Search results for: Safety compliance

Authors: Shu Hwang Ang, Choo Yee Yu, Geik Yong Ang, Yean Yean Chan, Yatimah Binti Alias, And Sook Mei Khor

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With the high prevalence of Type 2 diabetes mellitus across the world, the morbidities and mortalities associated with Type 2 diabetes have significant impact on the production line for a nation. With routine scheduled clinical visits to manage Type 2 diabetes, diabetic patients with hectic lifestyles can have low clinical compliance. Hence, it often decreases the effectiveness of diabetic management personalized for each diabetic patient. Here, we report a useful developed point-of-care (POC) device that detect glycated hemoglobin (HbA1c, biomarker for long-term Type 2 diabetic management). In fact, the established POC devices certified to be used in clinical setting are not only expensive ($ 8 to $10 per test), they also require skillful practitioners to perform sampling and interpretation. As a paper-based biosensor, the developed HbA1c biosensor utilized lateral flow principle to offer an alternative for cost-effective (approximately $2 per test) and end-user friendly device for household testing. Requiring as little as 2 L of finger-picked blood, the test can be performed at the household with just simple dilution and washings. With visual interpretation of numbers of test lines shown on the developed biosensor, it can be interpreted as easy as a urine pregnancy test, aided with scale of intensity provided. In summary, the developed HbA1c immunosensor has been tested to have high selectivity towards HbA1c, and is stable with reasonably good performance in clinical testing. Therefore, our developed HbA1c immunosensor has high potential to be an effective diabetic management tool to increase patient compliance and thus contain the progression of the diabetes.

Keywords: blood, glycated hemoglobin (HbA1c), lateral flow, type 2 diabetes mellitus

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Authors: Ladda Her, Juntip Kanjanasilp, Ratree Sawangjit, Nathorn Chaiyakunapruk

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Cough is the common symptom of the respiratory tract infections or non-infections; the duration of cough indicates a classification and severity of disease. Herbal medicines can be used as the alternative to drugs for relief of cough symptoms from acute and chronic disease. Eucalyptus was used for reducing cough with evidences suggesting it has an active role in reduction of airway inflammation. The present study aims to evaluate efficacy and safety of eucalyptus for relief of cough symptom in respiratory disease. Method: The Cochrane Library, MEDLINE (PubMed), Scopus, CINAHL, Springer, Science direct, ProQuest, and THAILIS databases. From its inception until 01/02/2019 for randomized control trials. We follow for the efficacy and safety of eucalyptus for reducing cough. Methodological quality was evaluated by using the Cochrane risk of bias tool; two reviewers in our team screened eligibility and extracted data. Result: Six studies were included for the review and five studies were included in the meta-analysis, there were 1.911 persons including children (n: 1) and adult (n: 5) studies; for study in children and adult were between 1 and 80 years old, respectively. Eucalyptus was used as mono herb (n: 2) and in combination with other herbs form (n: 4). All of the studies with eucalyptus were compared for efficacy and safety with placebo or standard treatment, Eucalyptus dosage form in studies included capsules, spray, and syrup. Heterogeneity was 32.44 used random effect model (I² = 1.2%, χ² = 1.01; P-value = 0.314). The efficacy of eucalyptus was showed a reduced cough symptom statistically significant (n = 402, RR: 1.40, 95%CI [1.19, 1.65], P-value < 0.0001) when compared with placebo. Adverse events (AEs) were reported mild to moderate intensity with mostly gastrointestinal symptom. The methodological quality of the included trials was overall poor. Conclusion: Eucalyptus appears to be beneficial and safe for relieving in respiratory diseases focus on cough frequency. The evidence was inconclusive due to limited quality trial. Well-designed trials for evaluating the effectiveness in humans, the effectiveness for reducing cough symptom in human is needed. Eucalyptus had safety as monotherapy or in combination with other herbs.

Keywords: cough, eucalyptus, cineole, herbal medicine, systematic review, meta-analysis

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Authors: Haruna Seidu, Francis Wilson Owusu, Michael Mensah, Felix Boakye, James Korang, Safia Ibrahim

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Over the years, wooden furniture produced in Ghana had no means of testing their products against standards. It was therefore difficult for such furniture producers to know whether their products conform to international standards. The setting up of the ISO 17025 compliant laboratory has become a reference and accessing point for determining the quality of the furniture they produce. The objective of the study includes the determination of mechanical safety, durability, strength, and stability of wooden furniture produced in Ghana. Twelve wooden furniture manufacturers were randomly selected to design furniture (chairs and tables) for testing. 9 out of the 12 produced chairs, and three provided tables. Standard testing methods were used in this experiment, including GS EN 581-1, GS EN 581-2, and GS EN 581-3. The test results analysis indicates 55.6% of the chairs tested passed all applicable tests. 66.7% of tables tested passed all the applicable tests. The percentage pass and failure of the 12 furniture were 58.3% and 41.7% respectively. In conclusion, chair manufacturers had good designs that withstand the standard testing of strength and durability; most failures occurred largely as a result of poor stability designs adopted for the construction of the chairs and tables. It was observed that the manufacturers did not use the software in designing their furniture.

