Search results for: care networks

Authors: Arthur D. Wiedemann, Christopher Fuller, Kyle A. Pascioni

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With the introduction of electric motors, small unmanned aerial vehicle designers have to consider trade-offs between acoustic noise and thrust generated. Currently, there are few low-computational tools available for predicting acoustic noise emitted by a propeller into the far-field. Artificial neural networks offer a highly non-linear and adaptive model for predicting isolated and interactive tonal noise. But neural networks require large data sets, exceeding practical considerations in modeling experimental results. A methodology known as physics guided machine learning has been applied in this study to reduce the required data set to train the network. After building and evaluating several neural networks, the best model is investigated to determine how the network successfully predicts the acoustic waveform. Lastly, a post-network transfer function is developed to remove discontinuity from the predicted waveform. Overall, methodologies from physics guided machine learning show a notable improvement in prediction performance, but additional loss functions are necessary for constructing predictive networks on small datasets.

Keywords: aeroacoustics, machine learning, propeller, rotor, neural network, physics guided machine learning

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Authors: Arielle Ferdinand

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A plant-based diet focuses on foods from plant sources, limiting or altogether omitting animal products. Some of the most common chronic illnesses seen in primary care are hypertension, hyperlipidemia, and diabetes type II. These common chronic illnesses can often be debilitating, costly, time-consuming, and, when left untreated, can lead to an early death. Treatment and maintenance of care are also labor intensive for the patient. They are often required to have at least four blood pressure checks yearly and a hemoglobin A1C checked quarterly. Though preventative interventions and prevention education should be included in patient visits in the primary care setting, education about dietary interventions, such as a plant-based diet, also yields positive outcomes for patients who already have hypertension, hyperlipidemia, and diabetes mellitus type 2. Evidence will show that incorporating a plant-based diet results in decreased blood pressure, as well as decreased levels of LDL-C, improved post-prandial glucose levels, and a reduction in HbA1C. It is cost-effective for the patient by generally lower grocery costs, and it can either reduce or prevent the need to pay for more office visits and pharmacotherapy. Incorporating this method of dietary changes is an easy intervention during a primary care office visit that would greatly benefit the patient in many ways.

Keywords: plant-based, nutrition, diabetes, hyperlipidemia

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Authors: Darawan Augsornwan, Artitaya Sabangbal, Maneewan Srijan, Kanokarn Kongpitee, Lalida Petphai, Palakorn Surakunprapha

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Background: Srinagarind Hospital, Ward 3C, has patients with head and neck cancer, congenital urology anomalies such as hypospadis, cleft lip and cleft palate and congenital megacolon who need surgery. Undergoing surgery is a difficult time for patients/ family; they feel fear and anxiety. Nurses work closely with patients and family for 24 hours in the process of patients care, so should have the good nursing ability, innovation and an efficient nursing care system to promote patients self-care ability reducing suffering and preventing complications. From previous nursing outcomes we found patients did not receive appropriate information, could not take care of their wound, not early ambulation after the operation and lost follow-up. Objective: to develop the nursing system for patients who were undergoing an operation. Method: this is a participation action research. The sample population was 11 nurses and 60 patients. This study was divided into 3 phase: Phase 1. Situation review In this phase we review the clinical outcomes, the process of care from documents such as nurses note and interview nurses, patients and family about the process of care by nurses. Phase 2: focus group with 11 nurses, searching guideline for specific care, nursing care system then establish the protocol. This phase we have the protocol for giving information, teaching protocol and teaching record, leaflet for all of top five diseases, make video media to convey information, ambulation package and protocol for patients with head and neck cancer, patients zoning, primary nurse, improved job description for each staff level. Program to record number of patients, kind of medical procedures for showing nurses activity each day. Phase 3 implementation and evaluation. Result: patients/family receive appropriate information about deep breathing exercise, cough, early ambulation after the operation, information during the stay in the hospital. Patients family satisfaction is 95.04 percent, appropriate job description for a practical nurse, nurse aid, and worker. Nurses satisfaction is 95 percent. The complications can be prevented. Conclusion: the nursing system is the dynamic process using evidence to develop nursing care. The appropriate system depends on context and needs to keep an eye on every event.

Keywords: development, nursing system, patients undergoing operation, 3C Ward

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Authors: Dorcas Matowe

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Inequality in health care for racial and ethnic minorities continues to be a growing concern for many Americans. Some of the barriers hindering the elimination of health disparities include lack of insurance, socioeconomic status (SES), and racism. This study will specifically focus on the association between some of these factors- health care access, which includes insurance coverage and frequency of doctor visits, race, ethnicity, and health status. The purpose of this study will be to address the following questions: is having health insurance associated with increased doctor visits? Are racial and ethnic minorities with health insurance more or less likely to see a doctor? Is the association between having health insurance moderated by being an ethnic minority? Given the current implications of the 2010 Affordable Care Act, this study will highlight the need to prioritize health care access for minorities and confront institutional racism. Critical Race Theory (CRT) will demonstrate how racism has reinforced these health disparities. This quantitative study design will analyze secondary data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire, a telephone survey conducted annually in all 50 states and three US territories by state health departments in conjunction with the Center for Disease Control (CDC). Non-identifying health-related data is gathered annually from over 400,000 adults 18 years and above about their health status and use of preventative services. Through Structural Equation Modeling (SEM), the relationship between the predictor variables of health care access, race, and ethnicity, the criterion variable of health status, and the latent variables of emotional support and life satisfaction will be examined. It is hypothesized that there will be an interaction between certain racial and ethnic minorities who went to see a doctor, had insurance coverage, experienced racism, and the quality of their health status, emotional support, and life satisfaction.

