Search results for: healthcare knowledge management

Authors: Kinga Zebrowska, Maria Falis, Katarzyna Kosinska-Kaczynska, Bartosz Godek, Olga Plaza, Katarzyna Kwiatkowska

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Introduction: According to the ministerial decree of 16 August 2018, each woman in Poland during childbirth has the right to the pharmacological and non-pharmacological labour pain management (LPM). Aim: The aim of the study was to assess the knowledge of Polish mothers about pharmacological and non-pharmacological LPM, to investigate which methods they chose and their satisfaction with chosen ones. Material And Methods: A prospective cross-sectional study was performed among women who gave birth between 2015 and 2018. The self-composed questionnaire was distributed via the Internet in October 2018. Results: 13.727 women participated in the study. 75% have learned about LPM from the Internet. 68% of them did not gain any information on LPM from doctors during their prenatal appointments Safety of the newborn (46%), midwife’s advice (40%) and the chance of the immediate pain relief (39%) were the most important issues while choosing LPM. Respondents used a wide range of non-pharmacological methods, such as the assistance of partner during labour (81%), physical activity (58%), immersion in water (37%), relaxation techniques (15%) and others. 11% of mothers did not use any of the LPM methods. 52% of women declared that they wanted to use the pharmacological anaesthesia, while 49% had it performed (28% epidural, 16% inhaled anaesthesia, 5% parenteral opioids). Pharmacological methods were unavailable due to lack of anaesthesiologist in the maternity ward (41%) or inaccessibility of the chosen methods in the hospital (31%) and too advanced labour (43%). 48% of respondents did not decide to use pharmacological methods, because the pain was bearable (29%), anxiety of child’s health (17%), or belief that the pain is natural and it should not be avoided (16%). 83% of respondents believed that epidural analgesia has no influence on the time needed to gain a full cervix dilatation and 81% of them claimed that serious spinal cord injury is a common side effect of epidural. 51% believed that epidural increases the risk of caesarean section. Conclusions: The knowledge about the methods of LPM is not satisfactory. We should focus on well- maintained education guided by doctors, midwives, and media.

Keywords: childbirth, labour pain management, maternity experiences, obstetrics

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Authors: Zulaikha Reesha Rashaad

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One of the major factors which can contribute greatly to success of catering businesses is to employ food and beverage staff having sound hygiene knowledge. Individuals having sound knowledge of hygiene has a higher chance of following safe food practices in food production. One of the leading causes of food poisoning and food borne illnesses has been identified as lack of hygiene knowledge among food and beverage staff working in catering establishments and restaurants. This research aims to analyze the hygiene knowledge among food and beverage staff working in top five restaurants of Male’, in relation to their age, educational background, occupation and training. The research uses quantitative and descriptive methods in data collection and in data analysis. Data was obtained through random sampling technique with self-administered survey questionnaires which was completed by 60 respondents working in 5 different restaurants operating at top level in Male’. The respondents of the research were service staff and chefs working in these restaurants. The responses to the questionnaires have been analyzed by using SPSS. The results of the research indicated that age, education level, occupation and training correlated with hygiene knowledge perception scores.

Keywords: food and beverage staff, food poisoning, food production, hygiene knowledge

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Authors: Favour Makuochukwu Orji, Yingkui Zhao

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A myriad of environmental issues face the Nigerian industrial region, resulting from; oil and gas production, mining, manufacturing and domestic wastes. Amidst these, much effort has been directed by stakeholders in the Nigerian oil producing regions, because of the impacts of the region on the wider Nigerian economy. Research to date has suggested that collaborative environmental management could be an effective approach in managing environmental issues; but little attention has been given to the roles and practices of stakeholders in effecting a collaborative environmental management framework for the Nigerian oil-producing region. This paper produces a framework to expand and deepen knowledge relating to stakeholders aspects of collaborative roles in managing environmental issues in the Nigeria oil-producing region. The knowledge is derived from analysis of stakeholders’ practices – studied through multiple case studies using document analysis. Selected documents of key stakeholders – Nigerian government agencies, multi-national oil companies and host communities, were analyzed. Open and selective coding was employed manually during document analysis of data collected from the offices and websites of the stakeholders. The findings showed that the stakeholders have a range of roles, practices, interests, drivers and barriers regarding their collaborative roles in managing environmental issues. While they have interests for efficient resource use, compliance to standards, sharing of responsibilities, generating of new solutions, and shared objectives; there is evidence of major barriers which includes resource allocation, disjointed policy and regulation, ineffective monitoring, diverse socio- economic interests, lack of stakeholders’ commitment and limited knowledge sharing. However, host communities hold deep concerns over the collaborative roles of stakeholders for economic interests, particularly, where government agencies and multi-national oil companies are involved. With these barriers and concerns, a genuine stakeholders’ collaboration is found to be limited, and as a result, optimal environmental management practices and policies have not been successfully implemented in the Nigeria oil-producing region. A framework is produced that describes practices that characterize collaborative environmental management might be employed to satisfy the stakeholders’ interests. The framework recommends critical factors, based on the findings, which may guide a collaborative environmental management in the oil producing regions. The recommendations are designed to re-define the practices of stakeholders in managing environmental issues in the oil producing regions, not as something wholly new, but as an approach essential for implementing a sustainable environmental policy. This research outcome may clarify areas for future research as well as to contribute to industry guidance in the area of collaborative environmental management.

