structural parameters like the lattice parameters, the bulk modulus B and their pressure derivative B' are in reasonable agreement with the available experimental and theoretical data. In addition, the elastic properties such as elastic constants (C11, C12, and C44), the shear modulus G, the Young modulus E, the Poisson’s ratio ν and the B/G ratio are also given. For the electronic properties calculations, the exchange and correlation effects were treated by the Tran-Blaha modified Becke-Johnson (TB-mBJ) potential to prevent the shortcoming of the underestimation of the energy gaps in both LDA and GGA approximations. The obtained results are compared to available experimental data and to other theoretical calculations.

Keywords: SrxPb1-xS, GGA-PBEsol+TB-MBJ, density functional, Perdew–Burke–Ernzerhor, FP-LAPW

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10225 The Impact of COVID-19 on Women’s Health in Bangladesh

Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud

Abstract:

COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.

Keywords: Covid-19, mental health, reproductive health, Bangladesh

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10224 Analog Railway Signal Object Controller Development

Authors: Ercan Kızılay, Mustafa Demi̇rel, Selçuk Coşkun

Abstract:

Railway signaling systems consist of vital products that regulate railway traffic and provide safe route arrangements and maneuvers of trains. SIL 4 signal lamps are produced by many manufacturers today. There is a need for systems that enable these signal lamps to be controlled by commands from the interlocking. These systems should act as fail-safe and give error indications to the interlocking system when an unexpected situation occurs for the safe operation of railway systems from the RAMS perspective. In the past, driving and proving the lamp in relay-based systems was typically done via signaling relays. Today, the proving of lamps is done by comparing the current values read over the return circuit, the lower and upper threshold values. The purpose is an analog electronic object controller with the possibility of easy integration with vital systems and the signal lamp itself. During the study, the EN50126 standard approach was considered, and the concept, definition, risk analysis, requirements, architecture, design, and prototyping were performed throughout this study. FMEA (Failure Modes and Effects Analysis) and FTA (Fault Tree) Analysis) have been used for safety analysis in accordance with EN 50129. Concerning these analyzes, the 1oo2D reactive fail-safe hardware design of a controller has been researched. Electromagnetic compatibility (EMC) effects on the functional safety of equipment, insulation coordination, and over-voltage protection were discussed during hardware design according to EN 50124 and EN 50122 standards. As vital equipment for railway signaling, railway signal object controllers should be developed according to EN 50126 and EN 50129 standards which identify the steps and requirements of the development in accordance with the SIL 4(Safety Integrity Level) target. In conclusion of this study, an analog railway signal object controller, which takes command from the interlocking system, is processed in driver cards. Driver cards arrange the voltage level according to desired visibility by means of semiconductors. Additionally, prover cards evaluate the current upper and lower thresholds. Evaluated values are processed via logic gates which are composed as 1oo2D by means of analog electronic technologies. This logic evaluates the voltage level of the lamp and mitigates the risks of undue dimming.

Keywords: object controller, railway electronic, analog electronic, safety, railway signal

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10223 Jordan, Towards Eliminating Preventable Maternal Deaths

Authors: Abdelmanie Suleimat, Nagham Abu Shaqra, Sawsan Majali, Issam Adawi, Heba Abo Shindi, Anas Al Mohtaseb

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The Government of Jordan recognizes that maternal mortality constitutes a grave public health problem. Over the past two decades, there has been significant progress in improving the quality of maternal health services, resulting in improved maternal and child health outcomes. Despite these efforts, measurement and analysis of maternal mortality remained a challenge, with significant discrepancies from previous national surveys that inhibited accuracy. In response with support from USAID, the Jordan Maternal Mortality Surveillance Response (JMMSR) System was established to collect, analyze, and equip policymakers with data for decision-making guided by interdisciplinary multi-levelled advisory groups aiming to eliminate preventable maternal deaths, A 2016 Public Health Bylaw required the notification of deaths among women of reproductive age. The JMMSR system was launched in 2018 and continues annually, analyzing data received from health facilities, to guide policy to prevent avoidable deaths. To date, there have been four annual national maternal mortality reports (2018-2021). Data is collected, reviewed by advisory groups, and then consolidated in an annual report to inform and guide the Ministry of Health (MOH); JMMSR collects the necessary information to calculate an accurate maternal mortality ratio and assists in identifying leading causes and contributing factors for each maternal death. Based on this data, national response plans are created. A monitoring and evaluation plan was designed to define, track, and improve implementation through indicators. Over the past four years, one of these indicators, ‘percent of facilities notifying respective health directorates of all deaths of women of reproductive age,’ increased annually from 82.16%, 92.95%, and 92.50% to 97.02%, respectively. The Government of Jordan demonstrated commitment to the JMMSR system by designating the MOH to primarily host the system and lead the development and dissemination of policies and procedures to standardize implementation. The data was translated into practical and evidence-based recommendations. The successful impact of results deepened the understanding of maternal mortality in Jordan, which convinced the MOH to amend the Bylaw now mandating electronic reporting of all births and neonatal deaths from health facilities to empower the JMMSR system, by developing a stillbirths and neonatal mortality surveillance and response system.

Keywords: maternal health, maternal mortality, preventable maternal deaths, maternal morbidity

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