Search results for: healthcare regulations
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2531

Search results for: healthcare regulations

1751 Impact of Treatment of Fragility Fractures Due to Osteoporosis as an Economic Burden Worldwide: A Systematic Review

Authors: Fabiha Tanzeem

Abstract:

BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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1750 No-Par Shares Working in European LLCs

Authors: Agnieszka P. Regiec

Abstract:

Capital companies are based on monetary capital. In the traditional model, the capital is the sum of the nominal values of all shares issued. For a few years within the European countries, the limited liability companies’ (LLC) regulations are leaning towards liberalization of the capital structure in order to provide higher degree of autonomy regarding the intra-corporate governance. Reforms were based primarily on the legal system of the USA. In the USA, the tradition of no-par shares is well-established. Thus, as a point of reference, the American legal system is being chosen. Regulations of Germany, Great Britain, France, Netherlands, Finland, Poland and the USA will be taken into consideration. The analysis of the share capital is important for the development of science not only because the capital structure of the corporation has significant impact on the shareholders’ rights, but also it reflects on relationships between creditors of the company and the company itself. Multi-level comparative approach towards the problem will allow to present a wide range of the possible outcomes stemming from the novelization. The dogmatic method was applied. The analysis was based on the statutes, secondary sources and judicial awards. Both the substantive and the procedural aspects of the capital structure were considered. In Germany, as a result of the regulatory competition, typical for the EU, the structure of LLCs was reshaped. New LLC – Unternehmergesellschaft, which does not require a minimum share capital, was introduced. The minimum share capital for Gesellschaft mit beschrankter Haftung was lowered from 25 000 to 10 000 euro. In France the capital structure of corporations was also altered. In 2003, the minimum share capital of société à responsabilité limitée (S.A.R.L.) was repealed. In 2009, the minimum share capital of société par actions simplifiée – in the “simple” version of S.A.R.L. was also changed – there is no minimum share capital required by a statute. The company has to, however, indicate a share capital without the legislator imposing the minimum value of said capital. In Netherlands the reform of the Besloten Vennootschap met beperkte aansprakelijkheid (B.V.) was planned with the following change: repeal of the minimum share capital as the answer to the need for higher degree of autonomy for shareholders. It, however, preserved shares with nominal value. In Finland the novelization of yksityinen osakeyhtiö took place in 2006 and as a result the no-par shares were introduced. Despite the fact that the statute allows shares without face value, it still requires the minimum share capital in the amount of 2 500 euro. In Poland the proposal for the restructuration of the capital structure of the LLC has been introduced. The proposal provides among others: devaluation of the capital to 1 PLN or complete liquidation of the minimum share capital, allowing the no-par shares to be issued. In conclusion: American solutions, in particular, balance sheet test and solvency test provide better protection for creditors; European no-par shares are not the same as American and the existence of share capital in Poland is crucial.

Keywords: balance sheet test, limited liability company, nominal value of shares, no-par shares, share capital, solvency test

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1749 Lobbying Regulation in the EU: Transparency’s Achilles’ Heel

Authors: Krambia-Kapardis Maria, Neophytidou Christina

Abstract:

Lobbying is an inherent aspect within the democratic regimes across the globe. Although it can provide decision-makers with valuable knowledge and grant access to stakeholders in the decision-making process, it can also lead to undue influence and unfair competition at the expense of the public interest if it not transparent. Given the multi-level governance structure of the EU, it is no surprise that the EU policy-making arena has become a place-to-be for lobbyists. However, in order to ensure that influence is legitimate and not biased of any business interests, lobbying must be effectively regulated. A comparison with the US and Canadian lobbying regulatory framework and utilising some good practices from EU countries it is apparent that lobbying is the Achilles’ heel to transparency in the EU. It is evident that EU institutions suffer from ineffective regulations and could in fact benefit from a more robust, mandatory and better implemented system of lobbying regulation.

Keywords: EU, lobbying regulation, transparency, democratic regimes

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1748 EMI Radiation Prediction and Final Measurement Process Optimization by Neural Network

Authors: Hussam Elias, Ninovic Perez, Holger Hirsch

Abstract:

The completion of the EMC regulations worldwide is growing steadily as the usage of electronics in our daily lives is increasing more than ever. In this paper, we introduce a novel method to perform the final phase of Electromagnetic compatibility (EMC) measurement and to reduce the required test time according to the norm EN 55032 by using a developed tool and the conventional neural network(CNN). The neural network was trained using real EMC measurements, which were performed in the Semi Anechoic Chamber (SAC) by CETECOM GmbH in Essen, Germany. To implement our proposed method, we wrote software to perform the radiated electromagnetic interference (EMI) measurements and use the CNN to predict and determine the position of the turntable that meets the maximum radiation value.