Keywords: ethnic minorities, health disparities, health access, racism

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Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

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Authors: Supranee Sittikan, Darunee Jongudomkarn, Rutja Phuphaibul

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Thai’s families with disabilities are diverse, poor economy, low education disproportionately characterized their living that includes stress and suffering. This article reports a preliminary study using a qualitative case study with six disabilities (five physical and one mental problem) Their six family caregivers who perceived they were managing well with their conditions as well. Data were collected by in-depth interviews during November-December 2017 in North-East of Thailand. Preliminary results were found factors of moving in comprised of three themes as followings Karma: the families believe that the disability happened because of bad-karma which attached to them. From the reason, the members of families have to deserve and accept it. Family attachment: the families believe in the importance of being the family so they have to take good care in one another whether happy or suffering Community support: the families can get more to received helping hands from local health care providers and community health volunteers. These activities are very important to be representative in taking the families through health accessibility, which help them face with disabling problems. Nevertheless, the study needs further exploring on other families’ and health care team's perspective in larger scales leading to develop an appropriate health care service system which can support and promote the well-being of the families living with disabilities in the future.

Keywords: families with disabilities, Karma, family attachment, community support

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Authors: Jacques Wels

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Japan has one of the highest average retirement ages within the OCDE and is paving the way to raise the retirement age to 70. However, the Japanese labour market is facing two main issues that can have detrimental effects on health: non-standard employment forms are widespread among the ageing workforce, and poor working conditions can contribute to explain poor health in late career. To assess such a relationship, the study uses data from JSTAR. Using mediation analysis, it particularly looks at the association between job dissatisfaction, employment status, self-perceived health (SPH), and use of health care services. Results show that work quality and employment status are associated with SPH. Contract work has a particularly negative impact and therefore contributes to explain the use of health care services but is not significantly associated with lower job satisfaction levels. SPH is a good predictor of the use of health care services.

Keywords: self-reported health, occupational health, employment, older workers, mediation

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Authors: A. Kardi, R. Zagrouba, M. Alqahtani

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The Internet of Everything (IoE) presents today a very attractive and motivating field of research. It is basically based on Wireless Sensor Networks (WSNs) in which the routing task is the major analysis topic. In fact, it directly affects the effectiveness and the lifetime of the network. This paper, developed from recent works and based on extensive researches, proposes a taxonomy of routing protocols in WSNs. Our main contribution is that we propose a classification model based on nine classes namely application type, delivery mode, initiator of communication, network architecture, path establishment (route discovery), network topology (structure), protocol operation, next hop selection and latency-awareness and energy-efficient routing protocols. In order to provide a total classification pattern to serve as reference for network designers, each class is subdivided into possible subclasses, presented, and discussed using different parameters such as purposes and characteristics.

Keywords: routing, sensor, survey, wireless sensor networks, WSNs

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Authors: Gokhan Kilic, Pelin Celik

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Structural health monitoring (SHM) is widely used in evaluating the state and health of membrane structures. In the past, in order to collect data and send it to a data collection unit on membrane structures, wire sensors had to be put as part of the SHM process. However, this study recommends using wireless sensors instead of traditional wire ones to construct an economical, useful, and easy-to-install membrane structure health monitoring system. Every wireless sensor uses a software translation program that is connected to the monitoring server. Operational neural networks (ONNs) have recently been developed to solve the shortcomings of convolutional neural networks (CNNs), such as the network's resemblance to the linear neuron model. The results of using ONNs for monitoring to evaluate the structural health of a membrane are presented in this work.

Keywords: wireless sensor network, non-destructive testing, operational neural networks, membrane structures, dynamic monitoring

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Authors: D. Mulligan, D. Casey

