Search results for: advance care planning

Authors: Sarojini Imran, Riza Firmansyah, Aula Ramadhan, Chudamul Furqon, Achfriyatama Oktariflandi

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This article delves into the participatory approach in formulating a master plan for the development of pioneer village tourism in Cibubuan, Sumedang. We explore the process of participatory mapping that involves the active participation of the local community in planning and envisioning the future of village tourism. This research considers the positive impact that arises when the community takes an active role in designing a master plan that benefits the local economy while preserving culture and the environment. The results of this research reveal that the participatory approach can create a more accurate and community-responsive mapping that aligns with the aspirations of the people in Cibubuan Village. It also provides a deep insight into how community-developed mapping can guide the development of sustainable tourism. By offering a deeper understanding of the participatory role in village tourism development planning, this article provides essential insights for stakeholders and researchers in this field. We hope this article will inspire more communities to adopt a participatory approach in planning the future of their village tourism.

Keywords: participatory masterplan, pioneer village tourism, sustainable tourism, community engagement, Cibubuan Village

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Authors: Jaishree Ellis

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

Keywords: health equity, inclusion, healthcare disparities, education

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Authors: Dongkyu Lee, Doan-Quoc Hoan, Soomi Shin

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This study shows an easy R&D innovation-activity methodology which embodies the methodological strategy of supplementing the disadvantages of 6 sigma by TRIZ and considers the acceptance of employees through the change in the concept of innovation-activity methodology from the focus of chapter development to that of stepwise executed task.

Keywords: idea thinking, 6 sigma, triz, visual planning, R&D, innovation-activity

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Authors: Fathia Elmenghawi

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The transformation of cities under colonial rule has received a great deal of scholarly work. Colonizers interpret their colonies differently and many urban and planning approaches can be traced. This paper focuses on the colonial approaches of urban expansion in the city of Tripoli, Libya during two colonial periods, the late Ottomans and the Italians, from the 1830s to 1940s. Both had perceived their approaches to the city’s expansion as means of practicing dominance over the colonized under the disguise of facilitating the process of modernization of the city. This research uses a historical method that based on archival documents such as maps, photos, and publications to uncover the planning practices followed by the two colonizers. The findings indicate that despite the similar intentions that both colonizers had when they expanded the city, one striking difference was distinguished, which is how the Ottomans and the Italians planned to treat the Walled City as, respectively, either a context for expansion or as merely remains to marginalize.

Keywords: colonial urban planning, Italian colonization, Ottoman provinces, walled city

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Authors: Esraa Alhadad

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Recently, there has been considerable debate surrounding the definition, conservation, and management of heritage. Over the past few years, there has been a growing call for the inclusion of local communities in heritage management. However, the perspectives on involvement, especially concerning key stakeholders like community members, often diverge significantly. While the theoretical foundation for community involvement is reasonably established, the application of this approach in heritage management has been sluggish. Achieving a balance to fulfill the diverse goals of stakeholders in any involvement project proves challenging in practice. Consequently, there is a dearth of empirical studies exploring the practical implications of effective tools in heritage management, and limited indication exists to persuade current authorities, such as governmental organizations, to share their influence with local community members. This research project delves into community involvement within heritage management as a potent means of constructing a robust management framework. Its objective is to assess both the extent and caliber of involvement within the management of heritage sites overall, utilizing a cultural mapping-centered methodology. The findings of this study underscore the significance of engaging the local community in both heritage management and planning endeavors. Ultimately, this investigation furnishes crucial empirical evidence and extrapolates valuable theoretical and practical insights that advance understanding of cultural mapping in pivotal areas, including the catalysts for involvement and collaborative decision-making processes.

Keywords: community involvement, heritage management, cultural mapping, stakeholder mangement

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Authors: Farzad Jafarpour Taher, Maghsud Solimanpur

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Production planning is one of the complex tasks in multi-product firms that produce a wide range of products. Since resources in mass production companies are limited and different products use common resources, there must be a careful plan so that firms can respond to customer needs efficiently. Azar-battery Company is a firm that provides twenty types of products for its customers. Therefore, careful planning must be performed in this company. In this research, the current conditions of Azar-battery Company were investigated to provide a mathematical programming model to determine the optimum production rate of the products in this company. The production system of this company is multi-stage, multi-product and multi-period. This system is studied in terms of a one-year planning horizon regarding the capacity of machines and warehouse space limitation. The problem has been modeled as a linear programming model with deterministic demand in which shortage is not allowed. The objective function of this model is to minimize costs (including raw materials, assembly stage, energy costs, packaging, and holding). Finally, this model has been solved by Lingo software using the branch and bound approach. Since the computation time was very long, the solver interrupted, and the obtained feasible solution was used for comparison. The proposed model's solution costs have been compared to the company’s real data. This non-optimal solution reduces the total production costs of the company by about %35.

