Search results for: healthcare access and efficiency

Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: Ofira Zloto, Ofir Fogel, Eyal Klang

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Purpose: The aim is to develop an automated framework based on machine learning to diagnose malignant eyelid skin tumors. Methods: This study utilized eyelid lesion images from Sheba Medical Center, a large tertiary center in Israel. Before model training, we pre-trained our models on the ISIC 2019 dataset consisting of 25,332 images. The proprietary eyelid dataset was then used for fine-tuning. The dataset contained multiple images per patient, aiming to classify malignant lesions in comparison to benign counterparts. Results: The analyzed dataset consisted of images representing both benign and malignant eyelid lesions. For the benign category, a total of 373 images were sourced. In comparison, the malignant category has 186 images. Based on the accuracy values, the model with 3 epochs and a learning rate of 0.0001 exhibited the best performance, achieving an accuracy of 0.748 with a standard deviation of 0.034. At a sensitivity of 69%, the model has a corresponding specificity of 82%. To further understand the decision-making process of our model, we employed heatmap visualization techniques, specifically Gradient-weighted Class Activation Mapping. Discussion: This study introduces a dependable model-aided diagnostic technology for assessing eyelid skin lesions. The model demonstrated accuracy comparable to human evaluation, effectively determining whether a lesion raises a high suspicion of malignancy or is benign. Such a model has the potential to alleviate the burden on the healthcare system, particularly benefiting rural areas and enhancing the efficiency of clinicians and overall healthcare.

Keywords: machine learning;, eyelid skin tumors;, decision-making process;, heatmap visualization techniques

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Authors: Roseanne Sharon Borromeo, Mariana Carvalho, Mariia Karizhenskaia

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Healthcare providers need to comprehend cultural diversity for optimal patient-centered care, especially near the end of life. Although a universal method for navigating cultural differences would be ideal, culture’s high complexity makes this strategy impossible. Adding cultural humility, a process of self-reflection to understand personal and systemic biases and humbly acknowledging oneself as a learner when it comes to understanding another's experience leads to a meaningful process in palliative care generating respectful, honest, and trustworthy relationships. This study is a systematic review of the literature on cultural humility in palliative care research and best practices. Race, religion, language, values, and beliefs can affect an individual’s access to palliative care, underscoring the importance of culture in palliative care. Cultural influences affect end-of-life care perceptions, impacting bereavement rituals, decision-making, and attitudes toward death. Cultural factors affecting the delivery of care identified in a scoping review of Canadian literature include cultural competency, cultural sensitivity, and cultural accessibility. As the different parts of the world become exponentially diverse and multicultural, healthcare providers have been encouraged to give culturally competent care at the bedside. Therefore, many organizations have made cultural competence training required to expose professionals to the special needs and vulnerability of diverse populations. Cultural competence is easily standardized, taught, and implemented; however, this theoretically finite form of knowledge can dangerously lead to false assumptions or stereotyping, generating poor communication, loss of bonds and trust, and poor healthcare provider-patient relationship. In contrast, Cultural humility is a dynamic process that includes self-reflection, personal critique, and growth, allowing healthcare providers to respond to these differences with an open mind, curiosity, and awareness that one is never truly a “cultural” expert and requires life-long learning to overcome common biases and ingrained societal influences. Cultural humility concepts include self-awareness and power imbalances. While being culturally competent requires being skilled and knowledgeable in one’s culture, being culturally humble involves the sometimes-uncomfortable position of healthcare providers as students of the patient. Incorporating cultural humility emphasizes the need to approach end-of-life care with openness and responsiveness to various cultural perspectives. Thus, healthcare workers need to embrace lifelong learning in individual beliefs and values on suffering, death, and dying. There have been different approaches to this as well. Some adopt strategies for cultural humility, addressing conflicts and challenges through relational and health system approaches. In practice and research, clinicians and researchers must embrace cultural humility to advance palliative care practices, using qualitative methods to capture culturally nuanced experiences. Cultural diversity significantly impacts patient-centered care, particularly in end-of-life contexts. Cultural factors also shape end-of-life perceptions, impacting rituals, decision-making, and attitudes toward death. Cultural humility encourages openness and acknowledges the limitations of expertise in one’s culture. A consistent self-awareness and a desire to understand patients’ beliefs drive the practice of cultural humility. This dynamic process requires practitioners to learn continuously, fostering empathy and understanding. Cultural humility enhances palliative care, ensuring it resonates genuinely across cultural backgrounds and enriches patient-provider interactions.