Keywords: collaborative environmental management framework, case studies, document analysis, multinational oil companies, Nigerian oil producing regions, Nigerian government agencies, stakeholders analysis

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Authors: Yingqi Cui, Changran Huang, Raymond Lee

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In this paper, we proposed an AI Tutor using ontology and natural language process techniques to generate a computer science domain knowledge graph and answer users’ questions based on the knowledge graph. We define eight types of relation to extract relationships between entities according to the computer science domain text. The AI tutor is separated into two agents: learning agent and Question-Answer (QA) agent and developed on JADE (a multi-agent system) platform. The learning agent is responsible for reading text to extract information and generate a corresponding knowledge graph by defined patterns. The QA agent can understand the users’ questions and answer humans’ questions based on the knowledge graph generated by the learning agent.

Keywords: artificial intelligence, natural Language processing, knowledge graph, intelligent agents, QA system

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Authors: Terence Soule, Tami Al Ghamdi

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To study how to transfer knowledge from multiple source problems to the target problem, we modeled the Transfer Learning (TL) process using Genetic Algorithms as the model solver. TL is the process that aims to transfer learned data from one problem to another problem. The TL process aims to help Machine Learning (ML) algorithms find a solution to the problems. The Genetic Algorithms (GA) give researchers access to information that we have about how the old problem is solved. In this paper, we have five different source problems, and we transfer the knowledge to the target problem. We studied different scenarios of the target problem. The results showed combined knowledge from multiple source problems improves the GA performance. Also, the process of combining knowledge from several problems results in promoting diversity of the transferred population.

Keywords: transfer learning, genetic algorithm, evolutionary computation, source and target

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Authors: Tsu-Yin Wu, Jenni Hoffman, Lydia McMurrows, Sarah Lally

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Recent events of the Flint Water Crisis and elevated lead levels in Detroit public school water have highlighted a specific public health disparity and shown the need for better education of healthcare providers on lead education. Identifying children and pregnant women with a high risk for lead poisoning and ensuring lead testing is completed is critical. The purpose of this study is to explore the impact of an educational intervention on knowledge and confidence levels among nursing students enrolled in the prelicensure Bachelor of Science in Nursing (BSN) and Registered Nurse to BSN program (R2B). The study used both quantitative and qualitative research methods to assess the impact of multi-modal pedagogy on knowledge and confidence of lead screening and prevention among prelicensure and R2B nursing students. The students received lead poisoning and prevention content in addition to completing an e-learning module developed by the Pediatric Environmental Health Specialty Units. A total of 115 students completed the pre-and post-test instrument that consisted of demographic, lead knowledge, and confidence items. Despite the increase of total knowledge, three dimensions of lead poisoning, and confidence from pre- to post-test scores for both groups, there was no statistical significance on the increase between prelicensure and R2B students. Thematic analysis of qualitative data showed five themes from participants' learning experiences: lead exposure, signs and symptoms of lead poisoning, screening and diagnosis, prevention, and policy and statewide issues. The study is limited by a small sample and participants recalling some correct answers from the pretest, thus, scoring higher on the post-test. The results contribute to the minimally existent literature examining a critical public health concern regarding lead health exposure and prevention education of nursing students. Incorporating such content area into the nursing curriculum is essential in ensuring that such public health disparities are mitigated.

Keywords: lead poisoning, emerging public health issue, community health, nursing edducation

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Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid

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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.