Keywords: multi-period, multi-product production, multi-stage, production planning

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Authors: A.Halim Sahelan, Mohd Halid Abu, Jamaluddin Hashim, Zulisman Maksom, Mohd Afif Md Nasir

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This study aims to assess the students' needs for the tour planning e-guide. The study is developing on the contribution and importance of the Educational Tour Planning Guide (ETP) is a multimedia courseware as one of the effective methods in teaching and learning of environmental science among the students in primary schools of the Ministry of Education, Malaysia. It is to provide the student with knowledge and experience about tourism, environmental science activities and process. E-guide to ETP also hopes to strengthen the student understanding toward the subject learns in the tourism environmental science. In order to assess the student's needs on the e-Guide to Educational Tour Planning in Environmental Science, the study has produced a similar e-Guide to ETP in the form as a courseware to be tested during the study. The study has involved several steps in order to be completed. It is such as the formulation of the problem, the review of the literature, the formulation of the study methodology, the production of the e-Guide to ETP, field survey and finally the analyses and discussion made on the data gathered during the study. The survey has involved 100 respondents among the students in standard six primary schools in Kluang Johor. Through the findings, the study indicates that the currently tested product is acceptable among the students in learning environmental science as a guide to plan for the tour. The findings also show a slight difference between the respondents who are using the e-Guide to ETP, and those who are not on the basis of the e-Guide to ETP results. Due the important for the study, the researcher hopes to be having a fair discussion and excellence, recommendation for the development of the product of the current study. This report is written also important to provide a written reference for the future related study.

Keywords: the tour planning e-guide, the Educational Tour Planning Guide, environmental science, multimedia course ware

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Authors: Johnas Buhori, Meinrad Haule Lembuka

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

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

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Authors: Magdy Roman, Mostafa Shoeib, Mostafa Rostom

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Global vision, whether provided by overhead fixed cameras, on-board aerial vehicle cameras, or satellite images can always provide detailed information on the environment around mobile robots. In this paper, an intelligent vision-based method of path planning and obstacle avoidance for mobile robots is presented. The method integrates visual perception with a new proposed field-based path-planning method to overcome common path-planning problems such as local minima, unreachable destination and unnecessary lengthy paths around obstacles. The method proposes an exponential angle deviation field around each obstacle that affects the orientation of a close robot. As the robot directs toward, the goal point obstacles are classified into right and left groups, and a deviation angle is exponentially added or subtracted to the orientation of the robot. Exponential field parameters are chosen based on Lyapunov stability criterion to guarantee robot convergence to the destination. The proposed method uses obstacles' shape and location, extracted from global vision system, through a collision prediction mechanism to decide whether to activate or deactivate obstacles field. In addition, a search mechanism is developed in case of robot or goal point is trapped among obstacles to find suitable exit or entrance. The proposed algorithm is validated both in simulation and through experiments. The algorithm shows effectiveness in obstacles' avoidance and destination convergence, overcoming common path planning problems found in classical methods.

Keywords: path planning, collision avoidance, convergence, computer vision, mobile robots

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Authors: Zeynep Karakoc, Hasan Ilhan Mutaf

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

Keywords: orthodontics, dental care, brush, plaque

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Authors: Preeti Tiwari, Jay Wood, Duncan Babbage

