Search results for: healthcare costs

Authors: Vivianne Aggestam

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Purpose: Organic dairy products have steadily increased with consumer popularity in recent years in Sweden, permitting more transport activities. The main aim of this study was to compare the transport costs and the environmental emissions made by the organic and conventional dairy production in Sweden. The objective was to evaluate differences and environmental impacts of transport between the two different production systems, allowing a more transparent understanding of the real impact of transport within the supply chain. Methods: A partial attributional Life Cycle Assessment has been conducted based on a comprehensive survey of Swedish farmers, dairies and consumers regarding their transport needs and costs. Interviews addressed the farmers and dairies. Consumers were targeted through an online survey. Results: Higher transport inputs from conventional dairy transportation are mainly via feed and soil management on farm level. The regional organic milk brand illustrate less initial transport burdens on farm level, however, after leaving the farm, it had equal or higher transportation requirements. This was mainly due to the location of the dairy farm and shorter product expiry dates, which requires more frequent retail deliveries. Organic consumers tend to use public transport more than private vehicles. Consumers using private vehicles for shopping trips primarily bought conventional products for which price was the main deciding factor. Conclusions: Organic dairy products that emphasise its regional attributes do not ensure less transportation and may therefore not be a more “climate smart” option for the consumer. This suggests that the idea of localism needs to be analysed from a more systemic perspective. Fuel and regional feed efficiency can be further implemented, mainly via fuel type and the types of vehicles used for transport.

Keywords: supply chains, distribution, transportation, organic food productions, conventional food production, agricultural fossil fuel use

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Authors: Jisun Mo, Paola Boarin

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The impact of common buildings on climate and environment has prompted people to get involved in the green building standards aimed at implementing rating tools or certifications. Thus, green building rating systems were introduced to the construction industry, and the demand for certified green buildings has increased gradually and succeeded considerably in enhancing people’s environmental awareness. However, the existing certification process has been unsatisfactory in attracting stakeholders and/or professionals who are actively engaged in adopting a rating system. It is because they have faced recurring barriers regarding limited information in understanding the rating process, time-consuming procedures and higher costs, which have a direct influence on pursuing green building rating systems. To promote the achievement of green building certifications within the building industry more successfully, this paper aims at designing a Pre-Assessment Tool (PAT) framework that can help stakeholders and/or professionals engaged in the construction industry to clarify their basic knowledge, timeframe and extra costs needed to activate a green building certification. First, taking the first steps towards the rating tool seems to be complicated because of upfront commitment to understanding the overall rating procedure is required. This conceptual PAT framework can increase basic knowledge of the rating tool and the certification process, mainly in terms of all resources or information of each credit requirements. Second, the assessment process of rating tools is generally known as a “lengthy and time-consuming system”, contributing to unenthusiastic reactions concerning green building projects. The proposed framework can predict the timeframe needed to identify how long it will take for a green project to process each credit requirement and the documentation required from the beginning of the certification process to final approval. Finally, most people often have the initial perception that pursuing green building certification costs more than constructing a non-green building, which makes it more difficult to execute rating tools. To overcome this issue, this PAT will help users to estimate the extra expenses such as certification fees and third-party contributions based on the track of the amount of time it takes to implement the rating tool throughout all the related stages. Also, it can prevent unexpected or hidden costs occurring in the process of assessment. Therefore, this proposed PAT framework can be recommended as an effective method to support the decision-making of inexperienced users and play an important role in promoting green building certification.

