Search results for: health system outcomes

Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

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Authors: Rujuta Matapurkar, Shivganesh Bhargava

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This paper discusses work-family enrichment and its relationship with certain antecedents and outcomes while considering effect of mindfulness and organizational pride as moderators. The work-family enrichment has been the topic of interest for researchers as well as practitioners for decades now. It focusses on the positive side of work family interaction rather that the scarcity or balance principle. Research shows that work family enrichment is linked to multiple work place outcomes like job satisfaction, organization citizenship behavior and turnover intention. Enrichment is also linked to life outcomes like life satisfaction, wellbeing. Thus not only the individuals but the organizations too want to engage in the activities resulting in the positive spillover between work and non-work domains. One of the recent focus areas in organization behavior literature has been Mindfulness. Mindfulness is defined as a trait or state in which the mind focuses on the present. It is the conscious attention and awareness of the present thought. The research in the area of mindfulness at work suggests that the same is related to work family balance and job satisfaction. This paper discusses the possibility of mindfulness having effect on the relationship between antecedents of enrichment and enrichment. On the outcome side job embeddedness and job ambivalence are the newest additions to the retention literature. Job ambivalence talks about having strong positive as well as negative feelings about the job. Job ambivalence is the work outcome which is linked to turnover intention. This paper talks about the relationship between enrichment and job ambivalence. Another measure for work place outcomes which is discussed in recent research is job embeddedness. This term talks about the advantages of continuing with the job rather than quitting it. It is described as like a net or a web in which an individual can become stuck and is focused on why people stay rather than on how they leave. The research has have found that establishing or increasing job embeddedness is likely to increase retention, attendance, citizenship and job performance. This paper studies the relationship between enrichment and embeddedness. Lastly this paper studies whether organizational pride has an an effect on the relationship between enrichment and its outcomes. This paper concludes with the direction for future research.

Keywords: work-family enrichment, mindfulness, job ambivalence, job embeddedness, organizational pride

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Authors: Yvonne A. Unrau

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Social work education is a competency-based curriculum that relies mostly on cognitive frameworks and problem-solving models. Absent from the curriculum is knowledge and skills that draw from an embodiment perspective, especially somatic practice methods. Embodiment broadly encompasses the understanding that biological, political, historical, and social factors impact human development via changes to the nervous system. In the past 20 years, research has well-established that unresolved traumatic events, especially during childhood, negatively impacts long-term health and well-being. Furthermore, traumatic stress compromises cognitive processing and activates reflexive action such as ‘fight’ or ‘flight,’ which are the focus of somatic methods. The main objective of this paper is to show how embodiment perspectives and somatic methods can enhance social work practice overall. Using an exploratory approach, the author shares a decade-long journey that involved creating an education-support program for college students who exited the state foster care system. Personal experience, program outcomes and case study narratives revealed that ‘classical’ social work methods were insufficient to fully address the complex needs of college students who were living with complex traumatic stressors. The paper chronicles select case study scenarios and key program development milestones over a 10-year period to show the benefit of incorporating embodiment perspectives in social work practice. The lessons reveal that there is an immediate need for social work curriculum to include embodiment perspectives so that social workers may be equipped to respond competently to their many clients who live with unresolved trauma.

Keywords: social work practice, social work curriculum, embodiment, traumatic stress

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Authors: Asma Qudrat, Abid Ullah, Rafi Ullah, Ali Raza, Shah Zeb, Syed Ali Shan Ul-Haq, Shahkar Ahmed Shah, Attiya Hameed Khan, Saad Zaheer, Umama Qasim, Kiran Jamal, Zahoor khan

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Objectives: Coronary artery disease (CAD) is the major public health issue associated with high mortality and morbidity rate worldwide. Young patients with ACS have unique characteristics with different demographic profiles and risk factors. The precise diagnosis and early risk stratification is important in guiding treatment and predicting the prognosis of young patients with ACS. To evaluate the associated demographics, risk factors, and outcomes profile of ACS in young age patients. Methods: The research follow a retrospective design, the single centre study of patients diagnosis with the first event of ACS in young age (>18 and <40) were included. Data collection included demographic profiles, risk factors, and in-hospital outcomes of young ACS patients. The patient’s data was retrieved through Electronic Medical Records (EMR) of Peshawar Institute of Cardiology (PIC), and all characteristic were assessed. Results: In this study, 77% were male, and 23% were female patients. The risk factors were assessed with CAD and shown significant results (P < 0.01). The most common presentation was STEMI, with (45%) most in ACS young patients. The angiographic pattern showed single vessel disease (SVD) in 49%, double vessel disease (DVD) in 17% and triple vessel disease (TVD) was found in 10%, and Left Artery Disease (LAD) (54%) was present to be the most common involved artery. Conclusion: It is concluded that the male sex was predominant in ACS young age patients. SVD was the common coronary angiographic finding. Risk factors showed significant results towards CAD and common presentations.