Keywords: conventional neural network, electromagnetic compatibility measurement, mean absolute error, position error

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1747 Online Dietary Management System

Authors: Kyle Yatich Terik, Collins Oduor

Abstract:

The current healthcare system has made healthcare more accessible and efficient by the use of information technology through the implementation of computer algorithms that generate menus based on the diagnosis. While many systems just like these have been created over the years, their main objective is to help healthy individuals calculate their calorie intake and assist them by providing food selections based on a pre-specified calorie. That application has been proven to be useful in some ways, and they are not suitable for monitoring, planning, and managing hospital patients, especially that critical condition their dietary needs. The system also addresses a number of objectives, such as; the main objective is to be able to design, develop and implement an efficient, user-friendly as well as and interactive dietary management system. The specific design development objectives include developing a system that will facilitate a monitoring feature for users using graphs, developing a system that will provide system-generated reports to the users, dietitians, and system admins, design a system that allows users to measure their BMI (Body Mass Index), the system will also provide food template feature that will guide the user on a balanced diet plan. In order to develop the system, further research was carried out in Kenya, Nairobi County, using online questionnaires being the preferred research design approach. From the 44 respondents, one could create discussions such as the major challenges encountered from the manual dietary system, which include no easily accessible information of the calorie intake for food products, expensive to physically visit a dietitian to create a tailored diet plan. Conclusively, the system has the potential of improving the quality of life of people as a whole by providing a standard for healthy living and allowing individuals to have readily available knowledge through food templates that will guide people and allow users to create their own diet plans that consist of a balanced diet.

Keywords: DMS, dietitian, patient, administrator

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1746 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

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1745 Risk Factors for Acute Respiratory Infection Among Children Under Five in Tanzania: A Systematic Review and Analysis of the 2015 Demographic and Health Survey for Tanzania

Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

Abstract:

It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

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1744 The Importance and Feasibility of Hospital Interventions for Patient Aggression and Violence Against Physicians in China: A Delphi Study

Authors: Yuhan Wu, CTB (Kees) Ahaus, Martina Buljac-Samardzic

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Patient aggression and violence is a complex occupational hazards for physicians working in hospitals, and it can have multiple severe negative effects for physicians and hospitals. Although there is a range of interventions in the healthcare sector applied in various countries, China lacks a comprehensive set of interventions at the hospital level in this area. Therefore, due to cultural differences, this study investigates whether international interventions are important and feasible in the Chinese cultural context by conducting a Delphi study. Based on a literature search, a list of 47 hospital interventions to prevent and manage patient aggression and violence was constructed, including 8 categories: hospital environment design, access and entrance, staffing and work practice, training and education, leadership and culture, support, during/after-the-event actions, and hospital policy. The list of interventions will be refined, extended and brought back during a three-round Delphi study. The panel consists of 17 Chinese experts, including physicians experiencing patient aggression and violence, hospital management team members, scientists working in this research area, and policymakers in the healthcare sector. In each round, experts will receive the possible interventions with the instruction to indicate the importance and feasibility of each intervention for preventing and managing patient violence and aggression in Chinese hospitals. Experts will be asked about the importance and feasibility of interventions for patient violence and aggression at the same time. This study will exclude or include interventions based on the score of importance. More specifically, an intervention will be included after each round if >80% of the experts judged it as important or very important and excluded if >50% judged an intervention as not or moderately important. The three-round Delphi study will provide a list of included interventions and assess which of the 8 categories of interventions are considered as important. It is expected that this study can bring new ideas and inspiration to Chinese hospitals in the prevention and management of patient aggression and violence.

Keywords: patient aggression and violence, hospital interventions, feasibility, importance

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1743 Sustainability of Offshore Petroleum Resources Extraction and Management of Bangladesh: International and Regional Frameworks

Authors: Muhammad Farhad Hosen

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This article examines the sustainability of offshore petroleum resource extraction and management in Bangladesh, focusing on international and regional frameworks. The analysis includes international conventions such as UNCLOS, IMO regulations, and SDGs, as well as regional cooperation through organizations like BIMSTEC and SAARC. The objective is to highlight the impact of these frameworks on sustainable extraction practices, address challenges, and offer recommendations for enhancing Bangladesh's legal and regulatory approaches to offshore resource management. The article underscores the need for harmonizing national laws with international standards, enhancing enforcement mechanisms, and promoting regional cooperation to ensure sustainable development.

