Search results for: logistics providers

Authors: Nicole Banton

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The maternal and infant mortality rate of Blacks is three times that of Whites in the US. Research indicates that breastfeeding lowers both. In this paper, the researcher examines how the ideas that Black/African American mothers had about breastfeeding before, during, and after pregnancy (postpartum) affected whether or not they initiated breastfeeding. The researcher used snowball sampling to recruit thirty African-American mothers from the Orlando area. At the time of her interview, each mother had at least one child who was at least three years old. Through in-depth face-to-face interviews, the researcher investigated how mothers’ healthcare providers affected their decision-making about infant feeding, as well as how the type of birth that she had (e.g., preterm, vaginal, c-section, full term) affected her actual versus idealized infant feeding practice. Through our discussions, we explored how pre-pregnancy perceptions, birth and postpartum experiences, social support, and the discourses surrounding motherhood within an African-American context affected the perceptions and experiences that the mothers in the study had with their infant feeding practice(s). Findings suggest that the pregnancy and birth experiences of the mothers in the study influenced whether or not they breastfed exclusively, combined breastfeeding and infant formula use, or used infant formula exclusively. Specifically, the interplay of invocation of agency (the ability to control their bodies before, during, and after birth), birth outcomes, and the interaction that the mothers in this study had with resources, human and material, had the highest impact on the initiation, duration, and attitude toward breastfeeding.

Keywords: African American mothers, maternal health, breastfeeding, birth, midwives, obstetricians, hospital birth, breast pumps, formula use, infant feeding, lactation consultant, postpartum, vaginal birth, c-section, familial support, social support, work, pregnancy

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Authors: Seyed Ali Hossein Zahraei, Iman Dianat

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The role of midwives and healthcare providers in applying pain relief methods to female patients is very important. different therapies like hydropathy, flavorer remedies, and respiratory techniques for pain relief do not work properly as what we expected. Lack of recognition of the physiological property of birth, despite findings that coming will attenuate the consequences of hurting, suggests the necessity for bigger awareness among expectant oldsters, educators, and health professionals of the potential of coming as a way of pain relief. Method: In our method we have 5 steps to achieve activation of oxytocin and dopamine pathways in order to reduce pain in all possible fields and reasons instead of using other treatments such as chemical painkillers. Step 1: First of all the patient should start by rubbing the clitoris up and down till occurring first clitoral orgasm. Step 2: Without stop rubing clitoris the patient must continue stimulate the clitoris in different way like circular motion in clock pathway until occurring second clitoral orgasm. Step 3: Immedietly the patient can change the position from clitoris to urethral opening where vestibular glands located. In this step the patient nock the urethral area very slowly without pressure and just like touching the area till feeling want to pee. But because of activation of sympathic nerves the gi tract is inactive. Step 4: In this step the patient should apply more pressure and change the motion to circular on urethral area in which the pee sensation increase but actually it is vestibular gland fluid. The patient should release it in small amount in this step. Step 5: The last step is combination of clitoral and urethral stimulation in up and down motion that cause more pee feeling and after clitoral orgasm occurred the amount of released fluid can be about 400ml.

Keywords: female, natural, method, pain

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Authors: Abdulfatah Al-Jaradi, Marzoq Ali Odhah, Abdulnasser A. Haza’a

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Background: Antenatal care can be defined as the care provided by skilled healthcare professionals to pregnant women and adolescent girls to ensure the best health conditions for both mother and baby during pregnancy. The components of ANC include risk identification; prevention and management of pregnancy-related or concurrent diseases; and health education and health promotion. The aim of this study: to assess the knowledge, attitude, and practice of pregnant women regarding antenatal care. Methodology: A descriptive KAP study was conducting in public hospitals in Sana'a City-Yemen. The study population was included all pregnant women that intended to the prenatal department and clinical outpatient department, the final sample size was 371 pregnant women, a self-administered questionnaire was used to collect the data, statistical package for social sciences SPSS was used to data analysis. The results: Most (79%) of pregnant women were had correct answers in total knowledge regarding antenatal care, and about two-thirds (67%) of pregnant women were had performance practice regarding antenatal care and two-third (68%) of pregnant women were had a positive attitude. Conclusions & Recommendations: We concluded that a significant association between overall knowledge and practice level toward antenatal care and demographic characteristics of pregnant women, women (residence place, level of education, did your husband support you in attending antenatal care and place of delivery of the last baby), at (P-value ≤ 0.05). We recommended more education and training courses, lecturers and education sessions in clinical facilitators focused ANC, which relies on evidence-based interventions provided to women during pregnancy by skilled healthcare providers such as midwives, doctors, and nurses.