Keywords: coronary artery disease, Non-ST elevation myocardial infarction, ST elevation myocardial infarction, unstable angina, acute coronary syndrome

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Authors: Charles Davidson

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This paper presents the Stoplight Analysis System of Partnering Organizations Readiness, offering a structured framework to evaluate conflict resolution collaboration feasibility, especially crucial in conflict areas, employing a colour-coded approach and specific assessment points, with implications for more informed decision-making and improved outcomes in peacebuilding initiatives. Derived from at total of 40 years of practical peacebuilding experience from the project’s two researchers as well as interviews of various other peacebuilding actors, this paper introduces the Stoplight Analysis System of Partnering Organizations Readiness, a comprehensive framework designed to facilitate effective collaboration in international/local peacebuilding partnerships by evaluating the readiness of both potential partner organisations and the location of the proposed project. ^The system employs a colour-coded approach, categorising potential partnerships into three distinct indicators: Red (no-go), Yellow (requires further research), and Green (promising, go ahead). Within each category, specific points are identified for assessment, guiding decision-makers in evaluating the feasibility and potential success of collaboration. The Red category signals significant barriers, prompting an immediate stoppage in the consideration of partnership. The Yellow category encourages deeper investigation to determine whether potential issues can be mitigated, while the Green category signifies organisations deemed ready for collaboration. This systematic and structured approach empowers decision-makers to make informed choices, enhancing the likelihood of successful and mutually beneficial partnerships. Methodologically, this paper utilised interviews from peacebuilders from around the globe, scholarly research of extant strategies, and a collaborative review of programming from the project’s two authors from their own time in the field. This method as a formalised model has been employed for the past two years across a litany of partnership considerations, and has been adjusted according to its field experimentation. This research holds significant importance in the field of conflict resolution as it provides a systematic and structured approach to peacebuilding partnership evaluation. In conflict-affected regions, where the dynamics are complex and challenging, the Stoplight Analysis System offers decision-makers a practical tool to assess the readiness of partnering organisations. This approach can enhance the efficiency of conflict resolution efforts by ensuring that resources are directed towards partnerships with a higher likelihood of success, ultimately contributing to more effective and sustainable peacebuilding outcomes.

Keywords: collaboration, conflict resolution, partnerships, peacebuilding

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Authors: Waleed A. Basuliman, Khalid S. AlSaleh, Mohamed Z. Ramadan

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Applying the anthropometric dimensions is considered one of the important factors when designing any human-machine system. In this study, the estimation of anthropometric dimensions has been improved by developing artificial neural network that aims to predict the anthropometric measurements of the male in Saudi Arabia. A total of 1427 Saudi males from age 6 to 60 participated in measuring twenty anthropometric dimensions. These anthropometric measurements are important for designing the majority of work and life applications in Saudi Arabia. The data were collected during 8 months from different locations in Riyadh City. Five of these dimensions were used as predictors variables (inputs) of the model, and the remaining fifteen dimensions were set to be the measured variables (outcomes). The hidden layers have been varied during the structuring stage, and the best performance was achieved with the network structure 6-25-15. The results showed that the developed Neural Network model was significantly able to predict the body dimensions for the population of Saudi Arabia. The network mean absolute percentage error (MAPE) and the root mean squared error (RMSE) were found 0.0348 and 3.225 respectively. The accuracy of the developed neural network was evaluated by compare the predicted outcomes with a multiple regression model. The ANN model performed better and resulted excellent correlation coefficients between the predicted and actual dimensions.

Keywords: artificial neural network, anthropometric measurements, backpropagation, real anthropometric database

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Authors: Dina A. Amu, Fifi N. Afifah, Catur Rosidati, Tirton Nefianto

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Indonesia was shaken up by the avian influenza cases that had caused the country suffered losses of millions of dollars. The avian influenza case had even been suspected as a bioterrorism attack since it was an uncommon case in epidemiology. Furthermore, this avian influenza virus is a high pathogenic one and Indonesia has the highest case of fatality rate in the world. Bioterrorism threats or epidemic potential disease outbreaks currently does not exist in Tanjung Priok port yet. However, the surveillance system enhancement on epidemic potential diseases should be taken as a prevention, especially because Indonesia is currently facing the ASEAN Economic Society (AES). Therefore, this research evaluates the health surveillance system which is organized by Control, Quarantine and Surveillance Department, Health Office of Tanjung Priok Port. This study uses qualitative-evaluative method which utilizes Urgency Seriousness Growth (USG) method to determine priority issues and Root Cause analysis to determine the cause of prior problem. The result of this research shows that the implementation of epidemic potential disease surveillance in Tanjung Priok port has not done in the best possible way. It is because the lack of time allocation and the succinctness of the check list of ship's environmental health inspection. Therefore, Health Ministry of Indonesia should recruit more employees at the health office of Tanjung Priok port, hold a simulation of ship's inspection and simplify the list for ship's environmental health inspection.

