Search results for: health services

Authors: Karthikeyan Srinivasan, Ranjana Singh, Yatin Talwar, Karthikeyan Srinivasan

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Healthcare services play a vital role in the life of human being. The Setup of Hospital varies in wide spectrum of cost, technology, and access. Hospital’s of Public sector satisfies need of a common man to poorer, which can differ at private owned hospitals on cost and treatment. Patient assessing hospital frequently assumes spending time at the hospital is miserable and not aware of what is happening around them. Mostly they are queued up round the clock waiting to be admitted on hospital beds. The idea here is to highlight the role in admitting patient population of Outdoor as well as Emergency entering the Post Graduate Institute of Medical Education and Research, Chandigarh with available hospital beds. This study emphasizes the trend forecasting and acquiring beds needed. The conception “if patient population increases’ likewise increasing hospital beds advertently perceived. If tend to increase the hospital beds, thereby exploring budget, Manpower, space, and infrastructure make compulsion. This survey ideally draws out planning and forecasting beds to cater patient population in and around neighboring state of Chandigarh for admission at territory healthcare and research institute on available hospital beds. Executing healthcare services for growing population needs to know Roemer’s law indicating "in an insured population, a hospital bed built is a filled bed".

Keywords: admissions, average length of stay, bed days, hospital beds, occupancy rates

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Authors: Sudipto Shanker Dasgupta

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One of the largest mining companies wanted to look at health analytics for their driverless trucks. These trucks were the key to their supply chain logistics. The automated trucks had multi-level sub-assemblies which would send out sensor information. The use case that was worked on was to capture the sensor signal from the truck subcomponents and analyze the health of the trucks from repair and replacement purview. Open source software was used to stream the data into a clustered Hadoop setup in Amazon Web Services cloud and Apache Spark SQL was used to analyze the data. All of this was achieved through a 10 node amazon 32 core, 64 GB RAM setup real-time analytics was achieved on ‘300 million records’. To check the scalability of the system, the cluster was increased to 100 node setup. This talk will highlight how Open Source software was used to achieve the above use case and the insights on the high data throughput on a cloud set up.

Keywords: streaming analytics, data science, big data, Hadoop, high throughput, sensor data

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Authors: Zhiwen Pan, Jesus Pacheco, Salim Hariri, Yiqiang Chen, Bozhi Liu

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The Internet of Things (IoT) will lead to the development of advanced Smart Home services that are pervasive, cost-effective, and can be accessed by home occupants from anywhere and at any time. However, advanced smart home applications will introduce grand security challenges due to the increase in the attack surface. Current approaches do not handle cybersecurity from a holistic point of view; hence, a systematic cybersecurity mechanism needs to be adopted when designing smart home applications. In this paper, we present a generic intrusion detection methodology to detect and mitigate the anomaly behaviors happened in Smart Home Systems (SHS). By utilizing our Smart Home Context Data Structure, the heterogeneous information and services acquired from SHS are mapped in context attributes which can describe the context of smart home operation precisely and accurately. Runtime models for describing usage patterns of home assets are developed based on characterization functions. A threat-aware action management methodology, used to efficiently mitigate anomaly behaviors, is proposed at the end. Our preliminary experimental results show that our methodology can be used to detect and mitigate known and unknown threats, as well as to protect SHS premises and services.

Keywords: Internet of Things, network security, context awareness, intrusion detection

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Authors: Zahra Karimian, Effat Merghati Khoei, Raziyeh Maasoumi