Keywords: antenatal care, knowledge, practice, attitude, pregnant women

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Authors: Sadia H. Syeda, Zain H. Malik

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As systems continue to become more complex and the interdependencies of processes and sub-systems continue to grow and transform, the need for a comprehensive method of tracking and linking the lifecycle of the systems in a digital form becomes ever more critical. Digital Engineering (DE) provides an approach to managing an authoritative data source that links, tracks, and updates system data as it evolves and grows throughout the system development lifecycle. DE enables the developing, tracking, and sharing system data, models, and other related artifacts in a digital environment accessible to all necessary stakeholders. The DE environment provides an integrated electronic repository that enables traceability between design, engineering, and sustainment artifacts. The DE activities' primary objective is to develop a set of integrated, coherent, and consistent system models for the program. It is envisioned to provide a collaborative information-sharing environment for various stakeholders, including operational users, acquisition personnel, engineering personnel, and logistics and sustainment personnel. Examining the processes that DE can support in the systems engineering life cycle (SELC) is a primary step in the DE adoption and implementation journey. Through an analysis of the U.S Department of Defense’s (DoD) Office of the Secretary of Defense (OSD’s) Digital Engineering Strategy and their implementation, examples of DE implementation by the industry and technical organizations, this paper will provide descriptions of the current DE processes and best practices of implementing DE across an enterprise. This will help identify the capabilities, environment, and infrastructure needed to develop a potential roadmap for implementing DE practices consistent with its business strategy. A capability maturity matrix will be provided to assess the organization’s DE maturity emphasizing how all the SELC elements interlink to form a cohesive ecosystem. If implemented, DE can increase efficiency and improve the systems engineering processes' quality and outcomes.

Keywords: digital engineering, digital environment, digital maturity model, single source of truth, systems engineering life-cycle

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Authors: Olorunsanya E. O., Adedeji S. O., Anyanwu A. A.

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Food insecurity is a challenge to many nations Nigeria inclusive. It is increasingly becoming a major problem among farm households due to many factors chief of which is low labour productivity. This study therefore profiles the food security status of a representative randomly selected 90 farming households in Chanchaga area of Nigeria’s Guinea Savana using structured interview schedule Descriptive and inferential statistics were used as analytical tools for the study. The results of the descriptive statistics show that majority (35.56%) of the surveyed household heads fall within the age range of 40 – 49 years and (88.89%) are male while (78.89) are married. More than half of the respondents have formal education. About 43.3% of the household heads have farm experience of 11- 20 years and a modal household size class range of 7 – 12. The results further reveal that majority (68.8%) earned more than N12, 500 (22.73 US Dollar) per month. The result of households’ food expenditure pattern reveals that an average household spends about N3, 644.44 (6.63 US Dollar) on food and food items on a weekly basis. The result of the analysis of food diversity intake in the study area shows that 63.33% of the sampled households fell under the low household food diversity intake, while 33 households, representing 36.67% ranks high in term of household food diversity intake. The result for the food security status shows that the sampled population was food secure (58.89%) while 41.11% falls below the recommended threshold. The result for the logistics regression model shows that age, engagement in off farm employment and household size are significant in determining the food security status of farm household in the study area. The three variables were significant at 10%, 5% and 1% respectively. The study therefore recommends among others, that measures be put in place by stakeholders to make agriculture attractive for youth since age is a significant determinant of food security in the study area. Awareness should also be created by stakeholders on the needs for effective family planning methods to be adopted by farm household in the study area.

Keywords: Niger State, Guinea Savana, food diversity, logit regression model and food security

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Authors: Martina I. Reinhold, Theresa Bacon-Baguley

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A core challenge of physician assistant education is preparing professionals for lifelong learning. While this conventionally has encompassed scientific advances, students must also embrace new care delivery models and technologies. Telemedicine, the provision of care via two-way audio and video, is an example of a technological advance reforming health care. During a three-semester sequence of Hospital Community Experiences, physician assistant students were assigned experiences with Answer Health on Demand, a telemedicine collaborative. Preceding the experiences, the agency lectured on the application of telemedicine. Students were then introduced to the technology and partnered with a provider. Prior to observing the patient-provider interaction, patient consent was obtained. Afterwards, students completed a reflection paper on lessons learned and the potential impact of telemedicine on their careers. Thematic analysis was completed on the students’ reflection papers (n=13). Preceding the lecture and experience, over 75% of students (10/13) were unaware of telemedicine. Several stated they were 'skeptical' about the effectiveness of 'impersonal' health care appointments. After the experience, all students remarked that telemedicine will play a large role in the future of healthcare and will provide benefits by improving access in rural areas, decreasing wait time, and saving cost. More importantly, 30% of students (4/13) commented that telemedicine is a technology they can see themselves using in their future practice. Initial results indicate that collaborative interaction between students and telemedicine providers enhanced student learning and exposed students to technological advances in the delivery of care. Further, results indicate that students perceived telemedicine more favorably as a viable delivery method after the experience.

Keywords: collaboration, physician assistant education, teaching innovative health care delivery method, telemedicine

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Authors: Hela Fathallah

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With 6,500 spoken languages all over the world but 80 percent of online content available only in 10 languages – English, Chinese, Spanish, Japanese, Arabic, Portuguese, German, French, Russian, and Korean – language represents a barrier to the universal access to knowledge, information and services that the internet wants to provide. Translation and its related fields of localization, interpreting, globalization, and internationalization, remove that barrier for billions of people worldwide, unlocking new markets for technology companies, mobile device makers, service providers and language vendors as well. This paper gathers different surveys conducted in different regions of the world that demonstrate a growing demand for consumption of web content with distinctive values and in languages others than the aforementioned ones. It also adds new insights to the contribution of translation in languages preservation. The idea that English is the language of internet and that, in a globalized world, everyone should learn English to cope with new technologies is no longer true. This idea has reached its limits. It collides with cultural diversity and differences around the world and generates an accelerated rate of languages extinction. Studies prove that internet exacerbates this rate and web giants such as Facebook or Google are, today, facing the impact of such a misconception of globalization. For internet and dot-com companies, localization is the solution; they are spending a significant amount of time to understand what people want and to figure out how to provide it. They are committed to making their content accessible, if not in all the languages spoken today, at least in most of them, and to adapting it to most cultures. Technology has broken down the barriers of time and space, and it will break down the language barrier as well by undertaking a process of translation and localization and through a new definition of globalization that takes into consideration these two processes.