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Introductory Statement: Delegation is when a registered nurse (RN) transfers a task or activity that is normally within their scope of practice to another person (delegatee). RN delegation is common practice with unregistered staff, e.g., student nurses and health care assistants (HCAs). As the role of the HCA is increasingly embedded as a direct care and support role, especially in long-term residential care for older adults, there is RN uncertainty as to their role as a delegator. The assignment is when a task is transferred to a person that is within the role specification of the delegatee. RNs in long-term care (LTC) for older people are increasingly working in teams where there are less RNs and more HCAs providing direct care to the residents. The RN is responsible and accountable for their decision to delegate and assign tasks to HCAs. In an interpretive, multiple case studies to explore how delegation of tasks by RNs to HCAs occurred in long-term care settings in Ireland the importance of the RN understanding their scope of practice emerged. Methodology: Focus group interviews and individual interviews were undertaken as part of a multiple case study. Both cases, anonymized as Case A and Case B, were within the public health service in Ireland. The case study sites were long-term care settings for older adults located in different social care divisions, and in different geographical areas. Four focus group interviews with staff nurses and three individual interviews with CNMs were undertaken. The interactive data analysis approach was the analytical framework used, with within-case and cross-case analysis. The theoretical lens of organizational role theory, applying the role episode model (REM), was used to understand, interpret, and explain the findings. Study Findings: RNs and CNMs understood the role of the nurse regulator and the scope of practice. RNs understood that the RN was accountable for the care and support provided to residents. However, RNs and CNM2s could not describe delegation in the context of their scope of practice. In both cases, the RNs did not have a standardized process for assessing HCA competence to undertake nursing tasks or interventions. RNs did not routinely supervise HCAs. Tasks were assigned and not delegated. There were differences between the cases in relation to understanding which nursing tasks required delegation. HCAs in Case A undertook clinical vital sign assessments and documentation. HCAs in Case B did not routinely undertake these activities. Delegation and assignment were influenced by the organizational factors, e.g., model of care, absence of delegation policies, inadequate RN education on delegation, and a lack of RN and HCA role clarity. Concluding Statement: Nurse staffing levels and skill mix in long-term care settings continue to change with more HCAs providing more direct care and support. With decreasing RN staffing levels RNs will be required to delegate and assign more direct care to HCAs. There is a requirement to distinguish between RN assignment and delegation at policy, regulation, and organizational levels.

Keywords: assignment, delegation, registered nurse, scope of practice

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Authors: Yahia. Kourd, N. Guersi D. Lefebvre

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In this paper we propose to study the faults diagnosis in squirrel-cage induction motor using MLP neural networks. We use neural healthy and faulty models of the behavior in order to detect and isolate some faults in machine. In the first part of this work, we have created a neural model for the healthy state using Matlab and a motor located in LGEB by acquirins data inputs and outputs of this engine. Then we detected the faults in the machine by residual generation. These residuals are not sufficient to isolate the existing faults. For this reason, we proposed additive neural networks to represent the faulty behaviors. From the analysis of these residuals and the choice of a threshold we propose a method capable of performing the detection and diagnosis of some faults in asynchronous machines with squirrel cage rotor.

Keywords: faults diagnosis, neural networks, multi-models, squirrel-cage induction motor

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Authors: Tao Feng, Fei Xing, Ye Lu, Jun Li Fang

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NDN is a kind of future Internet architecture. Due to the NDN design introduces four privacy challenges,Many research institutions began to care about the privacy issues of naming data network(NDN).In this paper, we are in view of the major NDN’s privacy issues to investigate privacy protection,then put forwards more effectively anonymous transfer policy for NDN.Firstly,based on mutual anonymity communication for MP2P networks,we propose NDN mutual anonymity protocol.Secondly,we add interest package authentication mechanism in the protocol and encrypt the coding coefficient, security of this protocol is improved by this way.Finally, we proof the proposed anonymous transfer protocol security and anonymity.

Keywords: NDN, mutual anonymity, anonymous routing, network coding, authentication mechanism

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Authors: Yeshanew Ayele Tiruneh, L. M. Modiba, S. M. Zuma

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Introduction- Healthcare waste is any waste generated by health care facilities, considered potentially hazardous to health. Solid health care waste is categorised into infectious and non-infectious wastes. Infectious waste is material suspected to contain pathogens. The non-infectious waste includes wastes that have not been in contact with infectious agents, hazardous chemicals, or radioactive substances. The purpose is to assess solid health care waste (SHCW) management practice toward developing guidelines. The setting is all health facilities found in Hossaena town. A mixed-method study design used. For the qualitative part, small purposeful samples were considered and large samples for the quantitative phase. Both samples were taken from the same population. Result - 17(3.1%) of health facility workers have hand washing facilities. 392 (72.6%) of the participants agree on the availability of one or more of personal protective equipment (PPE) in the facility ‘’the reason for the absence of some of the PPEs like boots, goggles, and shortage of disposable gloves are owing to cost inflation from time to time and sometimes absent from the market’’. The observational finding shows that colour coded waste bins are available at 23 (9.6%) of the rooms. Majority of the sharp container used in the health facility are reusable in the contrary to the health care waste management standards and most of them are plastic buckets and easily cleanable. All of the health facility infectious waste are collected transported and deposed daily. Regarding the preventive vaccination nearly half of the the fahealth facility workers wer vaccinated for Hep B virus. Conclusion- Hand washing facilities, personal protective equipment’s and preventive vaccinations are not easily available for health workers. Solid waste segregation practices are poor and these practices showed that SWMP is below the acceptable level.