Keywords: surveillance, epidemic potential disease, port health, bioterrorism

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Authors: Hong-Yi Kuo

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Leadership is a key factor of improving workplace safety, and there have been abundant of studies which support the positive effects of appropriate leadership on employee safety performance in the western academic. However, little safety research focus on the Chinese leadership style like paternalistic leadership. To fill this gap, the resent study aims to examine the relationship between authoritarian leadership (one of the ternary mode in paternalistic leadership) and safety outcomes. This study makes hypothesis on different levels. First, on the group level, as an authoritarian leader regards safety value as the most important tasks, there would be positive effect on group safety outcomes through strengthening safety group norms by the emphasis on etiquette. Second, on the cross level, when a leader with authoritarian style has high priority on safety, employees may more obey the safety rules because of fear due to emphasis on absolute authority over the leader. Therefore, employees may show more safety performance and then increase individual safety outcomes. Survey data would be collected from 50 manufacturing groups (each group with more than 5 members and a leader) and a hierarchical linear modeling analysis would be conducted to analyze the hypothesis. Above the predictive result, the study expects to be a cornerstone of safety leadership research in the Chinese academic and practice.

Keywords: safety leadership, authoritarian leadership, group norms, safety behavior, supervisor safety priority

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Authors: Saeed Sayyad Hagh Shomar

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Traffic congestion pricing as one of the demand management strategies constrains expenditure to network users so that it helps reduction in traffic congestion and environment pollution like air pollution. Despite the development of congestion pricing schemes for traffic in our country, the matters of traditional toll collection, drivers’ waste of time and delay in traffic are still widespread. Electronic toll collection as a part of the intelligent transportation system provides the possibility of collecting tolls without car-stop and traffic disruption. Unlike the satisfying outcomes of using intelligent systems in congestion pricing schemes, implementation costs and technological problems are the barriers in these schemes. In this research first, a variety of electronic pay toll systems and their components are introduced then their functional usage is discussed. In the following, by analyzing and comparing the barriers, limitations and advantages, the selection criteria of intelligent systems are described and the results show that the choice of the best technology depends on the various parameters which, by examining them, it is concluded that in a long-term run and by providing the necessary conditions, DSRC technology as the main system in the schemes and ANPR as a major backup system of the main one can be employed.

Keywords: congestion pricing, electronic toll collection, intelligent systems, technology, traffic

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Authors: Seham A. S. Mohamed, Sarah R. Baker, Christopher Deery, Mario V. Vettore

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Background: The link between oral health conditions and school performance and attendance remain unclear among Middle Eastern children. The association has been studied extensively in the Western region; however, several concerns have been raised regarding the reliability and validity of measures, low quality of studies, inadequate inclusion of potential confounders, and the lack of a conceptual framework. These limitations have meant that, to date, there has been no detailed understanding of the association or of the key social, clinical, behavioural and parental factors which may impact the association. Aim: To examine the association between oral health conditions and children’s school performance and attendance at Grade 2 in Muharraq city in the Kingdom of Bahrain using Heilmann et al.’s (2015) life course framework for oral health. Objectives: To (1) describe the prevalence of oral health conditions among 7-8 years old schoolchildren in the city of Muharraq; (2) analyse the social, biological, behavioural, and parental pathways that link early and current life exposures with children’s current oral health status; (3) examine the association between oral health conditions and school performance and attendance among schoolchildren; (4) explore the early and current life course social, biological, behavioural and parental factors associated with children’s school outcomes. Design: A time-ordered-cross-sectional study was conducted with 466 schoolchildren aged 7-8 years and their parents from Muharraq city in KoB. Data were collected through parents’ self-administered questionnaires, children’s face-face interviews, and dental clinical examinations. Outcome variables, including school performance and school attendance data, were obtained from the parents and school records. The data were analysed using structural equation modelling (SEM). Results: Dental caries, the consequence of dental caries (PUFA/pufa), and enamel developmental defects (EDD) prevalence were 93.4%, 25.7%, and 17.2%, respectively. The findings from the SEM showed that children born in families with high SES were less likely to suffer from dentine dental caries (β= -0.248) and more likely to earn high school performance (β= 0.136) at 7-8 years of age in Muharraq. From the current life course of children, the dental plaque was associated significantly and directly with enamel caries (β= 0.094), dentine caries (β= 0.364), treated teeth (filled or extracted because of dental caries) (β= 0.121), and indirectly associated with dental pain (β= 0.057). Further, dentine dental caries was associated significantly and directly with low school performance (β= -0.155). At the same time, the dental plaque was indirectly associated with low school performance via dental caries (β = −0.044). Conversely, treated teeth were associated directly with high school performance (β= 0.100). Notably, none of the OHCs, biological, SES, behavioural, or parental conditions was related to school attendance in children. Conclusion: The life course approach was adequate to examine the role of OHCs on children’s school performance and attendance. Birth and current (7-8-year-olds) social factors were significant predictors of poor OH and poor school performance.

