Search results for: alternative and complementary healthcare

Authors: Oluyomi Stephen Adeyemi, Kentaro Kato

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Toxoplasma gondii is the etiological agent of toxoplasmosis, a common parasitic disease capable of infecting a range of hosts, including nearly one-third of the human population. Current treatment options for toxoplasmosis patients are limited. In consequence, toxoplasmosis represents a large global burden that is further enhanced by the shortcomings of the current therapeutic options. These factors underscore the need for better anti-T. gondii agents and/or new treatment approach. In the present study, we sought to find out whether preparing and capping nanoparticles (NPs) in amino acids, would enhance specificity toward the parasite versus the host cell. The selection of amino acids was premised on the fact that T. gondii is auxotrophic for some amino acids. The amino acid-nanoparticles (amino-NPs) were synthesized, purified and characterized following established protocols. Next, we tested to determine the anti-T. gondii activity of the amino-NPs using in vitro experimental model of infection. Overall, our data show evidence that supports enhanced and excellent selective action against the parasite versus the host cells by amino-NPs. The findings are promising and provide additional support that warrants exploring the prospects of NPs as alternative anti-parasite agents. In addition, the anti-parasite action by amino-NPs indicates that nutritional requirement of parasite may represent a viable target in the development of better alternative anti-parasite agents. Furthermore, data suggest the anti-parasite mechanism of the amino-NPs involves multiple cellular processes including the production of reactive oxygen species (ROS), modulation of hypoxia-inducing factor-1 alpha (HIF-1α) as well as the activation of kynurenine pathway. Taken together, findings highlight further, the prospects of NPs as alternative source of anti-parasite agents.

Keywords: drug discovery, infectious diseases, mode of action, nanomedicine

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Authors: Masoumeh Khosravi

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Introduction: The complementary therapies and Qigong exercises is important in order to maintain physical and mental health. Objective: This study was done to compare and investigate well-being and mental health's state between practitioners of a Qigong practice (Falun Dafa) and non-practitioners. Method: It was a comparative study with 60 samples (30 practitioners of Falun Dafa, and 30 non-practitioners), who were selected by random sampling from Tehran city of Iran. Data were collected by mental health inventory (SCL90) and well-being questionnaire. Multivariate variance analyzing and t-test were used for analyzing data. Results: Results showed significant differences in most components of mental health including anxiety, aggressiveness, obsessive-compulsion, interpersonal sensitivity, somatization disorder, depression, phobia between practitioners and non-practitioners. Well-being was significantly higher in practitioners than non-practitioners. Conclusion: Accordingly, we concluded Falun Gong exercises have high impact on mental health and well-being in people.

Keywords: mental health, well-being, Qigong, Falun Dafa

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Authors: Simone Rondelli, Damiano Rondelli, Bishesh Poudyal, Juan Jose Cabrera-Lazarini

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One of the main obstacles for Social Entrepreneurship is to find a business model that is financially sustainable. In other words, the captured value generates enough cash flow to ensure business continuity and reinvestment for growth. Providing Health Services in poor countries for the uninsured population affected by a high-cost chronical disease is not the exception for this challenge. As a prime example, cancer has become a high impact on a global disease not only because of the high morbidity but also of the financial impact on both the patient family and health services in underdeveloped countries. Therefore, it is relevant to find a Social Entrepreneurship Model that provides affordable treatment for this disease while maintaining healthy finances not only for the patient but also for the organization providing the treatment. Using the methodology of Constructive Research, this paper applied a Positive Theory and four business models of Social Entrepreneurship to a case of a Private Foundation model whose mission is to address the challenge previously described. It was found that the Foundation analyzed, in this case, is organized as an Embedded Business Model and complies with the four propositions of the Positive Theory considered. It is recommended for this Private Foundation to explore implementing the Integrated Business Model to ensure more robust sustainability in the long term. It evolves as a scalable model that can attract investors interested in contributing to expanding this initiative globally.

Keywords: affordable treatment, global healthcare, social entrepreneurship theory, sustainable business model

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Authors: Nabil A. Albaser

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Background: There is a serious problem with adverse drug reactions (ADRs) everywhere, including Yemen. Since it helps with the detection, assessment, reporting and prevention of ADRs, pharmacovigilance (PV) is an essential part of the healthcare system. The unbiased reporting of ADRs remains the foundation of PV. Students majoring in healthcare should acquire the knowledge and skills necessary to conduct PV in a range of clinical settings. The primary objective of this study was to evaluate the understanding and attitudes of final-year Pharmacy, Nursing, and Midwifery students at Al-Razi University in Sana'a, Yemen, regarding PV and ADRs reporting. Methods: The study followed descriptive cross-sectional approach. A validated, self-administered questionnaire with three parts—demographic information, knowledge, and perceptions of Pharmacovigilance was online distributed to final-year Pharmacy, Nursing, and Midwifery students. The questionnaire was given to 175 students; 122 of them responded with a percentage (69.7%). Results: The majority of respondents were male (79.5%). More than the tow-third of the students, 68.9%, were beyond the age of 23. Although the majority of students, 80%, heard about the terms of ADRs and PV, but only 50% and 57.4% of the respondents, respectively, could define the both terms correctly. However, only 11.48 % of them, nevertheless, took a PV course. More than a half of them (56.6%) had a positive perceptions towards pharmacovigilance and ADR reporting and had a moderate degree of knowledge (68.9%). Conclusion: The study demonstrated that the participants lacked sufficient knowledge of pharmacovigilance and ADR reporting. They showed a moderate level of understanding of reporting ADRs as well as a favorable opinion of dealing with and reporting ADRs. Yemen's health care curriculum should include lessons on pharmacovigilance.

