Search results for: integrated healthcare

Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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Authors: Lloyd A. Taylor

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An increase in the prevalence of Attention Deficit-Hyperactivity Disorder (ADHD) highlights the need to consider factors that may be exacerbating symptom presentation. Traditional diagnostic criteria provide a little framework for healthcare providers to consider as they attempt to diagnose and treat children with behavioral problems. In fact, aside from exclusion criteria, limited alternative considerations are available, and approaches fail to consider the impact of outside factors that could increase or decrease the likelihood of appropriate diagnosis and success of interventions. This paper will consider specific systems-based factors that influence behavior and intervention successes that, when not considered, could account for the upsurge of diagnoses. These include understanding (1) challenges in the healthcare system, (2) the influence and impact of educators and the educational system, (3) technology use, and (4) patient and parental attitudes about the diagnosis of ADHD. These factors must be considered both individually and as a whole when considering both the increase in diagnoses and the subsequent increases in prescriptions for psychostimulant medication. A theoretical model based on a risk management approach will be presented. Finally, data will be presented that demonstrates pediatric provider satisfaction with this approach to diagnoses and treatment of ADHD as it relates to practice trends.

Keywords: ADHD, diagnostic criteria, risk management model, pediatricians

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Authors: Maryam Hamlehdar, Guillermo A. Narsilio

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To enhance the feasibility of utilising geothermal hot sedimentary aquifers (HSAs) for clean hydrogen production, one approach is the implementation of solar-integrated geothermal energy systems. This detailed modelling study conducts a thermo-economic assessment of an advanced Organic Rankine Cycle (ORC)-based hydrogen production system that uses low-temperature geothermal reservoirs, with a specific focus on hot sedimentary aquifers (HSAs) over a 30-year period. In the proposed hybrid system, solar-thermal energy is used to raise the water temperature extracted from the geothermal production well. This temperature increase leads to a higher steam output, powering the turbine and subsequently enhancing the electricity output for running the electrolyser. Thermodynamic modeling of a parabolic trough solar (PTS) collector is developed and integrated with modeling for a geothermal-based configuration. This configuration includes a closed regenerator cycle (CRC), proton exchange membrane (PEM) electrolyser, and thermoelectric generator (TEG). Following this, the study investigates the impact of solar energy use on the temperature enhancement of the geothermal reservoir. It assesses the resulting consequences on the lifecycle performance of the hydrogen production system in comparison with a standalone geothermal system. The results indicate that, with the appropriate solar collector area, a combined solar-geothermal hydrogen production system outperforms a standalone geothermal system in both cost and rate of production. These findings underscore a solar-assisted geothermal hybrid system holds the potential to generate lower-cost hydrogen with enhanced efficiency, thereby boosting the appeal of numerous low to medium-temperature geothermal sources for hydrogen production.

Keywords: clean hydrogen production, integrated solar-geothermal, low-temperature geothermal energy, numerical modelling

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Authors: Felix Lankester, Alicia Davis, Safari Kinung'hi, Catherine Bunga, Shayo Alkara, Imam Mzimbiri, Jonathan Yoder, Sarah Cleaveland, Guy H. Palmer

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Achieving the London Declaration goal of a 90% reduction in neglected tropical diseases (NTDs) by 2030 requires cost-effective strategies that attain high and comprehensive coverage. The first objective of this trial was to assess the impact on cost and coverage of employing a novel integrative One Health approach linking two NTD control programs: mass drug administration (MDA) for soil-transmitted helminths in humans (STH) and mass dog rabies vaccination (MDRV). The second objective was to compare the coverage achieved by the MDA, a community-wide deworming intervention, with that of the existing national primary school-based deworming program (NSDP), with particular focus on the proportion of primary school-age children reached and their school enrolment status. Our approach was unconventional because, in line with the One Health approach to disease control, it coupled the responsibilities and resources of the Ministries responsible for human and animal health into one program with the shared aim of preventing multiple NTDs. The trial was carried out in hard-to-reach pastoral communities comprising 24 villages of the Ngorongoro District, Tanzania, randomly allocated to either Arm A (MDA and MDRV), Arm B (MDA only) or Arm C (MDRV only). Objective one: The percentage of people in each target village that received treatment through MDA in Arms A and B was 63% and 65%, respectively (χ2 = 1, p = 0.32). The percentage of dogs vaccinated in Arm A and C was 70% and 81%, respectively (χ2 =9, p = 0.003). It took 33% less time for a single person and a dog to attend the integrated delivery than two separate events. Cost per dose (including delivery) was lower under the integrated strategy, with delivery of deworming and rabies vaccination reduced by $0.13 (54%) and $0.85 (19%) per dose, respectively. Despite a slight reduction in the proportion of village dogs vaccinated in the integrated event, both the integrated and non-integrated strategies achieved the target threshold of 70% required to eliminate rabies. Objective two: The percentages of primary school age children enrolled in school that was reached by this trial (73%) and the existing NSDP (80%) were not significantly different (F = 0.9, p = 0.36). However, of the primary school age children treated in this trial, 46% were not enrolled in school. Furthermore, 86% of the people treated would have been outside the reach of the NSDP because they were not primary school age or were primary school age children not enrolled in school. The comparable reach, the substantial reductions in cost per dose delivered and the decrease in participants’ time support this integrated One Health approach to control multiple NTDs. Further, the recorded level of non-enrolment at primary school suggests that, in remote areas, school-based delivery strategies could miss a large fraction of school-age children and that programs that focus delivery solely at the level of the primary school will miss a substantial proportion of both primary school age children as well as other individuals from the community. We have shown that these populations can be effectively reached through extramural programs.