Keywords: dental caries, life course, Bahrain, school outcomes

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Authors: Rohan M. Dalal, Elena Pirondini, Shanu Somvanshi

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Introduction: The current state of reproductive health outcomes in lower-income countries is poor, with inadequate knowledge and culture among adolescent boys. Moreover, boys have traditionally not been a priority target. To explore the opportunity to educate adolescent boys in the developing world regarding accurate reproductive health information, the purpose of this study is to investigate how adolescent boys in the developing world engage and use technology, utilizing cell phones. This electronic survey and video interview study were conducted to determine the feasibility of a mobile phone platform for an educational video game specifically designed for boys that will improve health knowledge, influence behavior, and change health outcomes, namely teen pregnancies. Methods: With the assistance of Plan India, a subsidiary of Plan International, informed consent was obtained from parents of adolescent males who participated in an electronic survey and video interviews via Microsoft Teams. An electronic survey was created with 27 questions, including topics of mobile phone usage, gaming preferences, and sexual and reproductive health, with a sample size of 181 adolescents, ages 11-25, near New Delhi, India. The interview questions were written to explore more in-depth topics after the completion of the electronic survey. Eight boys, aged 15, were interviewed for 40 minutes about gaming and usage of mobile phones as well as sexual and reproductive health. Data/Results. 154 boys and 27 girls completed the survey. They rated their English fluency as relatively high. 97% of boys (149/154) had access to mobile phones. The majority of phones were smartphones (97%, 143/148). 48% (71/149) of boys borrowed cell phones. The most popular phone platform was Samsung (22%, 33/148). 36% (54/148) of adolescent males looked at their phones 1-10 times per day for 1-2 hours. 55% (81/149) of the boys had parental restrictions. 51% (76/148) had 32 GB of storage on their phone. 78% (117/150) of the boys had wifi access. 80% (120/150) of respondents reported ease in downloading apps. 97% (145/150) of male adolescents had social media, including WhatsApp, Facebook, and YouTube. 58% (87/150) played video games. Favorite video games included Free Fire, PubG, and other shooting games. In the video interviews, the boys revealed what made games fun and engaging, including customized avatars, progression to higher levels, realistic interactive platforms, shooting/guns, the ability to perform multiple actions, and a variety of worlds/settings/adventures. Ideas to improve engagement in sexual and reproductive health classes included open discussions in the community, enhanced access to information, and posting on social media. Conclusion: This study involving an electronic survey and video interviews provides an initial foray into understanding mobile phone usage among adolescent males and understanding sexual and reproductive health education in New Delhi, India. The data gathered from this study support using mobile phone platforms, and this will be used to create a serious video game to educate adolescent males about sexual and reproductive health in an attempt to lower the rate of unwanted pregnancies in the world.

Keywords: adolescent males, India, mobile phone, sexual and reproductive health

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Khosro Barkhordari, Fateme Sadr, Mina Pashang

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Back ground: Blood transfusion is one of the major issues in cardiac surgery patients. Transfusing patients based on fixed cut-off points of hemoglobin is the current protocol in most institutions. The hemoglobin level of 7- 10 has been suggested for blood transfusion in cardiac surgery patients. We aimed to evaluate if blood transfusion based on change in percentage of hematocrit has different outcomes. Methods: In this retrospective cohort study, we investigated the early postoperative outcome of cardiac surgery patients who received blood transfusions at Tehran Heart Center Hospital, IRAN. We reviewed and analyzed the basic characteristics and clinical data of 700 patients who met our exclusion and inclusion criteria. The two groups of blood transfused patients were compared, those who have 30-50 percent decrease in basal hematocrit versus those with 10 -29 percent decrease. Results: This is ongoing study, and the results would be completed in two weeks after analysis of the date. Conclusion: Early analysis has shown no difference in early post-operative outcomes between the two groups, but final analysis will be completed in two weeks. 1-Department of Anesthesiology and Critical Care, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, IRAN 2- Department of Research, Tehran Heart Center, Tehran, IRAN Quantitative variables were compared using the Student t-test or the Mann‐Whitney U test, as appropriate, while categorical variables were compared using the χ2 or the Fisher exact test, as required. Our intention was to compare the early postoperative outcomes between the two groups, which include 30 days mortality, Length of ICU stay, Length of hospital stay, Intubation time, Infection rate, acute kidney injury, and respiratory complications. The main goal was to find if transfusing blood based on changes in hematocrit from a basal level was better than to fixed cut-off point regarding early post-operative outcomes. This has not been studied enough and may need randomized control trials.