Keywords: green building rating tools, Pre-Occupancy Evaluation (PrOE), client’s decision-making, certification

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Authors: Rasouli Divkalaee Zeinab, Kalteh Safa, Roudbari Aliakbar

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Introduction: Medical waste can lead to the generation and transmission of many infectious and contagious diseases due to the presence of pathogenic agents, thereby necessitating the need for special management to collect, decontaminate, and finally dispose of such products. This study aimed to design a centralized health care (medical) waste management program for the cities of Semnan, Mahdishahr, and Shahmirzad. Methods: This descriptive-analytical study was conducted for six months in the cities of Semnan, Mahdishahr, and Shahmirzad. In this study, the quantitative and qualitative characteristics of the generated wastes were determined by taking samples from all medical waste production centers. Then, the equipment, devices, and machines required for separate collection of the waste from the production centers and for their subsequent decontamination were estimated. Next, the investment costs, current costs, and working capital required for collection, decontamination, and final disposal of the wastes were determined. Finally, the payment for proper waste management of each category of medical waste-producing centers was determined. Results: 1021 kilograms of medical waste are produced daily in the cities of Semnan, Mahdishahr, and Shahmirzad. It was estimated that a 1000-liter autoclave, a machine for collecting medical waste, four 60-liter bins, four 120-liter bins, and four 1200-liter bins were required for implementing the study plan. Also, the estimated total annual medical waste management costs for Semnan City were determined (23,283,903,720 Iranian Rials). Conclusion: The study results showed that establishing a proper management system for medical wastes generated in the three studied cities will cost between 334,280 and 1,253,715 Iranian Rials in fees for the medical centers. The findings of this study provided comprehensive data regarding medical wastes from the generation point to the landfill site, which is vital for the government and the private sector.

Keywords: clinics, decontamination, management, medical waste

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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 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: Allison Herlene Du Plessis, Dalena (R.M.) Van Rooyen, Wilma Ten Ham-Baloyi, Sihaam Jardien-Baboo

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Introduction: Women die in pregnancy and childbirth for five main reasons—severe bleeding, infections, unsafe abortions, hypertensive disorders (pre-eclampsia and eclampsia), and medical complications including cardiac disease, diabetes, or HIV/AIDS complicated by pregnancy. In 2015, WHO classified sepsis as the third highest cause for maternal mortalities in the world. Chorioamnionitis is a clinical syndrome of intrauterine infection during any stage of the pregnancy and it refers to ascending bacteria from the vaginal canal up into the uterus, causing infection. While the incidence rates for chorioamnionitis are not well documented, complications related to chorioamnionitis are well documented and midwives still struggle to identify this condition in time due to its complex nature. Few diagnostic methods are available in public health services, due to escalated laboratory costs. Often the affordable biomarkers, such as C-reactive protein CRP, full blood count (FBC) and WBC, have low significance in diagnosing chorioamnionitis. A lack of screening impacts on effective and timeous management of chorioamnionitis, and early identification and management of risks could help to prevent neonatal complications and reduce the subsequent series of morbidities and healthcare costs of infants who are health foci of perinatal infections. Objective: This integrative literature review provides an overview of current best research evidence on the screening of women at risk for chorioamnionitis. Design: An integrative literature review was conducted using a systematic electronic literature search through EBSCOhost, Cochrane Online, Wiley Online, PubMed, Scopus and Google. Guidelines, research studies, and reports in English related to chorioamnionitis from 2008 up until 2020 were included in the study. Findings: After critical appraisal, 31 articles were included. More than one third (67%) of the literature included ranked on the three highest levels of evidence (Level I, II and III). Data extracted regarding screening for chorioamnionitis was synthesized into four themes, namely: screening by clinical signs and symptoms, screening by causative factors of chorioamnionitis, screening of obstetric history, and essential biomarkers to diagnose chorioamnionitis. Key conclusions: There are factors that can be used by midwives to identify women at risk for chorioamnionitis. However, there are a paucity of established sociological, epidemiological and behavioral factors to screen this population. Several biomarkers are available to diagnose chorioamnionitis. Increased Interleukin-6 in amniotic fluid is the better indicator and strongest predictor of histological chorioamnionitis, whereas the available rapid matrix-metalloproteinase-8 test requires further testing. Maternal white blood cells count (WBC) has shown poor selectivity and sensitivity, and C-reactive protein (CRP) thresholds varied among studies and are not ideal for conclusive diagnosis of subclinical chorioamnionitis. Implications for practice: Screening of women at risk for chorioamnionitis by health care providers providing care for pregnant women, including midwives, is important for diagnosis and management before complications arise, particularly in resource-constraint settings.