Keywords: durability, international standards, mechanical safety, wooden furniture design

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Authors: Max Butler

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Melanoma accounts for 80% of skin cancer-related deaths globally. The poor prognosis and increasing incidence of melanoma impose a significant burden on global healthcare systems. Early detection, precise diagnosis, and preventative strategies are critical to improving patient outcomes. Dermoscopy is the gold standard for specialist assessments of pigmented skin lesions, as it can differentiate between benign and malignant growths with greater accuracy than visual inspection. In the United Kingdom, guidelines from the National Institute of Clinical Excellence (NICE) state dermoscopy should be used in all specialist assessments of pigmented skin lesions. Compliance with this guideline is low, resulting in missed and delayed melanoma diagnoses. To address this problem, a quality improvement project was initiated at Buckinghamshire Healthcare Trust (BHT) within the plastic surgery department. The target group was a trainee and consultant plastic surgeons conducting outpatient skin cancer clinics. Analysis of clinic documentation over a one-month period found that only 62% (38/61) of patients referred with pigmented skin lesions were examined using dermoscopy. To increase dermoscopy rates, teaching was delivered to the department highlighting national guidelines and the evidence base for dermoscopic examination. In addition, clinic paperwork was redesigned to include a text box for dermoscopic examination. Reauditing after the intervention found a significant increase in dermoscopy rates (52/61, p = 0.014). In conclusion, implementing a quality improvement project with targeted teaching and documentation template templates successfully increased dermoscopy rates. This is a promising step toward improving early melanoma detection and patient outcomes.

Keywords: melanoma, dermoscopy, plastic surgery, quality improvement

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Authors: Jan Karl, Ondrej Suchy, Eliska Fiserova, Milan Ruzicka

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The evolving electromobility and all the electronics also bring an increase of danger with used Li-batteries. Li-batteries have been used in many industries, and currently many types of the batteries are available. Batteries have different compositions that affect their behavior. In the field of Li-battery safety, there are some areas of little discussion, such as extinguishing of fires caused by Li-batteries as well as toxicity of gaseous compounds released from Li batteries, transport or storage. Technical Institute of Fire Protection, which is a part of Fire Brigades of the Czech Republic, is dealing with the safety of Li batteries. That is the reason why we are dealing with toxicity of gaseous compounds released under conditions of fire, mechanical damage, overcharging and other emergencies that may occur. This is necessary for protection of intervening of fire brigade units, people in the vicinity and other envirnomental consequences. In this work, different types of batteries (Li-ion, Li-Po, LTO, LFP) with different kind of damage were tested, and the toxicity and total amount of released gases were studied. These values were evaluated according to their environmental hazard. FTIR spectroscopy was used for the evaluation of toxicity. We used a FTIR gas cell for continuous measurement. The total amount of released gases was determined by collecting the total gas phase through the absorbers and then determining the toxicants absorbed into the solutions. Based on the obtained results, it is possible to determine the protective equipment necessary for the event of an emergency with a Li-battery, to define the environmental load and the immediate danger in an emergency.

Keywords: Li-battery, toxicity, gaseous toxic compounds, FTIR spectroscopy

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Authors: Karl Bryant Buan, Owaida Macadadaya Jr., Mon Eleazar Nonato, Zeke Andrew Palabrica, Charistabelle Mae Santiago

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This study explored the occupational health risks faced by employees in the Business Process Outsourcing (BPO) industry, particularly in the Telco Account department of Alorica. The study used a stratified sampling method and a diagnostic tool called Workplace Integrated Safety and Health (WISH) Assessment to measure and evaluate the employees' perception of workplace health and safety. The results showed that more than 50% of call center workers reported feeling emotionally drained, sleep deprived, burnt out, and in need of anxiety or stress medication due to their work. Additionally, there was a significant difference in the perception of employee diversity, specifically in terms of leadership commitment, participation, policies, programs, and practices. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) results revealed that most employees complained of discomfort in their lower back, shoulder, upper back, neck, and hip. The researchers recommended an implementation plan for alternative work set-up, a satisfaction survey for employees, team-building activities or programs, and motivational approaches through benefits, incentives, and rewards.

Keywords: WISH assessment, CMDQ, ANOVA, diverse SOGIESC

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Authors: Nditsheni Ramakuela, Sonto Maputle, Base Khoza, Augustine Tugli

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Inadequate health literacy can cause difficulties in understanding and compliance to treatment plan. With diabetic condition, self-care activities include behaviours of following a diet plan, avoiding high fat foods, increased exercise, self-glucose monitoring, and foot care. Patients with poor health literacy have difficulty interpreting medication warning labels, following directions on a prescription label and identifying their medications. Difficulties in understanding and performing self-care and health-related activities may ultimately lead to poor health outcomes. The study explored and described factors affecting health literacy and self-care to diabetic regimen by female patients at selected hospital in Limpopo Province of South Africa. Qualitative and explorative research design was used. Female patients who were admitted and diagnosed with diabetes in female medical ward constituted the study population. Non-probability, purposive sampling was used to select 20 female patients diagnosed with diabetes, who were above 18 years and admitted during April–November 2014. An in-depth face-to-face, unstructured interview was used to collect data. Data were analysed using open coding method. Measures to ensure trustworthiness and ethical considerations were adhered to. Findings revealed factors affecting health literacy for diabetic self-care activities amongst patients were; patient, family, disease and facility related. Proposed recommendations were; to strengthen diabetes education and patient-provider partnership. This is important and must be transferred to strengthen self-care activities to fully benefit the patient.