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Background: Women's sexual well-being is center of focus in the field of sexology. Study of sexual behavior and investigating its predictors is important in women's health promotion. Objectives: This study aimed to explore the components of sexual behaviors and their possible associations with the women's demographic. Methods: A National Sexual Behavior Assessment Questionnaire was administered to 500 women ages 15 to 45 who referred to the public health centers seeking for health care services. The associations with demographic were examined. Results: From all participant, 31.8% of women obtain high score in the sexual capacity 21.2% in sexual motivation and 0.2% in sexual function. In sexual script component, 86.2% of women were holding traditional beliefs toward sexual behaviors; the majority (91.5%) of women believed in mutual and relational sexuality, 83.4% believed in androcentricity (male-dominated sexuality). Pearson correlation test showed significant positive correlations between sexual capacity, motivation, function and sexual script (p < 0.05). Regression model showed that sexual capacity is associated with women's education, age of her spouse. Sexual function and sexual motivation were significantly associated with the age of subjects' spouses. Conclusion: In this study, lower score was found in sexual performance while women were scored higher in the sexual capacity and motivation. We argue that these lower score in sexual performance more likely is due to the level of participants' religiosity and formation of their sexuality through an androcentric culture. Women's level of education and the spouse age appear to be predicting factors in the scores the subjects gained. We suggest that gender-specific and culturally sensitive sexuality education should be focus of women's health programs in Iran.

Keywords: sexual behaviors, women, health, Iran

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Authors: nafees mahbub, blake tindol, utkarsh shrivastava, kuanchin chen

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Online shopping has become an integral part of businesses today. Big players such as Amazon are setting the bar for delivery services, and many businesses are working towards meeting them. However, what happens if a seller underestimates or overestimates the delivery time? Does it translate to consumer comments, ratings, or lost sales? Although several prior studies have investigated the impact of poor logistics on customer satisfaction, that impact of under estimation of delivery times has been rarely considered. The study uses real-time customer online purchase data to study the impact of missed delivery times on satisfaction.

Keywords: LOST SALES, DELIVERY TIME, CUSTOMER SATISFACTION, CUSTOMER REVIEWS

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Authors: Rajendra Kumar Pandey

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Forest genetic resources not only represent regional biodiversity but also have immense value as the wealth for securing livelihood of poor people. These are vulnerable to ecological due to depletion/deforestation and /or impact of climate change. These resources of various plant categories are vulnerable on the floor of natural tropical forests, and leading to the threat on the growth and development of future forests. More than 170 species, including NTFPs, are in critical condition for their survival in natural tropical forests of Central India. Forest degradation, commensurate with biodiversity loss, is now pervasive, disproportionately affecting the rural poor who directly depend on forests for their subsistence. Looking ahead the interaction between forest and water, soil, precipitation, climate change, etc. and its impact on biodiversity of tropical forests, it is inevitable to develop co-operation policies and programmes to address new emerging realities. Forests ecosystem also known as the 'wealth of poor' providing goods and ecosystem services on a sustainable basis, are now recognized as a stepping stone to move poor people beyond subsistence. Poverty alleviation is the prime objective of the Millennium Development Goals (MDGs). However, environmental sustainability including other MDGs, is essential to ensure successful elimination of poverty and well being of human society. Loss and degradation of ecosystem are the most serious threats to achieving development goals worldwide. Millennium Ecosystem Assessment (MEA, 2005) was an attempt to identify provisioning and regulating cultural and supporting ecosystem services to provide livelihood security of human beings. Climate change may have a substantial impact on ecological structure and function of forests, provisioning, regulations and management of resources which can affect sustainable flow of ecosystem services. To overcome these limitations, policy guidelines with respect to planning and consistent research strategy need to be framed for conservation and sustainable development of forest genetic resources.

Keywords: climate change, forest ecosystem services, sustainable forest management, biodiversity conservation

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Authors: Lawrence Ngalim

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The paucity of entrepreneurial finance in Sub-Saharan Africa (SSA) can plausibly be tied to her comparatively less-developed capital markets, which potentially hurts entrepreneurial activities. The high rate of informality in SSA worsens information asymmetry, which restricts the supply of funds in a heavily bank-led environment. In this paper, we ask whether the adoption of recent technological improvements in delivering financial services, such as crowdfunding, assists the financially excluded within Africa. Secondly, we investigate the individual determinants of crowdfunding, such as income, level of education, demographics, culture/trust, and the effects of crowdfunding on households’ usage of formal financial services. The paper discusses the long-term policy implications of this particular type of fintech in achieving financial inclusion within the regional bloc and its advantage for Africa-Agenda-2063.