Keywords: cultural competency, cultural diversity, cultural humility, palliative care, self-awareness

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Authors: Raphaël Weuts, Mykyta Petik, Anton Vedder

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Artificial Intelligence has the potential to create and already creates enormous value in healthcare. Prescriptive systems might be able to make the use of healthcare capacity more efficient. Such systems might entail interpretations that exclude the effect of confounders that brings risks with it. Those risks might be mitigated by regulation that prevents systems entailing such risks to come to market. One modality of regulation is that of legislation, and the European AI Act is an example of such a regulatory instrument that might mitigate these risks. To assess the risk mitigation potential of the AI Act for those risks, this research focusses on a case study of a hypothetical application of medical device software that entails the aforementioned risks. The AI Act refers to the harmonised norms for already existing legislation, here being the European medical device regulation. The issue at hand is a causal link between a confounder and the value the algorithm optimises for by proxy. The research identifies where the AI Act already looks at confounders (i.a. feedback loops in systems that continue to learn after being placed on the market). The research identifies where the current proposal by parliament leaves legal uncertainty on the necessity to check for confounders that do not influence the input of the system, when the system does not continue to learn after being placed on the market. The authors propose an amendment to article 15 of the AI Act that would require high-risk systems to be developed in such a way as to mitigate risks from those aforementioned confounders.

Keywords: AI Act, healthcare, confounders, risks

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Authors: Luedech Girdwichai, Witthaya Mekhum, Namthip Kleebbuaban

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This research is aimed at studying work efficiency of the supporting staff at Suan Sunandha Rajabhat University by different categories. Supporting staff of Suan Sunandha Rajabhat University consists of government officers, permanent employees, permanent university staff, temporary university staff, and staff of the temporary university employees and government employees, totaling 242. The tools used in this research were questionnaires and data were analyzed by using computer software packages. Statistics includes frequency distribution, percentage, mean and standard deviation. The results showed that the work efficiency of the supporting staff at Suan Sunandha Rajabhat University is high in all areas: flexibility in operation, ability to work with others, productivity and work efficiency, human relations with colleagues and commanders, understanding of the work, and communication with others, the university, colleagues, and commanders.

Keywords: satisfaction, work efficiency, supporting staff, Suan Sunandha Rajabhat University

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Authors: El Hadji Mamadou Sonko, Ndiogou Sankhare, Maïmouna Lo, Jean Birane Gning, Cheikh Diop

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In Senegal, access to water, hygiene, and sanitation in small island towns is a particular problem, which is still poorly understood by the public authorities and development aid actors. The main objective of this study carried out in the Municipality of Foundiougne is to contribute to the knowledge of the problems related to the supply of drinking water, access to sanitation, and hygiene in small island towns in Senegal. The methodology adopted consisted of a literature review and quantitative surveys of a sample of 100 households in the Municipality. Semi-structured interviews using interview guides and informal interviews were also conducted with mechanical and manual emptiers, municipal authorities, public toilet managers, and neighbourhood leaders. Direct observation with photography was also used. The results show that, with regard to access to drinking water, 35% of households have unimproved water services, 46% have a limited level of service, and 19% have a basic level of service. Regarding sanitation, 77% of households are considered to have access to basic sanitation services, compared to 23% with limited sanitation services. However, these figures hide the dysfunctions of the sanitation system. Indeed, manual emptying is practiced exclusively by 4% of households, while 17% of households combine it with mechanical emptying. In addition, domestic wastewater is mainly evacuated outside the sanitation facilities, and all the sludge extracted from the pits is discharged directly into the environment without treatment. As a matter of fact, the surveys showed that 52% of households do not have access to a basic level of hygiene-related to handwashing when leaving the toilet. These results show that there is real work to be done at the level of small urban centres if we want to achieve MDG 6.