Keywords: compliance, diabetes mellitus, diabetic regimen, health literacy, self activities

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Authors: Gary Young, David Zepeda, Gilbert Nyaga

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This study investigated whether vertical integration of hospitals and physicians is associated with better care for patients with cardiac conditions. A dramatic change in the U.S. hospital industry is the integration of hospital and physicians through hospital acquisition of physician practices. Yet, there is little evidence regarding whether this form of vertical integration leads to better operational performance of hospitals. The study was conducted as an observational investigation based on a pooled, cross-sectional database. The study sample comprised over hospitals in the State of California. The time frame for the study was 2010 to 2012. The key performance measure was hospitals’ degree of compliance with performance criteria set out by the federal government for managing patients with cardiac conditions. These criteria relate to the types of clinical tests and medications that hospitals should follow for cardiac patients but hospital compliance requires the cooperation of a hospital’s physicians. Data for this measure was obtained from a federal website that presents performance scores for U.S. hospitals. The key independent variable was the percentage of cardiologists that a hospital employs (versus cardiologists who are affiliated but not employed by the hospital). Data for this measure was obtained from the State of California which requires hospitals to report financial and operation data each year including numbers of employed physicians. Other characteristics of hospitals (e.g., information technology for cardiac care, volume of cardiac patients) were also evaluated as possible complements or substitutes for physician employment by hospitals. Additional sources of data included the American Hospital Association and the U.S. Census. Empirical models were estimated with generalized estimating equations (GEE). Findings suggest that physician employment is positively associated with better hospital performance for cardiac care. However, findings also suggest that information technology is a substitute for physician employment.

Keywords: physician employment, hospitals, verical integration, cardiac care

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Authors: Margarida Porfírio Tomás, Paula Pereira, José Palma Oliveira

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Robotic grasping is advancing rapidly, but transferring techniques from rigid to deformable objects remains a challenge. Deformable and flexible items, such as food containers, demand nuanced handling due to their changing shapes. Bridging this gap is crucial for applications in food processing, surgical robotics, and household assistance. AGILEHAND, a Horizon project, focuses on developing advanced technologies for sorting, handling, and packaging soft and deformable products autonomously. These technologies serve as strategic tools to enhance flexibility, agility, and reconfigurability within the production and logistics systems of European manufacturing companies. Key components include intelligent detection, self-adaptive handling, efficient sorting, and agile, rapid reconfiguration. The overarching goal is to optimize work environments and equipment, ensuring both efficiency and safety. As new technologies emerge in the food industry, there will be some implications, such as labour force, safety problems and acceptance of the new technologies. To overcome these implications, AGILEHAND emphasizes the integration of social sciences and humanities, for example, the application of the Technology Acceptance Model (TAM). The project aims to create a change management manual, that will outline strategies for developing digital skills and managing health and safety transitions. It will also provide best practices and models for organizational change. Additionally, AGILEHAND will design effective training programs to enhance employee skills and knowledge. This information will be obtained through a combination of case studies, structured interviews, questionnaires, and a comprehensive literature review. The project will explore how organizations adapt during periods of change and identify factors influencing employee motivation and job satisfaction. This project received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No101092043 (AGILEHAND).

Keywords: change management, technology acceptance model, organizational change, health and safety

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Authors: Yong Cang

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RJV001 is a subcutaneous injection containing mutated recombinant Collagenase H (ColH), leading to disruption of collagen matrix in adipose tissue and programmed cell death of adipocytes. Here we reported our clinical investigation of the safety, tolerance and pharmacodynamics of localized RJV001 injection into healthy human abdominal fat tissues (NCT04821648, Arizona Research Center). Investigate the safety, tolerance and clinical pharmacodynamics of subcutaneous RJV001 in humans. In the dose-escalating study, 18 subjects completed the study, 100% female, 78% white, with a mean age of 42[±9.9]. All three tested dose (0.05, 0.075 and 0.15 mg/injection), up to 30 injections, were safe and well-tolerated. Bruising and tenderness to palpation, mild to moderate, were the most frequent local skin reactions but nearly all resolved within 30 days. Additionally, physician-monitored ultrasound measurement showed that a reduction in abdominal fat tissue thickness was consistently observed in Cohort C (0.075, 0.15 mg/injection, 30injections), with a mean reduction of 7.37 [± 2.020] mm. Based on this clinical study, RJV001 has been advanced to phase II clinical studies. In the dose-escalating study, subcutaneously administered RJV001 was safe and well-tolerated in healthy adults up to 0.15 mg/injection, 30 injections. Fat reduction and adipocytolysis were observed by ultrasound measurements and histological analysis for exploratory purposes.

Keywords: fat reduction, mutant collagenase, clinical trial, subcutaneous injection

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Authors: Ai Chin Wong, Wan Ahmad Jaafar Wan Yahaya, Balakrishnan Muniandy

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This study aims to explore the impact of Virtual Reality (VR) using visual signaling principles in learning about the science laboratory safety guide; this study involves students with different spatial ability. There are two types of science laboratory safety lessons, which are Virtual Reality with Signaling (VRS) and Virtual Reality Non Signaling (VRNS). This research has adopted a 2 x 2 quasi-experimental factorial design. There are two types of variables involved in this research. The two modes of courseware form the independent variables with the spatial ability as the moderator variable. The dependent variable is the students’ performance. This study sample consisted of 141 students. Descriptive and inferential statistics were conducted to analyze the collected data. The major effects and the interaction effects of the independent variables on the independent variable were explored using the Analyses of Covariance (ANCOVA). Based on the findings of this research, the results exhibited low spatial ability students in VRS outperformed their counterparts in VRNS. However, there was no significant difference in students with high spatial ability using VRS and VRNS. Effective learning in students with different spatial ability can be boosted by implementing the Virtual Reality with Signaling (VRS) in the design as well as the development of Virtual Science Laboratory (ViSLab).