Keywords: fintech, banks, entrepreneurship, regional integration

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Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

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Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

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Authors: Jang-Hwan Jo

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Implementing sustainable island forest management policies requires categorizing islands into groups based on key indicators and establishing a consistent management system. Building on the results of previous studies, a typology of forested islands was established: Type 1 – connected islands with high natural vegetation cover; Type 2 – connected islands with moderate natural vegetation cover; Type 3 – connected islands with low natural vegetation cover; Type 4 – unconnected islands with high natural vegetation cover; Type 5 – unconnected islands with moderate natural vegetation cover; and Type 6 – unconnected islands with low natural vegetation cover. An AHP analysis was conducted with island forest experts to identify priority ecosystem services (ESs) for the sustainable management of each island type. In connected islands, provisioning services (natural resources, natural medicines, etc.) assumed greater importance than regulating (erosion control) and supporting services (genetic diversity). In unconnected islands, particularly those with a small proportion of natural vegetation, regulating services (erosion control) requires greater emphasis in management. Considering that Type 3 islands require urgent management as connectivity to the mainland makes natural vegetation-sparse island forest ecosystems vulnerable to anthropogenic activities, the land-use scoring method was carried out on Jin-do, a Type 3 forested island. Comparisons between AHP-derived expert demand for key island ESs and the spatial distribution of ES supply potential revealed mismatches between the supply and demand of erosion control, freshwater supply, and habitat provision. The framework developed in this study can help guide decisions and indicate where interventions should be focused to achieve sustainable island management.

Keywords: ecosystem service, sustainable management, forested islands, Analytic hierarchy process

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Musa Mayanja Lwanga, Annet Adong

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This study provides a micro perspective on the impact of mobile money services on individual’s saving behavior using the 2013 Uganda FinScope data. Results show that although saving through the mobile phone is not a common practice in Uganda, being a registered mobile money user increases the likelihood to save with mobile money. Saving using mobile is more prevalent in urban areas and in Kampala and Central region compared to other regions. This can be explained by: first, rural dwellers tend on average to have lower incomes and thus have lower to saving compared to the urban counterpart. Similarly, residents of Kampala tend to have higher incomes and thus high savings compared to residents of other regions. Secondly, poor infrastructure in rural areas in terms of lack of electricity and poor telecommunication network coverage may limit the use of mobile phones and consequently the use of mobile money as a saving mechanism. Overall, the use of mobile money as a saving mechanism is still very low and this could be partly explained by limitations in the legislation that does not incorporate mobile finance services into mobile money. The absence of interest payments on mobile money savings may act as a disincentive to save through this mechanism. Given the emerging mobile banking services, there is a need to create more awareness and the need for enhanced synergies between telecom companies and commercial banks.

Keywords: financial inclusion, mobile money, savings, Uganda

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Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

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Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

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Authors: Hossein Panahi, Firouz Fallahi, Sima Nasibparast

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Background & Aim: Unnecessary growth in health expenditures of developing countries in recent decades, and also the importance of physicians’ behavior in health market, have made the theory of physician-induced demand (PID) as one of the most important issues in health economics. Therefore, the main objective of this study is to investigate the hypothesis of induced demand among mental patients who receive services from either psychologists or psychiatrists in East Azerbaijan province. Methods: Using data from questionnaires in 2020 and employing the theoretical model of Jaegher and Jegers (2000) and hierarchical linear modeling (HLM), this study examines the PID hypothesis of selected psychologists and psychiatrists. The sample size of the study, after removing the questionnaires with missing data, is 45 psychologists and 203 people of their patients, as well as 30 psychiatrists and 160 people of their patients. Results: The results show that, although psychiatrists are ‘profit-oriented physicians’, there is no evidence of inducing unnecessary demand by them (PID), and the difference between the behavior of employers and employee doctors is due to differences in practice style. However, with regard to psychologists, the results indicate that they are ‘profit-oriented’, and there is a PID effect in this sector. Conclusion: According to the results, it is suggested that in order to reduce competition and eliminate the PID effect, the admission of students in the field of psychology should be reduced, patient information on mental illness should be increased, and government monitoring and control over the national health system must be increased.