Keywords: adverse drug reaction reporting, pharmacovigilance, yemen, knowlegde

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Authors: Nadeem Qaiser, Sherjeel Munsif Khan, Muhammad Mustafa Hussian, Vincent Tung

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One of the emerging fields in the detection of chronic diseases is based on the point-of-care (POC) early monitoring of the symptoms and thus provides a state-of-the-art personalized healthcare system. Nowadays, wearable and flexible sensors are being used for analyzing sweat, glucose, blood pressure, and other skin conditions. However, localized jaw-bone swelling called parotid-swelling caused by some viruses has never been tracked before. To track physical motion or deformations, strain sensors, especially piezoresistive ones, are widely used. This work, for the first time, reports carbon nanotubes (CNTs)-based piezoresistive sensing patch that is highly flexible and stretchable and can record muscle deformations in real-time. The developed patch offers an excellent gauge factor for in-plane stretching and spatial expansion with low hysteresis. To calibrate the volumetric muscle expansion, we fabricated the pneumatic actuator that experienced volumetric expansion and thus redefined the gauge factor. Moreover, we employ a Bluetooth-low-energy system that can send information about muscle activity in real-time to a smartphone app. We utilized COMSOL calculations to reveal the mechanical robustness of the patch. The experiments showed the sensing patch's greater cyclability, making it a patch for personal healthcare and an excellent choice for monitoring the real-time POC monitoring of the human muscle swelling.

Keywords: piezoresistive strain sensor, FEM simulations, CNTs sensor, flexible

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Authors: Zhuang Yiwen

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The paper examines the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. One of the major challenges identified is the lack of a standard coding system for medical devices, which makes it difficult to track them effectively. The paper suggests the use of the Unique Device Identifier (UDI) as a single standard for medical devices to improve tracking and reduce errors. The paper also explores the use of barcoding and image recognition to identify and document medical devices in nursing practices. In nursing practices, the use of barcodes for identifying medical devices is common. However, the information contained in these barcodes is often inconsistent, making it challenging to identify which segment contains the model identifier. Moreover, the use of barcodes may be improved with the use of UDI, but many subsidized accessories may still lack barcodes. The paper suggests that the readiness for UDI and barcode standardization requires standardized information, fields, and logic in electronic medical record (EMR), operating theatre (OT), and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. Nursing workflow and data flow also need to be taken into account. The paper also explores the use of image recognition, specifically the Tesseract OCR engine, to identify and document implants in public hospitals due to limitations in barcode scanning. The study found that the solution requires an implant information database and checking output against the database. The solution also requires customization of the algorithm, cropping out objects affecting text recognition, and applying adjustments. The solution requires additional resources and costs for a mobile/hardware device, which may pose space constraints and require maintenance of sterile criteria. The integration with EMR is also necessary, and the solution require changes in the user's workflow. The paper suggests that the long-term use of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) as a supporting terminology to improve clinical documentation and data exchange in healthcare. SNOMED CT provides a standardized way of documenting and sharing clinical information with respect to procedure, patient and device documentation, which can facilitate interoperability and data exchange. In conclusion, the paper highlights the challenges facing the Singapore healthcare system related to the tracking and traceability of medical devices. The paper suggests the use of UDI and barcode standardization to improve tracking and reduce errors. It also explores the use of image recognition to identify and document medical devices in nursing practices. The paper emphasizes the importance of standardized information, fields, and logic in EMR, OT, and billing systems, as well as barcode scanners that can read various formats and selectively parse barcode segments. These recommendations could help the Singapore healthcare system to improve tracking and traceability of medical devices and ultimately enhance patient safety.

Keywords: medical device tracking, unique device identifier, barcoding and image recognition, systematized nomenclature of medicine clinical terms

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Authors: Nir Nissim, Erez Shalom, Tomer Lancewiki, Yuval Elovici, Yuval Shahar