Keywords: post-operative, cardiac surgery, outcomes, blood transfusion

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Authors: Christine Okello

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Physical Education (PE) curriculum provides school age students to explore issues that are likely to impact on health, safety, and well-being. The current curriculum includes the physical activity component, intended to improve physical fitness, social skills as well as building confidence. While this viewpoint is vital, there are challenges and stigma attached when specific issues are either ignored, inadequately addressed, or not seen to be important. The department stipulates that students attend a school that is closest to their home, to access available government transportation to and from school. Equivalently, parents of students with a disability decide where their children attend school. A choice between a regular classroom, mainstream Special Unit classroom, or a School for Specific Purposes (SSP). Parents who take their children to regular schools may be oblivious of the details of the curriculum. Physical Education outcomes does not stipulate the extent to which a student must perform or expected to perform. It is therefore due to the classroom teacher to adjust their teaching goals or outcomes to suit all students in their classroom. A student who can run a hundred meters race in 20 seconds may belong in the same classroom as a student in a wheelchair. While these students are challenged because of a lack of performance, teachers are challenged to effectively teach successful PE lessons, and on the other hand students without a disability may not be able to attain their optimum. This paper will identify areas of need, address the challenges, and explore a possible solution.

Keywords: special needs, disability, challenges, physical education

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Authors: Minjeong Kim, Seungchul Lee, Iman Janghorban Esfahani, Jeong Tai Kim, ChangKyoo Yoo

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A trajectory of set-point of ventilation control systems plays an important role for efficient ventilation inside subway stations since it affects the level of indoor air pollutants and ventilation energy consumption. To maintain indoor air quality (IAQ) at a comfortable range with lower ventilation energy consumption, the optimal trajectory of the ventilation control system needs to be determined. The concentration of air pollutants inside the station shows a diurnal variation in accordance with the variations in the number of passengers and subway frequency. To consider the diurnal variation of IAQ, an iterative dynamic programming (IDP) that searches for a piecewise control policy by separating whole duration into several stages is used. When outdoor air is contaminated by pollutants, it enters the subway station through the ventilation system, which results in the deteriorated IAQ and adverse effects on passenger health. In this study, to consider the influence of outdoor air quality (OAQ), a new performance index of the IDP with the passenger health risk and OAQ is proposed. This study was carried out for an underground subway station at Seoul Metro, Korea. The optimal set-points of the ventilation control system are determined every 3 hours, then, the ventilation controller adjusts the ventilation fan speed according to the optimal set-point changes. Compared to manual ventilation system which is operated irrespective of the OAQ, the IDP-based ventilation control system saves 3.7% of the energy consumption. Compared to the fixed set-point controller which is operated irrespective of the IAQ diurnal variation, the IDP-based controller shows better performance with a 2% decrease in energy consumption, maintaining the comfortable IAQ range inside the station.

Keywords: indoor air quality, iterative dynamic algorithm, outdoor air information, ventilation control system

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Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

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Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

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Authors: Ada Garus

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This paper presents the outcomes of the sustainability assessment of food delivery with a last-mile delivery service introduced in a real-world case study. The methodology used in the sustainability assessment integrates multi-criteria decision-making analysis, sustainability pillars, and scenario analysis to best reflect the conflicting needs of stakeholders involved in the last mile delivery system. The case study provides an application of the framework to the food delivery system of the Joint Research Centre of the European Commission where three alternative solutions were analyzed I) the existent state in which individuals frequent the local cantine or pick up their food, using their preferred mode of transport II) the hypothetical scenario in which individuals can only order their food using the delivery droid system III) a scenario in which the food delivery droid based system is introduced as a supplement to the current system. The environmental indices are calculated using a simulation study in which decision regarding the food delivery is predicted using a multinomial logit model. The vehicle dynamics model is used to predict the fuel consumption of the regular combustion engines vehicles used by the cantine goers and the electricity consumption of the droid. The sustainability assessment allows for the evaluation of the economic, environmental, and social aspects of food delivery, making it an apt input for policymakers. Moreover, the assessment is one of the first studies to investigate automated delivery droids, which could become a frequent addition to the urban landscape in the near future.