Keywords: physician-induced demand, national health system, hierarchical linear modeling methods, multilevel modela

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Authors: E. Neidhardt

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Mobility is not only an aspect of personal freedom, but for many people mobility is also a requirement to be able to satisfy the needs of daily life. They must buy food, get to work, or go to the doctor. Many people are dependent on public transport to satisfy their needs. Especially in rural areas with a low population density this is difficult. In these areas it is often not cost-effective to provide public transport with sufficient coverage and frequency. Therefore, the available public transport is unattractive. As a result, people use their own car, which is not desirable from a sustainable point of view. Children and some elderly people also do not have this option. Sometimes people organize themselves and volunteer transport services are created, which function similarly to the demand-oriented taxis. With a platform for demand-oriented transport, we want to make the available public transport more usable and attractive by linking scheduled transport with voluntary transport services.

Keywords: demand-oriented, HubChain, living lab, public transport

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Authors: Akram Sadat Jafari Roodbandi, Alireza Choobineh, Nazanin Hosseini, Vafa Feyzi

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Introduction: Physical fitness and optimum functional movement are essential for efficiently performing job tasks without fatigue and injury. Functional Movement Screening (FMS) tests are used in screening of athletes and military forces. Nurses and emergency medical staff are obliged to perform many physical activities such as transporting patients, CPR operations, etc. due to the nature of their jobs. This study aimed to assess relationship between FMS test score and the prevalence of musculoskeletal disorders (MSDs) in emergency nurses and emergency medical services (EMS) staff. Methods: 134 male and female emergency nurses and EMS technicians participated in this cross-sectional, descriptive-analytical study. After video tutorial and practical training of how to do FMS test, the participants carried out the test while they were wearing comfortable clothes. The final score of the FMS test ranges from 0 to 21. The score of 14 is considered weak in the functional movement base on FMS test protocol. In addition to the demographic data questionnaire, the Nordic musculoskeletal questionnaire was also completed for each participant. SPSS software was used for statistical analysis with a significance level of 0.05. Results: Totally, 49.3% (n=66) of the subjects were female. The mean age and work experience of the subjects were 35.3 ± 8.7 and 11.4 ± 7.7, respectively. The highest prevalence of MSDs was observed at the knee and lower back with 32.8% (n=44) and 23.1% (n=31), respectively. 26 (19.4%) health worker had FMS test score of 14 and less. The results of the Spearman correlation test showed that the FMS test score was significantly associated with MSDs (r=-0.419, p < 0.0001). It meant that MSDs increased with the decrease of the FMS test score. Age, sex, and MSDs were the remaining significant factors in linear regression logistic model with dependent variable of FMS test score. Conclusion: FMS test seems to be a usable screening tool in pre-employment and periodic medical tests for occupations that require physical fitness and optimum functional movements.

Keywords: functional movement, musculoskeletal disorders, health care worker, screening test

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Authors: Sonia P. Marrero Duran, Lilian Noya Dominguez, Lisandra Quintana Alvarez, Evert Martinez Perez, Ana Julia Acevedo Urquiaga

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Cuban business and economic policy are in the constant update as well as facing a client ever more knowledgeable and demanding. For that reason become fundamental for companies competitiveness through the optimization of its processes and services. One of the Cuban’s pillars, which has been sustained since the triumph of the Cuban Revolution back in 1959, is the free health service to all those who need it. This service is offered without any charge under the concept of preserving human life, but it implied costly management processes and logistics services to be able to supply the necessary medicines to all the units who provide health services. One of the key actors on the medicine supply chain is the Havana Distribution Center (HDC), which is responsible for the delivery of medicines in the province; as well as the acquisition of medicines from national and international producers and its subsequent transport to health care units and pharmacies in time, and with the required quality. This HDC also carries for all distribution centers in the country. Given the eminent need to create an actor in the supply chain that specializes in the medicines supply, the possibility of centralizing this operation in a logistics service provider is analyzed. Based on this decision, pharmacies operate as clients of the logistic service center whose main function is to centralize all logistics operations associated with the medicine supply chain. The HDC is precisely the logistic service provider in Havana and it is the center of this research. In 2017 the pharmacies had affectations in the availability of medicine due to deficiencies in the distribution routes. This is caused by the fact that they are not based on routing studies, besides the long distribution cycle. The distribution routs are fixed, attend only one type of customer and there respond to a territorial location by the municipality. Taking into consideration the above-mentioned problem, the objective of this research is to optimize the routes system in the Havana Distribution Center. To accomplish this objective, the techniques applied were document analysis, random sampling, statistical inference and tools such as Ishikawa diagram and the computerized software’s: ArcGis, Osmand y MapIfnfo. As a result, were analyzed four distribution alternatives; the actual rout, by customer type, by the municipality and the combination of the two last. It was demonstrated that the territorial location alternative does not take full advantage of the transportation capacities or the distance of the trips, which leads to elevated costs breaking whit the current ways of distribution and the currents characteristics of the clients. The principal finding of the investigation was the optimum option distribution rout is the 4th one that is formed by hospitals and the join of pharmacies, stomatology clinics, polyclinics and maternal and elderly homes. This solution breaks the territorial location by the municipality and permits different distribution cycles in dependence of medicine consumption and transport availability.