Keywords: chorioamnionitis, guidelines, best evidence, screening, diagnosis, pregnant women

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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: M. Feliciano, F. Rodrigues, A. Gonçalves, J. M. R. C. A. Santos, V. Leite

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With the objective of characterizing the profile and performance of energy use by slaughterhouses, surveys and audits were performed in two different facilities located in the northeastern region of Portugal. Energy consumption from multiple energy sources was assessed monthly, along with production and costs, for the same reference year. Gathered data was analyzed to identify and quantify the main consuming processes and to estimate energy efficiency indicators for benchmarking purposes. Main results show differences between the two slaughterhouses concerning energy sources, consumption by source and sector, and global energy efficiency. Electricity is the most used source in both slaughterhouses with a contribution of around 50%, being essentially used for meat processing and refrigeration. Natural gas, in slaughterhouse A, and pellets, in slaughterhouse B, used for heating water take the second place, with a mean contribution of about 45%. On average, a 62 kgoe/t specific energy consumption (SEC) was found, although with differences between slaughterhouses. A prominent negative correlation between SEC and carcass production was found specially in slaughterhouse A. Estimated Specific Energy Cost and Greenhouse Gases Intensity (GHGI) show mean values of about 50 €/t and 1.8 tCO2e/toe, respectively. Main results show that there is a significant margin for improving energy efficiency and therefore lowering costs in this type of non-energy intensive industries.

Keywords: meat industry, energy intensity, energy efficiency, GHG emissions

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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: Ángel de J. López-Pérez, Sonia E. Ruiz, Vanessa A. Segovia

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Buildings vulnerability due to seismic activity has been highly studied since the middle of last century. As a solution to the structural and non-structural damage caused by intense ground motions, several seismic energy dissipating devices, such as buckling-restrained braces (BRB), have been proposed. BRB have shown to be effective in concentrating a large portion of the energy transmitted to the structure by the seismic ground motion. A design approach for buildings with BRB elements, which is based on a seismic Displacement-Based formulation, has recently been proposed by the coauthors in this paper. It is a practical and easy design method which simplifies the work of structural engineers. The method is used here for the design of the structure-BRB damper system. The objective of the present study is to extend and apply a methodology to find the best combination of design parameters on multiple-degree-of-freedom (MDOF) structural frame – BRB systems, taking into account simultaneously: 1) initial costs and 2) an adequate engineering demand parameter. The design parameters considered here are: the stiffness ratio (α = K_frame/K_total), and the strength ratio (γ = V_damper/V_total); where K represents structural stiffness and V structural strength; and the subscripts "frame", "damper" and "total" represent: the structure without dampers, the BRB dampers and the total frame-damper system, respectively. The selection of the best combination of design parameters α and γ is based on an initial costs analysis and on the structural dynamic response of the structural frame-damper system. The methodology is applied to a 12-story 5-bay steel building with BRB, which is located on the intermediate soil of Mexico City. It is found the best combination of design parameters α and γ for the building with BRB under study.

Keywords: best combination of design parameters, BRB, buildings with energy dissipating devices, buckling-restrained braces, initial costs

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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: Desiree Vandenberghe, Johan Albrecht

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Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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Authors: Rusne Kregzdaite

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The value of the cultural sector stems from the symbolic exploration that differentiates cultural organisations from other product or service organisations. As a result, the cultural sector has a dual impact on the socio-economic system: the economic value (expressed in terms of market relations) created influences the dynamics of the country's financial indicators, while the cultural (non-market) value indirectly contributes to the welfare of the state through changes in societal values, creativity transformations and cultural needs of the country. Measurement of indirect (cultural value) impacts is difficult, but in the case of the cultural sector (especially when it comes to economically inefficient state-funded culture), it helps to reveal the essential characteristics of the sector. The study aims to analyze the value of cultural organisations that are invisible in market processes and to base it on quantified calculations. This was be done by analyzing the usefulness of the consumer, incorporating not only the price paid but also the social and cultural decision-making factors that determine the spectator's choice (time dedicated for a visit, additional costs, content, previous experiences, corporate image). This may reflect the consumer's real choice to consume (all the costs he incurs may be considered the financial equivalent of his experience with the cultural establishment). The research methodology was tested by analyzing the performing arts sector and applying methods to the Lithuanian national drama theatre case. The empirical research consisted of a survey (more than 800 participants) of Lithuanian national drama theatre visitors to different performances. The willingness to pay and travel costs methods were used. Analysis of different performances lets identifies the factor that increases willingness to pay for the performance and affects theatre attendance. The research stresses the importance of cultural value and social perspective of the cultural sector and relates it to the discussions of public funding of culture.