Keywords: health care waste, waste management, disposal, private health facilities

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Authors: Raya Kathreen T. Fuentes, Christian Owen P. Domingo, Kaisha V. Durana, Kristine Chelsea Shynne M. Evangelista, Nicole A. Feliciano, Kathleen Patricia Q. Ferido, Christianna Joy J. Ferrer

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Diabetes Mellitus (DM) is a global public health concern. The foot ulcer is one of the most serious and costly complications of DM. Among the components of diabetes self-management (DSM), foot self-care was found to be one of the best preventive measures for foot ulcers yet is seldom performed. Thus, the purpose of this study is to determine how adequate foot self-care practices (FSP) are among Filipino adults with DM with the following objectives: 1) determine their DSM, 2) describe their FSP, 3) determine the relationship between FSP and DSM, and 4) determine the relationship of FSP to sociodemographic characteristics, disease-related characteristics, social support, and knowledge. A descriptive correlational design was utilized. 114 respondents aged 19-65 were selected through purposive sampling from diabetes clinics. A self-administered questionnaire regarding FSP, DSM, sociodemographic and disease-related characteristics, social support, and knowledge on diabetes were used. Pearson's correlation was utilized to determine the relationship between FSP and DSM while simple linear regression was used to determine the relationship of FSP to the factors aforementioned. Results showed that majority of the respondents have desirable DSM but inadequate FSP. FSP and DSM were shown to be positively correlated but not statistically significant (p = 0.8). Disparity among the two suggests that there is less emphasis on foot self-care compared to other components of DSM. Findings further revealed that patients diagnosed with DM for < 5 years demonstrated more adequate FSP compared to patients diagnosed for > 5 years which may suggest that newly diagnosed patients are more receptive to new information about DSM. Health education on DSM should place more emphasis on FSP. Reiteration of health education and continuous motivation should be done to all DM patients, not just to newly diagnosed patients, to improve compliance to FSP and enhance patient empowerment regarding self-care.

Keywords: diabetes mellitus, diabetes self-management, foot self-care practices, foot ulcer

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Authors: Stephen Bahooshy

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Our understanding of gender inequality has advanced in recent years. Differences in pay and societal gendered behaviour expectations have been emphasized. It is acknowledged globally that gender shapes everyone’s experiences of health and social care, including access to care, use of services and products, and the interaction with care providers. NHS Digital in England collects data from local authorities on the number of carers and people with support needs and the services they access. This data does not provide a gender breakdown. Caring can have many positive and negative impacts on carers’ health and wellbeing. For example, caring can improve physical health, provide a sense of pride and purpose, and reduced stress levels for those who undertake a caring role by choice. Negatives of caring include financial concerns, social isolation, a reduction in earnings, and not being recognized as a carer or involved and consulted by health and social care professionals. Treating male and female carers differently is by definition unequitable and precludes one gender from receiving the benefits of caring whilst potentially overburdening the other with the negatives of caring. In order to explore the issue on a preliminary basis, five local authorities who provide statutory adult social care services in England were sent Freedom of Information requests in 2019. The authorities were selected to include county councils and London boroughs. The authorities were asked to provide data on the amount of money spent on care at home packages to people over 65 years, broken down by gender and carer gender for each financial year between 2013 and 2019. Results indicated that in each financial year, female carers supporting someone over 65 years received less financial support for care at home support packages than male carers. Over the six-year period, this difference equated to a £9.5k deficit in financial support received on average per female carer when compared to male carers. An example of a London borough with the highest disparity presented an average weekly spend on care at home for people over 65 with a carer of £261.35 for male carers and £165.46 for female carers. Consequently, female carers in this borough received on average £95.89 less per week in care at home support than male carers. This highlights a real and potentially detrimental disparity in the care support received to female carers in order to support them to continue to care in parts of England. More research should be undertaken in this area to better explore this issue and to understand if these findings are unique to these social care providers or part of a wider phenomenon. NHS Digital should request local authorities collect data on gender in the same way that large employers in the United Kingdom are required by law to provide data on staff salaries by gender. People who allocate social care packages of support should consider the impact of gender when allocating support packages to people with support needs and who have carers to reduce any potential impact of gender bias on their decision-making.

Keywords: caregivers, carers, gender equality, social care

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Authors: Jérémie Ochin

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Soccer analytics are built on two data sources: the frame-by-frame position of each player on the terrain and the sequences of events, such as ball drive, pass, cross, shot, throw-in... With more than 2000 ball-events per soccer game, their precise and exhaustive annotation, based on a monocular video stream such as a TV broadcast, remains a tedious and costly manual task. State-of-the-art methods for spatio-temporal action detection from a monocular video stream, often based on 3D convolutional neural networks, are close to reach levels of performances in mean Average Precision (mAP) compatibles with the automation of such task. Nevertheless, to meet their expectation of exhaustiveness in the context of data analytics, such methods must be applied in a regime of high recall – low precision, using low confidence score thresholds. This setting unavoidably leads to the detection of false positives that are the product of the well documented overconfidence behaviour of neural networks and, in this case, their limited access to contextual information and understanding of the game: their predictions are highly unstructured. Based on the assumption that professional soccer players’ behaviour, pose, positions and velocity are highly interrelated and locally driven by the player performing a ball-action, it is hypothesized that the addition of information regarding surrounding player’s appearance, positions and velocity in the prediction methods can improve their metrics. Several methods are compared to build a proper representation of the game surrounding a player, from handcrafted features of the local graph, based on domain knowledge, to the use of Graph Neural Networks trained in an end-to-end fashion with existing state-of-the-art 3D convolutional neural networks. It is shown that the inclusion of information regarding surrounding players helps reaching higher metrics.