Keywords: canine mediated human rabies, integrated health interventions, mass drug administration, neglected tropical disease, One Health, soil-transmitted helminths

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos.

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Authors: Majda Al Salti

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Tourism industry is considered globally as one of the leading industries due to its noticeable contribution to countries' gross domestic product (GDP) and job creation. However, tourism is vulnerable to crisis and disaster that requires its preparedness. With its limited capabilities, there is a need to improve links and the understanding between the tourism industry and the emergency services, thus facilitating future emergency response to any potential incident. This study aims to develop the concept of an integrated emergency management system for the tourism industry. The study used face-to-face semi-structured interviews to evaluate the level of crisis and disaster preparedness of the tourism industry in Oman. The findings suggested that there is a lack of understanding of crisis and disaster management, and hence preparedness level among Oman Tourism Authorities appears to be under-expectation. Therefore, a clear need for tourism sector inter- and intra-integration and collaboration is important in the pre-disaster stage. The need for such integrations can help the tourism industry in Oman to prepare for future incidents as well as identifying its requirements in time of crisis for effective response.

Keywords: tourism, emergency services, crisis, disaster

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Authors: S. O. Obasa, J. A. Soaga, O. I. Afolabi, N. A. Bamidele, O. E. Babalola

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Attempt to improve the income of the rural population is a welcome development in Nigeria. Integrated fish-crop farming has been suggested as a means of raising farm income, reducing wastage and mitigating the risk component in production through the complementarity gain. A feeding trial was carried out to investigate the replacement of maize with fermented unripe plantain (Musa paradisiaca) peel meal in the diet of Nile tilapia, Oreochromis niloticus. The economics of the integrated enterprise was assessed using budgetary analysis techniques. The analysis incorporated the material and labour costs as well as the returns from sale of matured fish and plantain. A total of 60 fingerlings of Nile tilapia (1.70±0.1 g) were stocked at 10 per plastic tank. Two iso-nitrogenous diets containing 35% crude protein in which maize meal was replaced by fermented unripe plantain peel meal at 0% (FUP0/Control diet), and 100% (FUP100) were formulated and prepared. The fingerlings were fed at 5% body weight per day for 56 days. Lowest feed conversion ratio of 1.39 in fish fed diet FUP100 was not significantly different (P > 0.05) from the highest 1.42 of fish fed the Control diet. The highest percentage profit of 88.85% in fish fed diet FUP100 was significantly higher than 66.68% in fish fed diet FUP0, while the profit index of 1.89 in fish fed diet FUP100 was significantly different from 1.67 in fish fed diet FUP0. Therefore, fermented unripe plantain peel meal can completely replace maize in the diet of O. niloticus fingerlings. Profitability assessment shows that the net income from the integration was ₦ 463,000 per hectare and the integration resulted to an increase of ₦ 87,750.00 representing a 12.2% increase than in separate production.

Keywords: fish-crop, income, Nile tilapia, waste management

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Authors: Chryssa Thermolia, Ekaterini S. Bei, Stelios Sotiriadis, Kostas Stravoskoufos, Euripides G. M. Petrakis

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Moving into a new era of healthcare, new tools and devices are developed to extend and improve health services, such as remote patient monitoring and risk prevention. In this concept, Internet of Things (IoT) and Cloud Computing present great advantages by providing remote and efficient services, as well as cooperation between patients, clinicians, researchers and other health professionals. This paper focuses on patients suffering from bipolar disorder, a brain disorder that belongs to a group of conditions called effective disorders, which is characterized by great mood swings.We exploit the advantages of Semantic Web and Cloud Technologies to develop a patient monitoring system to support clinicians. Based on intelligently filtering of evidence-knowledge and individual-specific information we aim to provide treatment notifications and recommended function tests at appropriate times or concluding into alerts for serious mood changes and patient’s non-response to treatment. We propose an architecture, as the back-end part of a cloud platform for IoT, intertwining intelligence devices with patients’ daily routine and clinicians’ support.