Keywords: Foundiougne, Senegal, small island, small town, water-sanitation, hygiene

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Authors: Rizwan Rizwan

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This paper provides an overview of Federated Learning (FL) and its application in enhancing data security, privacy, and efficiency. FL utilizes three distinct architectures to ensure privacy is never compromised. It involves training individual edge devices and aggregating their models on a server without sharing raw data. This approach not only provides secure models without data sharing but also offers a highly efficient privacy--preserving solution with improved security and data access. Also we discusses various frameworks used in FL and its integration with machine learning, deep learning, and data mining. In order to address the challenges of multi--party collaborative modeling scenarios, a brief review FL scheme combined with an adaptive gradient descent strategy and differential privacy mechanism. The adaptive learning rate algorithm adjusts the gradient descent process to avoid issues such as model overfitting and fluctuations, thereby enhancing modeling efficiency and performance in multi-party computation scenarios. Additionally, to cater to ultra-large-scale distributed secure computing, the research introduces a differential privacy mechanism that defends against various background knowledge attacks.

Keywords: federated learning, differential privacy, gradient descent strategy, convergence, stability, threats

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Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene

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The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.

Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers

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Authors: Ho-Wa Li, Sai-Wing Tsang

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The excitonic effect in organic semiconductors plays a key role in determining the electronic devices performance. Strong exciton binding energy has been regarded as the detrimental factor limiting the further improvement in organic photovoltaic cells. To the best of our knowledge, only limited reported can be found in measuring the exciton binding energy in organic photovoltaic materials. Conventional sophisticated approach using photoemission spectroscopy (UPS and IPES) would limit the wide access of the investigation. Here, we demonstrate a facile approach to study the electrical and optical quantum efficiencies of a series of conjugated photovoltaic polymer, fullerene and non-fullerene materials. Quantitative values of the exciton binding energy in those prototypical materials were obtained with concise photovoltaic device structure. And the extracted binding energies have excellent agreement with those determined by the conventional photoemission technique. More importantly, our findings can provide valuable information on the excitonic dissociation in the first excited state. Particularly, we find that the high binding energy of some non-fullerene acceptors limits the combination of polymer acceptors for efficiency exciton dissociation. The results bring insight into the engineering of excitonic effect for the development of efficient organic photovoltaic cells.

Keywords: organic photovoltaics, quantum efficiency, exciton binding energy, device physics

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Authors: Aykut Bedük, Kemalettin Eryeşil, Osman Eşmen

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The aim of this study is to examine the relationship between organizational commitment which is defined as a strong belief in and acceptance of the organization’s goals and values, and burnout syndrome and organizational cynicism. Accordingly, a field research based on survey method was conducted on the employees of a health institution operating in the province of Konya. The findings of the research show that there is a positive statistically significant relationship between organizational cynicism and burnout while there is a negative statistically significant relationship between organizational commitment and burnout. Furthermore, it has been also realized that there is a negative and statistically significant relationship between organizational commitment and organizational cynicism.