Keywords: Bangladesh, international frameworks, offshore petroleum, regional framework, sustainability

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1742 The Impact of Artificial Intelligence on Food Industry

Authors: George Hanna Abdelmelek Henien

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Quality and safety issues are common in Ethiopia's food processing industry, which can negatively impact consumers' health and livelihoods. The country is known for its various agricultural products that are important to the economy. However, food quality and safety policies and management practices in the food processing industry have led to many health problems, foodborne illnesses and economic losses. This article aims to show the causes and consequences of food safety and quality problems in the food processing industry in Ethiopia and discuss possible solutions to solve them. One of the main reasons for food quality and safety in Ethiopia's food processing industry is the lack of adequate regulation and enforcement mechanisms. Inadequate food safety and quality policies have led to inefficiencies in food production. Additionally, the failure to monitor and enforce existing regulations has created a good opportunity for unscrupulous companies to engage in harmful practices that endanger the lives of citizens. The impact on food quality and safety is significant due to loss of life, high medical costs, and loss of consumer confidence in the food processing industry. Foodborne diseases such as diarrhoea, typhoid and cholera are common in Ethiopia, and food quality and safety play an important role in . Additionally, food recalls due to contamination or contamination often cause significant economic losses in the food processing industry. To solve these problems, the Ethiopian government began taking measures to improve food quality and safety in the food processing industry. One of the most prominent initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to monitor and control the quality and safety of food and beverage products in the country. EFDA has implemented many measures to improve food safety, such as carrying out routine inspections, monitoring the import of food products and implementing labeling requirements. Another solution that can improve food quality and safety in the food processing industry in Ethiopia is the implementation of food safety management system (FSMS). FSMS is a set of procedures and policies designed to identify, assess and control food safety risks during food processing. Implementing a FSMS can help companies in the food processing industry identify and address potential risks before they harm consumers. Additionally, implementing an FSMS can help companies comply with current safety and security regulations. Consequently, improving food safety policy and management system in Ethiopia's food processing industry is important to protect people's health and improve the country's economy. . Addressing the root causes of food quality and safety and implementing practical solutions that can help improve the overall food safety and quality in the country, such as establishing regulatory bodies and implementing food management systems.

Keywords: food quality, food safety, policy, management system, food processing industry food traceability, industry 4.0, internet of things, block chain, best worst method, marcos

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1741 SWOT Analysis of Renewable Energy

Authors: Bahadır Aydın

Abstract:

Being one of the most important elements of social evolution, energy has a vital role for a sustainable economy and development. Energy has great importance to level up the welfare. By this importance, countries having rich resources can apply energy as an political instrument. While needs of energy is increasing, sources to respond this need is very limited. Therefore, countries seek for alternative resources to meet their needs. Renewable energy sources have firstly taken into consideration. Being clean and belonging to countries own sources, renewable energy resources have been widely applied during the last decades. However, renewable energy cannot meet all the expectation of energy needs. In this respect, energy efficiency can be seen as an alternative. Energy efficiency can minimize energy consumption without degrading standard of living, lessening quality of products and without increasing energy bills. In this article, energy resources, SWOT analysis of renewable sources, and energy efficiency topics are mainly discussed.

Keywords: energy efficiency, renewable energy, energy regulations, oil, international relations

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1740 Analysis of the Recovery of Burnility Index and Reduction of CO2 for Cement Manufacturing Utilizing Waste Cementitious Powder as Alternative Raw Material of Limestone

Authors: Kwon Eunhee, Park Dongcheon, Jung Jaemin

Abstract:

In countries around the world, environmental regulations are being strengthened, and Korea is no exception to this trend, which means that environment pollution and the environmental load have recently become a significant issue. For this reason, in this study limestone was replaced with cementitious powder to reduce the volume of construction waste as well as the emission of carbon dioxide caused by Tal-carbonate reaction. The research found that cementitious powder can be used as a substitute for limestone. However, the mix proportions of fine aggregate and powder included in the cementitious powder appear to have a great effect on substitution. Thus, future research should focus on developing a technology that can effectively separate and discharge fine aggregate and powder in the cementitious powder.