Keywords: cultural economics, performing arts, willingness to pay, travel cost analysis, performing arts management

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Authors: Samera Salimpour Abkenar

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In traditional dyeing of natural fibers with natural dyes, metal salts are commonly used to increase color stability. This method always carries the risk of environmental pollution (contamination of arable soils and fresh groundwater) due to the release of dyeing effluents containing large amounts of metal. Therefore, researchers are always looking for new methods to obtain a green dyeing system. In this research, the use of the enzymatic dyeing method to prevent environmental pollution with metals and reduce production costs has been proposed. After degumming and bleaching, raw silk fabrics were dyed with natural dyes (Madder and Sumac) by three methods (pre-mordanting with a metal salt, one-step enzymatic dyeing, and two-step enzymatic dyeing). Results show that silk dyed with natural dyes by the enzymatic method has higher color strength and colorfastness than the pretreated with a metal salt. Also, the amount of remained dyes in the dyeing wastewater is significantly reduced by the enzymatic method. It is found that the enzymatic dyeing method leads to improvement of dye absorption, color strength, soft hand, no change in color shade, low production costs (due to low dyeing temperature), and a significant reduction in environmental pollution.

Keywords: eco-friendly, natural dyes, silk, traditional dyeing

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Authors: Luca Bertola, Tom Cox, Pat Wheeler, Seamus Garvey, Herve Morvan

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Electromagnetic launch systems have been proposed for military applications to accelerate jet planes on aircraft carriers. This paper proposes the implementation of similar technology to aid civil aircraft take-off, which can provide significant economic, environmental and technical benefits. Assisted launch has the potential of reducing ground noise and emissions near airports and improving overall aircraft efficiency through reducing engine thrust requirements. This paper presents a take-off performance analysis for an Airbus A320-200 taking off with and without the assistance of the electromagnetic catapult. Assisted take-off allows for a significant reduction in take-off field length, giving more capacity with existing airport footprints and reducing the necessary footprint of new airports, which will both reduce costs and increase the number of suitable sites. The electromagnetic catapult may allow the installation of smaller engines with lower rated thrust. The consequent fuel consumption and operational cost reduction are estimated. The potential of reducing the aircraft operational costs and the runway length required making electromagnetic launch system an attractive solution to the air traffic growth in busy airports.

Keywords: electromagnetic launch, fuel consumption, take-off analysis, weight reduction

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Authors: Mirian Graciella Dalla Porta, Humberto Jorge José, Danielle de Bem Luiz, Regina de F. P. M.Moreira