Keywords: burnout, organizational commitment, organizational cynicism, healthcare management

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Authors: M. Brockes, S. Beck, A. Sigaroudi, C. Brockes

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Over the last few years, telemedicine and telemonitoring have become popular ways of treatment, especially in other chronic diseases. Therefore, this type of treatment methodology was also implemented in patients with interstitial lung disease (ILD). In January 2024, a new service for patients with interstitial lung disease (ILD) treated with Nintedanib was established, which contains daily telemonitoring (home spirometry, pulse oximetry, and daily level of activity), daily evaluation of parameters as well as a telemedical availability answered by doctors and telemedical specialists throughout 365 days per year. The main motivational points of this service are the early detection of first signs of exacerbations and/or other symptoms/complications, as well as easier access to healthcare professionals. The evaluation of the patient’s quality of life and the subjective feeling of safetyness was measured through patient-reported experience measurements (PREMs) and patient-reported outcome measurements (PROMs). Patients were introduced to the telemedical and telemonitoring service six months ago. Within this period, every sixty days, the questionnaires were conducted by the scientific employees. Due to the unlimited time frame of the long-term service, the evaluation has not been completed. The first analysis of patient-reported experience measurements (PREMs) and patient reported outcome measurements (PROMs) had shown an increased positive effect on the patients' quality of life as well as an increased positive effect on the subjective feeling of safety at home, plus a reduction and avoidance of secondary damages (e.g., exacerbations, deterioration of typical interstitial lung disease ILD symptoms and pharmaceutical side effects). The first results have shown a tendency that the telemedical treatment combined with telemonitoring at home and the encouragement of patients to actively participate in their healthcare has a positive effect on the patient’s overall well-being and could be implemented as a complementation of the traditional standard of care.

Keywords: avoidance of secondary damages, interstitial lung disease, telemedicine and telemonitoring, subjective feeling of safety

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Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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Authors: Shao-Ku Kao

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This paper presents an active rectifier with time-domain delay compensation to enhance the efficiency. A delay calibration circuit is designed to convert delay time to voltage and adaptive control on/off delay in variable input voltage. This circuit is designed in 0.18 mm CMOS process. The input voltage range is from 2 V to 3.6 V with the output voltage from 1.8 V to 3.4 V. The efficiency can maintain more than 85% when the load from 50 Ω ~ 1500 Ω for 3.6 V input voltage. The maximum efficiency is 92.4 % at output power to be 38.6 mW for 3.6 V input voltage.

Keywords: wireless power transfer, active diode, delay compensation, time to voltage converter, PCE

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Authors: Latef M. Ali, Farah A. Abed

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In this paper, the effect of the Barium fluoride (BaF2) layer on the absorption efficiency of GaAs/InAs nanowire solar cells was investigated using the finite difference time domain (FDTD) method. By inserting the BaF2 as antireflection with the dominant size of 10 nm to fill the space between the shells of wires on the Si (111) substrate. The absorption is significantly improved due to the strong reabsorption of light reflected at the shells and compared with the reference cells. The present simulation leads to a higher absorption efficiency (Qabs) and reaches a value of 97%, and the external quantum efficiencies (EQEs) above 92% are observed. The current density (Jsc) increases by 0.22 mA/cm2 and the open-circuit voltage (Voc) is enhanced by 0.11 mV.

Keywords: nanowire solar cells, absorption efficiency, photovoltaic, band structures, fdtd simulation

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Authors: Abdenour Bourabaa, Malika Fekih, Mohamed Saighi

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A numerical investigation of the fin efficiency and temperature distribution of an annular fin under dehumidification has been presented in this paper. The non-homogeneous second order differential equation that describes the temperature distribution from the fin base to the fin tip has been solved using the central finite difference method. The effects of variations in parameters including relative humidity, air temperature, air face velocity on temperature distribution and fin efficiency are investigated and compared with those under fully dry fin conditions. Also, the effect of fin pitch on the dimensionless temperature has been studied.