Keywords: spatial ability, science laboratory safety, visual signaling principles, virtual reality

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Authors: A. Roomy

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The dramatic rise in violence against game officials has affected all levels of sports including recreational, amateur, and professional sports. One way to combat this rise in violence is through the creation of laws specifically aimed at preventing and punishing this kind of violence. This paper will use related legal cases as a starting point to explore possible ways of better protecting the safety of game officials. It will do this by looking at relevant cases, related legal issues, and two specific ways of reducing violence against game officials. In closing, it will be argued that there needs to be a more robust legal approach with emphasis on criminal and civil penalties for assault and battery, and a more comprehensive social approach with emphasis on raising social awareness on the need to protect game officials from violence.

Keywords: game officials, legal issues, safety, violence

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Authors: Kamal Tolani, Sandeep Kumar, Rohit Luthra, Ankit Dadhania, Krishnaprasad K., Ram Gupta, Deepa Joshi

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Background: Post-operative analgesia remains a clinical challenge, with central and peripheral sensitization playing a pivotal role in treatment-related complications and impaired quality of life. Centrally acting opioids offer poor risk benefit profile with increased intensity of gastrointestinal or central side effects and slow onset of clinical analgesia. The objective of this study was to assess the clinical feasibility of induction and maintenance therapy with Tapentadol Nasal Spray (NS) in moderate to severe acute post-operative pain. Methods: Phase III, randomized, active-controlled, non-inferiority clinical trial involving 294 cases who had undergone surgical procedures under general anesthesia or regional anesthesia. Post-surgery patients were randomized to receive either Tapentadol NS 45 mg or Tramadol 100mg IV as a bolus and subsequent 50 mg or 100 mg dose over 2-3 minutes. The frequency of administration of NS was at every 4-6 hours. At the end of 24 hrs, patients in the tramadol group who had a pain intensity score of ≥4 were switched to oral tramadol immediate release 100mg capsule until the pain intensity score reduced to <4. All patients who had achieved pain intensity ≤ 4 were shifted to a lower dose of either Tapentadol NS 22.5 mg or oral Tramadol immediate release 50mg capsule. The statistical analysis plan was envisaged as a non-inferiority trial involving comparison with Tramadol for Pain intensity difference at 60 minutes (PID60min), Sum of Pain intensity difference at 60 minutes (SPID60min), and Physician Global Assessment at 24 hrs (PGA24 hrs). Results: The per-protocol analyses involved 255 hospitalized cases undergoing surgical procedures. The median age of patients was 38.0 years. For the primary efficacy variables, Tapentadol NS was non-inferior to Inj/Oral Tramadol in relief of moderate to severe post-operative pain. On the basis of SPID60min, no clinically significant difference was observed between Tapentadol NS and Tramadol IV (1.73±2.24 vs. 1.64± 1.92, -0.09 [95% CI, -0.43, 0.60]). In the co-primary endpoint PGA24hrs, Tapentadol NS was non–inferior to Tramadol IV (2.12 ± 0.707 vs. 2.02 ±0.704, - 0.11[95% CI, -0.07, 0.28). However, on further assessment at 48hr, 72 hrs, and 120hrs, clinically superior pain relief was observed with the Tapentadol NS formulation that was statistically significant (p <0.05) at each of the time intervals. Secondary efficacy measures, including the onset of clinical analgesia and TOTPAR, showed non-inferiority to Tramadol. The safety profile and need for rescue medication were also similar in both the groups during the treatment period. The most common concomitant medications were anti-bacterial (98.3%). Conclusion: Tapentadol NS is a clinically feasible option for improved compliance as induction and maintenance therapy while offering a sustained and persistent patient response that is clinically meaningful in post-surgical settings.

Keywords: tapentadol nasal spray, acute pain, tramadol, post-operative pain

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Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

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Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

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Authors: Zakari Mustapha, Clinto Aigbavboa, Wellinton Didi Thwala

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Occupational Health and Safety (OHS) issues has been a major challenge to the Ghanaian government. The purpose of the study was to examine OHS practices in Ghana. The study looked at various views from different scholars about OHS practices in order to achieve the objective of the study. Literature review was conducted on OHS in Ghana. Findings from the study shows Ministry of Roads and Transport (MRT) and Ministry of Water Resources, Works and Housing (MWRWH) are two government ministries in charge of construction and implementation of the construction sector policy. The Factories, Offices and Shops Act 1970, Act 328 and the Mining Regulations 1970 LI 665 are the two major edicts. The study presents a strong background on OHS practices in Ghana and contribute to the body of knowledge on the solution to the current trends and challenges of OHS in the construction sector.