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Family planning plays a role in saving lives across the globe by preventing unwanted pregnancies. The purpose of this multidisciplinary research was to determine the impact of mHealth tools have on psychosocial determinants of behaviour for family planning. The present study examines a topic that is very relevant in times where human-technology interaction is at its peak. It is probably one of the first studies that have investigated the impact of mobile phone technology on the underlying mechanisms of behaviour change for family planning using primary data. To examine the association between exposure to mHealth tools and predictors of behaviour, data was collected from mHealth intervention areas in India. A post-intervention quasi-experimental study with a 2x2 factorial design was conducted among 831 men and women from the state of Bihar. The quantitative data analysis evaluated the extent of influence that predictors of behaviour (beliefs, social norms, perceived behaviour control, and outcome behaviour) have on a woman’s decisions about family planning. The results indicated an association between exposure to mHealth tools and improved communication about family planning among various family members after receiving health information from a health worker (H1). A relationship between exposure to mHealth tools and increased support women received from their husbands and extended family (mothers-in-law specifically) and peers (H2) was also found. A further result showed that knowledge about family planning was greater among users of family planning (H4). mHealth tools empower women to communicate with family members. This has important implications for developing mobile phone-based tools, as they can be used as a crucial communication channel that can be an effective method of increasing communication among family members about contraceptives. Thus, it can be implied that where women feel nervous talking about contraception, the successful application of mHealth tools can strengthen the interactivity of the health communication and could increase the likelihood of using contraception. However, while it may improve health communication that can inform health decisions, it may be insufficient on its own to cause behaviour change.

Keywords: contraceptive, e-health, psycho-social, women

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Authors: Abhishek Oswal

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

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

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Authors: Ghorbanali Mohammadi

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

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

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Authors: Moser Stephan, Lukasser Gerald, Weitlaner Robert

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Urban structures will be used more intensively in the future through redensification or new planned districts with high building densities. Especially, to achieve positive energy balances like requested for Positive Energy Districts (PED) the single use of roofs is not sufficient for dense urban areas. However, the increasing share of window significantly reduces the facade area available for use in PV generation. Through the use of PV technology at other building components, such as external venetian blinds, onsite generation can be maximized and standard functionalities of this product can be positively extended. While offering advantages in terms of infrastructure, sustainability in the use of resources and efficiency, these systems require an increased optimization in planning and control strategies of buildings. External venetian blinds with PV technology require an intelligent control concept to meet the required demands such as maximum power generation, glare prevention, high daylight autonomy, avoidance of summer overheating but also use of passive solar gains in wintertime. Today, geometric representation of outdoor spaces and at the building level, three-dimensional geometric information is available for planning with Building Information Modeling (BIM). In a research project, a web application which is called HELLA DECART was developed to provide this data structure to extract the data required for the simulation from the BIM models and to make it usable for the calculations and coupled simulations. The investigated object is uploaded as an IFC file to this web application and includes the object as well as the neighboring buildings and possible remote shading. This tool uses a ray tracing method to determine possible glare from solar reflections of a neighboring building as well as near and far shadows per window on the object. Subsequently, an annual estimate of the sunlight per window is calculated by taking weather data into account. This optimized daylight assessment per window provides the ability to calculate an estimation of the potential power generation at the integrated PV on the venetian blind but also for the daylight and solar entry. As a next step, these results of the calculations as well as all necessary parameters for the thermal simulation can be provided. The overall aim of this workflow is to advance the coordination between the BIM model and coupled building simulation with the resulting shading and daylighting system with the artificial lighting system and maximum power generation in a control system. In the research project Powershade, an AI based control concept for PV integrated façade elements with coupled simulation results is investigated. The developed automated workflow concept in this paper is tested by using an office living lab at the HELLA company.

Keywords: BIPV, building simulation, optimized control strategy, planning tool

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Authors: Liane J. Ioannou, Jonathan Serpell, Cino Bendinelli, David Walters, Jenny Gough, Dean Lisewski, Win Meyer-Rochow, Julie Miller, Duncan Topliss, Bill Fleming, Stephen Farrell, Andrew Kiu, James Kollias, Mark Sywak, Adam Aniss, Linda Fenton, Danielle Ghusn, Simon Harper, Aleksandra Popadich, Kate Stringer, David Watters, Susannah Ahern