Keywords: innovations in transportation technologies, behavioural change and mobility, urban freight logistics, innovative transportation systems

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Authors: Ling-Lang Huang

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Background: The holistic health care should ideally cover physical, mental, spiritual, and social aspects of a patient. With very constrained time in current clinical practice system, medical decisions often tip the balance in favor of evidence-based medicine (EBM) in comparison to patient's personal values. Even in the era of competence-based medical education (CBME), when scrutinizing the items of entrustable professional activities (EPAs), we found that EPAs of establishing doctor-patient relationship remained incomplete or even missing. This phenomenon prompted us to raise this project aiming at advocating value-based medicine (VBM), which emphasizes the importance of patient’s values in medical decisions. A true and effective doctor-patient communication and relationship should be a well-balanced harmony of EBM and VBM. By constructing VBM into current EPAs, we can further promote genuine shared decision making (SDM) and fix the missing link in holistic health care. Methods: In this project, we are going to find out EPA elements crucial for establishing an ideal doctor-patient relationship through three distinct pairs of doctor-patient relationships: patients with pulmonary arterial hypertension (relatively young but with grave disease), patients undergoing surgery (facing critical medical decisions), and patients with terminal diseases (facing forthcoming death). We’ll search for important EPA elements through the following steps: 1. Narrative approach to delineate patients’ values among 2. distinct groups. 3.Hermeneutics-based interview: semi-structured interview will be conducted for both patients and physicians, followed by qualitative analysis of collected information by compiling, disassembling, reassembling, interpreting, and concluding. 4. Preliminarily construct those VBM elements into EPAs for doctor-patient relationships in 3 groups. Expected Outcomes: The results of this project are going to give us invaluable information regarding the impact of patients’ values, while facing different medical situations, on the final medical decision. The competence of well-blending and -balanced both values from patients and evidence from clinical sciences is the missing link in holistic health care and should be established in future EPAs to enhance an effective SDM.

Keywords: value-based medicine, shared decision making, entrustable professional activities, holistic health care

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: E. Knisel, H. Rupprich, A. Heissel

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Health Literacy is defined as the degree to which people have the capacity to obtain and understand information to make health decisions. Illustrated are three levels of health literacy: (1) Functional literacy refers to the transmission of information about e. g. physical activity and nutrition; (2) interactive literacy implies the development of personal and social skills to adopt health-related behaviour and (3) critical health literacy indicates advanced cognitive skills connected with personal empowerment to critically analyse health information, to define self-determined goals and taking action in various situations accordingly. The achievement of the third level refers to self-determination and autonomy which should be outcomes of exercise programs for overweight children as health-related behaviour change will occur and persist if it is autonomously motivated. Method: We adopted a quasi-experimental design with group (autonomy supportive coaching, control) and session (pre-test, intervention, post-test, and follow-up-test). Overweight and obese children and adolescents at the age of 8-14 years (N=40) received a 6-month (20 sessions) exercise program with autonomy supportive coaching implemented by the coaches and sandwiched between pre-test and post-test. All participants (N=92) completed the German version of the Basic Needs Satisfaction Scale Sport and Exercise. Additionally, we assessed the engagement in the exercise program by the MVPA (Moderate-to-Vigorous Physical Activity) and by the adherence and drop-out-rate. Results: Participants in the intervention group perceived their autonomy as moderate in the post-test and the follow-up-test. However, the psychological intervention failed to develop a high autonomy, as both groups show moderate perceived autonomy from the pre-test to the post-test. Participants in the intervention group were higher engaged in MVPA in the exercise program and they attend the program more regularly. Discussion: Young overweight and obese children and adolescents can acquire autonomy using autonomy supporting coaching. However, research identifying the extent they achieve critical health literacy is required to implement an autonomy-supportive coaching style into exercise programs for this target group.

Keywords: autonomy support, coaching, health literacy, health promotion

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Authors: Zia Ul Haq, Saleem Muhammad, Naeem Ullah, Abbas Shah, Abdullah Shah