Keywords: globalization, internet, localization, translation

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Authors: Harini Chakkera

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Background: Inpatient hyperglycemia is an established independent risk factor among several patient cohorts with hospital readmission. This has not been studied after kidney transplantation. Nearly one-third of patients who have undergone a kidney transplant reportedly experience 30-day readmission. Methods: Data on first-time solitary kidney transplantations were retrieved between September 2015 to December 2018. Information was linked to the electronic health record to determine a diagnosis of diabetes mellitus and extract glucometeric and insulin therapy data. Univariate logistic regression analysis and the XGBoost algorithm were used to predict 30-day readmission. We report the average performance of the models on the testing set on five bootstrapped partitions of the data to ensure statistical significance. Results: The cohort included 1036 patients who received kidney transplantation, and 224 (22%) experienced 30-day readmission. The machine learning algorithm was able to predict 30-day readmission with an average AUC of 77.3% (95% CI 75.30-79.3%). We observed statistically significant differences in the presence of pretransplant diabetes, inpatient-hyperglycemia, inpatient-hypoglycemia, and minimum and maximum glucose values among those with higher 30-day readmission rates. The XGBoost model identified the index admission length of stay, presence of hyper- and hypoglycemia and recipient and donor BMI values as the most predictive risk factors of 30-day readmission. Additionally, significant variations in the therapeutic management of blood glucose by providers were observed. Conclusions: Suboptimal glucose metrics during hospitalization after kidney transplantation is associated with an increased risk for 30-day hospital readmission. Optimizing the hospital blood glucose management, a modifiable factor, after kidney transplantation may reduce the risk of 30-day readmission.

Keywords: kidney, transplant, diabetes, insulin

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Authors: Joanna Smoluk-Sikorska, Władysława Łuczka

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Organic farming is an important element of sustainable agriculture. It has been developing very dynamically in Poland, especially since Poland’s accession to the EU. Nevertheless, properly functioning organic market is a necessary condition justifying development of organic agriculture. Despite significant improvement, this market in Poland is still in the initial stage of growth. An important element of the market is distribution, especially retail, which offers specified product range to consumers. Therefore, there is a need to investigate retail outlets offering organic food in order to improve functioning of this part of the market. The inquiry research conducted in three types of outlets offering organic food, between 2011 and 2012 in the 8 largest Polish cities, shows that the majority of outlets offer cereals, processed fruit and vegetables as well as spices and the least shops – meat and sausages. The distributors mostly indicate unsatisfactory product range of suppliers as the reason for this situation. The main providers of the outlets are wholesalers, particularly in case of processed products, and in fresh products – organic farms. A very important distribution obstacle is dispersion of producers, which generates high transportation costs and what follows that, high price of organics. In the investigated shops, the most often used price calculation method is a cost method. The majority of the groceries and specialist shops apply margins between 21 and 40%. The margin in specialist outlets is the highest, in regard to the qualified service and advice. In turn, most retail networks declare the margin between 0 and 20%, which is consistent with low-price strategy applied in these shops. Some lacks in the product range of organics and in particular high prices cause that the demand volume is rather low. Therefore there is a need to support certain market actions, e.g. on-farm processing or promotion.

Keywords: organic food, retail, product range, supply sources

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Authors: Maria Jose Mendoza Gordillo

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Introduction: Research regarding breastfeeding is devoted to how essential breastfeeding is to guarantee wellbeing for the mother and the baby from a medical standpoint relegating the cultural, material and social barriers for breastfeeding. Consequently, worldwide breastfeeding rates are low, and Ecuador is not the exception, especially among working mothers. Worldwide, health care providers have low rates of breastfeeding due to several barriers to lactation, such as the work schedule, a lack of private places for pumping while at work, and negative emotions. Goals and Methods: This study aimed to explore how do Ecuadorian women embrace their identities as nutritionists and mothers within their breastfeeding experience. The primary data come from 20 synchronous semi-structured interviews, which follow a topic guide. The interviews were recorded and transcribed verbatim. The data analysis followed the Phronetic Iterative Approach. Results: Women shifted the preconceived idea of the ideal breastfeeding that came from the medicalized discourse of breastfeeding, and that was constructed in their training as nutritionists. Although these women believe that breast milk and breastfeeding is the best way to feed a baby, the internalized ideal of breastfeeding shifted through the experience of motherhood. When these women developed their identity as mothers, they understood that the ideal breastfeeding is different from the medicalized discourse. Although they have that clash between the ideal and the external reality, they continued breastfeeding their babies and those experiences made them improve their professional practice. Conclusions: The narratives that women shared illustrate how complex it was to manage the different roles and identities that they wanted to fulfill to keep their identity of a good mother who breastfeeds her baby and, at the same time, a good healthcare provider identity. The process of breastfeeding for this group of women who are mothers and healthcare professionals appears to be a unique relational and identity negotiation process.