Keywords: bipolar disorder, intelligent systems patient monitoring, semantic web technologies, healthcare

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Authors: Vitor S. Mendonca, Maria Luisa S. Schmidt

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The Brazilian medical profession is viewed as being error-free, so healthcare professionals who commit an error are condemned there. Medical errors occur frequently in the Brazilian healthcare system, so identifying better options for handling this issue has become of interest primarily for physicians. The purpose of this study is to better understand the tensions involved in the fear of making an error due to the harm and risk this would represent for those involved. A qualitative study was performed by means of the narratives of the lived experiences of ten acting physicians in the State of Sao Paulo. The concept and characterization of errors were discussed, together with the fear of making an error, the near misses or error in itself, how to deal with errors and what to do to avoid them. The analysis indicates an excessive pressure in the medical profession for error-free practices, with a well-established physician-patient relationship to facilitate the management of medical errors. The error occurs, but a lack of information and discussion often leads to its concealment due to fear or possible judgment by society or peers. The establishment of programs that encourage appropriate medical conduct in the event of an error requires coherent answers for humanization in Brazilian medical science. It is necessary to improve the discussion about medical errors and disseminate models of communication and notification of errors in Brazil.

Keywords: medical error, narrative, physician-patient relationship, qualitative research

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Authors: Leslie Beale

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Being a patient with a chronic disease is both a physical and emotional experience. The ability to recognize a patient’s emotional health is an important part of a health care provider’s skills. For the purposes of this paper, emotional health is viewed as the way that we feel, and the way that our feelings affect us. Understanding the patient’s emotional health leads to improved provider-patient relationships and health outcomes. For example, when a patient first hears his or her diagnosis from a provider, they might find it difficult to cope with their emotions. Struggling to cope with emotions interferes with the patient’s ability to read, understand, and act on health information and services. As a result, the patient becomes more frustrated and confused, creating barriers to accessing healthcare services. These barriers are challenging for both the patient and their healthcare providers. There are five basic emotions that are part of who we are and are always with us: fear, anger, sadness, joy, and compassion. Living with a chronic disease however can cause a patient to experience and express these emotions in new and unique ways. Within the provider-patient relationship, there needs to be an understanding that each patient experiences these five emotions and, experiences them at different times. In response to this need, the paper highlights a health promotion framework for patients with chronic disease. This framework emphasizes the emotional health of patients.

Keywords: health promotion, emotional health, patients with chronic disease, patient-centered care

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Authors: Qingsong Xiong, Cheng Yuan, Qingzhao Kong, Haibei Xiong

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Deep-learning-driven approaches based on vibration responses have attracted larger attention in rapid structural condition assessment while obtaining sufficient measured training data with corresponding labels is relevantly costly and even inaccessible in practical engineering. This study proposes an integrated label propagation network for structural condition assessment, which is able to diffuse the labels from continuously-generating measurements by intact structure to those of missing labels of damage scenarios. The integrated network is embedded with damage-sensitive features extraction by deep autoencoder and pseudo-labels propagation by optimized fuzzy clustering, the architecture and mechanism which are elaborated. With a sophisticated network design and specified strategies for improving performance, the present network achieves to extends the superiority of self-supervised representation learning, unsupervised fuzzy clustering and supervised classification algorithms into an integration aiming at assessing damage conditions. Both numerical simulations and full-scale laboratory shaking table tests of a two-story building structure were conducted to validate its capability of detecting post-earthquake damage. The identifying accuracy of a present network was 0.95 in numerical validations and an average 0.86 in laboratory case studies, respectively. It should be noted that the whole training procedure of all involved models in the network stringently doesn’t rely upon any labeled data of damage scenarios but only several samples of intact structure, which indicates a significant superiority in model adaptability and feasible applicability in practice.

Keywords: autoencoder, condition assessment, fuzzy clustering, label propagation

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Authors: Sai Shruthi Sridhar, A. Madhumidha, Kreethika Guru, Priyanka Sekar, Ananthi Malayappan

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Numerous changes in technology and its recent development are structuring long withstanding effect to our world, one among them is the emergence of “Internet of Things” (IoT). Similar to Technology world, one industry stands out in everyday life–healthcare. Attention to “quality of health care” is an increasingly important issue in a global economy and for every individual. As per WHO (World Health Organization) it is estimated to be less than 50% adhere to the medication provided and only about 20% get their medicine on time. Medication adherence is one of the top problems in healthcare which is fixable by use of technology. In recent past, there were minor provisions for elderly and specially-skilled to get motivated and to adhere medicines prescribed. This paper proposes a novel solution that uses IOT based RFID Medication Reminder Solution to provide personal health care services. This employs real time tracking which offer quick counter measures. The proposed solution builds on the recent digital advances in sensor technologies, smart phones and cloud services. This novel solution is easily adoptable and can benefit millions of people with a direct impact on the nation’s health care expenditure with innovative scenarios and pervasive connectivity.