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Pakistan being the developing country is facing double burden of communicable and non-communicable disease. The aspect of secondary prevention of ischemic heart disease in developing countries is the dire need for public health specialists, clinicians and policy makers. There is some evidence that psychotherapeutic measures, including psychotherapy, recreation, exercise and stress management training have positive impact on secondary prevention of cardiovascular diseases but there are some contradictory findings as well. Cardiac rehabilitation program (CRP) has not yet fully implemented in Pakistan. Psychological, physical and specific health-related quality of life (HRQoL) outcomes needs assessment with respect to its practicality, effectiveness, and success. Objectives: To determine the effect of cardiac rehabilitation program (CRP) on the health-related quality of life (HRQoL) measures of post MI patients compared to the usual care. Hypothesis: Post MI patients who receive the interventions (CRP) will have better HRQoL as compared to those who receive the usual cares. Methods: The randomized control trial was conducted at a Cardiac Rehabilitation Unit of Lady Reading Hospital (LRH), Peshawar. LRH is the biggest hospital of the Province Khyber Pakhtunkhwa (KP). A total 206 participants who had recent first myocardial infarction were inducted in the study. Participants were randomly allocated into two group i.e. usual care group (UCG) and cardiac rehabilitation group (CRG) by permuted-block randomization (PBR) method. CRP was conducted in CRG in two phases. Three HRQoL outcomes i.e. general health questionnaire (GHQ), self-rated health (SRH) and MacNew quality of life after myocardial infarction (MacNew QLMI) were assessed at baseline and follow-up visits among both groups. Data were entered and analyzed by appropriate statistical test in STATA version 12. Results: A total of 195 participants were assessed at the follow-up period due to lost-to-follow-up. The mean age of the participants was 53.66 + 8.3 years. Males were dominant in both groups i.e. 150 (76.92%). Regarding educational status, majority of the participants were illiterate in both groups i.e. 128 (65.64%). Surprisingly, there were 139 (71.28%) who were non-smoker on the whole. The comorbid status was positive in 120 (61.54%) among all the patients. The SRH at follow-up among UCG and CRG was 4.06 (95% CI: 3.93, 4.19) and 2.36 (95% CI: 2.2, 2.52) respectively (p<0.001). GHQ at the follow-up of UCG and CRG was 20.91 (95% CI: 18.83, 21.97) and 7.43 (95% CI: 6.59, 8.27) respectively (p<0.001). The MacNew QLMI at follow-up of UCG and CRG was 3.82 (95% CI: 3.7, 3.94) and 5.62 (95% CI: 5.5, 5.74) respectively (p<0.001). All the HRQoL measures showed strongly significant improvement in the CRG at follow-up period. Conclusion: HRQOL improved in post MI patients after comprehensive CRP. Education of the patients and their supervision is needed when they are involved in their rehabilitation activities. It is concluded that establishing CRP in cardiac units, recruiting post-discharged MI patients and offering them CRP does not impose high costs and can result in significant improvement in HRQoL measures. Trial registration no: ACTRN12617000832370

Keywords: cardiovascular diseases, cardiac rehabilitation, health-related quality of life, HRQoL, myocardial infarction, quality of life, QoL, rehabilitation, randomized control trial

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Authors: Yannis Stavrakakis, Damian Gordon

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Critical Thinking and Reflective Practice are two vital skills that students undertaking postgraduate studies should ideally possess. To help students develop and enhance these skills, this research developed several authentic activities to be undertaken as part of a module that is delivered early in a taught MSc to enhance these skills. One of the challenges of these topics is that they are somewhat ill-defined in terms of precisely what they mean, and also, there is no clear route to operationalizing the teaching of these skills. This research focuses on identifying suitable models of these skills and delivering them in a manner that is both clear and highly motivating. To achieve this, a class of 22 Master's students was divided into two groups, one was provided with a presentation and checklist about critical thinking skills, and the other group was given the same materials on the reflective practice process. The groups were given two scenarios each to analyze using their respective checklists and were asked to present their outcomes to each other and give peer review. The results were coded and compared, and key differences were noted, including the fact that the Critical Thinking outcomes were more future-focused, and the Reflective Practice outcomes were more past-focused and present-focused, as well as the fact that the Reflective Practice process generated a significantly wider range of perspectives on the scenarios.

Keywords: critical thinking, ethical scenarios, formative assessment, reflective practice

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Authors: Seyedeh-Fariba Jahanbin, Hasan Yusefzadeh, Bahram Nabilou, Cyrus Alinia, Cyrus Alinia

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Background: Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-efectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods: We have measured this cost-efectiveness threshold with the participation of 2854 individuals from fve provinces, each representing an income quintile, using a modifed Time Trade-Of-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results: Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confrmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions: In the health system of Iran, any intervention that is with the incremental cost-efectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-efective.

Keywords: willingness to Pay, QALY, chained-approach, cost-efectiveness threshold, Iran

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Authors: Wenru Wang

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Over the past decades, Asia has emerged as the ‘diabetes epicentre’ in the world due to rapid economic development, urbanization and nutrition transition. There is an urgent need to develop more effective and cost-effective care management strategies in response to this rising diabetes epidemic. This study aims to develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes among type 2 diabetes patients with poor glycemic control in Singapore. We proposed a randomized controlled trial with pre- and repeated post-tests control group design. A total of 128 type 2 diabetes patients with poor glycemic control will be recruited from the diabetes clinic of an acute public hospital in Singapore through convenience sampling. Study participants will be either randomly allocated to the experimental group or control group. Outcome measures used will include the 10-item General Self-Efficacy Scale, 11-item Revised Summary of Diabetes Self-care Activities, and 19-item Diabetes-Dependent Quality of Life. Data will be collected at 3-time points: baseline, three months and six months from the baseline, respectively. It is expected that this programme will be an alternative offered to diabetes patients to master their self-care management skills, in addition to the existing diabetes service provided in diabetes clinics in Singapore hospitals. Also, the self-supporting and less resource-intensive nature of this programme, through the use of smartphone app as a mode of intervention delivery, will greatly reduce nurses’ direct contact time with patients and allow more time to be allocated to those who require more attention. The study has been registered with clinicaltrials.gov. The trial registration number is NCT03088475.