Keywords: fine-grained action recognition, human action recognition, convolutional neural networks, graph neural networks, spatio-temporal action recognition

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Authors: Akram Waheb Nasef Alzordoky

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The wars and armed conflicts have frequently ended in violations of global humanitarian law and regularly devote the maximum severe global crimes, which include war crimes, crimes towards humanity, aggression and genocide. But, simplest inside the XX century, the guideline changed into an articulated idea of establishing a frame of worldwide criminal justice so that you can prosecute those crimes and their perpetrators. The first steps on this subject were made with the aid of setting up the worldwide army tribunals for warfare crimes at Nuremberg and Tokyo, and the formation of ad hoc tribunals for the former Yugoslavia and Rwanda. Ultimately, the global criminal courtroom was established in Rome in 1998 with the aim of justice and that allows you to give satisfaction to the sufferers of crimes and their families. The aim of the paper was to provide an ancient and comparative analysis of the establishments of worldwide criminal justice primarily based on which those establishments de lege lata fulfilled the goals of individual criminal responsibility and justice. Moreover, the authors endorse de lege ferenda that the everlasting global crook Tribunal, in addition to the potential case, additionally takes over the current ICTY and ICTR cases.

Keywords: social networks privacy issues, social networks security issues, social networks privacy precautions measures, social networks security precautions measures

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Authors: Rahul Malhotra

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The field of wireless sensor networks (WSN) engages a lot of associates in the research community as an interdisciplinary field of interest. This type of network is inexpensive, multifunctionally attributable to advances in micro-electromechanical systems and conjointly the explosion and expansion of wireless communications. A mobile ad hoc network is a wireless network without fastened infrastructure or federal management. Due to the infrastructure-less mode of operation, mobile ad-hoc networks are gaining quality. During this work, we have performed an efficient performance study of the two major routing protocols: Ad hoc On-Demand Distance Vector Routing (AODV) and Dynamic Source Routing (DSR) protocols. We have used an accurate simulation model supported NS2 for this purpose. Our simulation results showed that AODV mitigates the drawbacks of the DSDV and provides better performance as compared to DSDV.

Keywords: routing protocol, MANET, AODV, On Demand Distance Vector Routing, DSR, Dynamic Source Routing

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Authors: Getiye Dejenu Kibret, Daniel Demant, Andrew Hayen

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Introduction: In Ethiopia, more than half of newborn babies do not have access to Emergency Obstetric and Neonatal Care (EmONC) services. Understanding the effect of distance to health facilities on service use and neonatal survival is crucial to recommend policymakers and improve resource distribution. We aimed to investigate the effect of distance to health services on maternal service use and neonatal mortality. Methods: We implemented a data linkage method based on geographic coordinates and calculated straight-line (Euclidean) distances from the Ethiopian 2016 demographic and health survey clusters to the closest health facility. We computed the distance in ESRI ArcGIS Version 10.3 using the geographic coordinates of DHS clusters and health facilities. Generalised Structural Equation Modelling (GSEM) was used to estimate the effect of distance on neonatal mortality. Results: Poor geographic accessibility to health facilities affects maternal service usage and increases the risk of newborn mortality. For every ten kilometres (km) increase in distance to a health facility, the odds of neonatal mortality increased by 1.33% (95% CI: 1.06% to 1.67%). Distance also negatively affected antenatal care, facility delivery and postnatal counselling service use. Conclusions: A lack of geographical access to health facilities decreases the likelihood of newborns surviving their first month of life and affects health services use during pregnancy and immediately after birth. The study also showed that antenatal care use was positively associated with facility delivery service use and that both positively influenced postnatal care use, demonstrating the interconnectedness of the continuum of care for maternal and neonatal care services. Policymakers can leverage the findings from this study to improve accessibility barriers to health services.