Keywords: cloud services, IoT, RFID, sensors

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Authors: Anatoliy Kharkhurin

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Modifications that the prefix ‘trans-‘ refers to start within a person. This presentation focuses on the transpersonal that goes beyond the individual (trans-personal) to encompass wider aspects of humanities, specifically peak experience as a culminating stage of the creative act. It proposes a model according to which the peak experience results from a harmonious vibration of four spheres, which transcend an individual’s capacities and bring one to a qualitatively different level of experience. Each sphere represents an aspect of creative activity: superconscious, intellectual, emotive and active. Each sphere corresponds to one of four creative functions: authenticity, novelty, aesthetics, and utility, respectively. The creative act starts in the superconscious sphere: the supreme pleasure of Creation is reflected in creative pleasure, which is realized in creative will. These three instances serve as a source of force axes, which penetrate other spheres, and in place of infiltration establish restrictive, expansive, and integrative principles, respectively; the latter balances the other two and ensures a harmonious vibration within a sphere. This Hegelian-like triad is realized within each sphere in the form of creative capacities. The intellectual sphere nurtures capacities to invent and to elaborate, which are integrated by capacity to conceptualize. The emotive sphere nurtures satiation and restrictive capacities integrated by capacity to balance. The active sphere nurtures goal orientation and stabilization capacities integrated by capacity for self-expression. All four spheres vibrate within each other – the superconscious sphere being in the core of the structure followed by intellectual, emotive, and active spheres, respectively – thereby reflecting the path of creative production. If the spheres vibrate in-phase, their amplitudes amplify the creative energy; if in antiphase – the amplitudes reduce the creative energy. Thus, creative act is perceived as continuum with perfectly harmonious vibration within and between the spheres on one side and perfectly disharmonious vibration on the other.

Keywords: creativity, model, transpersonal, peak experience

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Authors: Mahmoud Said Jneid, Péter Harth

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EVs with independent wheel driving greatly improve vehicle stability in poor road conditions. Wheel torques can be precisely controlled through electric motors driven using advanced technologies. As a result, various types of advanced chassis assistance systems (ACAS) can be implemented. This paper proposes an integrated torque vectoring control based on wheel slip regulation in both braking and traction modes. For generating the corrective yaw moment, the vehicle yaw rate and sideslip angle are monitored. The corrective yaw moment is distributed into traction and braking torques based on an equal-opposite components approach. The proposed torque vectoring control scheme is validated in simulation and the results show its superiority when compared to conventional schemes.

Keywords: all-wheel-drive, electric vehicle, torque vectoring, regenerative braking, stability control, traction control, yaw rate control

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Authors: Maryam Akbarzadeh, F. Esmaeilzadeh, A. Poostvar, M. Manuchehri

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Preparation of regional input-output tables requires statistical methods combined with high costs and too much time. Obtained estimates by non-statistical methods have low confidence coefficient. Therefore, integrated methods for this purpose are suggested by recent input–output studies. In this study, first GRIT method is introduced as an appropriate integrated method for preparation of input-output table of Fars province. Next, input-output table is prepared for Fars province using this method. Therefore, this study is based on input-output table of national economy in 2001. Necessary modifications performed in the field of changes at level of prices and differences of regional trade compared with other areas at national level. Moreover, up to date statistics and information and technical experts view on the various economic sectors along with input-output table 33 was used in 2011 followed by investigation of general structure of the province economy based on the amounts of added value obtained from this table.

Keywords: grit, input-output, table, regional

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Authors: Jacqui Robertson

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The sustainable governance of groundwater is of the utmost importance in an arid country like Australia. Groundwater has been relied on by our agricultural and pastoral communities since the State was settled by European colonialists. Nevertheless, the rapid establishment of a coal seam gas (CSG) industry in Queensland, Australia, has had extensive impacts on the pre-existing groundwater users. Managed aquifer recharge of important aquifers in Queensland, Australia, using treated coal seam gas produced water has been used to reduce the impacts of CSG development in Queensland Australia. However, the process has not been widely adopted. Negative environmental outcomes are now acknowledged as not only engineering, scientific or technical problems to be solved but also the result of governance failures. An analysis of the regulatory context for aquifer injection using treated CSG water in Queensland, Australia, using Ostrom’s Common Pool Resource (CPR) theory and a ‘heat map’ designed by the author, highlights the importance of governance arrangements. The analysis reveals the costs and benefits for relevant stakeholders of artificial recharge of groundwater resources in this context. The research also reveals missed opportunities to further active management of the aquifer and resolve existing conflicts between users. The research illustrates the importance of strategically and holistically evaluating innovations in technology that impact water resources to reveal incentives that impact resource user behaviors. The paper presents a proactive step that can be adapted to support integrated water resource management and sustainable groundwater development.