Keywords: computerized geographic software, distribution, distribution routs, vehicle problem routing (VPR)

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Authors: Nasir Baba Ahmed, Nicolas Daclin, Marc Olivaux, Gilles Dusserre

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The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.

Keywords: assessment framework, cyber resilience, cyber security, mobile field hospital

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Authors: Cherrie Lowe

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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.

Keywords: maternity, acuity, research, nursing workloads

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Authors: Jae Moon Lee

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In general, algorithms to find continuous k-nearest neighbors have been researched on the location based services, monitoring periodically the moving objects such as vehicles and mobile phone. Those researches assume the environment that the number of query points is much less than that of moving objects and the query points are not moved but fixed. In gaming environments, this problem is when computing the next movement considering the neighbors such as flocking, crowd and robot simulations. In this case, every moving object becomes a query point so that the number of query point is same to that of moving objects and the query points are also moving. In this paper, we analyze the performance of the existing algorithms focused on location based services how they operate under gaming environments.

Keywords: flocking behavior, heterogeneous agents, similarity, simulation

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Authors: Mohd Iskandar Illyas Tan, Zuhra Junaida Mohamad Husny, Farawahida Mohd Yusof

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The potentials of Muslim-friendly hospitality services bring huge opportunities to operators (hoteliers, tourist guides, and travel agents), especially among the Muslim countries. In order to provide guidelines that facilitate the operations among these operators, standards and manuals have been developing by the authorities. Among the challenges is the applicability and complexity of the standard to be adopted in the real world. Mobile digital technology can be implemented to overcome those challenges. A prototype has been developed to help operators and authorities to assess their readiness in complying with MS2610:2015. This study analyzes the of mobile digital technology characteristics that are suitable for the user in conducting sharia’ compliant hospitality audit. A focus group study was conducted in the state of Penang, Malaysia that involves operators (hoteliers, tourist guide, and travel agents) as well as agencies (Islamic Tourism Center, Penang Islamic Affairs Department, Malaysian Standard) that involved directly in the implementation of the certification. Both groups were given the 3 weeks to test and provide feedback on the usability of the mobile applications in order to conduct an audit on their readiness towards the Muslim-friendly hospitality services standard developed by the Malaysian Standard. The feedbacks were analyzed and the overall results show that three criteria (ease of use, completeness and fast to complete) show the highest responses among both groups for the mobile application. This study provides the evidence that the mobile application development has huge potentials to be implemented by the Muslim-friendly hospitality services operator and agencies.