Keywords: ILO convention, OHS challenges, OHS practices, OHS improvement

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Authors: Marco Sewald

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Due to the current enforcement of exterritorial U.S. legislation, up to 9 million U.S. (dual) citizens residing abroad are subject to U.S. double and surcharge taxation and at risk of losing access to otherwise basic financial services and investment opportunities abroad. The United States is the only OECD country that taxes non-resident citizens, lawful permanent residents and other non-resident aliens on their worldwide income, based on local U.S. tax laws. To enforce these policies the U.S. has implemented ‘saving clauses’ in all tax treaties and implemented several compliance provisions, including the Foreign Account Tax Compliance Act (FATCA), Qualified Intermediaries Agreements (QI) and Intergovernmental Agreements (IGA) addressing Foreign Financial Institutions (FFIs) to implement these provisions in foreign jurisdictions. This policy creates systematic cases of double and surcharge taxation. The increased enforcement of compliance rules is creating additional report burdens for U.S. persons abroad and FFIs accepting such U.S. persons as customers. FFIs in Europe react with a growing denial of specific financial services to this population. The numbers of U.S. citizens renouncing has dramatically increased in the last years. A case study is chosen as an appropriate methodology and research method, as being an empirical inquiry that investigates a contemporary phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident; and in which multiple sources of evidence are used. This evaluative approach is testing whether the combination of policies works in practice, or whether they are in accordance with desirable moral, political, economical aims, or may serve other causes. The research critically evaluates the financial and non-financial consequences and develops sufficient strategies. It further discusses these strategies to avoid the undesired consequences of exterritorial U.S. legislation. Three possible strategies are resulting from the use cases: (1) Duck and cover, (2) Pay U.S. double/surcharge taxes, tax preparing fees and accept imposed product limitations and (3) Renounce U.S. citizenship and pay possible exit taxes, tax preparing fees and the requested $2,350 fee to renounce. While the first strategy is unlawful and therefore unsuitable, the second strategy is only suitable if the U.S. citizen residing abroad is planning to move to the U.S. in the future. The last strategy is the only reasonable and lawful way provided by the U.S. to limit the exposure to U.S. double and surcharge taxation and the limitations on financial products. The results are believed to add a perspective to the current academic discourse regarding U.S. citizenship based taxation, currently dominated by U.S. scholars, while providing sufficient strategies for the affected population at the same time.

Keywords: citizenship based taxation, FATCA, FBAR, qualified intermediaries agreements, renounce U.S. citizenship

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Authors: M. A. M. Hayati Adilin, D. Ajau, A. S. Siti Khuzaimah, K. Mastura, R. Nik Muhammad Syafiq, M. N. Noor Fatin Nadiah

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The school environment is one of many factors related to the increment of overweight and obesity among children. There is an evidence to suggest that the school environmental factor has an independent effect towards health-related behaviour of children and school culture. It may have a significant impact towards the emergence of childhood obesity through their influence on eating pattern and physical activity level. The objective of this study is to identify the school environmental factors (i.e. physical, economic, political and socio-cultural) towards healthy eating and physical activity of urban and rural primary school children in preventing childhood obesity. This can be identified by examining the compliance of rural and urban school environment with whole-school environmental mapping framework. The study design was a cross-sectional study. A total of 60 schools were randomly selected (30 urban and 30 rural) in Selangor, Western Peninsular Malaysia in 2013 and 60 teachers (responsible for student affairs and the school curriculum) have been interviewed face to face by using a whole school mapping questionnaire followed by observation of the school environment . This study has demonstrated that schools in both areas (rural and urban) comply mostly with the physical environmental mapping (83.3%), followed by socio-cultural environmental mapping, 65%. Meanwhile, the political environmental mappings in both urban and rural schools show a low compliance percentage, which is 56.7%. For economic environmental mapping, only 10% of both schools are complied. As a conclusion, this study has demonstrated that schools in both areas do not fully comply with the whole school environmental mapping framework, especially economic and political. However, holistic approach is needed and many improvements can be proposed to promote healthy eating and physical activities among school children. Government, families and schools as well as communities and the media should be included together with any strategies for preventing childhood obesity.

Keywords: childhood obesity, healthy eating, physical activity, school environment

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Authors: Ujjal Chattaraj, M. Raviteja, Chaitanya Aemala

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Over the years vehicular traffic has been given priority over pedestrian traffic. With the increase of population in cities, pedestrian traffic is increasing day by day. Pedestrian safety has become a matter of concern for the Traffic Engineers. Pedestrian comfort is primary important for the Engineers who design different pedestrian facilities. Pedestrian comfort and safety can be measured in terms of different level of service (LOS) of the facilities. In this study video data on pedestrian movement have been collected from different railway foot over bridges (FOB) in India. The level of service of those facilities has been analyzed. A cellular automata based model has been formulated to mimic the route choice behaviour of the pedestrians on the foot over bridges.

Keywords: cellular automata model, foot over bridge, level of service, pedestrian

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Authors: Ahmed Z. Gabr, Ahmed A. Helal, Hussein E. Said

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With the incessant increase of power systems capacity and voltage grade, the safety of grounding grid becomes more and more prominent. In this paper, the designing substation grounding grid is presented by means of genetic algorithm (GA). This approach purposes to control the grounding cost of the power system with the aid of controlling grounding rod number and conductor lengths under the same safety limitations. The proposed technique is used for the design of the substation grounding grid in Khalda Petroleum Company “El-Qasr” power plant and the design was simulated by using CYMGRD software for results verification. The result of the design is highly complying with IEEE 80-2000 standard requirements.