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Similar to most processing industries, fish processing produces large volumes of wastewater, which contains especially organic contaminants, salts and oils dispersed therein. Different processes have been used for the treatment of fishery wastewaters, but the most commonly used are chemical coagulation and flotation. These techniques are well known but sometimes the characteristics of the treated effluent do not comply with legal standards for discharge. Electrocoagulation (EC) is an electrochemical process that can be used to treat wastewaters in terms of both organic matter and nutrient removal. The process is based on the use of sacrificial electrodes such as aluminum, iron or zinc, that are oxidized to produce metal ions that can be used to coagulate and react with organic matter and nutrients in the wastewater. While EC processes are effective to treatment of several types of wastewaters, applications have been limited due to the high energy demands and high current densities. Generally, the for EC process can be performed without additional chemicals or pre-treatment, but the costs should be reduced for EC processes to become more applicable. In this work, we studied the treatment of a real wastewater from fishmeal industry by electrocoagulation process. Removal efficiencies for chemical oxygen demand (COD), total organic carbon (TOC) turbidity, phosphorous and nitrogen concentration were determined as a function of the operating conditions, such as pH, current density and operating time. The optimum operating conditions were determined to be operating time of 10 minutes, current density 100 A.m-2, and initial pH 4.0. COD, TOC, phosphorous concentration, and turbidity removal efficiencies at the optimum operating conditions were higher than 90% for aluminum electrode. Operating costs at the optimum conditions were calculated as US$ 0.37/m3 (US$ 0.038/kg COD) for Al electrode. These results demonstrate that the EC process is a promising technology to remove nutrients from fishery wastewaters, as the process has both a high efficiency of nutrient removal, and low energy requirements.

Keywords: electrocoagulation, fish, food industry, wastewater

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Authors: Chithra A. V., Somoshree Datta, Sandeep Nithyanandan

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Sign Language Recognition (SLR) is the process of interpreting and translating sign language into spoken or written language using technological systems. It involves recognizing hand gestures, facial expressions, and body movements that makeup sign language communication. The primary goal of SLR is to facilitate communication between hearing- and speech-impaired communities and those who do not understand sign language. Due to the increased awareness and greater recognition of the rights and needs of the hearing- and speech-impaired community, sign language recognition has gained significant importance over the past 10 years. Technological advancements in the fields of Artificial Intelligence and Machine Learning have made it more practical and feasible to create accurate SLR systems. This paper presents a distinct approach to SLR by framing it as a video classification problem using Deep Learning (DL), whereby a combination of Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs) has been used. This research targets the integration of sign language recognition into healthcare settings, aiming to improve communication between medical professionals and patients with hearing impairments. The spatial features from each video frame are extracted using a CNN, which captures essential elements such as hand shapes, movements, and facial expressions. These features are then fed into an RNN network that learns the temporal dependencies and patterns inherent in sign language sequences. The INCLUDE dataset has been enhanced with more videos from the healthcare domain and the model is evaluated on the same. Our model achieves 91% accuracy, representing state-of-the-art performance in this domain. The results highlight the effectiveness of treating SLR as a video classification task with the CNN-RNN architecture. This approach not only improves recognition accuracy but also offers a scalable solution for real-time SLR applications, significantly advancing the field of accessible communication technologies.

Keywords: sign language recognition, deep learning, convolution neural network, recurrent neural network

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Authors: Nasim Babazadeh

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Growing demand for a quieter dwelling environment has turned the attention of construction companies to reducing the propagated noise of their project. In inner-city constructions, close distance between the construction site and surrounding buildings lessens the efficiency of passive noise control methods. Dwellers of the nearby areas may file complaints and lawsuits against the construction companies due to the emitted construction noise, thereby leading to the interruption of processes, compensation costs, or even suspension of the project. Therefore, construction noise should be predicted along with the project schedule. The advantage of managing the noise in the pre-construction phase is two-fold. Firstly, changes in the time plan and construction methods can be applied more flexibly. Thus, the costs related to rescheduling can be avoided. Secondly, noise-related legal problems are expected to be reduced. To implement noise mapping methods for the mentioned prediction, the required detailed information (such as the location of the noisy process, duration of the noisy work) can be exported from the 4D BIM model. The results obtained from the noise maps would be used to help the planners to define different work scenarios. The proposed approach has been applied for the foundation and earthwork of a site located in a residential area, and the obtained results are discussed.