Keywords: annular fin, dehumidification, fin efficiency, heat and mass transfer, wet fin

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Authors: Dilang Thouk Tharjiath

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This study seeks to examine determinants of access to finance: the case of micro and small enterprises in bonga town. It identifies the sector as the key to unlocking the economic potentials of the country. For the achievement of the objective of the study simple random and stratified sampling has been used to select 179 respondents, primary and secondary data were used, primary data were collected through face to face interview and preparing questionnaire and secondary data were collected through reviewing firms record and reports, quantitative research approach were used and the data obtained were analyzed using descriptive research design. Access to finance is one of the key obstacles of MSE’s not only when starting the business project but also when operating. Identifying the major determinants of access to finance is therefore quite crucial. Based on descriptive result the financiers specially formal financiers tend to grant credit easily for enterprises which are located near to town, having operators with higher educational level, experienced and with a positive attitudes towards or fulfill their lending procedures, and a firm having collateralized asset, prepare business plan, maintain accounting practice ,large and old enough. Finally the study recommended that As Educational level of entrepreneurs has significant effect on access to credit from bank and the managers or owners education level is low in Bonga town the concerned bodies of both the government and non-governmental institutions in collaboration with Bonga town MSE development office are recommended to create awareness and facilitate the provision of additional training for those with lower educational level.

Keywords: credit, entrepreneur, enterprise, manager

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Authors: William Coburn, Dylan Hauchard, Amel Naouali

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Background: The nature of the HIV epidemic in Puerto Rico (PR) is less understood than in the continental U.S. There is evidence to suggest that there are differences in health care access based on geographical location, such that rural areas are less underserved and have less immediate access to HIV prevention resources. Methods: The current study consists of a cross-sectional online survey of self-reporting HIV-negative sexual minority men (SMM) residing in PR. Results: In this sample, there were no differences between urban and rural-based services for SMM. However, more than half of the sample reported that they have never disclosed their gender identity and sexual practices to a physician. Conclusion: HIV is a significant public health concern affecting Latinos/Hispanics in the U.S. Findings in this paper can have implications for HIV prevention services in PR specifically, as few studies have directly focused on the impact of HIV and health care services in PR outside of the continental U.S.

Keywords: HIV, Puerto Rico, infectious diseases , public health

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Authors: Khouloud Safa Azoud, Süleyman Baştürk

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In the pursuit of cleaner and more sustainable urban environments, advanced technologies play a critical role in evolving sanitation systems. This paper presents two distinct advancements in automated cleaning machines designed to improve urban sanitation. The first advancement is a semi-automatic road surface cleaning machine that integrates human labor with solar energy to enhance environmental sustainability and adaptability, especially in regions with limited access to electricity. By reducing carbon emissions and increasing operational efficiency, this approach offers significant potential for urban sanitation enhancement. The second advancement is a multifunctional semi-automatic street cleaning machine equipped with a camera, Arduino programming, and GPS for an autonomous operation aimed at addressing cost barriers in developing countries. Prioritizing low energy consumption and cost-effectiveness, this machine provides versatile cleaning solutions adaptable to various environmental conditions. By integrating solar energy with autonomous operating systems and careful design, these developments represent substantial progress in sustainable urban sanitation, particularly in developing regions.

Keywords: automated cleaning machines, solar energy integration, operational efficiency, urban sanitation systems

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Authors: John Narh

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There is high rate of deforestation in Ghana due to agricultural expansion, illegal mining and illegal logging. While it is attempting to address the illegalities, Ghana has also initiated a reforestation program known as the Modified Taungya System (MTS). Within the MTS framework, farmers are allocated degraded forestland and provided with tree seedlings to practice agroforestry until the trees form canopy. Yet, the political, ecological and economic models that inform the selection of tree species, the motivations of participating farmers as well as the factors that accounts for differential access to the land and performance of farmers engaged in the program lie underexplored. Using a sequential explanatory mixed methods approach in five forest-fringe communities in the Eastern Region of Ghana, the study reveals that economic factors and Ghana’s commitment to international conventions on the environment underpin the selection of tree species for the MTS program. Social network and access to remittances play critical roles in having access to, and enhances poor farmers’ chances in the program respectively. Farmers are more motivated by the access to degraded forestland to cultivate food crops than having a share in the trees that they plant. As such, in communities where participating farmers are not informed about their benefit in the tree that they plant, the program is largely unsuccessful.