Keywords: breastfeeding, identity, nutritionist, qualitative

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Authors: Oyediran Wasiu Oyeleke

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Melon is a popular economic cucurbit in Southwest, Nigeria. In recent time, many young farmers are shifting from melon to watermelon farming due to poor yield and low monetary returns. Hence, this study was carried out to assess the decline in melon yield and its contribution to young farmers’ diversification into watermelon farming in Oyo state, Nigeria. Purposive sampling technique was used in selecting 75 respondents from five villages in Ibarapa block of the Oyo State Agricultural Development Project (ADP). Data collected were analyzed using descriptive statistics and Pearson Product Moment Correlation (PPMC). Results show that majority of the respondents (77.3%) were between 31-40 years of age and 46.70% had secondary school education. Most of the respondents (80%) cultivated more than 3 ha of land for watermelon. Majority of the respondents (74.7%) intercropped melon with other crops while watermelon was cultivated as a sole crop. None of the respondents either grew improved melon seeds (certified seeds) or applied fertilizers but all respondents cultivated treated watermelon seeds, applied fertilizers, and agro-chemicals. The average yields of melon fell from 376.53kg/ha in 2009 to 280.70kg/ha in 2011. However, the respondents were shifting into watermelon production because of available quality seeds and its early maturity, easy harvest, and high sales. There was a significant relationship between melon output and young farmers’ diversification to watermelon in the study area at p < 0.05. The study concluded that decline in the melon yield discouraged youth to continue melon farming in the study area. It is hereby recommended that certified melon seeds should be made available while extension service providers should provide training support for the young farmers in order to reposition and boost melon production in the study area.

Keywords: decline, melon yield, contribution, watermelon, diversification, young farmers

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Authors: Ragi Poyyara, V. Vivek, Ashish Khaparde

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The Product Development Process (PDP) in the technology group plays a very important role in the launch of any product. While a manufacturing process encourages the use of certain measures to reduce Health, Safety and Environmental (HSE) risks on the shop floor, the PDP concentrates on the use of Geometric Dimensioning and Tolerancing (GD&T) to develop a flawless design. Furthermore, PDP distributes and coordinates activities between different departments such as marketing, purchasing, and manufacturing. However, it is seldom realized that PDP makes a significant contribution to developing a product that reduces HSE risks by encouraging the Technology group to use effective GD&T. The GD&T is a precise communication tool that uses a set of symbols, rules, and definitions to mathematically define parts to be manufactured. It is a quality assurance method widely used in the oil and gas sector. Traditionally it is used to ensure the interchangeability of a part without affecting its form, fit, and function. Parts that do not meet these requirements are rejected during quality audits. This paper discusses how the Technology group integrates this quality assurance tool into the PDP and how the tool plays a major role in helping the HSE department in its goal towards eliminating HSE incidents. The PDP involves a thorough risk assessment and establishes a method to address those risks during the design stage. An illustration shows how GD&T helped reduce safety risks by ergonomically improving assembling operations. A brief discussion explains how tolerances provided on a part help prevent finger injury. This tool has equipped Technology to produce fixtures, which are used daily in operations as well as manufacturing. By applying GD&T to create good fits, HSE risks are mitigated for operating personnel. Both customers and service providers benefit from reduced safety risks.

Keywords: HSE risks, product development process, geometric dimensioning and tolerances, mechanical engineering

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Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

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Authors: Munachiso A. Muoneke

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The global healthcare system faces unprecedented challenges of fragmented information systems, inefficient data management, and limited service accessibility. With the rapid evolution of digital technologies, there is a dire need to develop integrated technological infrastructures that can reinvent healthcare delivery from its core. This research addresses the significant gap between existing healthcare technologies and the growing demand for more responsive, secure, and patient-centered medical services. The study uses a mixed-method research approach, combining quantitative system performance analysis and qualitative healthcare provider interviews to comprehensively evaluate the limitations of the current digital health infrastructure. Across multiple healthcare settings, technological barriers are mapped to help develop a robust framework for assessing and redesigning digital health platforms. The research reveals significant potential for technology to transform healthcare delivery. It reveals that strategic technological interventions can reduce administrative inefficiencies by up to 40%, improving patient data security and creating more responsive healthcare ecosystems. The research shows how integrated digital infrastructure can bridge existing gaps in healthcare service delivery, improving patient access and healthcare provider coordination. By providing a practical framework for the transformation of digital health infrastructure, this research offers actionable insights for healthcare providers, technology developers and policy makers seeking to modernize healthcare service delivery in an increasingly digital world.