Keywords: building information modeling, construction noise management, noise mapping, 4D BIM

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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: 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: Indrani Gupta, Leena Vachasiddha, Rakesh Kumar

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Municipal Corporation of Greater Mumbai intends to undertake Mumbai Sewage Disposal (MSDP) for improvement of environment in and around Mumbai city. Sewage generated from the city currently gets partly into the inadequate collection system for treatment and the rest into nearby marine water body through drains. This paper addresses the cost benefit analysis of MSDP works for better compliance of sewage treatment and disposal. Cost benefit analysis indicates that the investment in sewage treatment is economically beneficial and will provide immense social, environmental, health and economic benefits. Monetary values of positive benefits such as avoided health costs, enhanced fish catches and improved tourism have been quantified. The total capital cost of the project is estimated to be about INR 51,510 million and operation and maintenance cost is about INR 2240.6 million per year. The cost benefit analysis indicates that a benefit of about 25,882 million per year can be achieved due to the implementation of this project. Other than these benefits, better marine ecosystem quality; higher property cost; improved recreational opportunities were not included because of lack of information.

Keywords: waste water treatment, cost-benefit analysis, health, tourism, fisheries

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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: Harun Aydilek, Asiye Aydilek, Ali Allahverdi

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The total tardiness is a widely used performance measure in the scheduling literature. This performance measure is particularly important in situations where there is a cost to complete a job beyond its due date. The cost of scheduling increases as the gap between a job's due date and its completion time increases. Such costs may also be penalty costs in contracts, loss of goodwill. This performance measure is important as the fulfillment of due dates of customers has to be taken into account while making scheduling decisions. The problem is addressed in the literature, however, it has been assumed zero setup times. Even though this assumption may be valid for some environments, it is not valid for some other scheduling environments. When setup times are treated as separate from processing times, it is possible to increase machine utilization and to reduce total tardiness. Therefore, non-zero setup times need to be considered as separate. A dominance relation is developed and several algorithms are proposed. The developed dominance relation is utilized in the proposed algorithms. Extensive computational experiments are conducted for the evaluation of the algorithms. The experiments indicated that the developed algorithms perform much better than the existing algorithms in the literature. More specifically, one of the newly proposed algorithms reduces the error of the best existing algorithm in the literature by 40 percent.

Keywords: algorithm, assembly flowshop, dominance relation, total tardiness

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Authors: Usman Asif, Klaus Schmidt

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In recent years, the development of alternate fuel vehicles has helped to reduce carbon emissions worldwide. As the number of vehicles will continue to increase in the future, the energy demand will also increase. Therefore, we must consider automotive technologies that are efficient and less harmful to the environment in the long run. Battery Electric Vehicles (BEVs) have gained popularity in recent years because of their lower maintenance, lower fuel costs, and lower carbon emissions. Nevertheless, BEVs show several disadvantages, such as slow charging times and lower range than traditional combustion-powered vehicles. These factors keep many people from switching to BEVs. The authors of this research believe that these limitations can be overcome by using fuel cell technology. Fuel cell technology converts chemical energy into electrical energy from hydrogen power and therefore serves as fuel to power the motor and thus replacing heavy lithium batteries that are expensive and hard to recycle. Also, in contrast to battery-powered electric vehicle technology, Fuel Cell Electric Vehicles (FCEVs) offer higher ranges and lower fuel-up times and therefore are more competitive with electric vehicles. However, FCEVs have not gained the same popularity as electric vehicles due to stringent legal frameworks, underdeveloped infrastructure, high fuel transport, and storage costs plus the expense of fuel cell technology itself. This research will focus on the legal frameworks for hydrogen-powered vehicles, and how a change in these policies may affect and improve hydrogen fueling infrastructure and lower hydrogen transport and storage costs. These policies may also facilitate reductions in fuel cell technology costs. In order to attain a better framework, a number of countries have developed conceptual roadmaps. These roadmaps have set out a series of objectives to increase the access of FCEVs to their respective markets. This research will specifically focus on policies in Japan, Europe, and the USA in their attempt to shape the automotive industry of the future. The researchers also suggest additional policies that may help to accelerate the advancement of FCEVs to mass-markets. The approach was to provide a solid literature review using resources from around the globe. After a subsequent analysis and synthesis of this review, the authors concluded that in spite of existing legal challenges that have hindered the advancement of fuel-cell technology in the automobile industry in the past, new initiatives that enhance and advance the very same technology in the future are underway.