Keywords: prevalence, hepatitis, viruses, healthcare workers, infection

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

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

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

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Authors: Nelomi Anandagoda, Leanne J. Eveson

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During the COVID-19 pandemic, the surge in in-patient admissions across the medical directorate of a district general hospital necessitated the implementation of an incident rota. Conscious of the impact on training and professional development, the idea of developing a virtual teaching programme was conceived. The programme initially aimed to provide junior doctors, specialist nurses, pharmacists, and allied healthcare professionals from medical specialties and those re-deployed from other specialties (e.g., ophthalmology, GP, surgery, psychiatry) the knowledge and skills to manage the deteriorating patient with COVID-19. The programme was later developed to incorporate the general internal medicine curriculum. To facilitate continuing medical education whilst maintaining social distancing during this period, a virtual platform was used to deliver teaching to junior doctors across two large district general hospitals and two community hospitals. Teaching sessions were recorded and uploaded to a common platform, providing a resource for participants to catch up on and re-watch teaching sessions, making strides towards reducing discrimination against the professional development of less than full-time trainees. Thus, creating a learning environment, which is inclusive and accessible to adult learners in a self-directed manner. The negative impact of the pandemic on the well-being of healthcare professionals is well documented. To support the multi-disciplinary team, the virtual teaching programme evolved to included sessions on well-being, resilience, and work-life balance. Providing teaching for learners across the multi-disciplinary team (MDT) has been an eye-opening experience. By challenging the concept that learners should only be taught within their own peer groups, the authors have fostered a greater appreciation of the strengths of the MDT and showcased the immense wealth of expertise available within the trust. The inclusive nature of the teaching and the ease of joining a virtual teaching session has facilitated the dissemination of knowledge across the MDT, thus improving patient care on the frontline. The weekly teaching programme has been running for over eight months, with ongoing engagement, interest, and participation. As described above, the teaching programme has evolved to accommodate the needs of its learners. It has received excellent feedback with an appreciation of its inclusive, multi-disciplinary, and holistic nature. The COVID-19 pandemic provided a catalyst to rapidly develop novel methods of working and training and widened access/exposure to the virtual technologies available to large organisations. By merging pedagogical expertise and technology, the authors have created an effective online learning environment. Although the authors do not propose to replace face-to-face teaching altogether, this model of virtual multidisciplinary team, cross-site teaching has proven to be a great leveler. It has made high-quality teaching accessible to learners of different confidence levels, grades, specialties, and working patterns.

Keywords: cross-site, cross-speciality, inter-disciplinary, multidisciplinary, virtual teaching

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Authors: Ana Paula Lisboa Sohn, Filipa Dionísio Vieria, Nelson Casarotto, Idaulo José Cunha

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This paper aims at identifying and analyzing the knowledge transmission channels in textile and clothing clusters located in Brazil and in Europe. Primary data was obtained through interviews with key individuals. The collection of primary data was carried out based on a questionnaire with ten categories of indicators of knowledge transmission. Secondary data was also collected through a literature review and through international organizations sites. Similarities related to the use of the main transmission channels of knowledge are observed in all cases. The main similarities are: influence of suppliers of machinery, equipment and raw materials; imitation of products and best practices; training promoted by technical institutions and businesses; and cluster companies being open to acquire new knowledge. The main differences lie in the relationship between companies, where in Europe the intensity of this relationship is bigger when compared to Brazil. The differences also occur in importance and frequency of the relationship with the government, with the cultural environment, and with the activities of research and development. It is also found factors that reduce the importance of geographical proximity in transmission of knowledge, and in generating trust and the establishment of collaborative behavior.

Keywords: industrial clusters, interorganizational learning, knowledge transmission channels, textile and clothing industry

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Authors: Sonia Butalia, Huong Luu, Alexis Guigue, Karen J. B. Martins, Khanh Vu, Scott W. Klarenbach