Keywords: acessibility, distance, maternal health service, neonatal mortality

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Authors: Jaishree Ellis

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The United States Centers for Disease Control tells us that many women with disabilities will not receive regular health screenings, including Pap Smears and mammograms. This article was comprised and written to recognize the barriers to care, gaps in existing healthcare implementation, and viable methodologies for the provision of comprehensive and robust gynecologic care for women with disabilities. According to the World Health Organization, 15% of the world's population, or approximately 1 billion people, have disabilities, most of whom are identified as women. Women with disabilities are described as being multi-disabled, as in some places, they suffer exclusion because of their disabilities as well as their gender. The paucity of information regarding how to create a healthcare system that is inclusive of every woman, regardless of her type of disability (physical, mental, intellectual or medical), has made it challenging to establish an environment that makes it possible for individuals to access care in an equitable, respectful and comprehensive way. A review of the current literature, institutional websites within the United States and American resource guides was implemented to determine where comprehensive models of care for women with disabilities exist, as well as the modalities that are being employed to meet their healthcare needs. The many barriers to care that women with disabilities face were also extracted from various sources within the literature to provide an exhaustive list that can be tackled, one by one. Of the 637 Hospital Systems in the United States, only 7 provide website documentation of health care services that address the unique needs of women with disabilities. The presumption is that if institutions have not marketed such interventions to the community, then it is likely that they do not have a robust suite of services with which to make gynecologic care available to patients with disabilities. Through this review, 7 main barriers to comprehensive gynecologic care were identified, with more than 20 sub-categories existing within those. As with many other areas of community life, inclusion remains lacking in the delivery of healthcare for women with disabilities. There are at least 7 barriers that must be overcome in order to provide equity in the medical office, the exam room, the hospital and the operating room. While few institutions have prioritized this, those few have provided blueprints that can easily be adopted by others. However, as the general population lives longer and ages, the incidence of disabilities increases, as do the healthcare disparities surrounding them. Further compounded by this is a lack of formal education for medical providers in the United States.

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: K. Thamizhmaran, Akshaya Devi Arivazhagan, M. Anitha

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On the case of most important systematic issue that must need to be solved in means of implementing a data transmission algorithm on the source of Mobile adhoc networks (MANETs). That is, how to save mobile nodes energy on meeting the requirements of applications or users as the mobile nodes are with battery limited. On while satisfying the energy saving requirement, hence it is also necessary of need to achieve the quality of service. In case of emergency work, it is necessary to deliver the data on mean time. Achieving quality of service in MANETs is also important on while. In order to achieve this requirement, Hence, we further implement the Energy-Aware routing protocol for system of Mobile adhoc networks were it being proposed, that on which saves the energy as on every node by means of efficiently selecting the mode of energy efficient path in the routing process by means of Enhanced AODV routing protocol.

Keywords: Ad-Hoc networks, MANET, routing, AODV, EAODV

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Authors: Yang Xiong, Hua Cheng

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In this paper, for the basic problem of wireless sensor network topology control and deployment, the Roesser model in rectangular grid sensor networks is presented. In addition, a general constructive realization procedure will be proposed. The procedure enables a distributed implementation of linear systems on a sensor network. A non-trivial example is illustrated.

Keywords: grid sensor networks, Roesser model, state-space realization, multidimensional systems

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Authors: Johnas Buhori, Meinrad Haule Lembuka

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Introduction: Social work expands its boundary to accommodate indigenous knowledge and practice for better competence and services. In Tanzania, Mama Mkubwa Mkubwa (MMM) (Mother’s elder sister) is an indigenous practice of alternative child care that represents other traditional practices across African societies known as Ubuntu practice. Ubuntu is African Humanism with values and approaches that are connected to the social work. MMM focuses on using the elder sister of a deceased mother or father, a trusted elder woman from the extended family or indigenous community to provide alternative care to an orphan or vulnerable child. In Ubuntu's perspective, it takes a whole village or community to raise a child, meaning that every person in the community is responsible for child care. Methodology: A desk review method guided by Ubuntu theory was applied to enrich the study. Findings: MMM resembles the Ubuntu ideal of traditional child protection of those in need as part of alternative child care throughout Tanzanian history. Social work practice, along with other formal alternative child care, was introduced in Tanzania during the colonial era in 1940s and socio-economic problems of 1980s affected the country’s formal social welfare system, and suddenly HIV/AIDS pandemic triggered the vulnerability of children and hampered the capacity of the formal sector to provide social welfare services, including alternative child care. For decades, AIDS has contributed to an influx of orphans and vulnerable children that facilitated the re-emerging of traditional alternative child care at the community level, including MMM. MMM strongly practiced in regions where the AIDS pandemic affected the community, like Njombe, Coastal region, Kagera, etc. Despite of existing challenges, MMM remained to be the remarkably alternative child care practiced in both rural and urban communities integrated with social welfare services. Tanzania envisions a traditional mechanism of family or community environment for alternative child care with the notion that sometimes institutionalization care fails to offer children all they need to become productive members of society, and later, it becomes difficult to reconnect in the society. Implications to Social Work: MMM is compatible with social work by using strengths perspectives; MMM reflects Ubuntu's perspective on the ground of humane social work, using humane methods to achieve human goals. MMM further demonstrates the connectedness of those who care and those cared for and the inextricable link between them as Ubuntu-inspired models of social work that view children from family, community, environmental, and spiritual perspectives. Conclusion: Social work and MMM are compatible at the micro and mezzo levels; thus, application of MMM can be applied in social work practice beyond Tanzania when properly designed and integrated into other systems. When MMM is applied in social work, alternative care has the potential to support not only children but also empower families and communities. Since MMM is a community-owned and voluntary base, it can relieve the government, social workers, and other formal sectors from the annual burden of cost in the provision of institutionalized alternative child care.