Keywords: decentralized healthcare, digital health, healthcare systems transformation, patient-centric technology

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Authors: Adrian Ionita, Ana-Maria Ghimes

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The lack of features, design and the lack of promoting an integrated booking application are some of the reasons why most online travel platforms only offer automation of old booking processes, being limited to the integration of a smaller number of services without addressing the user experience. This paper represents a practical study on how to improve travel applications creating user-profiles through data-mining based on neural networks and genetic algorithms. Choices made by users and their ‘friends’ in the ‘social’ network context can be considered input data for a recommendation engine. The purpose of using these algorithms and this design is to improve user experience and to deliver more features to the users. The paper aims to highlight a broader range of improvements that could be applied to travel applications in terms of design and service integration, while the main scientific approach remains the technical implementation of the neural network solution. The motivation of the technologies used is also related to the initiative of some online booking providers that have made the fact that they use some ‘neural network’ related designs public. These companies use similar Big-Data technologies to provide recommendations for hotels, restaurants, and cinemas with a neural network based recommendation engine for building a user ‘DNA profile’. This implementation of the ‘profile’ a collection of neural networks trained from previous user choices, can improve the usability and design of any type of application.

Keywords: artificial intelligence, big data, cloud computing, DNA profile, genetic algorithms, machine learning, neural networks, optimization, recommendation system, user profiling

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Authors: Alessandro Suardi, Rodolfo Picchio, Domenico Coaloa, Maria Bonaventura Forleo, Nadia Palmieri, Luigi Pari

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The reconversion process of the Italian sugar supply chain to bio-energy supply chains, as a result of the 2006 Sugar CMO reform, have involved research to define the best logistics, the most adapted energy crops for the Italian territory and their sustainability. Rapeseed (Brassica napus L.), Giant reed (Arundo donax L.) and Poplar (Poplar ssp.) are energy crops considered strategic for the development of Italian energy supply-chains. This study analyzed the environmental and the economic impacts on the farm level of these three energy crops. The environmental assessment included six farming units, two per crop, which were extracted from a sample of 251 rapeseed farm units (2751 ha), 7 giant reed farm units (7.8 ha), and 91 poplar farm units (440 ha) using a statistical multivariate analysis. Life Cycle Assessment (LCA) research method has been used to evaluate and compare the sustainability of the agricultural phases of the crops studied. The impact analyses have been performed at mid-point and end-point levels. The results of the analysis shown that the fertilization, is the major source of environmental impact of the agricultural phase due to the production of the fertilizers and the soil emissions of GHG following the treatment. The perennial energy crops studied (Arundo donax L., Poplar ssp.) were environmentally more sustainable if compared with the annual crop (Brassica napus L.) for all the impact categories at mid-point and end-point levels analyzed. The most relevant impact category influenced by the agricultural process result the fossil depletion, mainly due to the fossil fuels consumed during the mineral fertilizers production (urea). Human health was the most affected damage category at the end point level. Poplar result the energy crop with the best environmental performance for the Italian territory, in the distribution areas most suitable for its cultivation.

Keywords: LCA, energy crops, rapeseed, giant reed, poplar

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Authors: Munachiso A. Muoneke

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Telecare and telehealth are transformative innovations that expand healthcare access, improve service efficiency and enhance patient outcomes. This study explores the core objectives of telecare and telehealth, focusing on their role in overcoming geographical and logistical barriers to healthcare delivery. By leveraging digital platforms, remote monitoring tools and virtual consultations, these technologies address the pressing challenges of modern healthcare systems, including provider shortages and escalating costs. The research begins with an overview of telecare and telehealth objectives, highlighting their potential to bridge care gaps in underserved regions. It examines key methodologies, such as the integration of wearable devices, video conferencing and secure patient data platforms, to enhance real-time patient monitoring and personalized care. The study employs case studies and statistical analyses to compare patient outcomes in traditional care versus telehealth enables models. Preliminary findings demonstrate that telecare and telehealth significantly reduce hospital readmissions, improve chronic disease management and foster proactive health engagement. These outcomes emphasize the importance of aligning telehealth initiatives with healthcare policies and infrastructural investments. To conclude, the study lays emphasis on telecare and telehealth as indispensable tools for achieving universal health coverage. By fostering collaboration among healthcare providers, policy makers and technology developers, these innovations hold the potential to create a more accessible, efficient and patient-centered healthcare ecosystem.

Keywords: healthcare access and efficiency, remote monitoring, virtual consultations, telecare and telehealth innovations

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Authors: Alhage Drammeh

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The research is on the occurrence of certain diseases among children in rural and far-flung parts of the Gambia and the extent to which they are caused by lack of access to clean water. A baseline survey was used to discover, describe, and explain the actual processes. The paper explains the purpose of the research, which is majorly to improve the health condition of children, especially those living in rural communities. The paper also gives a brief overview of the socio-economic situation of The Gambia, emphasizing its status as a Least Developed Country (LDC) and the majority of its population living below the poverty line, with women and children hardest hit. The research used as case studies of two rural communities in the Gambia -Basse Dampha Kunda Village and Foni Besse. Data was collected through oral interviews and medical tests conducted among people in both villages, with an emphasis on children. The demographic detail of those tested is tabulated for a clearer understanding. The results were compared, revealing that skin rashes, hepatitis, and certain other diseases are more prevalent in communities lacking access to safe drinking water. These results were also presented in a tabular form. The study established how some policy failures and neglect on the part of the Government of The Gambia are imperiling the health of many rural dwellers in the country, the most glaring being that the research team was unable to test water samples collected from the two communities, as there are no laboratory reagents for testing water anywhere in The Gambia. Many rural communities lack basic amenities, especially clean and potable water, as well as health facilities. The study findings also highlighted the need for healthcare providers and medical NGOs to voice the plight of rural dwellers and collaborate with the government to set up health facilities in rural areas of The Gambia.