Keywords: waste cementitious powder, fine aggregate powder, CO2 emission, decarbonation reaction, calcining process

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1739 Health Services for Women Refugees: A Quantitative Exploratory Study in Ottawa, Canada

Authors: Kholoud Sheba

Abstract:

Women refugees expectedly are physical, socially and mentally vulnerable due to their past traumatic experiences and their novel circumstances in their receiving countries. They may have a wide range of general, mental, and reproductive health problems, but reportedly avoid visiting health care facilities owing to complex elements. Women refugees are usually unfamiliar with their new country health system and unable to navigate it efficiently. They have limited English language skills, which makes it even harder to access culturally insensitive health services. This study examines barriers to health care for refugee women in Ottawa and offers suggestions to address these challenges. Drawing from culturally congruent health care models in Canada, the United Kingdom, and some parts of the United States, this study highlights the importance of cultivating compassion in the provision of health care for women refugees as a way of addressing some of the disparities in health care in Canada. To address the study purpose, a survey questionnaire was designed and pretested questionnaire and was administrated using SurveyMonkey, a paid source survey application, over a period of two weeks. Snowballing sampling procedures were used to recruit the participants. Data was measured using frequencies, percentages, t-test, ANOVA, and chi-square. The test of significance is set at p < .05. The study asked how refugees perceive their experience in accessing and navigating public health services in Ottawa; what challenges refugees face with healthcare in Canada, and, if gender is related to refugees’ perceptions of the health care system they are forced to use? Results show refugees perceived their experience accessing the healthcare services in Canada to be a positive experience and the health providers to be culturally sensitive and allowing enough time listening to their complaints. The language stood tall in their barriers accessing the services due to low English proficiency and the need for interpretation services to encourage them attending the services.

Keywords: women refugee, access barriers, Ottawa, resettlement

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1738 Covid-19 Frontliners Survey: Assessing Complications and Quality of Life in Health Care Workers in District Swat, Khyber Pakhtunkhwa, Pakistan

Authors: Mohsin Shahab, Shagufta Rehmat, Faisal F. Khan

Abstract:

Background: The global COVID-19 pandemic has generated health problems worldwide. Health care workers are the front-line warriors against the pandemic. The aim of this study was to find out the prevalence of COVID-19 (7th May 2021 to 3rd August 2021) amongst Health Care Workers (HCWs) and to assess the complications associated with it and its effects on their quality of life. Material and Method: The study was conducted in healthcare facilities which serve as pandemic hospitals in district Swat. A total of 140 healthcare workers, who were employed in the COVID-19 health care facilities, including the department of Pulmonology, Intensive Care Unit (ICU), and COVID-19 wards. Participants were tested for COVIID-19 using RT PCR test. A Case Report Form (CRF) for conditions during and post COVID-19 was filled to assess the complications and quality of life of health care workers. Results: A total of 140 Health Care Workers were studied, out of which 40% were doctors, 22% nursing staff, 17% paramedic staff, 9% cleaning staff, lab technologist 6%, 2% operation theater staff, administration staff, and pharmacist. The respondents were also investigated for pre-existing illness prior to SARS-CoV-2 infection, hypertension was the most prevalent, followed by chronic heart diseases and neurological disorders. Fever was the most common symptom, recorded 76.42% in the participants, while 55.71% of participants had dry cough, 55% had a sore throat, following by chest pain 43.56%. Reinfection rate was 10%, with chest pain being recorded in 85.71%. Post disease complication analysis showed that 47.14% of the participants were diagnosed with a new diagnosis after the COVID-19 recovery. Pulmonological diseases were recorded the most as a new diagnosis in, followed by gastrointestinal and psychological problems. Conclusions: The results of the study illustrates how COVID-19 has affected the overall health and quality of life of HCWs in District Swat of Khyber Pakhtunkhwa, Pakistan.