Keywords: translocality, deforestation, forest management, social network

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Authors: Tanvi P. Medshinge, Prasad Vaidya, Monisha E. Royan

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In India, cooling loads in residential sector is a major contributor to its total energy consumption. Due to the increasing cooling need, the market penetration of air-conditioners is further expected to rise. Natural Ventilation (NV), however, possesses great potential to save significant energy consumption especially for residential buildings in moderate climates. As multifamily residential apartment buildings are designed by repetitive use of prototype designs, deriving individual NV based design prototype solutions for a combination of different wind incidence angles and orientations would provide significant opportunity to address the rise in cooling loads by residential sector. This paper presents the results of NV performance of a selected prototype apartment design with a cluster of four units in Pune, India, and an attempt to improve the NV performance through design modifications. The water table apparatus, a physical modelling tool, is used to study the flow patterns and simulate wind-induced NV performance. Quantification of NV performance is done by post processing images captured from video recordings in terms of percentage of area with good and poor access to ventilation. NV performance of the existing design for eight wind incidence angles showed that of the cluster of four units, the windward units showed good access to ventilation for all rooms, and the leeward units had lower access to ventilation with the bedrooms in the leeward units having the least access. The results showed improved performance in all the units for all wind incidence angles to more than 80% good access to ventilation. Some units showed an additional improvement to more than 90% good access to ventilation. This process of design and performance evaluation improved some individual units from 0% to 100% for good access to ventilation. The results demonstrate the ease of use and the power of the water table apparatus for performance-based design to simulate wind induced NV.  

Keywords: fluid dynamics, prototype design, natural ventilation, simulations, water table apparatus, wind incidence angles

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Authors: Saleh Hayat

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Efficiency, productivity and sustainability are important factors for structure and the application of processes in green building. Various previous studies have addressed efficiency, productivity and sustainability separately. This research study aims to investigate the implications of these three factors taking together. Frequency analysis and the ranking techniques are carried out to explore the connection between these factors. The interconnection matrix has been developed and functional grouping is made based upon data from expert opinion and field professionals. The existence of a relationship, the type of relationship and the scaled impact have been drawn. Additionally, a system diagram has been developed to show the variable correlation. The results of expert opinion show that efficiency, productivity and sustainability have a stronger impact on green buildings.

Keywords: efficiency, green building, productivity, sustainability

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Authors: Elkington Sibusiso Mnguni

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Although South Africa has made good progress in providing basic water and sanitation services to its citizens, there is still a large section of the population that has no access to these services. This paper reviews the performance of the government’s municipal infrastructure grant programme in providing basic water and sanitation services which are part of the constitutional requirements to the citizens. The method used to gather data and information was a desk top study which sought to review the progress made in rolling out the programme. The successes and challenges were highlighted and possible solutions were identified that can accelerate the elimination of the remaining backlogs and improve the level of service to the citizens. Currently, approximately 6.5 million citizens are without access to basic water services and approximately 10 million are without access to basic sanitation services.