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BACKGROUND: There are significant variations in the management, treatment and outcomes of thyroid cancer, particularly in the role of: diagnostic investigation and pre-treatment scanning; optimal extent of surgery (total or hemi-thyroidectomy); use of active surveillance for small low-risk cancers; central lymph node dissections (therapeutic or prophylactic); outcomes following surgery (e.g. recurrent laryngeal nerve palsy, hypocalcaemia, hypoparathyroidism); post-surgical hormone, calcium and vitamin D therapy; and provision and dosage of radioactive iodine treatment. A proven strategy to reduce variations in the outcome and to improve survival is to measure and compare it using high-quality clinical registry data. Clinical registries provide the most effective means of collecting high-quality data and are a tool for quality improvement. Where they have been introduced at a state or national level, registries have become one of the most clinically valued tools for quality improvement. To benchmark clinical care, clinical quality registries require systematic measurement at predefined intervals and the capacity to report back information to participating clinical units. OBJECTIVE: The aim of this study was to develop a core set clinical indicators that enable measurement and reporting of quality of care for patients with thyroid cancer. We hypothesise that measuring clinical quality indicators, developed to identify differences in quality of care across sites, will reduce variation and improve patient outcomes and survival, thereby lessening costs and healthcare burden to the Australian community. METHOD: Preparatory work and scoping was conducted to identify existing high quality, clinical guidelines and best practice for thyroid cancer both nationally and internationally, as well as relevant literature. A bi-national panel was invited to participate in a modified Delphi process. Panelists were asked to rate each proposed indicator on a Likert scale of 1–9 in a three-round iterative process. RESULTS: A total of 236 potential quality indicators were identified. One hundred and ninety-two indicators were removed to reflect the data capture by the Australian and New Zealand Thyroid Cancer Registry (ANZTCR) (from diagnosis to 90-days post-surgery). The remaining 44 indicators were presented to the panelists for voting. A further 21 indicators were later added by the panelists bringing the total potential quality indicators to 65. Of these, 21 were considered the most important and feasible indicators to measure quality of care in thyroid cancer, of which 12 were recommended for inclusion in the final set. The consensus indicator set spans the spectrum of care, including: preoperative; surgery; surgical complications; staging and post-surgical treatment planning; and post-surgical treatment. CONCLUSIONS: This study provides a core set of quality indicators to measure quality of care in thyroid cancer. This indicator set can be applied as a tool for internal quality improvement, comparative quality reporting, public reporting and research. Inclusion of these quality indicators into monitoring databases such as clinical quality registries will enable opportunities for benchmarking and feedback on best practice care to clinicians involved in the management of thyroid cancer.

Keywords: clinical registry, Delphi survey, quality indicators, quality of care

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: Sao-Jeng Chao, Wen-Cheng Chen, Wei-Humg Lu

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In order to prevent encountering unpredictable factors, geotechnical engineers always conduct numerical analysis for braced excavation design. Simulation work in advance can predict the response of subsequent excavation and thus will be designed to increase the security coefficient of construction. The parameters that are considered include geological conditions, soil properties, soil distributions, loading types, and the analysis and design methods. National Ilan University is located on the LanYang plain, mainly deposited by clayey soil and loose sand, and thus is vulnerable to external influence displacement. National Ilan University experienced a construction of braced excavation with a complete program of monitoring excavation. This study takes advantage of a one-dimensional finite element method RIDO to simulate the excavation process. The predicted results from numerical simulation analysis are compared with the monitored results of construction to explore the differences between them. Numerical simulation analysis of the excavation process can be used to analyze retaining structures for the purpose of understanding the relationship between the displacement and supporting system. The resulting deformation and stress distribution from the braced excavation cab then be understand in advance. The problems can be prevented prior to the construction process, and thus acquire all the affected important factors during design and construction.

Keywords: excavation, numerical simulation, RIDO, retaining structure

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Authors: Yafa Haron, Hanna Adami

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Background: World Health Organization emphasizes the contribution of nurses in planning and implementing health policies and reforms. Aim: To evaluate nursing students’ attitudes towards nurses’ involvement in health policy issues. Methods: Mixed-methods; qualitative and quantitative – a descriptive study. Participants - nursing students who were enrolled in their last year in the undergraduate program (BSN). Qualitative data included two open-ended questions: What is health policy and what is the importance of studying health policy, and 18 statements on the Likert Scale range 1-5. Results: Qualitativeanalysisrevealed that the majority of students defined health policy as a set of rules and regulations that defined procedures, borders, and proper conduct. 73% of students responded that nurses should be active in policymaking, but only 22% thought that nurses were currently involved in political issues. 28% thought that nurses do not have the knowledge and the time needed (60%) for political activity. 77% thought that the work environment did not encourage nurses to be politically active. Nursing students are aware of the importance towards nurses’ involvement in health policy issues, however, they do not have role models based on their low evaluation regarding nurses’ involvement in the health policy decision making process at the local or national level. Conclusions: Results emphasize the importance and the need of implementation the recommendation to include “advance policy changes” as core competency in nursing education and practice.