Keywords: genetic algorithm, optimum grounding grid design, power system analysis, power system protection, single layer model, substation

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Authors: Oscar Norman Nekesa, Yoshitaka Kajita

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Tom Mboya Street is a vital urban corridor within the spectrum of Nairobi city, it experiences high volumes of pedestrian and vehicular traffic. Despite past intervention measures to lessen this catastrophe, rates have remained high. This highlights significant safety concerns that need urgent attention. This study investigates the correlation and pedestrian accident predictability with significant independent variables using multiple linear regression to model to develop effective mobility management strategies for accident mitigation. The methodology involves collecting and analyzing data on pedestrian accidents and various related independent variables. Data sources include the National Transport and Safety Authority (NTSA), Kenya National Bureau of Statistics, and Nairobi City County records, covering five years. This study aims to investigate that traffic volumes (pedestrian and vehicle), Vehicular speed, human factors, illegal parking, policy issues, urban-land use, built environment, traffic signals conditions, inadequate lighting, and insufficient traffic control measures significantly have predictability with the rate of pedestrian accidents. Explanatory variables related to road design and geometry are significant in predictor models for the Tom Mboya Road link but less influential in junction along the 5 km stretch road models. The most impactful variable across all models was vehicular traffic flow. The study recommends infrastructural improvements, enhanced enforcement, and public awareness campaigns to reduce accidents and improve urban mobility. These insights can inform policy-making and urban planning to enhance pedestrian safety along the dense packed Tom Mboya Street and similar urban settings. The findings will inform evidence-based interventions to enhance pedestrian safety and improve urban mobility.

Keywords: multiple linear regression, urban mobility, traffic management, Nairobi, Tom Mboya street, infrastructure conditions., pedestrian safety, correlation and prediction

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Authors: Ciaran Smiddy, Fergus Nugent, Karen Fitzmaurice

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A measure of prescribing and administration of Antimicrobial Prophylaxis before and during Covid-19(2019 vs. 2021) was desired to assess how these were affected by Covid-19. Antimicrobial Prophylaxis was assessed for 60 patients, under 3 Orthopaedic Consultants, against local guidelines. The study found that compliance with guidelines improved significantly, from 60% to 83%, but Appropriate use of Vancomycin reduced from 37% to 29%.

Keywords: antimicrobial stewardship, prescribing, spinal surgery, vancomycin

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Authors: José Manuel Palma, Paula Pereira, Margarida Tomás

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Foreseen the future: Human factors integration in European Horizon Projects The development of new technology as artificial intelligence, smart sensing, robotics, cobotics or intelligent machinery must integrate human factors to address the need to optimize systems and processes, thereby contributing to the creation of a safe and accident-free work environment. Human Factors Integration (HFI) consistently pose a challenge for organizations when applied to daily operations. AGILEHAND and FORTIS projects are grounded in the development of cutting-edge technology - industry 4.0 and 5.0. AGILEHAND aims to create advanced technologies for autonomously sort, handle, and package soft and deformable products, whereas FORTIS focuses on developing a comprehensive Human-Robot Interaction (HRI) solution. Both projects employ different approaches to explore HFI. AGILEHAND is mainly empirical, involving a comparison between the current and future work conditions reality, coupled with an understanding of best practices and the enhancement of safety aspects, primarily through management. FORTIS applies HFI throughout the project, developing a human-centric approach that includes understanding human behavior, perceiving activities, and facilitating contextual human-robot information exchange. it intervention is holistic, merging technology with the physical and social contexts, based on a total safety culture model. In AGILEHAND we will identify safety emergent risks, challenges, their causes and how to overcome them by resorting to interviews, questionnaires, literature review and case studies. Findings and results will be presented in “Strategies for Workers’ Skills Development, Health and Safety, Communication and Engagement” Handbook. The FORTIS project will implement continuous monitoring and guidance of activities, with a critical focus on early detection and elimination (or mitigation) of risks associated with the new technology, as well as guidance to adhere correctly with European Union safety and privacy regulations, ensuring HFI, thereby contributing to an optimized safe work environment. To achieve this, we will embed safety by design, and apply questionnaires, perform site visits, provide risk assessments, and closely track progress while suggesting and recommending best practices. The outcomes of these measures will be compiled in the project deliverable titled “Human Safety and Privacy Measures”. These projects received funding from European Union’s Horizon 2020/Horizon Europe research and innovation program under grant agreement No101092043 (AGILEHAND) and No 101135707 (FORTIS).

Keywords: human factors integration, automation, digitalization, human robot interaction, industry 4.0 and 5.0

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Authors: Abeer N. Alshukairi, Abdulrahman A. Alrajhi, Abdulfattah W. Alamri, Adel F. Alothman

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We described the nosocomial transmission of a pre-XDR or an MDR case of pulmonary tuberculosis in a HIV negative health care worker in an area endemic for MDR & XDR tuberculosis. With inadequate therapy and non-compliance, his strain developed acquired resistance and he presented with extra-pulmonary XDR tuberculosis in the form of multi-focal osteomyelitis and encysted pleural effusion. He was cured after 2 years of therapy with various anti-tuberculous drugs in addition to interferon gamma.