Keywords: hospitality, innovation, audit, compliance, mobile application

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Authors: Tasha L. Golden

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Girls in the U.S. juvenile justice system are most often arrested for truancy, drug use, or running from home, all of which are symptoms of abuse. In fact, some have called this 'The Sexual Abuse to Prison Pipeline.' Such abuse has consequences for girls' health, education, employment, and parenting, often resulting in significant health disparities. Yet when arrested, girls rarely encounter services designed to meet their unique needs. Instead, they are expected to cope with a system that was historically designed for males. In fact, even literature advocating for increased gender equity frequently fails to include girls’ voices and firsthand accounts. In response to these combined injustices, public health researchers launched a trauma-informed creative writing intervention in a southern juvenile detention facility. The program was designed to improve the health of detained girls, while also establishing innovative methods of both data collection and social justice advocacy. Girls’ poems and letters were collected and coded, adding rich qualitative data to traditional survey responses. In addition, as part of the intervention, these poems are regularly published by international literary publisher Sarabande Books—and distributed to judges, city leaders, attorneys, state representatives, and more. By utilizing a creative medium, girls generated substantial civic engagement with their concerns—thus expanding their influence and improving policy advocacy efforts. Researchers hypothesized that having access to their communities and policy makers would provide its own health benefits for incarcerated girls: cultivating self-esteem, locus of control, and a sense of leadership. This paper discusses the establishment of this intervention, examines findings from its evaluation, and includes several girls’ poems as exemplars. Grounded in social science regarding expressive writing, stigma, muted group theory, and health promotion, the paper theorizes about the application of arts-based advocacy efforts to other social justice endeavors.

Keywords: advocacy, public health, social justice, women’s health

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: Ilir Rexhepi, Naim Ismajli

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Quality and quality management are key factors of success nowadays. Public sector and quality management in this sector contains many challenges and difficulties, most notably in a new country like Kosovo. This study analyses the process of implementation of quality management system in public administration institutions in this country. The main objective is to show how to set up a quality management system and how does the quality management system setup affect the overall public administration services in Kosovo. This study shows how the efficiency and effectiveness of public institution services/performance is rapidly improving through the establishment and functionalization of Quality Management System. The specific impact of established QMC within the organization has resulted with the identification of mission related processes within the entire system including input identification, the person in charge and the way of conversion to the output of each activity though the interference with other service processes within the system. By giving detailed analyses of all steps of implementation of the Quality Management System, its effect and consequences towards the overall public institution service performance, we try to go one step further, by showing it as a very good example or tool of other public institutions for improving their service performance. Interviews with employees, middle and high level managers including the quality manager and general secretaries are also part of analyses in this paper.

Keywords: quality, quality management system, efficiency, public administration institutions

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Authors: Nurulhuda A. Manaf, Nor Najihah Zainal Abidin, Nur Amalina Jamaludin

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Coordinating service interactions are a vital part of developing distributed applications that are built up as networks of autonomous participants, e.g., software components, web services, online resources, involve a collaboration between a diverse number of participant services on different providers. The complexity in coordinating service interactions reflects how important the techniques and approaches require for designing and coordinating the interaction between participant services to ensure the overall goal of a collaboration between participant services is achieved. The objective of this research is to develop capability of steering a complex service interaction towards a desired outcome. Therefore, an efficient technique for modelling, generating, and verifying the coordination of service interactions is developed. The developed model describes service interactions using service choreographies approach and focusing on a declarative approach, advocating an Object Management Group (OMG) standard, Semantics of Business Vocabulary and Rules (SBVR). This model, namely, SBVR model for service choreographies focuses on a declarative deontic rule expressing both obligation and prohibition, which can be more useful in working with coordinating service interactions. The generated SBVR model is then be formulated and be transformed into Alloy model using Alloy Analyzer for verifying the generated SBVR model. The transformation of SBVR into Alloy allows to automatically generate the corresponding coordination of service interactions (service choreography), hence producing an immediate instance of execution that satisfies the constraints of the specification and verifies whether a specific request can be realised in the given choreography in the generated choreography.

Keywords: service choreography, service coordination, behavioural modelling, complex interactions, declarative specification, verification, model transformation, semantics of business vocabulary and rules, SBVR

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Authors: Berna Kalkan, Kenan Aydin

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Companies give importance customer satisfaction to compete the developing and changing market. This is possible when customer reaches the right product, right quality, place, time and cost. In this regard, the extension of logistics services has played active role on formation and development of the different logistics services concept. The concept of logistics services has played important role involved in the healing of economic indicators today. Companies can use logistics providers, thus have competitive advantage and low cost, reducing time, tobe flexibility. In recent years, Fourth Party Logistics (4PL) has emerged as a new concept that includes relationship between suppliers and firms in outsourcing. 4PL provider is an integrator that offers comprehensive supply chain solutions with the technology, resources and capabilities that it possesses. Also, 4PL has attracted as a popular research topic attention in the recent past. In this paper, logistics outsourcing and 4PL concepts are analyzed and a literature review on 4PL activities is given. Also, the previous studies in literature and the approaches that are used in previous studies in literature is presented by analysing on 4PL activities. In this context, a field study will be applied to 4PL providers and service buyer in Turkey. If necessary, results related to this study will be shared in scientific areas.