Keywords: type 2 diabetes, poor glycaemic control, nurse-led, smartphone-based, self-management, health-relevant outcomes

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Authors: Goran Begović

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In recent years, many researchers are focusing on non-intrusive measuring methods when it comes to human biosignals. These methods provide solutions for everyday use, whether it’s health monitoring or finessing the workout routine. One of the biggest issues with these solutions is that the sensors’ accuracy is highly variable due to many factors, such as ambiental light, skin color diversity, etc. That is why we wanted to explore different outcomes under those kinds of circumstances in order to find the most optimal algorithm(s) for extracting heart rate (HR) information. The optimization of such algorithms can benefit the wider, cheaper, and safer application of home health monitoring, without having to visit medical professionals as often when it comes to observing heart irregularities. In this study, we explored the accuracy of infrared (IR), red, and green LED sensorics in a controlled environment and compared the results with a medically accurate ECG monitoring device.

Keywords: data science, ECG, heart rate, holter monitor, LED sensors

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Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

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Authors: Daniella Kucsma

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The examination of the Privat Service Organization’s performance evaluation includes several steps that help Public organizations to develop a more efficient system. Public sector organizations have different characteristics than the competitive sector, so it can be stated that other/new elements become more important in their performance processes. The literature in this area is diverse, so highlighting an indicator system can be useful for introducing a system, but it is also worthwhile to measure the specific elements of the organization. In the case of a public service organization, due to the service obligation, it is usually possible to talk about a high number of users, so compliance is more difficult. For the organization, it is an important target to place great emphasis on the increase of service standards and the development of related processes. In this research, the health sector is given a prominent role, as it is a sensitive area where both organizational and individual performance is important for all participants. As a primary step, the content of the strategy is decisive, as this is important for the efficient structure of the process. When designing any system, it is important to review the expectations of the stakeholders, as this is primary when considering the design. The goal of this paper is to build the foundations of a performance management and indexing framework that can help a hospital to provide effective feedback and a direction that is important in assessing and developing a service and can become a management philosophy.

Keywords: health sector, public sector, performance management, strategy

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Authors: Sami M. Alshareef

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The rapid growth of smart grid technology has brought significant advancements to the power industry. However, with the increasing interconnectivity and reliance on information and communication technologies, smart grids have become vulnerable to cyber-attacks, posing significant threats to the reliable operation of power systems. Among the critical components of smart grids, the Automatic Generation Control (AGC) system plays a vital role in maintaining the balance between generation and load demand. Therefore, protecting the AGC system from cyber threats is of paramount importance to maintain grid stability and prevent disruptions. Traditional security measures often fall short in addressing sophisticated and evolving cyber threats, necessitating the exploration of innovative approaches. Machine learning, with its ability to analyze vast amounts of data and learn patterns, has emerged as a promising solution to enhance AGC system security. Therefore, this research proposal aims to address the challenges associated with detecting and mitigating cyber-attacks on AGC in smart grids by leveraging machine learning techniques on automatic generation control of two-area power systems. By utilizing historical data, the proposed system will learn the normal behavior patterns of AGC and identify deviations caused by cyber-attacks. Once an attack is detected, appropriate mitigation strategies will be employed to safeguard the AGC system. The outcomes of this research will provide power system operators and administrators with valuable insights into the vulnerabilities of AGC systems in smart grids and offer practical solutions to enhance their cyber resilience.

Keywords: machine learning, cyber-attacks, automatic generation control, smart grid

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Authors: Cebrail Çiflikli, Emre Öner Tartan

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Parallel to the fast worldwide increase of elderly population and spreading unhealthy life habits, there is a significant rise in the number of patients and health problems. The supervision of people who have health problems and oversight in detection of people who have potential risks, bring a considerable cost to health system and increase workload of physician. To provide an efficient solution to this problem, in the recent years mobile applications have shown their potential for wide usage in health monitoring. In this paper we present an Android mobile application that records and evaluates ECG signal using Pan-Tompkins algorithm for QRS detection. The application model includes an alarm mechanism that is proposed to be used for sending message including abnormality information and location information to health supervisor.

Keywords: Android mobile application, ECG monitoring, QRS detection, Pan-Tompkins Algorithm

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Authors: Ashwini Mohan, Haris Batley

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An orthodontic index is used to rate or categorise an individual’s occlusion using a numeric or alphanumeric score. Indexing of malocclusions and their correction is important in epidemiology, diagnosis, communication between clinicians as well as their patients and assessing treatment outcomes. Many useful indices have been put forward, but to the author’s best knowledge, no one method to this day appears to be equally suitable for the use of epidemiologists, public health program planners and clinicians. This article describes the common clinical orthodontic indices and classifications used in United Kingdom.

Keywords: classification, indices, orthodontics, validity

Procedia PDF Downloads 151