Keywords: managed aquifer recharge, groundwater regulation, common-pool resources, integrated water resource management, Australia

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Authors: Mohammad Julhas Sujan, Md. Ferdous Alam

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Maternal, neonatal, and child health (MNCH) holds one of the prime focuses in Bangladesh’s national healthcare system. To save the lives of mothers and children, knowing the stock of MNCH medicines in different healthcare facilities and when to replenish them are essential. A robust information system not only facilitates efficient management of the essential MNCH medicines but also helps effective allocation of scarce resources. In Bangladesh, Supply chain management of the 25-essential life-saving medicines are currently tracked and monitored via an electronic logistics management information system (eLMIS). Our aim was to conduct a cross-sectional study with a year (2020) worth of data from 24 districts of Bangladesh to evaluate how eLMIS is helping the Government and other stakeholders in efficient supply chain management. Data were collected from 4711 healthcare facilities ranging from primary to secondary levels within a district. About 90% (4143) are community clinics which are considered primary health care facilities in Bangladesh. After eLMIS implementation, the average reporting rate across the districts has been increased (> 97%). The month of stock (MOS) of zinc is an average 6 months compared to Inj. Magnesium Sulphate which will take 2.5 years to consume according to the current average monthly consumption (AMC). Due to first approaching expiry, Tab. Misoprostol, 7.1% Chlorhexidine and Inj. Oxytocin may become unusable. Moreover, Inj. Oxytocin is temperature sensitive and may reduce its efficacy if it is stocked for a longer period. In contrast, Zinc should be sufficiently stocked to prevent sporadic stockouts. To understand how data are collected, transmitted, processed, and aggregated for MNCH medicines in a faster and timely manner, an electronic logistics management information system (eLMIS) is necessary. We recommend the use of such a system in developing countries like Bangladesh for efficient supply chain management of essential MNCH medicines.

Keywords: adaption, eLMIS, MNCH, live-saving medicines

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Authors: Mubarak Jan Beebee Zeba Mahetaab, Sumera Bibi Keenoo

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Background: Covid-19 was first reported in Wuhan. On 13th March 2020, WHO declared Covid-19 as a pandemic disease with 140,936 cases globally. The outbreak of covid-19 occurred in over 184 countries, and it created a lot of medical and mental burdens. Aside from the physical problems, the mental health of the medical staff has been of critical concern. Aims and Objectives: To determine the prevalence of burnout among HCW dealing with COVID-19, identify the risk factors and find measures to support their mental health while dealing with the current and future pandemic. Methodology: A cross-sectional study was conducted among the HCW who fought against COVID-19 in SSRN Hospital in Mauritius. The HCWs were recruited using the snowballing sampling technique. Age, gender, job category, income, duration of vacation, working environment and importance of mental health were measured. Results: The prevalence of burnout was highest among HCA. Age had no significant association with pandemic-related burnout. In Mauritius, burnout during the pandemic is linked with lower income and having less vacation days. Conclusion: Burnout is prevalent among healthcare workers working during the Covid-19 Pandemic. Interventions such as psychological counselling, yoga and financial increments need to be implemented to help the healthcare workers.

Keywords: burnout, Covid-19, health care professionals, pandemic

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Authors: Sadik Yigit

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The energy consumed in the buildings constitutes a large portion of the total energy consumption in the world. In this study, it was aimed to measure the impact of climate change on the energy consumption of residential building stock by analyzing a typical mid-rise residential building in four different climate regions of Turkey. An integrated system was developed using the "Distribution Evolutionary Algorithms in Python" tool and Energy Plus. By using the developed integrated system, the energy performance of the typical residential building was analyzed under the effect of different climate change scenarios. The results indicated that predicted overheating will be experienced in the future, which will significantly increase the cooling energy loads of the buildings. In addition, design solutions to improve the future energy performance of the buildings were proposed, considering budget constraints. The results of the study will guide researchers studying in this area of research and designers in the sector in finding climate change resilient design solutions.

Keywords: energy_efficient, residential buildings, climate change, energyplus

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Authors: Ahmadali Shirazytabar, Hamidreza Namazi

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As water resources are rapidly getting diminished, more and more interest is paid to the desalination of saline waters. Desalination has become a reliable and cost effective solution in provision of fresh water particularly in the arid areas of the world such as Middle East countries. However, the dramatic increase of utilizing desalination will cause a series of problems which are significantly related to energy consumption and environment impacts. The use of renewable energy sources to provide energy required by desalination processes is a feasible and simultaneously environmental friendly solution. In this study an attempt has been made to present a review on desalination technologies, desalination integrated with renewable energies, in brief, and practical progresses made during recent years particularly in the field of desalination by wind energy which is the most common form of renewable energies. Moreover, an economic analysis of a wind powered RO desalination system comprising of 10×2.5 MW wind turbines is done, and the results will be compared to those of a cogeneration system comprising of one 25 MW gas turbines, heat recovery steam generators (HRSG) and MED-TVC desalination.