Keywords: jaundice, skin rashes, children, rural communities, the Gambia, causes

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Authors: Renata Kurpiewska-Korbut

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Making an assumption that the use and sharing of data generated in humanitarian action constitute a core function of humanitarian organizations, the paper analyzes the position of the largest Polish humanitarian non-governmental organizations in the humanitarian data ecosystem in Ukraine and their approach to non-personal and personal data management since February of 2022. Both expert interviews and document analysis of non-profit organizations providing a direct response in the Ukrainian crisis context, i.e., the Polish Humanitarian Action, Caritas, Polish Medical Mission, Polish Red Cross, and the Polish Center for International Aid and the applicability of theoretical perspective of contingency theory – with its central point that the context or specific set of conditions determining the way of behavior and the choice of methods of action – help to examine the significance of data complexity and adaptive approach to data management by relief organizations in the humanitarian supply chain network. The purpose of this study is to determine how the existence of well-established and accurate internal procedures and good practices of using and sharing data (including safeguards for sensitive data) by the surveyed organizations with comparable human and technological capabilities are implemented and adjusted to Ukrainian humanitarian settings and data infrastructure. The study also poses a fundamental question of whether this crisis experience will have a determining effect on their future performance. The obtained finding indicate that Polish humanitarian organizations in Ukraine, which have their own unique code of conduct and effective managerial data practices determined by contingencies, have limited influence on improving the situational awareness of other assistance providers in the data ecosystem despite their attempts to undertake interagency work in the area of data sharing.

Keywords: humanitarian data ecosystem, humanitarian data management, polish NGOs, Ukraine

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Authors: Rajapaksha J. S. R. L., Rajapaksha R. G. D. T., Ranawaka A. U. R., Rangalla R. D. M. P., Ranwala R. D. E. B., Chandratilake M. N.

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Introduction: Lesbian, gay, bisexual, and transgender (LGBT) patients experience discrimination, insensitivity, and ignorance about LGBT-specific health needs among healthcare providers. Developing the correct attitudes among medical students towards LGBT may help provide them with optimal healthcare. Objectives: This study aimed at assessing the attitudes of medical students towards the LBGT community. Methodology: A cross-sectional descriptive study was among all the medical students in the Faculty of Medicine, University of Kelaniya, Sri Lanka, using a validated online questionnaire. The questionnaire focused on eight areas. The data were descriptively analyzed, and the demographic groups were compared. Results: 358 students completed the survey. The response rate was 34.26%. Their attitudes on traditional gender roles and comfortability in interacting with LGBT people were moderate, and they disagreed with negative LGBT social beliefs. They knew less about the origin of sexuality/gender of LGBT. Although they accepted LGBT as a part of diversity, they discouraged normalizing the social practices of LGBT people. Their acceptance and association of LGBT were moderately positive. A minority has encountered LGBT in close social circles, and the majority of them were batch-mates. Although males’ knowledge about the origin of LGBT was higher, they favoured traditional gender roles more. The religious groups showed no differences. The favourability of attitudes towards LGBT reflected respondents’ political ideology. Conclusion: Although medical students’ knowledge on the sexuality/gender basis of LGBT is poor, they have moderately favourable attitudes towards them. They accept LGBT as a part of social diversity but not their social practices. Poor knowledge, lack of encounters, cultural influences, and political ideology may have influenced their attitudes.

Keywords: medical students, attitude, LGBT, diversity

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Authors: A. Robbin

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Language selection can be an efficient negotiation strategy employed by both service or product providers and their customers to achieve transactional success. The transactional scenario in Gbagi Market, Ibadan, Nigeria provides an appropriate setting for the exploration of the Nigerian multilingual situation with its own interesting linguistic peculiarities which questions the functionality of the ‘Lingua Franca’ in trade situations. This study examined English Language proficiency among Yoruba Traders in Gbagi Market, Ibadan and its use as determinants of transactional success during service encounters. Randomly selected Yoruba-English bilingual traders and customers were administered questionnaires and the data subjected to statistical and descriptive analysis using Giles Communication Accommodation Theory. Findings reveal that only fifty percent of the traders used for the study were proficient in speaking English language. Traders with minimal proficiency in Standard English, however, resulted in the use of the Nigerian Pidgin English. Both traders and customers select the Mother Tongue, which is the Yoruba Language during service encounters but are quick to converge to the other’s preferred language as the transactional exchange demands. The English language selection is not so much for the prestige or lingua franca status of the language as it is for its functions, which include ease of communication, negotiation, and increased sales. The use of English during service encounters is mostly determined by customer’s linguistic preference which the trader accommodates to for better negotiation and never as a first choice. This convergence is found to be beneficial as it ensures sales and return patronage. Although the English language is not a preferred code choice in Gbagi Market, it serves a functional trade strategy for transactional success during service encounters in the market.