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Background: A Medical Device (MD) is an instrument, machine, implant, or similar device that includes a component intended for the purpose of the diagnosis, cure, treatment, or prevention of disease in humans or animals. Medical devices play increasingly important roles in health services eco-systems, including: (1) Patient Diagnostics and Monitoring; Medical Treatment and Surgery; and Patient Life Support Devices and Stabilizers. MDs are part of the medical device eco-system and are connected to the network, sending vital information to the internal medical information systems of medical centers that manage this data. Wireless components (e.g. Wi-Fi) are often embedded within medical devices, enabling doctors and technicians to control and configure them remotely. All these functionalities, roles, and uses of MDs make them attractive targets of cyber-attacks launched for many malicious goals; this trend is likely to significantly increase over the next several years, with increased awareness regarding MD vulnerabilities, the enhancement of potential attackers’ skills, and expanded use of medical devices. Significance: We propose to develop and implement Cyber-Med, a unique collaborative project of Ben-Gurion University of the Negev and the Clalit Health Services Health Maintenance Organization. Cyber-Med focuses on the development of a comprehensive detection framework that relies on a critical attack repository that we aim to create. Cyber-Med will allow researchers and companies to better understand the vulnerabilities and attacks associated with medical devices as well as providing a comprehensive platform for developing detection solutions. Methodology: The Cyber-Med detection framework will consist of two independent, but complementary detection approaches: one for known attacks, and the other for unknown attacks. These modules incorporate novel ideas and algorithms inspired by our team's domains of expertise, including cyber security, biomedical informatics, and advanced machine learning, and temporal data mining techniques. The establishment and maintenance of Cyber-Med’s up-to-date attack repository will strengthen the capabilities of Cyber-Med’s detection framework. Major Findings: Based on our initial survey, we have already found more than 15 types of vulnerabilities and possible attacks aimed at MDs and their eco-system. Many of these attacks target individual patients who use devices such pacemakers and insulin pumps. In addition, such attacks are also aimed at MDs that are widely used by medical centers such as MRIs, CTs, and dialysis engines; the information systems that store patient information; protocols such as DICOM; standards such as HL7; and medical information systems such as PACS. However, current detection tools, techniques, and solutions generally fail to detect both the known and unknown attacks launched against MDs. Very little research has been conducted in order to protect these devices from cyber-attacks, since most of the development and engineering efforts are aimed at the devices’ core medical functionality, the contribution to patients’ healthcare, and the business aspects associated with the medical device.

Keywords: medical device, cyber security, attack, detection, machine learning

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Authors: Kamal Ray, Tapati Bhattacharya

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Private use of public office for private gain could be a tentative definition of corruption and most distasteful event of corruption is that it is not there, nor that it is pervasive, but it is socially acknowledged in the global economy, especially in the developing nations. We attempted to assess the interrelationship between the Corruption perception index (CPI) and the principal components of governance indicators as per World Bank like Control of Corruption (CC), rule of law (RL), regulatory quality (RQ) and government effectiveness (GE). Our empirical investigation concentrates upon the degree of reflection of governance indicators upon the CPI in order to single out the most powerful corruption-generating indicator in the selected countries. We have collected time series data on above governance indicators such as CC, RL, RQ and GE of the selected eleven countries from the year of 1996 to 2012 from World Bank data set. The countries are USA, UK, France, Germany, Greece, China, India, Japan, Thailand, Brazil, and South Africa. Corruption Perception Index (CPI) of the countries mentioned above for the period of 1996 to 2012is also collected. Graphical method of simple line diagram against the time series data on CPI is applied for quick view for the relative positions of different trend lines of different nations. The correlation coefficient is enough to assess primarily the degree and direction of association between the variables as we get the numerical data on governance indicators of the selected countries. The tool of Granger Causality Test (1969) is taken into account for investigating causal relationships between the variables, cause and effect to speak of. We do not need to verify stationary test as length of time series is short. Linear regression is taken as a tool for quantification of a change in explained variables due to change in explanatory variable in respect of governance vis a vis corruption. A bilateral positive causal link between CPI and CC is noticed in UK, index-value of CC increases by 1.59 units as CPI increases by one unit and CPI rises by 0.39 units as CC rises by one unit, and hence it has a multiplier effect so far as reduction in corruption is concerned in UK. GE causes strongly to the reduction of corruption in UK. In France, RQ is observed to be a most powerful indicator in reducing corruption whereas it is second most powerful indicator after GE in reducing of corruption in Japan. Governance-indicator like GE plays an important role to push down the corruption in Japan. In China and India, GE is proactive as well as influencing indicator to curb corruption. The inverse relationship between RL and CPI in Thailand indicates that ongoing machineries related to RL is not complementary to the reduction of corruption. The state machineries of CC in S. Africa are highly relevant to reduce the volume of corruption. In Greece, the variations of CPI positively influence the variations of CC and the indicator like GE is effective in controlling corruption as reflected by CPI. All the governance-indicators selected so far have failed to arrest their state level corruptions in USA, Germany and Brazil.

Keywords: corruption perception index, governance indicators, granger causality test, regression

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Authors: Gulshan Kumar Jawa, Sandeep Mohan Ahuja

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With the increase in industrialization, the presence of heavy metals in wastewater streams has turned into a serious concern for the ecosystem. The metals diffuse through the food chains, causing various health hazards. Conventional methods used to remove these heavy metals from water have some limitations, such as cost, secondary pollution due to sludge formation, recovery of metal, economic viability at low metal concentrations, etc. Many of the biomaterials have been investigated by researchers for the adsorption of heavy metals from water solutions as an alternative technique for the last two decades and have found promising results. In this paper, the batch study on the use of pods of acacia karoo for the adsorption of Cd(II) and Pb(II) from aqueous solutions has been reported. The effect of various parameters on the removal of metal ions, such as pH, contact time, stirring speed, initial metal ion concentration, adsorbent dose, and temperature, have been established to find the optimum parameters through one parameter optimization. Further, kinetic, equilibrium, and thermodynamic studies have been conducted. The pods of acacia karoo have shown great potential for adsorption of Cd(II) and Pb(II) from aqueous solutions and have proven to be a better and more economical alternative for the purpose.