Keywords: health policy, nursing education, health systems, student perceptions

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Authors: Alisher Agzamov, Hanan Al Harbi

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BACKGROUND: The timely assessment and treatment of ICU Surgical and Medical Oncology patients is important for Oncology surgeons and Medical Oncologists and Intensivists (1). We hypothesized that the use of Robot Physician’s (RP - 7) ICU management and care in ICU can improve ICU physician rapid response to unstable ICU Oncology patients. METHODS: This is a prospective study of 1501 oncology patients using a before-after, cohort-control design to test the effectiveness of RP. We have used RP to make multidisciplinary ICU rounds in the ICU and for Emergency cases. Data concerning several aspects of the RP interaction, including the latency of the response, the problem being treated, the intervention that was ordered, and the type of information gathered using the RP, were documented. The effect of RP on ICU length of stay and cost was assessed. RESULTS: The use of RP was associated with a reduction in latency of attending physician face-to-face response for routine and urgent pages compared to conventional care (RP: 10.2 +/- 3.3 minutes vs conventional: 210 +/- 40 minutes). The response latencies to Oncology Emergency (8.0 +/- 2.8 vs 140 +/- 35 minutes) and for Respiratory Failure (12 +/- 04 vs 110 +/- 45 minutes) were reduced (P < .001), as was the LOS for oncology patients (5 days) and ARDS (10 day). There was an increase in ICU occupancy by 29 % compared with the prerobot era, and there was an ICU cost savings of KD2.2 million attributable to the use of RP. CONCLUSION: The use of RP enabled rapid face-to-face ICU Intensivist - physician response to unstable ICU Oncology patients and resulted in decreased ICU cost and LOS.

Keywords: robot physician, oncology patients, icu management and care, cost and icu occupancy

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Authors: Néstor Iván Rojas, Wilson Medina Sierra

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Managing spatial information is described through a Geographic Information System (GIS), for some neighborhoods in the city of Tunja, in relation to the structural typology of the buildings. The use of GIS provides tools that facilitate the capture, processing, analysis and dissemination of cartographic information, product quality evaluation of the classification of buildings. Allows the development of a method that unifies and standardizes processes information. The project aims to generate a geographic database that is useful to the entities responsible for planning and disaster prevention and care for vulnerable populations, also seeks to be a basis for seismic vulnerability studies that can contribute in a study of urban seismic microzonation. The methodology consists in capturing the plat including road naming, neighborhoods, blocks and buildings, to which were added as attributes, the product of the evaluation of each of the housing data such as the number of inhabitants and classification, year of construction, the predominant structural systems, the type of mezzanine board and state of favorability, the presence of geo-technical problems, the type of cover, the use of each building, damage to structural and non-structural elements . The above data are tabulated in a spreadsheet that includes cadastral number, through which are systematically included in the respective building that also has that attribute. Geo-referenced data base is obtained, from which graphical outputs are generated, producing thematic maps for each evaluated data, which clearly show the spatial distribution of the information obtained. Using GIS offers important advantages for spatial information management and facilitates consultation and update. Usefulness of the project is recognized as a basis for studies on issues of planning and prevention.

Keywords: microzonation, buildings, geo-processing, cadastral number

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Authors: Tobias Wissing, Peter Burggräf, Johannes Wagner

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Cost pressure, competitiveness and the increasing turbulence of globalized saturated markets has been the driver for a variety of research activities in the field of production planning and control (PPC) during the past decades. For some time past an increasing awareness for innovative technologies in terms of Industry 4.0 can be noticed. Although there are many promising approaches a solely installation of those smart solutions will not maximize the PPC performance. To accelerate the successful digital transformation the cooperation between employee and technology also has to be adapted. The existing processes and organizational structures might be not sufficient to maximize the utilization of technological innovations. This paper presents the key results of an extensive study which was conducted by the Laboratory for Machine Tools and Production Engineering (WZL) of the RWTH Aachen University to evaluate the current situation and examine the organizational readiness for this digital transformation.