Keywords: SARS-CoV-2, COVID-19, HCW's, symptoms, questionnaire, post COVID-19

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1737 Strategic Interventions to Address Health Workforce and Current Disease Trends, Nakuru, Kenya

Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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1736 Autonomy in Healthcare Organisations: A Comparative Case Study of Middle Managers in England and Iran

Authors: Maryam Zahmatkesh

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Middle managers form a significant occupational category in organisations. They undertake a vital role, as they sit between the operational and strategic roles. Traditionally they were acting as diplomat administrators, and were only in power to meet the demands of professionals. Following the introduction of internal market, in line with the principles of New Public Management, middle managers have been considered as change agents. More recently, in the debates of middle managers, there is emphasis on entrepreneurialism and enacting strategic role. It was assumed that granting autonomy to the local organisations and the inception of semi-autonomous hospitals (Foundation Trusts in England and Board of Trustees in Iran) would give managers more autonomy to act proactively and innovatively. This thesis explores the hospital middle managers’ perception of and responses to public management reforms (in particular, hospital autonomy) in England and Iran. In order to meet the aims of the thesis, research was undertaken within the interpretative paradigm, in line with social constructivism. Data were collected from interviews with forty-five middle managers, observational fieldwork and documentary analysis across four teaching university hospitals in England and Iran. The findings show the different ways middle managers’ autonomy is constrained in the two countries. In England, middle managers have financial and human recourses, but their autonomy is constrained by government policy and targets. In Iran, middle managers are less constrained by government policy and targets, but they do not have financial and human resources to exercise autonomy. Unbalanced autonomy causes tension and frustration for middle managers. According to neo-institutional theory, organisations are deeply embedded within social, political, economic and normative settings that exert isomorphic and internal population-level pressures to conform to existing and established modes of operation. Health systems which are seeking to devolve autonomy to middle managers must appreciate the multidimensional nature of the autonomy, as well as the wider environment that organisations are embedded, if they are about to improve the performance of managers and their organisations.

Keywords: autonomy, healthcare organisations, middle managers, new public management

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1735 Advances in Medication Reconciliation Tools

Authors: Zixuan Liu, Xin Zhang, Kexin He

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In the context of widespread prevalence of multiple diseases, medication safety has become a highly concerned issue affecting patient safety. Medication reconciliation plays a vital role in preventing potential medication risks. However, in medical practice, medication reconciliation faces various challenges, and there is a wide variety of medication reconciliation tools, making the selection of appropriate tools somewhat difficult. The article introduces and analyzes the currently available medication reconciliation tools, providing a reference for healthcare professionals to choose and apply the appropriate medication reconciliation tools.

Keywords: patient safety, medication reconciliation, tools, review

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1734 Examination of Occupational Health and Safety Practices in Ghana

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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1733 The Influences of Nurses’ Satisfaction on the Patient Satisfaction with and Loyalty to Korean University Hospitals

Authors: Sung Hee Ahn, Ju Rang Han

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Background: With increasing importance in healthcare organization on patient satisfaction and nurses’ job satisfaction, many studies have been conducted. But no research has been administered how nurses’ satisfaction with healthcare organization influence patient satisfaction and loyalty. Purpose: This study aims to conceptualize nurses‘ satisfaction, patient satisfaction with and patient loyalty to hospitals using a hypothetical linear structural equation model, and to identify the significance of path coefficients and goodness of fit index of the structural equation model as well. Method: A total of 2,079 nurses and 6,776 patients recruited from 5 university hospitals in South Korea participated in this study. The data on nurses, including ward nurses and outpatient nurses, were collected from June 24th to July 12th, at the 204 departments of the 5 hospitals through an on-line survey. The data on the patients, including both inpatients and outpatients, were collected from September 30th to October 24th, 2013 at the 5 hospitals using a structured questionnaire. The variable of nurses’ satisfaction was measured using a scale evaluating internal client satisfaction, which is used in SSM Health Care System in the US. Patient satisfaction with the hospital and nurses and patient loyalty were measured by assessing the patient’s intention to revisit and to recommending the hospital to others using a visual analogue scale. The data were analyzed using SPSS version 21.0 and AMOS version 21.0. Result: The hypothetical model was fairly good in terms of goodness of fit (χ2= 64.897 (df=24, p <. 001), GFI=. 906, AGFI=.823, CFI=.921, NFI=.951, NNFI=.952. RMSEA=.114). The significance of path coefficients includes followings 1)The nurses’ satisfaction has significant influence on the patient satisfaction with nurses. 2)The patient satisfaction with nurses has significant influence on the patient satisfaction with the hospital. 3)The patient satisfaction with the hospital has significant influence on the patients’ revisit intention. 4)The patient satisfaction with the hospital has significant influence on the patients’ intention to the recommendations of the hospital. Conclusion: These results provide several practical implications to hospital administrators, who should incorporate ways of improving nurses' and patients' satisfaction with the hospital into their health care marketing strategies.