Keywords: osteomyelitis, treatment, XDR tuberculosis, successful treatment

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Authors: David Lloyd, David Owen, Martin Jardine

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Introduction: European weight regulations with respect to food products require a full understanding of regulation guidelines to assure regulatory compliance. It is suggested that the complexity of regulation leads to practices which result to over filling of food packages by food processors. Purpose: To establish current practices by food processors and the financial, sustainable and societal impacts on the food supply chain of ineffective food production practices. Methods: An analysis of food packing controls with 10 companies of varying food categories and quantitative based research of a further 15 food processes on the confidence in weight control analysis of finished food packs within their organisation. Results: A process floor analysis of manufacturing operations focussing on 10 products found over fill of packages ranging from 4.8% to 20.2%. Standard deviation figures for all products showed a potential for reducing average weight of the pack whilst still retain the legal status of the product. In 20% of cases, an automatic weight analysis machine was in situ however weight packs were still significantly overweight. Collateral impacts noted included the effect of overfill on raw material purchase and added food miles often on a global basis with one raw material alone creating 10,000 extra food miles due to the poor weight control of the processing unit. A case study of a meat and bakery product will be discussed with the impact of poor controls resulting from complex legislation. The case studies will highlight extra energy costs in production and the impact of the extra weight on fuel usage. If successful a risk assessment model used primarily on food safety but adapted to identify waste /sustainability risks will be discussed within the presentation.

Keywords: legislation, overfill, profile, waste

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Authors: Neeti Nayak, Khalid Duri

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Despite the many advances made in transportation planning, the number of injuries and fatalities in the United States which involve motorized vehicles near intersections remain largely unchanged year over year. Data from the National Highway Traffic Safety Administration for 2018 indicates accidents involving motorized vehicles at traffic intersections accounted for 8,245 deaths and 914,811 injuries. Furthermore, collisions involving pedal cyclists killed 861 people (38% at intersections) and injured 46,295 (68% at intersections), while accidents involving pedestrians claimed 6,247 lives (25% at intersections) and injured 71,887 (56% at intersections)- the highest tallies registered in nearly 20 years. Some of the causes attributed to the rising number of accidents relate to increasing populations and the associated changes in land and traffic usage patterns, insufficient visibility conditions, and inadequate applications of traffic controls. Intersections that were initially designed with a particular land use pattern in mind may be rendered obsolete by subsequent developments. Many accidents involving pedestrians are accounted for by locations which should have been designed for safe crosswalks. Conventional solutions for evaluating intersection safety often require costly deployment of engineering surveys and analysis, which limit the capacity of resource-constrained administrations to satisfy their community’s needs for safe roadways adequately, effectively relegating mitigation efforts for high-risk areas to post-incident responses. This paper demonstrates how geospatial technology can identify high-risk locations and evaluate the viability of specific intersection management techniques. GIS is used to simulate relevant real-world conditions- the presence of traffic controls, zoning records, locations of interest for human activity, design speed of roadways, topographic details and immovable structures. The proposed methodology provides a low-cost mechanism for empowering urban planners to reduce the risks of accidents using 2-dimensional data representing multi-modal street networks, parcels, crosswalks and demographic information alongside 3-dimensional models of buildings, elevation, slope and aspect surfaces to evaluate visibility and lighting conditions and estimate probabilities for jaywalking and risks posed by blind or uncontrolled intersections. The proposed tools were developed using sample areas of Southern California, but the model will scale to other cities which conform to similar transportation standards given the availability of relevant GIS data.

Keywords: crosswalks, cyclist safety, geotechnology, GIS, intersection safety, pedestrian safety, roadway safety, transportation planning, urban design

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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Authors: Alak Kumar Patra, Nilanjan Mitra

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Higher strength to weight ratio is the main advantage of sandwich composite structures. Interfacial delamination between the face sheet and core is a major problem in these structures. Many research works are devoted to improve the interfacial fracture toughness of composites majorities of which are on nano and laminated composites. Work on influence of multiwalled carbon nano-tubes (MWCNT) dispersed resin system on interface fracture of glass-epoxy PVC core sandwich composite is extremely limited. Finite element study is followed by experimental investigation on interface fracture toughness of glass-epoxy (G/E) PVC core sandwich composite with and without MWCNT. Results demonstrate an improvement in interface fracture toughness values (Gc) of samples with a certain percentages of MWCNT. In addition, dispersion of MWCNT in epoxy resin through sonication followed by mixing of hardener and vacuum resin infusion (VRI) technology used in this study is an easy and cost effective methodology in comparison to previously adopted other methods limited to laminated composites. The study also identifies the optimum weight percentage of MWCNT addition in the resin system for maximum performance gain in interfacial fracture toughness. The results agree with finite element study, high-resolution transmission electron microscope (HRTEM) analysis and fracture micrograph of field emission scanning electron microscope (FESEM) investigation. Interface fracture toughness (GC) of the DCB sandwich samples is calculated using the compliance calibration (CC) method considering the modification due to shear. Compliance (C) vs. crack length (a) data of modified sandwich DCB specimen is fitted to a power function of crack length. The calculated mean value of the exponent n from the plots of experimental results is 2.22 and is different from the value (n=3) prescribed in ASTM D5528-01for mode 1 fracture toughness of laminate composites (which is the basis for modified compliance calibration method). Differentiating C with respect to crack length (a) and substituting it in the expression GC provides its value. The research demonstrates improvement of 14.4% in peak load carrying capacity and 34.34% in interface fracture toughness GC for samples with 1.5 wt% MWCNT (weight % being taken with respect to weight of resin) in comparison to samples without MWCNT. The paper focuses on significant improvement in experimentally determined interface fracture toughness of sandwich samples with MWCNT over the samples without MWCNT using much simpler method of sonication. Good dispersion of MWCNT was observed in HRTEM with 1.5 wt% MWCNT addition in comparison to other percentages of MWCNT. FESEM studies have also demonstrated good dispersion and fiber bridging of MWCNT in resin system. Ductility is also observed to be higher for samples with MWCNT in comparison to samples without.