Keywords: wind turbine, desalination, RO, MED, cogeneration, gas turbine, HRSG

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Authors: Yolla Miranda, Marini Altyra, Karina Kalmapuspita Imas

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Oily sludge wastes always fill in upstream and downstream petroleum industry process. Sludge still contains oil that can use for energy storage. Recycling sludge is a method to handling it for reduce the toxicity and very probable to get the remaining oil around 20% from its volume. Froth flotation, a common method based on chemical unit for separate fine solid particles from an aqueous suspension. The basic composition of froth flotation is the capture of oil droplets or small solids by air bubbles in an aqueous slurry, followed by their levitation and collection in a froth layer. This method has been known as no intensive energy requirement and easy to apply. But the low efficiency and unable treat the high viscosity become the biggest problem in froth flotation unit. This study give the design to manage the high viscosity of sludge first and then entering the froth flotation including cavitation tube on it to change the bubbles into nano particles. The recovery in flotation starts with the collision and adhesion of hydrophobic particles to the air bubbles followed by transportation of the hydrophobic particle-bubble aggregate from the collection zone to the froth zone, drainage and enrichment of the froth, and finally by its overflow removal from the cell top. The effective particle separation by froth flotation relies on the efficient capture of hydrophobic particles by air bubbles in three steps. The important step is collision. Decreasing the bubble particles will increasing the collision effect. It cause the process more efficient. The pre-treatment, froth flotation, and cavitation tube integrated each other. The design shows the integrated unit and its process.

Keywords: sludge oil recovery, froth flotation, cavitation tube, nanobubbles, high viscosity

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Authors: Khadiza Akter, Tammy Greer, Raegan Bishop

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An in-depth study of the psycho-social effects of gynecological health disparities among immigrant women in the USA is the goal of this integrative review paper. Immigrant women frequently encounter unique obstacles that have severe psycho-social repercussions when it comes to receiving high-quality gynecological treatment. The review investigates the interaction of psychological, sociological, and health factors that affect the psycho-social effects that immigrant women experience in recognition of the significance of addressing these imbalances. The difficulties that immigrant women face in providing high-quality gynecological treatment in the USA are examined in this study. These difficulties are caused by a variety of psychological issues, including acculturation stress and stigma, as well as by social problems like prejudice, language hurdles, and cultural norms. Additionally, variations in healthcare access and affordability have a role. This study highlights the particular challenges that immigrant women have in receiving high-quality gynecological treatment in the United States. These difficulties are caused by both social problems like language obstacles, cultural norms, and biases, as well as psychological ones like acculturation stress and stigma. Additionally, variations in gynecological care for immigrant women are greatly influenced by variances in healthcare availability and price. To find pertinent research looking at the psychological effects of gynecological health disparities among immigrant women in the USA, a thorough search of numerous databases was done. Numerous approaches, including mixed, quantitative, and qualitative ones, were used in the studies. The important findings from various investigations were extracted and synthesized after they underwent a careful evaluation. In order to lessen these discrepancies and enhance the overall well-being of immigrant women, healthcare professionals, legislators, and researchers must collaborate to create specialized treatments, regulations, and health system reforms.

Keywords: cultural barriers, gynecological health disparities, health care access, immigrant women, mental health, psycho-social consequences, social stigma

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Authors: Silka Abyadati, Dadi Rusdiana, Enjang Akhmad Juanda

Abstract:

This study aims to investigate the students’ mastery concepts enhancement between students who are studying by using Integrated Real-Life Video and Animation (IRVA) and students who are studying without using IRVA. The development of IRVA is conducted by five stages: Analyze, Design, Development, Implementation and Evaluation (ADDIE) based on constructivist for Rotational Dynamics material in Physics learning. A constructivist model-based learning used is Interpretation Construction (ICON), which has the following phases: 1) Observation, 2) Construction interpretation, 3) Contextualization prior knowledge, 4) Conflict cognitive, 5) Learning cognitive, 6) Collaboration, 7) Multiple interpretation, 8) Multiple manifestation. The IRVA is developed for the stages of observation, cognitive conflict and cognitive learning. The sample of this study consisted of 32 students experimental group and a control group of 32 students in class XI of the school year 2015/2016 in one of Senior High Schools Bandung. The study was conducted by giving the pretest and posttest in the form of 20 items of multiple choice questions to determine the enhancement of mastery concept of Rotational Dynamics. Hypothesis testing is done by using T-test on the value of N-gain average of mastery concepts. The results showed that there is a significant difference in an enhancement of students’ mastery concepts between students who are studying by using IRVA and students who are studying without IRVA. Students in the experimental group increased by 0.468 while students in the control group increased by 0.207.