Keywords: linear structural equation model, loyalty, nurse, patient satisfaction

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1732 A Decision Support System for Flight Disruptions Management

Authors: Burak Erkayman, Emin Gundogar, Hayrettin Evirgen, Murat Sarı

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With the increasing competition in recent years, airline companies tend to manage their operations aiming fewer losses in a robust manner. Airline operations are complex operations and have the necessity of being performed just in time and more knock-on relevant elements in the event of a disruption. In this study a knowledge based decision support system is suggested and software is developed. The developed software includes knowledge bases which are based on expert experience and government regulations, model bases and data bases. The results of the suggested approach are presented and improvable aspects of the approach are discussed.

Keywords: knowledge based systems, irregular operations, decision support systems, flight disruptions management

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1731 Plasma Systems Application in Treating Automobile Exhaust Gases for a Clean Environment (Case Study)

Authors: Tahsen Abdalwahab Ibraheem Albehege

Abstract:

Exhaust fuel purification is of great importance to prevent the emission of major pollutants into the atmosphere such as diesel particulates and nitrogen oxides and meet environmental regulations, so environmental impacts are a primary concern of Diesel Exhaust Gas (DEG) which contains hazardous substances harmful to the environment as well as human health.We can not plasma formed through directing electrical energy to create free electrons, which in turn can react with gaseous species, but we can by used to treat engine exhaust gases. . By NO that has been reportedly oxidized to HNO3 and then into ammonium nitrate, and then condensed and removed. In general, thermal plasmas are formed by heating a system to high temperatures 2,000 degrees C, however this can be inefficient and can require extensive thermal management.

Keywords: plasma system application, project physics, oxidizing environment, electromagnetically

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1730 Design and Control Algorithms for Power Electronic Converters for EV Applications

Authors: Ilya Kavalchuk, Mehdi Seyedmahmoudian, Ben Horan, Aman Than Oo, Alex Stojcevski

Abstract:

The power electronic components within Electric Vehicles (EV) need to operate in several important modes. Some modes directly influence safety, while others influence vehicle performance. Given the variety of functions and operational modes required of the power electronics, it needs to meet efficiency requirements to minimize power losses. Another challenge in the control and construction of such systems is the ability to support bidirectional power flow. This paper considers the construction, operation, and feasibility of available converters for electric vehicles with feasible configurations of electrical buses and loads. This paper describes logic and control signals for the converters for different operations conditions based on the efficiency and energy usage bases.

Keywords: electric vehicles, electrical machines control, power electronics, powerflow regulations

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1729 Improving Lone Worker Safety In Latin America

Authors: Ernesto Ghini

Abstract:

Workplace accidents are an unfortunate reality. However, they are also predictable and avoidable. We conducted research into a variety of legislation covering lone working, and conducted a study into the use of connected technology and how it can help improve the safety of lone workers in Latin America. We implemented quantitative research into regulations coupled with case study research into a real-life scenario that demonstrated the benefits of technology, and discuss our findings in this paper. Connected safety solutions can improve the bottom line, delivering significant return on investment in terms of improved efficiency and the avoidance of cost associated with worker injury. And, most importantly, such solutions, as demonstrated through our research, make the difference between life and death in time-critical incident situations.

Keywords: ione worker, legislation, technology, connected safety, connectivity

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1728 The Legal Position of the Sporting Directors in Saudi Football Clubs

Authors: Ammar Alrefaei

Abstract:

Sporting directors in football clubs plays a prominent and important role in managing and controlling many issues related to the affairs of professional players. In view of this great importance of the role of the sporting directors, the Saudi regulation of the professional players and their transfers took over the organization and control of many aspects related to the conditions that must be met by the sporting director and the obligations that fall on his responsibility with the sport club or the Saudi Football Association. However, this regulation does not avoid ambiguity at times and shortcomings at other times in many places, as some of the texts contained in regulation raise many questions, some of which point out to the need to find more comprehensive and accurate treatment than those in the current regulations, accordingly this study comes to shed light on the aspects related to the sporting directors in sport clubs and the development of provisions.