Keywords: grant, municipal infrastructure, sanitation, services, water

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Authors: Arvind Aggarwal

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We have developed a comprehensive global healthcare delivery System based on information technology. It has medical consultation system where a virtual consultant can give medical consultation to the patients and Doctors at the digital medical centre after reviewing the patient’s EMR file consisting of patient’s history, investigations in the voice, images and data format. The system has the surgical operation system too, where a remote robotic consultant can conduct surgery at the robotic surgical centre. The instant speech and text translation is incorporated in the software where the patient’s speech and text (language) can be translated into the consultant’s language and vice versa. A consultant of any specialty (surgeon or Physician) based in any country can provide instant health care consultation, to any patient in any country without loss of time. Robotic surgeons based in any country in a tertiary care hospital can perform remote robotic surgery, through patient friendly telemedicine and tele-surgical centres. The patient EMR, financial data and data of all the consultants and robotic surgeons shall be stored in cloud. It is a complete comprehensive business model with healthcare medical and surgical delivery system. The whole system is self-financing and can be implemented in any country. The entire system uses paperless, filmless techniques. This eliminates the use of all consumables thereby reduces substantial cost which is incurred by consumables. The consultants receive virtual patients, in the form of EMR, thus the consultant saves time and expense to travel to the hospital to see the patients. The consultant gets electronic file ready for reporting & diagnosis. Hence time spent on the physical examination of the patient is saved, the consultant can, therefore, spend quality time in studying the EMR/virtual patient and give his instant advice. The time consumed per patient is reduced and therefore can see more number of patients, the cost of the consultation per patients is therefore reduced. The additional productivity of the consultants can be channelized to serve rural patients devoid of doctors.

Keywords: e-health, telemedicine, telecare, IT-based healthcare

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Authors: Fulufhelo Oscar Makananise

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Digital technologies have played a significant role in bridging the information gap between the haves and the have nots in society. In developing countries such as South Africa, historically marginalised groups such as women in rural communities have an opportunity to use digital technologies to network among themselves as well as interact with their government, thereby enhancing prospects for poverty eradication, political participation, community development and democracy. However, the extent to which these goals can be achieved in a developing context through harnessing digital technologies is not quite clear, particularly given the fact that access to these technologies is not evenly distributed and the fact that women’s access to digital technologies is hampered by factors that go beyond the question of infrastructure. Informed by the technological dependency theory, this paper is about how female youth in rural South Africa are deploying digital media tools for socio-economic empowerment. In particular, the study investigated the extent to which female youth in Limpopo province, South Africa access and use digital media platforms and gadgets and the extent to which those technologies are breaking down barriers that stand in the way of female youth empowerment. Data were gathered using a self-administered questionnaire disseminated to selected 100 female youth in Limpopo Province, South Africa. The data were analysed using SPSS version 9, and the results were analysed using descriptive statistics. The paper argues that wider and constant access to digital media by female youth in rural areas is indicative of the great potential for empowering female youth in rural areas through harnessing digital media. The study established that the majority of female youth had access to digital media technologies and used them to share valuable information among themselves. The study further established that female youth are active users of digital media in South Africa, which is the significant driver for socio-economic empowerment.

Keywords: digital technologies, empowerment, female youth, South Africa, survey, technological dependency

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Authors: Ying-Hsiu Chen, Pao-Peng Hsu

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This paper adopts a two-stage data envelopment analysis to explore the impacts of financial development and bank operational scale on bank efficiencies. The sample comprises of unbalanced panel data of 32 Taiwanese enlisted in domestic commercial banks over the period 1998 to 2013. Empirical results show that technical efficiency is positively related to financial development, whereas the effect of financial development on scale efficiency is insignificant. The effect of operational scale exerts a significantly positive effect on bank efficiencies, but the gain of efficiency is decreased gradually when operational scale increases. Furthermore, increase in capital adequacy ratio and market power of banks leads to a growth of bank efficiencies.

Keywords: financial development, operational scale, efficiency, DEA

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Authors: Raed El-Khalil, Hussein Zeaiter

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Managing and improving efficiency in the current highly competitive global automotive industry demands that companies adopt leaner and more flexible systems. During the past 20 years the domestic automotive industry in North America has been focusing on establishing new management strategies in order to meet market demands. 98The lean management process also known as Toyota Manufacturing Process (TPS) or lean manufacturing encompasses tools and techniques that were established in order to provide the best quality product with the fastest lead time at the lowest cost. The following paper presents a study that focused on improving labor efficiency at one of the Big Three (Ford, GM, Chrysler LLC) domestic automotive facility in North America. The objective of the study was to utilize several lean management tools in order to optimize the efficiency and utilization levels at the “Pre-Marriage” chassis area in a truck manufacturing and assembly facility. Utilizing three different lean tools (i.e. Standardization of work, 7 Wastes, and 5S) this research was able to improve efficiency by 51%, utilization by 246%, and reduce operations by 14%. The return on investment calculated based on the improvements made was 284%.