Keywords: communication accommodation theory, language selection, proficiency, service encounter, transaction

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Authors: C. O’Brien, Chloe Reiss

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While South Africa has been the chosen host country for over 1,2 million asylum seekers/refugees it has at the same time, been struggling to address the needs of its own people who are still trapped in poverty with little prospects of employment. This limited exploratory, qualitative study was undertaken in Cape Town with a purposive sample of 21 key personnel from various NPOs providing a service to asylum seekers/refugees. Individual in-depth face to face interviews were carried out and the main findings were: Some of the officials at the Department of Home Affairs, health personnel, landlords, school principals, employers, bank officials and police officers were prejudicial in their practices towards asylum seekers/ refugees. The major constraints experienced by NPOs in this study were linked to a lack of funding and minimal government support, strained relationship with the Department of Home Affairs and difficulties in accessing refugees. And finally, the strategies adopted by these NPOs included networking with other service providers, engaging in advocacy, raising community awareness and liaising with government. Thus, more focused intervention strategies are needed to build social cohesion, address prejudices which fuels xenophobic attacks and raise awareness/educate various sectors about refugee rights. Given this burgeoning global problem, social work education and training should include curriculum content on migrant issues. Furthermore, larger studies using mixed methodology approaches would yield more nuanced data and provide for more strategic interventions.

Keywords: refugees and asylum seekers, constraints of service delivery, non-profit organisations, refugee challenges

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Authors: R. K. Yadav, S. Baral, H. R. Paudel, R. Basnet

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The Public-Private Mix (PPM) approach is a strategic initiative that involves engaging all private and public healthcare providers in the fight against tuberculosis using international healthcare standards. For tuberculosis control in Nepal, the PPM approach could be a milestone. This study aimed to explore the barriers to a public-private mix approach in the management of tuberculosis cases in Nepal. A total of 20 respondents participated in the study. Barriers to PPM were identified in the following three themes: 1) Obstacles related to TB case detection, 2) Obstacles related to patients, and 3) Obstacles related to the healthcare system. PPM implementation was challenged by following subthemes that included staff turnover, low private sector participation in workshops, a lack of training, poor recording and reporting, insufficient joint monitoring and supervision, poor financial benefit, lack of coordination and collaboration, and non-supportive TB-related policies and strategies. The study concludes that numerous barriers exist in the way of effective implementation of the PPM approach, including TB cases detection barriers such as knowledge of TB diagnosis and treatment, HW attitude, workload, patient-related barriers such as knowledge of TB, self-medication practice, stigma and discrimination, financial status, and health system-related barriers such as staff turnover and poor engagement of the private sector in workshops, training, recording, and re-evaluation. Government stakeholders must work together with private sector stakeholders to perform joint monitoring and supervision. Private practitioners should receive training and orientation, and presumptive TB patients should be given adequate time and counseling as well as motivation to visit a government health facility.

Keywords: barrier, tuberculosis, case finding, PPM, nepal

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Authors: Adrita Banerjee, Ajeet Kumar Singh

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Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy and delivery. The quality of antenatal care can be monitored through the content of services received and the kind of information mothers are given during their visit. Objective: The paper tries to examine the association between ANC check-ups and size/ birth weight. It also focuses on investigating the relationship between utilization of recommended prenatal care for mothers and its effect on infant survival in Nepal. Data and methods: This paper uses data from Nepal demographic Health Survey 2011. To understand the relationship bi-variate statistical analysis and logistic regressions has been done. Maternal health care utilization include ANC check-ups i.e. the type of ante-natal care providers, the number and timing of the visit. The various components of the check-ups include intake of iron tablets/syrups, intestinal parasitic drugs, etc. Results: The results show that women who had no antenatal care visits about 40% had small sized babies at the time of birth compared to women to had at least 3 ANC check up. Women who had at least 3 check-ups 17% of the babies have a small size. It has also been found that about 50 % of the women prefer ANC check-ups during pregnancies which have resulted in lowering the infant mortality by about 40% during 1996-2011. Conclusion: Ante natal care check is care and monitoring of the pregnant woman and her foetus throughout pregnancy. ANC checks have an effect on the infant health and child survival. A woman who had at least three check-ups the possibilities of adverse effect on infant health and infant survival was significantly lower. The findings argue for a more enhanced focus on ANC check-ups for improving the maternal and child health in Nepal.

Keywords: maternal, health, pregnancy, outcome

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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: John Akpesiri Olotewo

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One of the controversies in existing marketing literatures is on how to retain existing and new customers to have repurchase intention in the long-run; however, empirical answer to this question is scanty in existing studies. Thus, this study investigates the moderating effect of consumer loyalty on long-run repurchase intentions in telecommunication industry using Lagos State environs. The study adopted field survey research design using questionnaire to elicit responses from 250 respondents who were selected using random and stratified random sampling techniques from the telecommunication industry in Lagos State, Nigeria. The internal consistency of the research instrument was verified using the Cronbach’s alpha, the result of 0.89 implies the acceptability of the internal consistency of the survey instrument. The test of the research hypotheses were analyzed using Pearson Product Method of Correlation (PPMC), simple regression analysis and inferential statistics with the aid of Statistical Package for Social Science version 20.0 (SPSS). The study confirmed that customer satisfaction has a significant relationship with customer loyalty in the telecommunication industry; also Service quality has a significant relationship with customer loyalty to a brand; loyalty programs have a significant relationship with customer loyalty to a network operator in Nigeria and Customer loyalty has a significant effect on the long run repurchase intentions of the customer. The study concluded that one of the determinants of long term profitability of a business entity is the long run repurchase intentions of its customers which hinges on the level of brand loyalty of the customer. Thus, it was recommended that service providers in Nigeria should improve on factors like customer satisfaction, service quality, and loyalty programs in order to increase the loyalty of their customer to their brands thereby increasing their repurchase intentions.