Keywords: fuel cell electric vehicles, fuel cell technology, legal frameworks, policies and regulations

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Authors: İbrahi̇m Kara, Seher Arslankaya

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Frequently preferred in the field of engineering in particular, data mining has now begun to be used in the field of health as well since the data in the health sector have reached great dimensions. With data mining, it is aimed to reveal models from the great amounts of raw data in agreement with the purpose and to search for the rules and relationships which will enable one to make predictions about the future from the large amount of data set. It helps the decision-maker to find the relationships among the data which form at the stage of decision-making. In this study, it is aimed to determine the risk of heart attack at the first stage, to control it, and to make its resource planning with the method of data mining. Through the early and correct diagnosis of heart attacks, it is aimed to reveal the factors which affect the diseases, to protect health and choose the right treatment methods, to reduce the costs in health expenditures, and to shorten the durations of patients’ stay at hospitals. In this way, the diagnosis and treatment costs of a heart attack will be scrutinized, which will be useful to determine the risk of the disease at the first stage, to control it, and to make its resource planning.

Keywords: data mining, decision support systems, heart attack, health sector

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Authors: Nahid Hassanshahi, Ayoub Karimi-Jashni, Nasser Talebbeydokhti

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Due to the economic and environmental benefits of producing less waste, the US Environmental Protection Agency (EPA) introduces source reduction as one of the most important means to deal with the problems caused by increased landfills and pollution. Waste reduction involves all waste management methods, including source reduction, recycling, and composting, which reduce waste flow to landfills or other disposal facilities. Source reduction of waste can be studied from two perspectives: avoiding waste production, or reducing per capita waste production, and waste deviation that indicates the reduction of waste transfer to landfills. The present paper has investigated home composting as a managerial solution for reduction of waste transfer to landfills. Home composting has many benefits. The use of household waste for the production of compost will result in a much smaller amount of waste being sent to landfills, which in turn will reduce the costs of waste collection, transportation and burial. Reducing the volume of waste for disposal and using them for the production of compost and plant fertilizer might help to recycle the material in a shorter time and to use them effectively in order to preserve the environment and reduce contamination. Producing compost in a home-based manner requires very small piece of land for preparation and recycling compared with other methods. The final product of home-made compost is valuable and helps to grow crops and garden plants. It is also used for modifying the soil structure and maintaining its moisture. The food that is transferred to landfills will spoil and produce leachate after a while. It will also release methane and greenhouse gases. But, composting these materials at home is the best way to manage degradable materials, use them efficiently and reduce environmental pollution. Studies have shown that the benefits of the sale of produced compost and the reduced costs of collecting, transporting, and burying waste can well be responsive to the costs of purchasing home compost machine and the cost of related trainings. Moreover, the process of producing home compost may be profitable within 4 to 5 years and as a result, it will have a major role in reducing waste management.

Keywords: compost, home compost, reducing waste, waste management

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Authors: Garcia J., Garcia S., Sanz D. S., Trueba A.

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The marine biofouling phenomenon is the undesirable accumulation of biological matter on the surfaces of submerged floating or fixed structures and ship hulls. The roughness increased on the ship hull surface is directly related to biofouling growth which directly affects other factors that will make the ship's performance suboptimal, such as increased resistance to advance, fuel consumption increase, higher pollutant gas emissions, freight costs and maintenance costs. Antifouling paints follow a co-polymer approach where a biocide compound is embedded within a resin by which, through interaction with water, a constant release rate of settlement-inhibiting organo-metals and biocide is achieved. This study evaluates the action of biofouling on ship hull surfaces with different enamel coatings. The coatings were tested in a real environment according to ASTM D4939-89. The results obtained corroborated that the behaviour of ship hulls with enamel coatings maintained the antifouling properties intact compared to conventional paints during the experiment. The CFD results show that the drag in hulls coated with conventional paint is 22% greater than that in hulls with enamel coating.

Keywords: biofouling, coating, hull ship, enamel, antifouling

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