Keywords: lean manufacturing, standardized work, operation efficiency, utilization

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Authors: Daniel Afolayan, Christina Olawepo, Francis Olowookanga, Nguhemen Tingir, Olawale Fadare, John Oko

Abstract:

In Nigeria, traditional birth attendants (TBAs) can play an important role in the prevention of mother-to-child transmission of HIV. However, their role in improving access to antiretroviral therapy (ART) is unclear. Catholic Caritas Foundation of Nigeria (Caritas Nigeria) is an implementing agency supporting increased access to HIV testing and treatment services in Lagos state through health facilities including Mother Theresa Hospital. Despite intra-facility testing and community outreaches, ART uptake at Mother Theresa Hospital, Lagos was low with 6 individuals on antiretroviral drugs 3 months post-activation. This study explored improving access to ART through linkages with TBAs for ART uptake at the facility. Plan-Do-Study-Act model was used. The goal was to improve uptake of ART from 6 to 80 in 5 months (end of project year). Scanning revealed a network of 15 TBAs with potential as satellites for HIV testing. Caritas Nigeria linked the facility with 15 TBAs who were provided with HIV test kits and trained on HIV testing services for provider-initiated testing and outreaches. Weekly reports and referrals of positives were received, tracked and feedback given on testing yield. These TBAs serve individuals of various age and gender at their trado-medical centres. At the end of 5 months, HIV testing increased by 10,575 (78% from TBAs) and HIV positives obtained improved by 77 (44.2% from TBAs). 55 new individuals were enrolled and commenced on ART (61.8% from TBAs). There was a successful linkage of all clients with escort services due to incentives. Total uptake of ART was 61 (76.3% of target). Structured partnerships between TBAs and HIV care and treatment centers should be strengthened to improve access to ART.

Keywords: access improvement, antiretroviral therapy, traditional birth attendants, uptake

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Authors: Nisful Laila, Fatin Fadhilah Hasib, Puji Sucia Sukmaningrum, Achsania Hendratmi

Abstract:

The purpose of this study is to determine and comparing the level of efficiency of Islamic Banks in Indonesia and United Kingdom during eurozone sovereign debt crisis. This study using a quantitative non-parametric approach with Data Envelopment Analysis (DEA) VRS assumption, and a statistical tool Mann-Whitney U-Test. The samples are 11 Islamic Banks in Indonesia and 4 Islamic Banks in England. This research used mediating approach. Input variable consists of total deposit, asset, and the cost of labour. Output variable consists of financing and profit/loss. This study shows that the efficiency of Islamic Bank in Indonesia and United Kingdom are varied and fluctuated during the observation period. There is no significant different the efficiency performance of Islamic Banks in Indonesia and United Kingdom.

Keywords: data envelopment analysis, efficiency, eurozone crisis, islamic bank

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Authors: Shoohira Aftab, Hammad Afzal

Abstract:

Information integration is a well known procedure to provide consolidated view on sets of heterogeneous information sources. It not only provides better statistical analysis of information but also facilitates users to query without any knowledge on the underlying heterogeneous information sources The problem of providing a consolidated view of information can be handled using Semantic data (information stored in such a way that is understandable by machines and integrate-able without manual human intervention). However, integrating information using semantic web technology without any access management enforced, will results in increase of privacy and confidentiality concerns. In this research we have designed and developed a framework that would allow information from heterogeneous formats to be consolidated, thus resolving the issue of interoperability. We have also devised an access control system for defining explicit privacy constraints. We designed and applied our framework on both semantic and non-semantic data from heterogeneous resources. Our approach is validated using scenario based testing.

Keywords: information integration, semantic data, interoperability, security, access control system

Procedia PDF Downloads 358