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Obesity-related health conditions impose a substantial economic burden on payers due to increased healthcare use. Estimates of healthcare resource use and costs associated with obesity-related comorbidities are needed to inform policies and interventions targeting these conditions. Methods: Adults living with obesity were identified (a procedure-related body mass index code for class 2/3 obesity between 2012 and 2019 in Alberta, Canada; excluding those with bariatric surgery), and outcomes were compared over 1-year (2019/2020) between those who had and did not have specific obesity-related comorbidities. The probability of using a healthcare service (based on the odds ratio of a zero [OR-zero] cost) was compared; 95% confidence intervals (CI) were reported. Logistic regression and a generalized linear model with log link and gamma distribution were used for total healthcare cost comparisons ($CDN); cost ratios and estimated cost differences (95% CI) were reported. Potential socio-demographic and clinical confounders were adjusted for, and incremental cost differences were representative of a referent case. Results: A total of 220,190 adults living with obesity were included; 44% had hypertension, 25% had osteoarthritis, 24% had type-2 diabetes, 17% had cardiovascular disease, 12% had insulin resistance, 9% had chronic back pain, and 4% of females had polycystic ovarian syndrome (PCOS). The probability of hospitalization, ED visit, and ambulatory care was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (hospitalization: 1.8-times [OR-zero: 0.57 [0.55/0.59]] / ED visit: 1.9-times [OR-zero: 0.54 [0.53/0.56]] / ambulatory care visit: 2.4-times [OR-zero: 0.41 [0.40/0.43]]), cardiovascular disease (2.7-times [OR-zero: 0.37 [0.36/0.38]] / 1.9-times [OR-zero: 0.52 [0.51/0.53]] / 2.8-times [OR-zero: 0.36 [0.35/0.36]]), osteoarthritis (2.0-times [OR-zero: 0.51 [0.50/0.53]] / 1.4-times [OR-zero: 0.74 [0.73/0.76]] / 2.5-times [OR-zero: 0.40 [0.40/0.41]]), type-2 diabetes (1.9-times [OR-zero: 0.54 [0.52/0.55]] / 1.4-times [OR-zero: 0.72 [0.70/0.73]] / 2.1-times [OR-zero: 0.47 [0.46/0.47]]), hypertension (1.8-times [OR-zero: 0.56 [0.54/0.57]] / 1.3-times [OR-zero: 0.79 [0.77/0.80]] / 2.2-times [OR-zero: 0.46 [0.45/0.47]]), PCOS (not significant / 1.2-times [OR-zero: 0.83 [0.79/0.88]] / not significant), and insulin resistance (1.1-times [OR-zero: 0.88 [0.84/0.91]] / 1.1-times [OR-zero: 0.92 [0.89/0.94]] / 1.8-times [OR-zero: 0.56 [0.54/0.57]]). After fully adjusting for potential confounders, the total healthcare cost ratio was higher in those with a following obesity-related comorbidity versus those without: chronic back pain (1.54-times [1.51/1.56]), cardiovascular disease (1.45-times [1.43/1.47]), osteoarthritis (1.36-times [1.35/1.38]), type-2 diabetes (1.30-times [1.28/1.31]), hypertension (1.27-times [1.26/1.28]), PCOS (1.08-times [1.05/1.11]), and insulin resistance (1.03-times [1.01/1.04]). Conclusions: Adults with obesity who have specific disease-related health conditions have a higher probability of healthcare use and incur greater costs than those without specific comorbidities; incremental costs are larger when other obesity-related health conditions are not adjusted for. In a specific referent case, hypertension was costliest (44% had this condition with an additional annual cost of $715 [$678/$753]). If these findings hold for the Canadian population, hypertension in persons with obesity represents an estimated additional annual healthcare cost of $2.5 billion among adults living with obesity (based on an adult obesity rate of 26%). Results of this study can inform decision making on investment in interventions that are effective in treating obesity and its complications.

Keywords: administrative data, healthcare cost, obesity-related comorbidities, real world evidence

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Authors: Aminath Waseela, Vinesh Chandra, Shaun Nykvist,

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The success of technology integration initiatives hinges on the knowledge and skills of teachers to effectively integrate technology in classroom teaching. Consequently, gaining an understanding of teachers' technology knowledge and its integration can provide useful insights on strategies that can be adopted to enhance teaching and learning, especially in developing country contexts where research is scant. This paper extends existing knowledge on teachers' use of technology by developing a conceptual framework that recognises how three key types of knowledge; content, pedagogy, technology, and their integration are at the crux of teachers' technology use while at the same time is amenable to empirical studies. Although the aforementioned knowledge is important for effective use of technology that can result in enhanced student engagement, literature on how this knowledge leads to effective technology use and enhanced student engagement is limited. Thus, this theoretical paper proposes a framework to explore teachers' knowledge through the lens of the Technological Pedagogical and Content Knowledge (TPACK); the integration of technology in classroom teaching through the Substitution Augmentation Modification and Redefinition (SAMR) model and how this affects students' learning through the Bloom's Digital Taxonomy (BDT) lens. Studies using this framework could inform the design of professional development to support teachers to develop skills for effective use of available technology that can enhance student learning engagement.