Keywords: carbon nanotube, epoxy resin, foam, glass fibers, interfacial fracture, sandwich composite

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Authors: Qirat Naz

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The aim of this research study is to explore the perspectives of migrants and interpreters from diverse backgrounds on language barriers, their English language proficiency and access to health care facilities. A qualitative research methodology was used including in-depth interviews and focus group discussions. Data was collected from 20 migrants who have difficulty conversing in the English language and 12 interpreters including family members and friends who provide translation services as part of accessing health care. The findings seek to address three key research questions: how language is a barrier for non-national language speakers to access the health care facilities, what is the impact of various socio-cultural and linguistic backgrounds on health compliance, and what is the role of interpreters in providing access to, usage of, and satisfaction with health-care facilities. The most crucial component of providing care was found to be effective communication between patient and health care professionals. Language barrier was the major concern for healthcare professionals in providing and for migrants in accessing sufficient, suitable, and productive health care facilities. Language and sociocultural background play a significant role in health compliance as this research reported; respondents believe that patients who interact with the doctors who have same sociocultural and linguistic background benefit from receiving better medical care than those who do not. Language limitations and the socio-cultural gap make it difficult for patients and medical staff to communicate clearly with one another, which has a negative effect on quality of care and patient satisfaction. The use of qualified interpreters was found to be beneficial but there were also drawbacks such as accessibility and availability of them in a timely manner for patient needs. The findings of this research can help health care workers and policy makers working to improve health care delivery system and to create appropriate strategies to overcome this challenge.

Keywords: migration, migrants, language barrier, healthcare access

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Authors: Huang Wei-Chi, Li Wei, Yu Tien-Chieh

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Medication adherence is crucial for treatment success. Adherence problem is common in patients with polypharmacy, especially in the geriatric population who are vulnerable to multiple chronic conditions but averagely less knowledgeable about diseases and medications. In order to help patients take medications appropriately and enhance the understanding of diseases or medications, a Line official account named e-Pharmacist was designed. The line is a popular freeware app with the highest penetration rate (95.7%) in Taiwan. The interface of e-Pharmacist is user-friendly for easy-to-read and convenient operating. Differ from other medication adherence apps, users just added e-Pharmacist as a LINE friend without installing any more apps and the drug lists were automatically downloaded from the personal electronic medical records with security permission. Over and above medication reminder, several additional capabilities were set up and engaged in the platform of e-Pharmacist including prescription refill reservation, laboratory examination consultation, medical appointment registration, and “Daily Health Log” where patients can record and track data of blood pressure/blood sugar and daily meals for self-health management as well as can share the important information to clinical professionals when seeking medical help. Additionally, a Line chatbot was utilized to provide tailored medicine information for the individual user. From July 2020 to March 2022, around 3000 patients added e-pharmacist as Line friends. Every day more than 1500 patients receive messages from e-pharmacist to notify them to take medicine. Thanks to the e-pharmacist alert system and Chatbot, the low-compliance patients (defined by Program on Adherence to Medication, PAM) significantly dropped from 36% to 6%, whereas the high-compliance patients dramatically increased from 13% to 77%. The user satisfaction is 98%. In brief, an e-pharmacist is not only a medication reminder but also a tailored personal assistant with value-added service for health management.

Keywords: e-pharmacist, self-health management, medication reminder, value-added service

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Authors: Munirajulu M, Srikanth Modem

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A large cricket stadium with the capacity to accommodate several thousands of spectators has the seating arena consisting of a two-tier arrangement with an upper and a lower bowl and an intermediate concourse podium level for pedestrian movement to access the bowls. The uniqueness of the stadium is that spectators can have an unobstructed view from all around the podium towards the field of play. Upper and lower bowls are connected by stairs. The stairs landing is a precast slab supported by cantilevered steel beams. These steel beams are fixed to precast columns supporting the stadium structure. The stair slabs are precast concrete supported on a landing slab and cantilevered steel beams. During an event of a fire at podium level between two staircases, fire resistance of steel beams is very critical to life safety. If the steel beam loses its strength due to lack of fire resistance, it will be weak in supporting stair slabs and may lead to a hazard in evacuating occupants from the upper bowl to the lower bowl. In this study, to ascertain fire rating and life safety, a performance-based design using CFD analysis is used to evaluate the steel beams' fire resistance. A fire size of 3.5 MW (convective heat output of fire) with a wind speed of 2.57 m/s is considered for fire and smoke simulation. CFD results show that the smoke temperature near the staircase/ around the staircase does not exceed 1500 C for the fire duration considered. The surface temperature of cantilevered steel beams is found to be less than or equal to 1500 C. Since this temperature is much less than the critical failure temperature of steel (5200 C), it is concluded that the design of structural steel supports on the staircase is adequate and does not need additional fire protection such as fire-resistant coating. CFD analysis provided an engineering basis for the performance-based design of steel structural elements and an opportunity to optimize fire protection requirements. Thus, performance-based design using CFD modeling and simulation of fire and smoke is an innovative way to evaluate fire rating requirements, ascertain life safety and optimize the design with regard to fire protection on structural steel elements.

Keywords: fire resistance, life safety, performance-based design, CFD analysis

Procedia PDF Downloads 192