Keywords: customer loyalty, long run repurchase intentions, brands, service quality and customer satisfaction

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Authors: Antonella Poce, Deborah Seid Howes, Maria Rosaria Re, Mara Valente

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The Creative Industries education contexts, Museum Education in particular, generally presents a low emphasis on the use of new digital technologies, digital abilities and transversal skills development. The spread of the Covid-19 pandemic has underlined the importance of these abilities and skills in cultural heritage education contexts: gaining digital skills, museum professionals will improve their career opportunities with access to new distribution markets through internet access and e-commerce, new entrepreneurial tools, or adding new forms of digital expression to their work. However, the use of web, mobile, social, and analytical tools is becoming more and more essential in the Heritage field, and museums, in particular, to face the challenges posed by the current worldwide health emergency. Recent studies highlight the need for stronger partnerships between the cultural and creative sectors, social partners and education and training providers in order to provide these sectors with the combination of skills needed for creative entrepreneurship in a rapidly changing environment. Considering the above conditions, the paper presents different examples of digital learning experiences carried out in Italian and USA contexts with the aim of promoting digital skills in museum professionals. In particular, a quali-quantitative research study has been conducted on two international Postgraduate courses, “Advanced Studies in Museum Education” (2 years) and “Museum Education” (1 year), in order to identify the educational effectiveness of the online learning strategies used (e.g., OBL, Digital Storytelling, peer evaluation) for the development of digital skills and the acquisition of specific content. More than 50 museum professionals participating in the mentioned educational pathways took part in the learning activity, providing evaluation data useful for research purposes.

Keywords: digital skills, museum professionals, technology, education

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: Farida Habib, Haya Alfozan, Eman Miligi, Najla Alotaibi

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Background: Women’s satisfaction with maternity services, especially care during labor and birth, has become highly significant to healthcare providers, administrators, and policymakers. Purpose: The aims of this study were to assess maternal satisfaction regarding the quality of care during labor and to compare the level of maternal satisfaction between women who delivered by physicians and those delivered by midwives. Methodology: A descriptive, cross-sectional, correlational design was used. A convenient sample of 180 low-risk cases of immediate postpartum women who delivered at King Abdul-Aziz medical city was recruited. Women whose babies were diagnosed with serious health problems were excluded from the study. Data were collected using a self-administered questionnaire. The validity and reliability of the questionnaire were ensured. The questionnaire included three parts, namely: demographics data, medical history, and obstetrical history, and the last part is the satisfaction assessment tool. Ethical confederations were ensured. Maternal satisfaction during labor was classified in terms of health care, health workers' communication, and the environment. Results: Regarding health care, women were highly satisfied with care received from nurse (M = 4.21 + 0.88), medical care received (M = 4.17 + 0.79), and comfort techniques (M = 4.04 + 0.91). Regarding health workers' communication, women were highly satisfied with the provider to treat with dignity and respect (M = 4.03 + 0.91) and orientation to the toilet, bathroom, washing area (M = 4.00 + 0.93). Regarding the environment, women were highly satisfied with the experience of their baby's birth (M = 4.18 + 0.98) and supplies with drugs and supplies (M = 4.09 + 0.97). There was no statistically significant difference in maternal satisfaction between women who delivered by physicians and those delivered by midwives. Conclusion: Women were generally satisfied with their labor and delivery experience. There was no difference in maternal satisfaction on the labor process between women who delivered by physicians and those delivered by midwives.

Keywords: maternity, satisfaction, labor, delivery

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Authors: Sarinra Thongmee, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk, Krittaphon Prakobsaeng

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The purposes of this research and development was to develop and evaluation of clinical nursing practice guideline (CNPG) for the prevention of infection during intubation in patient withsuspected or confirmedCOVID-19 patient. This study was developed by using the evidence based practice model of Soukup (2000) as a conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patients with confirmed COVID-19, 2) development the CNPG, 3) apply the NPG to trial, and 4) evaluation of the NPG. Thesample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) CNPG, 2) the nurses anesthetist opinion questionnaire to the guideline, 3) the evaluation practice form, and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results found that this developed NPG consists of 4 sections: 1) NPG for Preventing Airborne Infection Prevention2) preparation of anesthetic and intubation equipments 3) roles and duties of the intubation team 4) guidelines for intubation in suspected or confirmed COVID-19patients. The result found that 1) provider: using NPG in providers revealed that nurse anesthetist had higher mean of knowledge scores than before using NPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% in all activities. The anesthetic team was not infected with COVID-19from intubation outside operating room.2) Client: the patient was safe, no complications from intubation. Summary CNPG to prevent infection in intubation of suspected or confirmedCOVID-19 patient was appropriate and applicable to practice.

Keywords: nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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