Keywords: information and communication technology, ICT, in-service training, small island developing states, SIDS, student engagement, technology integration, technology professional development training, technological pedagogical and content knowledge, TPACK

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Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

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The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

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Authors: Arjun K., Arumugam Sankaran, Sanjay Kumar, Mousumi Das

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The paper analyses the existence of endogenous growth scenario emanating from the demographic dividend in India during the liberalization period starting from 1980. Demographic dividend creates a fertile ground for the cultivation of human and knowledge capitals contributing to technological progress which can be measured using total factor productivity. The relationship among total factor productivity, human and knowledge capitals are examined in an open endogenous framework for the period 1980-2016. The control variables such as foreign direct investment, trade openness, energy consumption are also employed. The data are sourced from Reserve Bank of India, World Bank, International Energy Agency and The National Science and Technology Management Information System. To understand the dynamic association among variables, ARDL bounds approach to cointegration followed by Toda-Yamamoto causality test are used. The results reveal a short run and long run relationship among the variables supported by the existence of causality. This calls for an integrated policy to build and augment human capital and research and development activities to sustain and pace up growth and development in the nation.

Keywords: demographic dividend, young population, open endogenous growth models, human and knowledge capital

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Authors: Muhammad Zafarullah Khan, Sumeera Abbasi

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The Farmers Field School (FFS) aims at benefiting poor farmers by improving their knowledge of existing agricultural technologies and integrated crop management to become independent and confident in their decision. The study on effect of farmer’s field school on vegetables production before and after FFS implementation in district Peshawar in four selected villages on each crop in 2011 was conducted from 80 farmers. The results were compared by using paired t-test. It was observed that 80% of the respondents were satisfied with FFS approach as there was a significant increase in vegetable production. The seed rate of tomato and cucumber decreased from 0.185kg/kanal to 0.1 kg/ kanal and 0.120kg/kanal to 0.01kg/kanal while production of tomato and cucumber were increased from 8158.75kgs/kanal to 1030.25kgs/kanal and 3230kgs/kanal to 5340kgs/kanal, respectively after the activities of FFS. FFS brought a positive effect on vegetable production and technology adoption improving their income, skills and knowledge ultimately lead farmers towards empowerment. The input cost including seed, crop management, FYM, and weedicides for tomato were reduced by Rs.28, Rs. 3170 and Rs.658 and cucumber reduced by Rs.35, Rs.570 and Rs.430. Only fertilizers cost was increased by Rs. 2200 in case of tomato and 465 in case of cucumber. FFS facilitator and coordinator should be more skilled and practical oriented to facilitate poor farmers. In light of the above study, more FFS should be planned so that the more farmers should be benefited.

Keywords: effect, farmer field school, vegetables production, integrated crop management

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Authors: Al Huuskonen, Clio Lake, K. M. Naude, Polina Petlitsyna, Sorsha Henning, Julia Wimmers-Klick

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This project presents the outcomes of a community-based participatory action initiative aimed at advocating for equitable healthcare and human rights for trans, two-spirit, and gender-diverse individuals, building upon the University of British Columbia (UBC) Trans Coalition's ongoing efforts. Participatory Action Research (PAR) was chosen as the research method with the goal of improving trans rights on the UBC campus, particularly regarding equitable access to healthcare. PAR involves active community contribution throughout the research process, which in this case was done by way of liaising with student resource groups and advocacy leaders. The goals of this project were as follows: a) identify gaps in gender-affirming healthcare for UBC students by consulting the community and collaborating with UBC services, b) develop an information package outlining provincial and university-based health insurance for gender-affirming care (including hormone therapy and surgeries), FAQs, and resources for UBC's trans students, c) make this package available to UBC students and other national transgender advocacy organizations. The initiative successfully expanded the UBC AMS Student Health and Dental Plan to include gender-affirming procedural coverage, developed a care access guide for students, and advocated for improved health records inclusivity, mechanisms for trans students to report negative care experiences, and increased access to gender-affirming primary care through the on-campus health clinic. Collaboration with other universities' pride organizations and Trans Care BC yielded positive outcomes through broader coalition building and resource sharing. Ongoing efforts are underway to update provincial policies, particularly through expanding coverage under fair pharma care and addressing the compounding effects of the primary care crisis for trans individuals. The project's tangible results include improved trans rights on campus, especially in terms of healthcare access. Expanding healthcare coverage through student care benefits thousands of students, making the ability to undergo important affirming procedures more affordable. Providing students with information on extended coverage options and communication with their doctors further removes barriers to care and positively impacts student wellbeing. This initiative demonstrates the effectiveness of community-based participatory action in advancing equitable healthcare for trans and gender-diverse individuals and serves as a model for other institutions and organizations striving to promote inclusivity and advocate for marginalized populations' rights.