Keywords: fourth party logistics, literature review, outsourcing, supply chain management

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Authors: Thirakorn Maneerat, Darunee Jongudomkarn, Jiraporn Khiewyoo

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Family quality of life of families who have persons with disabilities is a core concern in government services and community health promotion to deal with the multidimensionality of today’s health and societal issues. The number of families who have persons with disabilities in Thailand is gradually increasing. However, facilitation and evaluation of such family quality of life are limited by the lack of feasible tools. As a consequence, service provided for the families is not optimally facilitated and evaluated. This paper is part of a larger project which is aimed to develop a scale for measuring of family quality of life of families who have persons with developmental disabilities in Thailand, presenting the results of a three-round Delphi method involving 11 experts. The study was obtained during December 2013 to May 2014. The first round consisted of open-ended questionnaire and content analysis of the answers. The second round comprised a 5-point Likert scale structured questionnaire based on the first round analysis, with required the experts to identify the most relevant studied tool aspects. Their feedbacks levels of agreements were statistic analysis using the median, interquartile range and quartile deviation. The included criteria for items acceptance were greater than 3.50 of the median, lesser than 1.50 of interquartile range, and 0.65 or less of a quartile deviation. Finally, the proposed questionnaire was structured and validated by the experts in the third round. The results found that across all three rounds, the experts achieved 100% agreement on the five factors regarding to quality of life of a family who have person with disability were considered. These five factors with 38 items were included: 1) 10 items of family interactions; 2) 9 items of child rearing; 3) 7 items of physical and material resources; 4) 5 items of social-emotional status; and 7 items of disability-related services and welfare. Next step of the study was examined the construct validity by using factor analysis methods.

Keywords: tool development, family quality of life scale, person with disability, Delphi study

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Authors: Neetesh Saxena, Narendra S. Chaudhari

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Nowadays, SMS is a very popular mobile service and even the poor, illiterate people and those living in rural areas use SMS service very efficiently. Although many mobile operators have already started 3G and 4G services, 2G services are still being used by the people in many countries. In 2G (GSM), only encryption provided is between the MS and the BTS, there is no end-to-end encryption available. Sometimes we all need to send some confidential message to other person containing bank account number, some password, financial details, etc. Normally, a message is sent in plain text only to the recipient and it is not an acceptable standard for transmitting such important and confidential information. Authors propose an end-to-end encryption approach by proposing a terminal for sending/receiving a secure message. An asymmetric key exchange algorithm is used in order to transmit secret shared key securely to the recipient. The proposed approach with terminal device provides authentication, confidentiality, integrity and non-repudiation.

Keywords: AES, DES, Diffie-Hellman, ECDH, A5, SMS

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Authors: Claudia Valderrama-Ulloa, Cristian Schmitt, Juan Pablo Marchetti, Viviana Bucarey

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Access to adequate housing is a fundamental human right and a crucial factor for health. Housing should be inclusive, accessible, and able to meet the needs of all its inhabitants at every stage of their lives without hindering their health, autonomy, or independence. This article addresses the importance of designing housing for people with disabilities, which varies depending on individual abilities, preferences, and cultural considerations. Based on the components of the International Classification of Functioning, Disability and Health, wheelchair users, little people (achondroplasia), children with autism spectrum disorder and Down syndrome were characterized, and six domains of activities related to daily life inside homes were defined. The article describes the main barriers homes present for this group of people. It proposes a list of architectural and design aspects to reduce barriers to housing use. The aspects are divided into three main groups: space management, building services, and supporting facilities. The article emphasizes the importance of consulting professionals and users with experience designing for diverse needs to create inclusive, safe, and supportive housing for people with disabilities.