Keywords: professional contract, sporting directors, professional player, labor law

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1727 Legal Rights of Parents of Justice-Involved Youth in the United Arab Emirates

Authors: Yusra Ibrahim

Abstract:

Parental involvement in their children’s education and behavioral modification is important. This article provides a policy analysis that describes laws and public education regulations concerning justice-involved youth and youth at risk of delinquency in the United Arab Emirates. The article aims to clarify the UAE laws for parents and guardians regarding their involvement in addressing school violations and crimes committed by their children, particularly those with emotional and behavioral disorders, youths at risk for delinquency, and justice-involved youths. The article concludes with implications for parents, policymakers, and educators and suggests ways to improve services and support for these parents and their youth.

Keywords: justice-involved youth, parents, incarceration, incarcerated youth, United Arab Emirates.

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1726 Structural Behavior of Incomplete Box Girder Bridges Subjected to Unpredicted Loads

Authors: E. H. N. Gashti, J. Razzaghi, K. Kujala

Abstract:

In general, codes and regulations consider seismic loads only for completed structures of the bridges while, evaluation of incomplete structure of bridges, especially those constructed by free cantilever method, under these loads is also of great importance. Hence, this research tried to study the behavior of incomplete structure of common bridge type (box girder bridge), in construction phase under vertical seismic loads. Subsequently, the paper provided suitable guidelines and solutions to withstand this destructive phenomena. Research results proved that use of preventive methods can significantly reduce the stresses resulted from vertical seismic loads in box cross sections to an acceptable range recommended by design codes.

Keywords: box girder bridges, prestress loads, free cantilever method, seismic loads, construction phase

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1725 Investigation of Soot Regeneration Behavior in the DPF Cleaning Device

Authors: Won Jun Jo, Man Young Kim

Abstract:

To meet stringent diesel particulate matter regulations, DPF system is essential after treatment technology providing exceptional reliability and filtration performance. At low load driving conditions, the passive type of DPF system is ineffective for regeneration method due to the inadequate of engine exhaust heat in removing accumulated soot from the filter. Therefore, DPF cleaning device is necessary to remove the soot particles. In this work, the numerical analysis on the active regeneration of DPF in DPF cleaning device is performed to find the optimum operating conditions. In order to find the DPF regeneration characteristics during active regeneration, 5 different initial soot loading condition are investigated. As the initial soot mass increases, the maximum temperature of DPF and regeneration rate also increase.

Keywords: active regeneration, DPF cleaning device, pressure drop, Diesel Particulate Filter, particulate matters, computational fluid dynamics

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1724 Analysis of Biomarkers Intractable Epileptogenic Brain Networks with Independent Component Analysis and Deep Learning Algorithms: A Comprehensive Framework for Scalable Seizure Prediction with Unimodal Neuroimaging Data in Pediatric Patients

Authors: Bliss Singhal

Abstract:

Epilepsy is a prevalent neurological disorder affecting approximately 50 million individuals worldwide and 1.2 million Americans. There exist millions of pediatric patients with intractable epilepsy, a condition in which seizures fail to come under control. The occurrence of seizures can result in physical injury, disorientation, unconsciousness, and additional symptoms that could impede children's ability to participate in everyday tasks. Predicting seizures can help parents and healthcare providers take precautions, prevent risky situations, and mentally prepare children to minimize anxiety and nervousness associated with the uncertainty of a seizure. This research proposes a comprehensive framework to predict seizures in pediatric patients by evaluating machine learning algorithms on unimodal neuroimaging data consisting of electroencephalogram signals. The bandpass filtering and independent component analysis proved to be effective in reducing the noise and artifacts from the dataset. Various machine learning algorithms’ performance is evaluated on important metrics such as accuracy, precision, specificity, sensitivity, F1 score and MCC. The results show that the deep learning algorithms are more successful in predicting seizures than logistic Regression, and k nearest neighbors. The recurrent neural network (RNN) gave the highest precision and F1 Score, long short-term memory (LSTM) outperformed RNN in accuracy and convolutional neural network (CNN) resulted in the highest Specificity. This research has significant implications for healthcare providers in proactively managing seizure occurrence in pediatric patients, potentially transforming clinical practices, and improving pediatric care.

Keywords: intractable epilepsy, seizure, deep learning, prediction, electroencephalogram channels

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1723 Socio-Demographic and Clinical Characteristics and Use of Herbal Medicine among Patients Seeking Consultation for Knee Osteoarthritis at Secondary Healthcare Facilities in Oman

Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

Abstract:

Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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1722 Telemedicine and Telemonitoring for Interstitial Lung Disease Patients with Nintedanib

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

Abstract:

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

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

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