Keywords: adsorption, heavy metals, biomaterials, Cadmium(II), Lead(II), pods of acacia karoo

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Authors: K. C. Surekha

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The natural habitat forms the setting for every urban development. The tangible and intangible characteristics of the site contributed to the sustenance of various urban dimensions of early civilizations. However, as the towns were continuously evolving and developing, the attitude towards the natural habitat changed. The after effects of this self-centered attitude resulted in various natural and manmade catastrophes. At the same time the social habitat, cities and new towns were increasingly over-populated; and will become even more numerous and crowded in the future. The coexistence of natural and urban components is necessary for a sustainable future and preserving the region’s unique features. Therefore, there is an urgent need to rethink actively on alternative development paradigms to achieve sustenance of all living forms on the planet in a more sustainable way. The main aim of this paper is to understand bioregionalism as an alternative development paradigm, its theory, concepts as well as the key aspects of bioregional planning. The paper will try to understand the concept of bioregionalism theoretically and take case studies. The critical interpretation of theory and analysis of case studies will be used to form a set of design parameters which can be physically implemented from an urban design and planning standpoint.

Keywords: bioregion, bioregionalism, holistic, sustainable

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Authors: Domenico Chizzoniti, Monica Moscatelli, Letizia Cattani, Luca Preis

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A primary healthcare facility in developing countries should be a multifunctional space able to respond to different requirements: Flexibility, modularity, aggregation and reversibility. These basic features could be better satisfied if applied to an architectural artifact that complies with the typological, figurative and constructive aspects of the context in which it is located. Therefore, the purpose of this paper is to identify a procedure that can define the figurative aspects of the architectural structure of the health prototype for the marginal areas of developing countries through a critical approach. The application context is the rural areas of the Northeast of Bahia in Brazil. The prototype should be located in the rural district of Quingoma, in the municipality of Lauro de Freitas, a particular place where there is still a cultural fusion of black and indigenous populations. Based on the historical analysis of settlement strategies and architectural structures in spaces of public interest or collective use, this paper aims to provide a procedure able to identify the categories and rules underlying typological and figurative aspects, in order to detect significant and generalizable elements, as well as materials and constructive techniques typically adopted in the rural areas of Brazil. The object of this work is therefore not only the recovery of certain constructive approaches but also the development of a procedure that integrates the requirements of the primary healthcare prototype with its surrounding economic, social, cultural, settlement and figurative conditions.

Keywords: architectural typology, developing countries, local construction techniques, primary health care.

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Authors: Chinelle van der Westhuizen

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The introduction of cryptocurrencies as an alternative payment system have placed governments in a challenging position in relation to the regulatory status of cryptocurrencies and the money laundering activities associated with it. In April 2018, the Australian government amended its Anti-Money Laundering laws to regulate digital currency exchanges in an attempt to regulate money laundering activities and the introduction of ‘know-your-customer’ policies within the digital currency sector. Part one of this paper explores the use of cryptocurrencies for money laundering purposes and its significance to money launderers. Part two studies the efficacy of the current Australian Anti-Money Laundering laws and whether more can be done on a regulatory level. This paper will, therefore, highlight recent court decisions and legislation in terms of money laundering activities within these alternative payment systems in Australia and the United Kingdom. Part three of the paper will further analyze recent case studies by the Australian Transaction Reports and Analysis Centre and the Office for Professional Body Anti-Money Laundering Supervision in the United Kingdom as the regulatory bodies for money laundering activities. The case studies and research will explore the legal disputes and future regulation concerning the use of cryptocurrencies and money laundering on a national as well as international level. This paper intends to highlight that although cryptocurrency is viewed as an innovative global phenomenon and an alternative method of payment, there are a number of legal issues associated with its use that indicate the need for regulatory reform. It is recommended in this paper that the Financial Action Task Force, International Monetary Fund as well as concerned governments have ongoing discussions on these regulatory issues and how to address it appropriately, whether through legislation or universal guidelines. Therefore, the conclusion of this paper will emphasize the benefits of a regulatory regime for money laundering activities within the cryptocurrency space and that the lack of such a regime may be detrimental to countries.

Keywords: cryptocurrency, know-your-customer policy, money laundering, regulation

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Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

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Authors: Lauren G. Coggins

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Catheter-associated urinary tract infections (CAUTI) and central line-associated bloodstream infections (CLABSI) are among the most common healthcare-associated infections (HAI), contributing to prolonged lengths of stay, greater costs of patient care, and increased patient mortality. Evidence-based preventative care bundles exist to establish consistent, safe patient-care practices throughout an entire organization, helping to ensure the collective application of care strategies that aim to improve patient outcomes and minimize complications. The cardiac intensive care unit at a nationally ranked teaching and research hospital in the United States exceeded its annual CAUTI and CLABSI targets in the fiscal year 2019, prompting examination into the unit’s infection prevention efforts that included preventative care bundles for both HAIs. Adherence to the CAUTI and CLABSI preventative care bundles was evaluated through frequent audits conducted over three months, using standards and resources from The Joint Commission, a globally recognized leader in quality improvement in healthcare and patient care safety. The bundle elements with the lowest scores were identified as the most commonly missed elements. Three elements from both bundles, six elements in total, served as key content areas for the educational interventions targeted to bedside nurses. The CAUTI elements included appropriate urinary catheter order, appropriate continuation criteria, and urinary catheter care. The CLABSI elements included primary tubing compliance, needleless connector compliance, and dressing change compliance. An integrated, multi-platform education campaign featured content on each CAUTI and CLABSI preventative care bundle in its entirety, with additional reinforcement focused on the lowest scoring elements. One-on-one educational materials included an informational pamphlet, badge buddy, a presentation to reinforce nursing care standards, and real-time application through case studies and electronic health record demonstrations. A digital hub was developed on the hospital’s Intranet for quick access to unit resources, and a bulletin board helped track the number of days since the last CAUTI and CLABSI incident. Audits continued to be conducted throughout the education campaign, and staff were given real-time feedback to address any gaps in adherence. Nearly every nurse in the cardiac intensive care unit received all educational materials, and adherence to all six key bundle elements increased after the implementation of educational interventions. Recommendations from this implementation include providing consistent, comprehensive education across multiple teaching tools and regular audits to track adherence. The multi-platform education campaign brought focus to the evidence-based CAUTI and CLABSI bundles, which in turn will help to reduce CAUTI and CLABSI rates in clinical practice.