Keywords: ADDIE, constructivist learning, Integrated Real-Life Video and Animation, mastery concepts, rotational dynamics

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Authors: Yi-Guang Li, Suresh Sampath

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Gas turbine performance degrades over time, and the degradation is greatly affected by environmental, ambient, and operating conditions. The engines may degrade slowly under favorable conditions and result in a waste of engine life if a scheduled maintenance scheme is followed. They may also degrade fast and fail before a scheduled overhaul if the conditions are unfavorable, resulting in serious secondary damage, loss of engine availability, and increased maintenance costs. To overcome these problems, gas turbine owners are gradually moving from scheduled maintenance to condition-based maintenance, where condition monitoring is one of the key supporting technologies. This paper presents an integrated adaptive GPA diagnostics and performance monitoring system developed at Cranfield University for gas turbine gas path condition monitoring. It has the capability to predict the performance degradation of major gas path components of gas turbine engines, such as compressors, combustors, and turbines, using gas path measurement data. It is also able to predict engine key performance parameters for condition monitoring, such as turbine entry temperature that cannot be directly measured. The developed technology has been implemented into digital twin computer Software, Pythia, to support the condition monitoring of gas turbine engines. The capabilities of the integrated GPA condition monitoring system are demonstrated in three test cases using a model gas turbine engine similar to the GE aero-derivative LM2500 engine widely used in power generation and marine propulsion. It shows that when the compressor of the model engine degrades, the Adaptive GPA is able to predict the degradation and the changing engine performance accurately using gas path measurements. Such a presented technology and software are generic, can be applied to different types of gas turbine engines, and provide crucial engine health and performance parameters to support condition monitoring and condition-based maintenance.

Keywords: gas turbine, adaptive GPA, performance, diagnostics, condition monitoring

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Authors: Osuagwu Justine Ugochukwu

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Investigating the effects of transformational and transactional leadership styles on the performance of healthcare employees at the University Teaching Hospital (UNTH) in Enugu, Nigeria, was the goal of the research. The respondents were asked to fill out a structured questionnaire. The respondents were chosen using a straightforward random sampling technique and consisted of 370 health workers at the hospital. The result of the analysis revealed that transactional and transformational leadership style has a positive while ambidextrous leadership has a negative effect on healthcare workers' performance in UNTH, Enugu. Therefore, the management of public hospitals that have the capacity to change their top management approach to leadership styles will gain substantial support from their employees’ thereby increasing organizational commitment and performance among health workers. This will have remarkable social implications, one of which is a change in the work culture and attitude of medical personnel from the seemingly anti-community of patients to friendly engagement and treatment of patients leading to a harmonious coexistence among these individuals in society. Investigating ambidextrous leadership and the use of nonparametric analysis is unique and has brought brand-new knowledge to leadership literature.

Keywords: workers performance, transformational leadership, transactional leadership, governance quality, ambidextrous leadership

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Authors: Harriet Bothwell, Lowri Evans, Kevin Jones

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Background: The University of Bristol provides all medical students the opportunity to undertake student selected components (SSCs) at multiple stages of the undergraduate programme. SSCs enable students to explore areas of interest that are not necessarily covered by the curriculum. Students are required to produce a written report and most use SSCs as an opportunity to undertake an audit or small research project. In 2013 Swindon Academy, based at the Great Western Hospital, offered eight students the opportunity of a global health SSC which included a two week trip to rural hospital in Uganda. This SSC has since expanded and in 2017 a total of 20 students had the opportunity to undertake small research projects at two hospitals in rural Uganda. 'Tomorrows Doctors' highlights the importance of understanding healthcare from a 'global perspective' and student feedback from previous SSCs suggests that self-assessed knowledge of global health increases as a result of this SSC. Through the most recent version of this SSC students had the opportunity to undertake projects in a wide range of specialties including paediatrics, palliative care, surgery and medical education. Methods: An anonymous online questionnaire was made available to students following the SSC. There was a response rate of 80% representing 16 out of the 20 students. This questionnaire surveyed students’ satisfaction and experience of the SSC including the level of academic, project and spiritual support provided as well as perceived challenges in completing the project and barriers to healthcare delivery in the low resource setting. This survey had multiple open questions allowing the collection of qualitative data. Further qualitative data was collected from the students’ project report. The suggested format included a reflection and all students completed these. All qualitative data underwent thematic analysis. Results: All respondents rated the overall experience of the SSC as 'good' or 'excellent'. Preliminary data suggest that students’ confidence in their knowledge of global health, diagnosis of tropical diseases and management of tropical diseases improved after completing this SSC. Thematic analysis of students' reflection is ongoing but suggests that students gain far more than improved knowledge of tropical diseases. Students reflect positively on having the opportunity to research in a low resource setting and feel that by completing these projects they will be 'useful' to the hospital. Several students reflect the stark contrast to healthcare delivery in the UK and recognise the 'privilege' of having a healthcare system that is free at the point of access. Some students noted the different approaches that clinicians in Uganda had to train in 'taking ownership' of their own learning. Conclusions: Students completing this SSC report increased knowledge of global health and tropical medicine. However, their reflections reveal much broader learning outcomes and demonstrate considerable insight in multiple topics including conducting research in the low resource setting, training and healthcare inequality.