Keywords: cyber-physical production system, digital transformation, industry 4.0, production planning and control

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Authors: William Li

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Lane-change path planning is a crucial and yet complex task in autonomous driving. The traditional path planning approach based on a system of carefully-crafted rules to cover various driving scenarios becomes unwieldy as more and more rules are added to deal with exceptions and corner cases. This paper proposes to divide the entire path planning to two stages. In the first stage the ego vehicle travels longitudinally in the source lane to reach a safe state. In the second stage the ego vehicle makes lateral lane-change maneuver to the target lane. The paper derives the safe state conditions based on lateral lane-change maneuver calculation to ensure collision free in the second stage. To determine the acceleration sequence that minimizes the time to reach a safe state in the first stage, the paper proposes three schemes, namely, kinetic model based optimization, deep reinforcement learning, and 5G vehicle-to-vehicle (V2V) communications. The paper investigates these schemes via simulation. The model-based optimization is sensitive to the model assumptions. The deep reinforcement learning is more flexible in handling scenarios beyond the model assumed by the optimization. The 5G V2V eliminates uncertainty in predicting future behaviors of surrounding vehicles by sharing driving intents and enabling cooperative driving.

Keywords: lane change, path planning, autonomous driving, deep reinforcement learning, 5G, V2V communications, connected vehicles

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Authors: Adisorn Bansong, Walai Isarankura Na Ayudhaya, Aumporn Makanong

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A Development of an Instructional Model for Health Education was the aim to develop and study the effectiveness of an instructional model for health education to enhance self-regulation and learning achievement of lower secondary school students. It was the Quasi-Experimental Designs, used a Single-group Interrupted Time-series Designs, conducted by 2 phases: 1. To develop an instructional model based on Social Cognitive Theory and Strategic Life Planning. 2. To trial and evaluate effectiveness of an instructional model. The results as the following: i. An Instructional Model for Health Education consists of five main components: a) Attention b) Forethought c) Tactic Planning d) Execution and e) Reflection. ii. After an Instructional Model for Health Education has used for a semester trial, found the 4.07 percent of sample’s Self-Regulation higher and learning achievement on post-test were significantly higher than pre-test at .05 levels (p = .033, .000).

Keywords: social cognitive theory, strategic life planning, self-regulation, learning achievement

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Gudakesh Yadav

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Utter Pradesh, which is one of the largest states of India with unequal distribution of resources and different socioeconomic and cultural characteristics, level of different new born health care indicators varies a lot from one district to another district. State shared more than 21 percent of total live births of India; whereas, it accounts for 28 percent of total infant deaths of the country, with the 53 per thousand infant mortality rate. The present paper attempts to examine tempo-spatial changes in new born care practices during NFHS-1 to NFHS-3 and DLHS-2 to DLHS-3 in Uttar Pradesh and different regions. Descriptive statistics, rate-ratios, concentration index, multivariate and decomposition analysis has been used for the study. Findings of the study reveal that new born care practices have improved over the time in the state and across all the regions because of giving more emphasis on venerable groups like poor, rural, less educated mothers and scheduled caste & tribes but still it did not achieve the desired successes. Regional analysis of third rounds of DLHS shows that, coverage of intuitional delivery was the lowest in the central region. Performance of the southern region was the lowest in terms of initiation of breastfeeding, keeping baby warm and dry after the birth. The study calls for proper follow up of new born children to accelerate new born and child health care service and prioritises increasing antenatal check-ups and institutional delivery, which helps to improve level of other new born care services. At the policy level there is need to reach venerable groups like scheduled caste and tribes, poor and uneducated, and new mother especially in rural areas. High focused district should be allocated for better implementation of new born care promotion programme in low performing districts. Partnership with the private sector health professional is necessary to reach the every part of population.

Keywords: decomposition, inequality, initiation of breastfeeding, institutional delivery

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Authors: Alexey Abilov

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The article highlights the experience of training master's and doctoral students at Satbayev University by preparing their course works for disciplines "Principles of Sustainable Architecture", "Energy Efficiency in Urban planning", "Urban planning analysis, "Social foundations of Architecture". The purpose of these works is the acquisition by students of practical skills necessary in their future professional activities, which are achieved through comprehensive assessment of individual sections of the Almaty urban environment. The methodology of student’s researches carried out under the guidance of the author of this publication is based on an expert assessment of the territory through its full-scale survey, analysis of project documents and statistical data, as well as on a social assessment of the territory based on the results of a questionnaire survey of residents. A comprehensive qualitative and quantitative assessment of the selected sites according to the criteria of the quality of the living environment also allows to formulate specific recommendations for designers who carry out a pre-project analysis of the city territory in the process of preparing draft master plans and detailed planning projects.