Keywords: education, healthcare-associated infections, infection, nursing, prevention

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Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

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Authors: Sahin Yakut, H. Kemal Ulutas, Deniz Deger

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Plasma Assisted Physical Vapor Deposition (PAPVD) method used to produce Poly(ethylene oxide) (pPEO) thin films. Depositions were progressed at various plasma discharge powers as 0, 2, 5 and 30 W for pPEO at 500nm film thicknesses. The capacitance and dielectric dissipation of the thin films were measured at 0,1-107 Hz frequency range and 173-353 K temperature range by an impedance analyzer. Then, alternative conductivity (σac) and activation energies were derived from capacitance and dielectric dissipation. σac of conventional PEO (PEO precursor) was measured to determine the effect of plasma discharge. Differences were observed between the alternative conductivity of PEO’s and pPEO’s depending on plasma discharge power. By this purpose, structural characterization techniques such as Differential Scanning Calorimetry (DSC) and Fourier Transform Infrared Spectroscopy (FT-IR) were applied on pPEO thin films. Structural analysis showed that density of crosslinking is plasma power dependent. The crosslinking density increases with increasing plasma discharge power and this increase is displayed as increasing dynamic glass transition temperatures at DSC results. Also, shifting of frequencies of some type of bond vibrations, belonging to bond vibrations produced after fragmentation because of plasma discharge, were observed at FTIR results. The dynamic glass transition temperatures obtained from alternative conductivity results for pPEO consistent with the results of DSC. Activation energies exhibit Arrhenius behavior. Activation energies decrease with increasing plasma discharge power. This behavior supports the suggestion expressing that long polymer chains and long oligomers are fragmented into smaller oligomers or radicals.

Keywords: activation energy, dielectric spectroscopy, organic thin films, plasma polymer

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Authors: Lolwa Alansari, Abdelhamid Azhaghdani, Sufia Athar, Hanen Mrabet, Annaliza Cruz, Tamara Alshadafat, Almunzer Zakaria

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Introduction: Improving the patient experience is a fundamental pillar of healthcare's quadruple aims. Recognizing the importance of patient experiences and perceptions in healthcare interactions is pivotal for driving quality improvement. This abstract centers around the Patient Experience Program, an endeavor crafted with the purpose of comprehending and elevating the experiences of patients in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). Methodology: This comprehensive endeavor unfolded through a structured sequence of phases following Plan-Do-Study-Act (PDSA) model, spanning over 12 months, focused on enhancing patient experiences in the Obstetrics & Gynecology Emergency Department (OB/GYN ED). The study meticulously examined the journeys of patients with acute obstetrics and gynecological conditions, collecting data from over 100 participants monthly. The inclusive approach covered patients of different priority levels (1-5) admitted for acute conditions, with no exclusions. Historical data from March and April 2022 serves as a benchmark for comparison, strengthening causality claims by providing a baseline understanding of OB/GYN ED performance before interventions. Additionally, the methodology includes the incorporation of staff engagement surveys to comprehensively understand the experiences of healthcare professionals with the implemented improvements. Data extraction involved administering open-ended questions and comment sections to gather rich qualitative insights. The survey covered various aspects of the patient journey, including communication, emotional support, timely access to care, care coordination, and patient-centered decision-making. The project's data analysis utilized a mixed-methods approach, combining qualitative techniques to identify recurring themes and extract actionable insights and quantitative methods to assess patient satisfaction scores and relevant metrics over time, facilitating the measurement of intervention impact and longitudinal tracking of changes. From the themes we discovered in both the online and in-person patient experience surveys, several key findings emerged that guided us in initiating improvements, including effective communication and information sharing, providing emotional support and empathy, ensuring timely access to care, fostering care coordination and continuity, and promoting patient-centered decision-making. Results: The project yielded substantial positive outcomes, significantly improving patient experiences in the OB/GYN ED. Patient satisfaction levels rose from 62% to a consistent 98%, with notable improvements in satisfaction with care plan information and physician care. Waiting time satisfaction increased from 68% to a steady 97%. The project positively impacted nurses' and midwives' job satisfaction, increasing from 64% to an impressive 94%. Operational metrics displayed positive trends, including a decrease in the "left without being seen" rate from 3% to 1%, the discharge against medical advice rate dropping from 8% to 1%, and the absconded rate reducing from 3% to 0%. These outcomes underscore the project's effectiveness in enhancing both patient and staff experiences in the healthcare setting. Conclusion: The use of a patient experience questionnaire has been substantiated by evidence-based research as an effective tool for improving the patient experience, guiding interventions, and enhancing overall healthcare quality in the OB/GYN ED. The project's interventions have resulted in a more efficient allocation of resources, reduced hospital stays, and minimized unnecessary resource utilization. This, in turn, contributes to cost savings for the healthcare facility.