Keywords: achondroplasia, autism spectrum disorder, disability, down syndrome, wheelchair user

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Authors: Peter Palasti, Eva Kerepeczki

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Extensive fish farming is one of the most traditional forms of aquaculture in Europe, usually practiced in large pond systems with earthen beds, where the growth of fish is based on natural feed and supplementary foraging. These farms have semi-natural environmental conditions, sustaining diverse wildlife communities that have complex effects on fish production and also provide a livelihood for many wetland related taxa. Based on their characteristics, these communities could be sources of various ecosystem services (ESs), that could also enhance the value and enable the multifunctional use of these artificially constructed and maintained production zones. To identify and estimate the whole range of wildlife’s contribution we have conducted an integrated assessment in an extensively managed pond system in Biharugra, Hungary, where we studied 14 previously revealed ESs: fish and reed production, water storage, water and air quality regulation, CO2 absorption, groundwater recharge, aesthetics, recreational activities, inspiration, education, scientific research, presence of semi-natural habitats and useful/protected species. ESs were collected through structured interviews with the local experts of all major stakeholder groups, where we have also gathered information about the known forms, levels (none, low, high) and orientations (positive, negative) of the contributions of the wildlife community. After that, a quantitative analysis was carried out: we calculated the total mean value of the services being used between 2014-16, then we estimated the value and percentage of contributions. For the quantification, we mainly used biophysical indicators with the available data and empirical knowledge of the local experts. During the interviews, 12 of the previously listed services (85%) were mentioned to be related to wildlife community, consisting of 5 fully (e.g., recreation, reed production) and seven partially dependent ESs (e.g., inspiration, CO2 absorption) from our list. The orientation of the contributions was said to be positive almost every time; however, in the case of fish production, the feeding habit of some wild species (Phalacrocorax carbo, Lutra lutra) caused significant losses in fish stocks in the study period. During the biophysical assessment, we calculated the total mean value of the services and quantified the aid of wildlife community at the following services: fish and reed production, recreation, CO2 absorption, and the presence of semi-natural habitats and wild species. The combined results of our interviews and biophysical evaluations showed that the presence of wildlife community not just greatly increased the productivity of the fish farms in Biharugra (with ~53% of natural yield generated by planktonic and benthic communities) but also enhanced the multifunctionality of the system through expanding the quality and number of its services. With these abilities, extensively managed fishponds could play an important role in the future as refugia for wetland related services and species threatened by the effects of global warming.

Keywords: ecosystem services, fishpond systems, integrated assessment, wildlife community

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Authors: Olayinka Ariba, Abe Oudshoorn, Steve Rolfe, Carrie Anne Marshall, Deanna Befus, Jason Gilliland, Miranda Crockett, Susana Caxaj, Sarah McLean, Amy Van Berkum, Natasha Thuemler

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Background: Secure housing is a platform for health and well-being. Those who struggle with housing stability have complex life and health histories and often require some support services such as the provision of permanent supportive housing. Poor access to supportive resources creates an exacerbation of chronic homelessness, particularly affecting individuals who need immediate access to mental health and addiction supports. This paper presents the first phase of a three-part study examining how on-site support impacts housing stability for recently-re-housed persons. Method: This study utilized a community-based participatory research methodology. Twenty in-depth interviews were conducted with permanent supportive housing residents from a single-site dwelling. Interpretative description analysis was used to draw common themes and understand the experiences and challenges of housing support. Results: Three interconnected themes were identified: 1) Available and timely supports; 2) Affordability; and 3) Community, but with independence as desired. These interconnected components are helping residents transition from homelessness or long-term mental health inpatient care to live in the community. Despite some participant concerns about resident conflicts, staff availability, and affordability, this has been a welcome and successful move for most. Conclusion: Supportive housing is essential for successful tenancies as a platform for health and well-being among Canada’s most vulnerable and, from the perspective of persons recently re-housed, permanent supportive housing is a worthwhile investment.

Keywords: homelessness, supportive housing, rehoused, housing stability

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