Keywords: ubuntu, indigenous social work, african social work, ubuntu social work, child protection, child alternative care

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Authors: Rafi Ullah, Shah Muhammad Emaduddin, Taha Jilani

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Vehicle Adhoc Networks (VANET) belongs to a special class of Mobile Adhoc Network (MANET) with high mobility. Network is created by road side vehicles equipped with communication devices like GPS and Wifi etc. Since the environment is highly dynamic due to difference in speed and high mobility of vehicles and weak stability of the network connection, it is a challenging task to design an efficient routing protocol for such an unstable environment. Our proposed algorithm uses heuristic for the calculation of optimal path for routing the packet efficiently in collaboration with several other parameters like geographical location, speed, priority, the distance among the vehicles, communication range, and networks congestion. We have incorporated probabilistic, heuristic and machine learning based approach inconsistency with the relay function of the memory buffer to keep the packet moving towards the destination. These parameters when used in collaboration provide us a very strong and admissible heuristics. We have mathematically proved that the proposed technique is efficient for the routing of packets, especially in a medical emergency situation. These networks can be used for medical emergency, security, entertainment and routing purposes.

Keywords: heuristics routing, intelligent routing, VANET, route optimization

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Authors: Zeynep Karakoc, Hasan Ilhan Mutaf

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Plaque removal efficacy of different dental brushes and mouth wash during fixed orthodontic appliance therapy was evaluated in this single-blind, crossover and prospective study. Thirty orthodontic patients aged 18 and over undergoing fixed appliance therapy at the end of leveling stage were divided into three groups. Subjects brushed their teeth with a toothbrush under standardized conditions for a period of 30 days prior to inter-dental care products. The same procedure was repeated each time with a different, randomly assigned inter-dental care products in a crossover design. (Inter-dental brush, powered inter-dental brush and mouth wash). At start and end of each removal period, plaque indexes of participants were scored. Each brush achieved statistically significant plaque removal; however, there were no statistical differences among groups for all surfaces of teeth when the plaque score was evaluated. The mouth wash group presented significant improvement in reduction of visible plaque on mesial and distal surfaces of posterior teeth. (-60.9 %, P< .001) Plaque removal for right and left side of mouth showed no significant differences within groups, only mouth wash was more efficient in right side than left side. It is concluded that effectiveness of plaque removal may not be related to the kind of inter-dental products directly. However, toothbrush when used with inter-dental care products is significantly better at removing plaque deposits from fixed appliance patients.

Keywords: orthodontics, dental care, brush, plaque

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Authors: Khenfer-Koummich Fatima, Mesbahi Larbi, Hendel Fatiha

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This paper presents a recognition system for isolated words like robot commands. It’s carried out by Time Delay Neural Networks; TDNN. To teleoperate a robot for specific tasks as turn, close, etc… In industrial environment and taking into account the noise coming from the machine. The choice of TDNN is based on its generalization in terms of accuracy, in more it acts as a filter that allows the passage of certain desirable frequency characteristics of speech; the goal is to determine the parameters of this filter for making an adaptable system to the variability of speech signal and to noise especially, for this the back propagation technique was used in learning phase. The approach was applied on commands pronounced in two languages separately: The French and Arabic. The results for two test bases of 300 spoken words for each one are 87%, 97.6% in neutral environment and 77.67%, 92.67% when the white Gaussian noisy was added with a SNR of 35 dB.

Keywords: TDNN, neural networks, noise, speech recognition

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Authors: Elzbieta Sikorska-Simmons

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Dementia is a progressive terminal disease. Despite this recognition, research shows that most family caregivers do not know it, and it is unclear how this knowledge affects the quality of patient care. The aim of this qualitative study of 20 family caregivers for patients with advanced dementia is to examine how the caregiver's knowledge about dementia affects the quality of patient care in the context of healthcare decision-making, advanced care planning, and access to adequate support systems. Knowledge about dementia implies family caregivers' understanding of dementia trajectories, common symptoms/complications, and alternative treatment options (e.g., comfort feeding versus tube feeding). Data were collected in semi-structured interviews with 20 family caregivers. The interviews were conducted in person by the author and designed to elicit rich descriptions of family caregivers' experiences with healthcare decision-making and the management of common symptoms/complications of end-stage dementia as patient healthcare proxies. The study findings suggest that caregivers who recognize that dementia is a terminal disease are less likely to opt for life-extending treatments during the advanced stages. They are also more likely to seek palliative/hospice care, and consequently, they are better able to avoid unnecessary hospitalizations or medical procedures. For example, those who know that dementia is a terminal disease tend to opt for "comfort feeding" rather than "tube feeding" in managing the swallowing difficulties that accompany advanced dementia. In the context of advance care planning, family caregivers who know that dementia is a terminal disease tend to have more meaningful advance directives (e.g., Power of Attorney and Do Not Resuscitate orders). They are better prepared to anticipate common problems and pursue treatments that foster the best quality of patient life and care. Greater knowledge about advanced dementia helps them make more informed decisions that focus on enhancing the quality of patient life rather than just survival. In addition, those who know that dementia is a terminal disease are more likely to establish adequate support systems to help them cope with the complex demands of caregiving. For example, they are more likely to seek dementia-oriented primary care programs that offer house visits or respite services. Based on the study findings, knowledge about dementia as a terminal disease is critical in the optimal management of patient care needs and the establishment of adequate support systems. More research is needed to better understand what caregivers need to know to better prepare them for the complex demands of dementia caregiving.