Keywords: patient experience, patient survey, person centered care, quality initiatives

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Authors: Noor Abdelhamid

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Almost half of Cairo’s growing population is housed in self-built, self-governed informal settlements serving as an alternative in the absence of government-provided public housing. These settlements emerged as the spatial expression of informal practices or activities operating outside regulated, formal frameworks. A comprehensive narrative of political events, administrative decisions, and urban policies set the stage for the growth of informal expression in Egypt. The purpose of this qualitative inquiry is to portray informal self-governance practiced by residents in the Cairo region. This research argues that informal spatial practices offer an alternative urban framework for bottom-up development in the absence of government provisions. In the context of this study, informal self-governance is defined as the residents’ autonomous control and use of public urban space in informal settlements. The case study for this research is Ard al-Liwa, a semi-formal settlement representing the majority of informal settlement typologies in Egypt, which consist of the formal occupation of land through an uncontrolled land subdivision, zoning, and construction. An inductive methodological approach is adopted to first study informal practices as singular activities and then as components of a larger environment. The collected set of empirical data consists of audiovisual material and observations obtained during regular site visits and interviews with residents native to the settlement. Methods of analysis are synthesized to identify themes in the data: the static and dynamic use of sidewalks, the urban traces of informal building allocation and construction, the de facto right to urban space, and the resultant spatial patterns. The paper concludes by positioning the research in the context of the current architectural practice, questioning the role, and responsibility, of designers in these self-governed urban regions.

Keywords: Egypt, informal settlements, self-governance, urban framework

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Authors: Eunice Tan

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The purpose of this presentation is to look at an alternative to the approach and methodologies of working with a child with special needs. The strength-based approach to education embodies a paradigm shift. It is a strategy to move away from a deficit-based methodology which inadvertently may lead to an extensive list of things that the child cannot do or is unable to do. Today, many parents of individuals with special needs are focused on the individual’s deficits rather than on his or her strengths. Even when parents recognise and identify their child’s savant strengths to be valuable and wish to develop their abilities, they face the challenge that there are insufficient programs committed to supporting the development and improvement of such abilities. What is a strength-based approach in education? A strength-based approach in education focuses on students' positive qualities and contributions to class instead of the skills and abilities they may not have. Many schools are focused on the child’s special educational needs rather than the whole child. Parents interviewed have said that they have to engage external tutors to help hone in on their child’s interests and strengths. The strength-based approach to writing statements encourages educators to find out: • What a child can do • What a child can do when he or she is given educational support • Learning more about children with special needs and their strengths and talents will broaden our understanding of how we can help them with language acquisition, social skills, as well as self-help and independence skills.

Keywords: special needs, strengths, and talents, alternative educational approach, strength based approach

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Authors: Arturo J. Anci Alméstar, Jose D. Fernandez Huapaya, David Mauricio

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Companies make erroneous decisions by not evaluating the inherent difficulties of entering electronic commerce without a prior review of current digital and alternate means of payment. For this reason, it is very important for businesses to have reliable, complete and integrated information on the means of current digital and alternate payments that allow decisions to be made about which of these to use. However, there is no such consolidated information or criteria that companies use to make decisions about the means of payment according to their needs. In this paper, we propose a decision tree model based on a taxonomy that presents us with a categorization of digital and alternative means of payment, as well as the visualization of the flow of information at a high level from the company to obtain a recommendation. This will allow the company to make the most appropriate decision about the implementation of the digital means of payment or alternative ideal for their needs, which allows a reduction in costs and complexity of the payment process. Likewise, the efficiency of the proposed model was evaluated through a satisfaction survey presented to company personnel, confirming the satisfactory quality level of the recommendations obtained by the model.

Keywords: digital payment medium, decision tree, decision making, digital payments taxonomy

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Makkia Ahmad Ali Al-Falahi, Abdullah Abdelaziz Muharram

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Background: Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. Objective: To assess the prevalence of occupational health hazards among healthcare workers and associated risk factors in public hospitals in Sana'a City, Yemen. Method: Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. Results: More the half (60.6%) of HCWs aged between 20-30 years, (50.8%) were males, (56.3%) were married, and (45.5%) had a diploma qualification, while (65.2%) of HCWs had less than 6 years of experience. The result showed that the highest prevalence of occupational hazards was (99%), (ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p >0.05). Conclusion and recommendations: The study showed the highest prevalence of occupational hazards; regarding the prevalence of biological hazards exposure to sharp-related injury, the most prevalent physical hazards were slip/trip/and fall. Ergonomic hazards had back or neck pain during work. Chemical hazards were allergic to medical gloves powder. On psychosocial hazards was suffered from verbal and physical harassment. The study concluded by raising awareness among HCWs by conducting training courses to prevent occupational hazards.