Keywords: urban environment, expert/social assessment of the territory, questionnaire survey, comprehensive approach

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Authors: B. B. van Schalkwyk, C. B. Schoeman, E. J. Cilliers

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High levels of urbanisation and the lingering effects of Apartheid have caused South African municipalities to experience difficulties in planning for sustainability and, more specifically, sustainable community development. Sustainable community development is needed in order to achieve more integrated and sustainable towns and cities with an improved living environment and a higher quality of life. Due to this, sustainable community development is of particular relevance to South Africa. Although policies and legislation exist at international, national and local level, there is a lack of suitable planning instruments to guide sustainable community development. Tlokwe Local Municipality is researched in this paper as study area to test and develop planning instruments for sustainable community development. A comparative assessment matrix of sustainability indicators is linked to Multi-Criteria Analysis (MCA) and applied to identify the themes and sub-themes applicable to sustainability in which intervention is required to improve the sustainability rating of the municipality. The result of the comparative sustainability assessment is that the Tlokwe Local Municipality is considered to be relatively sustainable, performing overall better than the three spheres of government against which it was measured. It is recommended that municipalities use the comparative assessment matrix method to determine its level of sustainability when developing respective sectorial plans (SDFs, ITPs, EMFs and IDPs). Areas in which there is a lack of sustainability are highlighted and can consequently be addressed through intervention strategies. The comparative assessment matrix method is a valuable planning instrument with which to achieve sustainable community development.

Keywords: sustainable community development, sustainability indicators, comparative sustainability, urbanisation, development planning, urban management

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Authors: C. P. Griffin

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This paper seeks to critically review special educational needs (SEN) policy in the Irish education system since the introduction of the Education Act in 1998. In particular, the author seeks to focus on the impact of SEN policy on inclusionary practices for children with significant care needs in light of the introduction on the Special Needs Assistant (SNA) scheme. Following a systematic review of the literature, the growth of the SNA scheme in Ireland will be critically reviewed. Strengths and weaknesses of the scheme will be forwarded and comparisons drawn between contrasting international models of teaching assistant support. Based on this review, avenues for future research will be forwarded, with the aim of supporting effective inclusionary practices for children with SEN based on evidence-based practice.

Keywords: care needs, inclusion, Ireland, special needs assistants

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Authors: Tianjie Zhang, Bingqian Cheng, Peng Zeng

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Engineering science and technology progress and innovation have become an important engine to promote social development. The reform exploration of "new engineering" in China has drawn extensive attention around the world, with its connotation as "to cultivate future diversified, innovative and outstanding engineering talents by taking ‘fostering character and civic virtue’ as the guide, responding to changes and shaping the future as the construction concept, and inheritance and innovation, crossover and fusion, coordination and sharing as the principal approach". In this context, Tianjin University, as a traditional Chinese university with advantages in engineering, further launched the CCII (Coherent-Collaborative-Interdisciplinary-Innovation) program, raising the cultivation idea of integrating new liberal arts education, multidisciplinary engineering education and personalized professional education. As urban planning practice in China has undergone the evolution of "physical planning -- comprehensive strategic planning -- resource management-oriented planning", planning education has also experienced the transmutation process of "building foundation -- urban scientific foundation -- multi-disciplinary integration". As a characteristic and advantageous discipline of Tianjin University, the major of Urban and Rural Planning, in accordance with the "CCII Program of Tianjin University", aims to build China's top and world-class major, and implements the following educational reform measures: 1. Adding corresponding English courses, such as advanced course on GIS Analysis, courses on comparative studies in international planning involving ecological resources and the sociology of the humanities, etc. 2. Holding "Academician Forum", inviting international academicians to give lectures or seminars to track international frontier scientific research issues. 3. Organizing "International Joint Workshop" to provide students with international exchange and design practice platform. 4. Setting up a business practice base, so that students can find problems from practice and solve them in an innovative way. Through these measures, the Urban and Rural Planning major of Tianjin University has formed a talent training system with multi-disciplinary cross integration and orienting to the future science and technology.

Keywords: China, higher education reform, innovation, new engineering education, rural and urban planning, Tianjin University

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Authors: M. A. Brown, K. Hugill, D. Meredith

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Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

Procedia PDF Downloads 135