Keywords: dementia education, family caregiver, management of dementia, quality of care

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Authors: Abhishek Oswal

Abstract:

Background: Inconsistencies between the guidelines for childhood asthma can pose a diagnostic challenge to clinicians. NICE guidelines are the most commonly followed guidelines in primary care in the UK; they state that to be diagnosed with asthma, a child must be more than 5 years old and must have objective evidence of the disease. When diagnoses are coded in general practice (GP), these guidelines may be superseded by communications from secondary care. Hence it is imperative that diagnoses are correct, as per up to date guidelines and evidence, as this affects follow up and management both in primary and secondary care. Methods: A snapshot audit at a general practice surgery was undertaken of children (less than 16 years old) with a coded diagnosis of 'asthma', to review the age at diagnosis and whether any objective evidence of asthma was documented at diagnosis. 50 cases of asthma in children presenting to the emergency department (ED) were then audited to review the age at presentation, whether there was evidence of previous asthma diagnosis and whether the patient was discharged from ED. A repeat audit is planned in ED this winter. Results: In a GP surgery, there were 83 coded cases of asthma in children. 51 children (61%) were diagnosed under 5, with 9 children (11%) who had objective evidence of asthma documented at diagnosis. In ED, 50 cases were collected, of which 4 were excluded as they were referred to the other services, or for incorrect coding. Of the 46 remaining, 27 diagnoses confirmed to NICE guidelines (59%). 33 children (72%) were discharged from ED. Discussion: The most likely reason for the apparent low rate of a correct diagnosis is the significant challenge of obtaining objective evidence of asthma in children. There were a number of patients who were diagnosed from secondary care services and then coded as 'asthma' in GP, without having objective documented evidence. The electronic patient record (EPR) system used in our emergency department (ED) did not allow coding of 'suspected diagnosis' or of 'viral induced wheeze'. This may have led to incorrect diagnoses coded in primary care, of children who had no confirmed diagnosis of asthma. We look forward to the re-audit, as the EPR system has been updated to allow suspected diagnoses. In contrast to the NICE guidelines used here, British Thoracic Society (BTS) guidelines allow for a trial of treatment and subsequent confirmation of diagnosis without objective evidence. It is possible that some of the cases which have been classified as incorrect in this audit may still meet other guidelines. Conclusion: The diagnosis of asthma in children is challenging. Incorrect diagnoses may be related to clinical pressures and the provision of services to allow compliance with NICE guidelines. Consensus statements between the various groups would also aid the decision-making process and diagnostic dilemmas that clinicians face, to allow more consistent care of the patient.

Keywords: asthma, diagnosis, primary care, emergency department, guidelines, audit

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Authors: Ghorbanali Mohammadi

Abstract:

Background: Due to the widespread outbreak of the COVID-19 virus, a large number of people become infected with the disease every day and go to hospitals. The acute condition of this disease has caused the death of many people. Since all the stages of treatment for these people happen in the hospitals, nurses are at the forefront of the fight against this virus. This causes nurses to suffer from physical and mental health problems. Methods: Physical and mental problems in nurses were assessed using the Depression, Anxiety and Stress Scale (DASS-42) of Lovibond (1995) and the Nordic Questionnaire. Results: 90 nurses from emergency, intensive care, and coronary care units were examined, and a total of 180 questionnaires were collected and evaluated. It was found that 37.78%, 47.78%, and 21.11% of nurses have symptoms of depression, anxiety, and stress, respectively. 40% of the nurses had physical problems. In total, 65.17% of them were involved in one or more mental or physical illnesses. Conclusions: Of the three units surveyed, the nurses in intensive care, emergency room, and coronary care units worked more than ten hours a day. Examining the interaction of physical and mental health problems indicated that physical problems can aggravate mental problems.

Keywords: depression anxiety and stress scale of Lovibond, nordic questionnaire, mental health of nurses, physical health problems in nurses

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Authors: Noppatee Sabpayakom, Somporn Sirisumrannukul

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Due to incentive policies to promote renewable energy and energy efficiency, high penetration levels of very small power producers (VSPP) located in distribution networks have imposed technical barriers and established new requirements for protection and control of the networks. Although VSPPs have economic and environmental benefit, they may introduce negative effects and cause several challenges on the issue of protection and control system. This paper presents comprehensive studies of possible impacts on control and protection systems based on real distribution systems located in a metropolitan area. A number of scenarios were examined primarily focusing on state of islanding, and un-disconnected VSPP during faults. It is shown that without proper measures to address the issues, the system would be unable to maintain its integrity of electricity power supply for disturbance incidents.

Keywords: control and protection systems, distributed generation, renewable energy, very small power producers

Procedia PDF Downloads 476