Keywords: health workers, occupational hazards, risk factors, the prevalence

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Authors: Anne Sørebø

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The present study was designed to test how fulfilment of three basic psychological needs influence students development of perceived usefulness (PU) and ease of use (EOU) in connection with use of a spreadsheet. Both PU and EOU are assumed to be critical for development of students' willingness to utilize spreadsheet in future work within business administration. A questionnaire was completed by 196 business students in Norway. We found that satisfying the need for competence and autonomy is most critical for willingness to utilize the software package. The results also indicate that satisfying the need for relatedness, surprisingly, has no influence on students’ willingness to utilize the software package. A key implication of the present research is that teachers mainly should focus on fulfilling students need for competence and self-determination when the purpose is to motivate them to utilize new software. That students’ should develop their own competence when using a new technology is somewhat obvious, but that the feeling of being self-determined needs to be a complementary element in this connection is not necessary seen as obvious.

Keywords: spreadsheet, business students, technology acceptance, basic psychological needs

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Authors: Jwan J. Abdullah, Greetham Darren, Gregory A, Tucker, Chenyu Du

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Solid-state fermentation (SSF) is an alternative to liquid fermentations for the production of commercially important products such as antibiotics, single cell proteins, enzymes, organic acids, or biofuels from lignocellulosic material. This paper describes the optimisation of SSF on municipal solid waste (MSW) for the production of cellulase enzyme. Production of cellulase enzymes was optimised by Trichoderma reesei or Aspergillus niger for temperature, moisture content, inoculation, and period of incubation. Also, presence of minerals, and alternative carbon and nitrogen sources. Optimisation revealed that production of cellulolytic enzymes was optimal when using Trichoderma spp at 30°C with an incubation period of 168 hours with a 60% moisture content. Crude enzymes produced from MSW, by Trichoderma were evaluated for the saccharification of MSW and compared with activity of a commercially available enzyme, results demonstrated that MSW can be used as inexpensive lignocellulosic material for the production of cellulase enzymes using Trichoderma reesei.

Keywords: SSF, enzyme hydrolysis, municipal solid waste (MSW), optimizing conditions, enzyme hydrolysis

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Authors: Calassandra Nwokoro

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Introduction: The nursing profession requires a lot of commitment, effort, and time to efficiently manage patients and provide them quality healthcare services, this work load may eventually cause the nurses to become burned out and experience psychological distress. This study assessed the prevalence of burnout, risk factors, and the coping strategies among nurses working in Lagos University Teaching Hospital (LUTH), Lagos state, Nigeria. Methodology: A descriptive cross-sectional study design was conducted among 308 nurses working in LUTH. Simple random sampling was used in selection of study respondents. The questionnaire comprised three parts; the sociodemographic characteristics of the respondents, the extent of burnout syndrome using the Maslach Burnout Inventory, and the coping strategies used among the respondents using the BRIEF-COPE Inventory. Results: This study revealed relatively high levels of burnout among the nurses in LUTH with a prevalence of 16.9%, 31.2% and 20.1% for high emotional exhaustion, high depersonalization and reduced professional accomplishment respectively. It also showed that burnout was significantly associated with long working hours. Religion was found to be the most commonly used coping strategy overall, while emotional support was the most frequently used coping strategy among nurses who had burnout. Conclusion: This study has revealed a relatively high prevalence of burnout among the nurses in Lagos University Teaching Hospital. In order to minimize the negative health impacts of burnout, the government should collaborate with psychologists and psychiatrists to implement regular stress management and stress inoculation programs for nurses and other health professionals in the country.

Keywords: burnout, nurses, coping strategies, healthcare

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Authors: Junaid Bin Aamir, Ma Fanhua

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Methanol is one of the most suitable alternative fuels for replacing gasoline in present and future spark-ignited engines. However, for pure methanol engines, cold start problems and misfires are observed under certain operating conditions. Hydrogen provides a solution for such problems. This paper experimentally investigated the effect of hydrogen on the performance of a pure methanol SI-engine at city driving conditions (1500 rpm speed and 1.18 excess air ratio). Hydrogen was used as a part of methanol reformed syngas (67% hydrogen by volume). 4% by mass of the total methanol converted to hydrogen and other constituent gases, was used in each cycle. Port fuel injection was used to inject methanol and hydrogen-rich syngas into the 4-cylinder engine. The results indicated an increase in brake thermal efficiency up to 5% with the addition of hydrogen, a decrease in brake specific fuel consumption up to 200 g/kWh, and a decrease in exhaust gas temperature by 100°C for all mean effective pressures. Hydrogen addition also decreased harmful exhaust emissions significantly. There was a reduction in THC emissions up to 95% and CO emissions up to 50%. NOx emissions were slightly increased (up to 15%), but they can be reduced to zero by lean burn strategy.

Keywords: alternative fuels, hydrogen, methanol, performance, spark ignition engines

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Authors: Yuan-Jye Tseng, Jia-Shu Li