Keywords: global health, medical education, student feedback, undergraduate

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Authors: Charlotte Bach, Albrecht Jahn, Mahnaz Motamedi, Maryam Karimi-Ghahfarokhi

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Background: Maternal and infant deaths are most prevalent in the first month after birth, emphasizing the critical need for quality healthcare services during this period. Immigrant women, who are more susceptible to adverse pregnancy outcomes, often face neglect in accessing proper healthcare. The lack of adequate postpartum care significantly contributes to mortality rates. Therefore, utilizing maternal health care services and implementing postpartum care is crucial in reducing maternal and child mortality. Aims: This study aims to evaluate the assessment of pre- and postnatal care among women with and without migration background. In addition, the study explores the impact of COVID-19 procedures on women's experiences during pregnancy, birth, and the postpartum period. Methods: This research employs a cross-sectional Mixed-Method design. Data collection was facilitated through structured questionnaires administered to participants, alongside the utilization of patient bases, including Maternity and child medical records. Following the assumption that the investigator aimed to gain comprehensive insights, qualitative sampling focused on individuals with substantial experiences related to COVID-19, regarded as rich cases. Results: our study highlighted the influence of educational level, marital status, and consensual partnerships on the likelihood of Cesarean deliveries. Regarding breastfeeding practices, migrant women exhibited higher rates of breastfeeding initiation and continuation. Contraception utilization revealed interesting patterns, with non-migrants displaying higher odds of contraceptive use. The qualitative component of our research adds depth to the exploration of women's experiences during the COVID-19 pandemic, revealing nuanced challenges related to anxiety, hospital restrictions, breastfeeding support, and postnatal ward routines. Conclusion: Dissimilarity among studies toward cesarean rate between migrants and non-migrants underscores the importance of targeted interventions considering the diverse needs of distinct population groups. It also acknowledges potential cultural, contextual, and healthcare system influences on the association between mode of delivery and infant feeding practices. Studies acknowledge the influence of contextual variables on contraceptive preferences among migrants and non-migrants, emphasizing the need for tailored healthcare policies. The findings contribute to existing research, highlighting the need for a nuanced understanding of the impact of birth preparation courses on maternal and infant outcomes. Furthermore, they emphasize the universality of certain maternity care experiences, regardless of pandemic contexts, reinforcing the importance of patient-centred approaches in healthcare delivery.

Keywords: migration background, pregnancy outcome, covid-19, postpartum

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Authors: Ju May Wen, Chun Hung Lin, Eric Zhi Feng Liu

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Flow theory implies that people are persuaded by happiness. By focusing on an activity, people turn a blind eye to external factors. This study explores the influence of educational board games and fundamental Chinese language teaching on students’ learning motivation and flow experience. Fifty-three students studying Chinese language fundamental courses were used in the study. These students were divided into three groups: (1) flash card teaching group; (2) educational original board game teaching group; and (3) educational Chinese board game teaching group. Chinese language teaching was integrated with the educational board game titled ‘Transportation GO.’ The students were observed playing this game as the teacher collected quantitative and qualitative data. Quantitative data was collected from the learning motivation scale and flow experience scale. Qualitative data was collected through observing, recording, and visiting. The first result found that the three groups integrated with Chinese language teaching could maintain students’ high learning motivation and high flow experience. Second, there was no significant difference between the flow experience of the flash card group and the educational original board game group. Third, there was a significant difference in the flow experience and learning motivation of the educational Chinese board game group vs. the other groups. This study suggests that the experimental model can be applied to advanced Chinese language teaching. Apart from oral and literacy skills, the study of educational board games integrated with Chinese language teaching to enforce student writing skills will be continued.

Keywords: Chinese language instruction, educational board game, learning motivation, flow experience

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Authors: Salihah Alghamdi, Surajit Ray

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Space-time data can be observed over irregularly shaped manifolds, which might have complex boundaries or interior gaps. Most of the existing methods do not consider the shape of the data, and as a result, it is difficult to model irregularly shaped data accommodating the complex domain. We used a method that can deal with space-time data that are distributed over non-planner shaped regions. The method is based on partial differential equations and finite element analysis. The model can be estimated using a penalized least squares approach with a regularization term that controls the over-fitting. The model is regularized using two roughness penalties, which consider the spatial and temporal regularities separately. The integrated square of the second derivative of the basis function is used as temporal penalty. While the spatial penalty consists of the integrated square of Laplace operator, which is integrated exclusively over the domain of interest that is determined using finite element technique. In this paper, we applied a spatio-temporal regression model with partial differential equations regularization (ST-PDE) approach to analyze a remote sensing data measuring the greenness of vegetation, measure by an index called enhanced vegetation index (EVI). The EVI data consist of measurements that take values between -1 and 1 reflecting the level of greenness of some region over a period of time. We applied (ST-PDE) approach to irregular shaped region of the EVI data. The approach efficiently accommodates the irregular shaped regions taking into account the complex boundaries rather than smoothing across the boundaries. Furthermore, the approach succeeds in capturing the temporal variation in the data.

Keywords: irregularly shaped domain, partial differential equations, finite element analysis, complex boundray

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