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To design a product with the given product requirement and design objective, there can be alternative ways to propose the detailed design specifications of the product. In the design modeling stage, alternative design cases with detailed specifications can be modeled to fulfill the product requirement and design objective. Therefore, in the design evaluation stage, it is required to perform an evaluation of the alternative design cases for deciding the final design. The purpose of this research is to develop a product evaluation model for evaluating the alternative design cases by integrated evaluating the criteria of functional design, Kansei design, and design for supply chain. The criteria in the functional design group include primary function, expansion function, improved function, and new function. The criteria in the Kansei group include geometric shape, dimension, surface finish, and layout. The criteria in the design for supply chain group include material, manufacturing process, assembly, and supply chain operation. From the point of view of value and cost, the criteria in the functional design group and Kansei design group represent the design value of the product. The criteria in the design for supply chain group represent the supply chain and manufacturing cost of the product. It is required to evaluate the design value and the supply chain cost to determine the final design. For the purpose of evaluating the criteria in the three criteria groups, a fuzzy analytic network process (FANP) method is presented to evaluate a weighted index by calculating the total relational values among the three groups. A method using the technique for order preference by similarity to ideal solution (TOPSIS) is used to compare and rank the design alternative cases according to the weighted index using the total relational values of the criteria. The final decision of a design case can be determined by using the ordered ranking. For example, the design case with the top ranking can be selected as the final design case. Based on the criteria in the evaluation, the design objective can be achieved with a combined and weighted effect of the design value and manufacturing cost. An example product is demonstrated and illustrated in the presentation. It shows that the design evaluation model is useful for integrated evaluation of functional design, Kansei design, and design for supply chain to determine the best design case and achieve the design objective.

Keywords: design for supply chain, design evaluation, functional design, Kansei design, fuzzy analytic network process, technique for order preference by similarity to ideal solution

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Authors: Jennifer Chen, Pei Y. Hsu, Yu W. Chen

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Groundwater resources play a vital role in regional water supply because over 1/3 of total demand is satisfied by groundwater resources. Because over-pumpage might cause environmental impact such as land subsidence, a sustainable management of groundwater resource is required. In this study, a blueprint of smart management for groundwater resource is proposed and planned. The framework of the smart management can be divided into two major parts, hardware and software parts. First, an internet of groundwater (IoG) which is inspired by the internet of thing (IoT) is proposed to observe the migration of groundwater usage and the associated response, groundwater levels. Second, algorithms based on data mining and signal analysis are proposed to achieve the goal of providing highly efficient management of groundwater. The entire blueprint is a 4-year plan and this year is the first year. We have finished the installation of 50 flow meters and 17 observation wells. An underground hydrological model is proposed to determine the associated drawdown caused by the measured pumpages. Besides, an alternative to the flow meter is also proposed to decrease the installation cost of IoG. An accelerometer and 3G remote transmission are proposed to detect the on and off of groundwater pumpage.

Keywords: groundwater management, internet of groundwater, underground hydrological model, alternative of flow meter

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Authors: Sevinj Asgarova

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Within the last few decades, major advances in the field of prenatal testing have transpired yet little research regarding the experiences of mothers who chose to continue their pregnancies after prenatally receiving a diagnosis of Down Syndrome (DS) has been undertaken. Using social constructionism and interpretive description, this retrospective research study explores this topic from the point of view of the mothers involved and provides insight as to how the experience could be improved. Using purposive sampling, 23 mothers were recruited from British Columbia (n=11) and Ontario (n=12) in Canada. Data retrieved through semi-structured in-depth interviews were analyzed using inductive, constant comparative analysis, the major analytical techniques of interpretive description. Four primary phases emerged from the data analysis 1) healthcare professional-mothers communications, 2) initial emotional response, 3) subsequent decision-making and 4) an adjustment and reorganization of lifestyle to the preparation for the birth of the child. This study validates the individualized and contextualized nature of mothers’ decisions as influenced by multiple factors, with moral values/spiritual beliefs being significant. The mothers’ ability to cope was affected by the information communicated to them about their unborn baby’s diagnosis and the manner in which that information was delivered to them. Mothers used emotional coping strategies, dependent upon support from partners, family, and friends, as well as from other families who have children with DS. Additionally, they employed practical coping strategies, such as engaging in healthcare planning, seeking relevant information, and reimagining and reorganizing their lifestyle. Over time many families gained a sense of control over their situation and readjusted to the preparation for the birth of the child. Many mothers expressed the importance of maintaining positivity and hopefulness with respect to positive outcomes and opportunities for their children. The comprehensive information generated through this study will also provide healthcare professionals with relevant information to assist them in understanding the informational and emotional needs of these mothers. This should lead to an improvement in their practice and enhance their ability to intervene appropriately and effectively, better offering improved support to parents dealing with a diagnosis of DS for their child.

Keywords: continuing affected pregnancy, decision making, disability, down syndrome, eugenic social attitudes, inequalities, life change events, prenatal care, prenatal testing, qualitative research, social change, social justice

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Authors: Amaal Almigal

Abstract:

Technology has been argued to offer distinct advantages and benefits for teaching children with autism spectrum disorder (ASD) to communicate. One aspect of this technology is augmentative and alternative communication (AAC) systems such as picture exchange or speech generation devices. Whilst there has been significant progress in teaching these children to request their wants and needs with AAC, there remains a need for developing technologies that can really make a difference in teaching them to ask questions. iPad-based AAC can be effective for communication. However, the effectiveness of this type of AAC in teaching children to ask questions needs to be examined. Thus, in order to examine the effectiveness of iPad-based AAC in teaching children with ASD to ask questions, This research will test whether iPad leads to more learning than a traditional approach picture and text cards does. Two groups of children who use AAC will be taught to ask ‘What is it?’ questions. With the first group, low-tech AAC picture and text cards will be used, while an iPad-based AAC application called Proloquo2Go will be used with the second group. Interviews with teachers and parents will be conducted before and after the experiment. The children’s perspectives will also be considered. The initial outcomes of this research indicate that iPad can be an effective tool to help children with autism to ask questions.

Keywords: autism, communication, information, iPad, pictures, requesting

Procedia PDF Downloads 260