Keywords: equitable healthcare, trans and gender-diverse individuals, inclusivity, participatory action research project

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Authors: Chalermsri Sorasit, Siriporn Mongkhonthawornchai, Darawan Augsornwan, Sudthanom Kamollirt

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Background: Although knowledge of pain and pain management is improving, they are still inadequate to patients. The Nursing Division of Srinagarind Hospital is responsible for setting the pain management system, including work instruction development and pain management indicators. We have developed an information technology program for monitoring pain quality indicators, which was implemented to all nursing departments in April 2013. Objective: To study outcomes of acute pain management in process and outcome indicators. Method: This is a retrospective descriptive study. The sample population was patients who had acute pain 24-48 hours after receiving a procedure, while admitted to Srinagarind Hospital in 2014. Data were collected from the information technology program. 2709 patients with acute pain from 10 Nursing Departments were recruited in the study. The research tools in this study were 1) the demographic questionnaire 2) the pain management questionnaire for process indicators, and 3) the pain management questionnaire for outcome indicators. Data were analyzed and presented by percentages and means. Results: The process indicators show that nurses used pain assessment tool and recorded 99.19%. The pain reassessment after the intervention was 96.09%. The 80.15% of the patients received opioid for pain medication and the most frequency of non-pharmacological intervention used was positioning (76.72%). For the outcome indicators, nearly half of them (49.90%) had moderate–severe pain, mean scores of worst pain was 6.48 and overall pain was 4.08. Patient satisfaction level with pain management was good (49.17%) and very good (46.62%). Conclusion: Nurses used pain assessment tools and pain documents which met the goal of the pain management process. Patient satisfaction with pain management was at high level. However the patients had still moderate to severe pain. Nurses should adhere more strictly to the guidelines of pain management, by using acute pain guidelines especially when pain intensity is particularly moderate-high. Nurses should also develop and practice a non-pharmacological pain management program to continually improve the quality of pain management. The information technology program should have more details about non-pharmacological pain techniques.

Keywords: outcome, pain management, acute pain, Srinagarind Hospital

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Authors: Raphaël Weuts, Mykyta Petik, Anton Vedder

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Artificial Intelligence has the potential to create and already creates enormous value in healthcare. Prescriptive systems might be able to make the use of healthcare capacity more efficient. Such systems might entail interpretations that exclude the effect of confounders that brings risks with it. Those risks might be mitigated by regulation that prevents systems entailing such risks to come to market. One modality of regulation is that of legislation, and the European AI Act is an example of such a regulatory instrument that might mitigate these risks. To assess the risk mitigation potential of the AI Act for those risks, this research focusses on a case study of a hypothetical application of medical device software that entails the aforementioned risks. The AI Act refers to the harmonised norms for already existing legislation, here being the European medical device regulation. The issue at hand is a causal link between a confounder and the value the algorithm optimises for by proxy. The research identifies where the AI Act already looks at confounders (i.a. feedback loops in systems that continue to learn after being placed on the market). The research identifies where the current proposal by parliament leaves legal uncertainty on the necessity to check for confounders that do not influence the input of the system, when the system does not continue to learn after being placed on the market. The authors propose an amendment to article 15 of the AI Act that would require high-risk systems to be developed in such a way as to mitigate risks from those aforementioned confounders.

Keywords: AI Act, healthcare, confounders, risks

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Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong

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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.

Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids

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Authors: Waleerak Sittisom

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The objectives of this research were to analyze transportation route management, to identify potential cost reductions in logistic operation. In-depth interview techniques and small group discussions were utilized with 25 participants from various backgrounds in the areas of logistics. The findings of this research revealed that there were four areas that companies are able to effectively manage a logistic cost reduction: managing the space within the transportation vehicles, managing transportation personnel, managing transportation cost, and managing control of transportation. On the other hand, there were four areas that companies were unable to effectively manage a logistic cost reduction: the working process of transportation, the route planning of transportation, the service point management, and technology management. There are five areas that cost reduction is feasible: personnel management, process of working, map planning, service point planning, and technology implementation. To be able to reduce costs, the transportation companies should suggest that customers use a file system to save truck space. Also, the transportation companies need to adopt new technology to manage their information system so that packages can be reached easy, safe, and fast. Staff needs to be trained regularly to increase knowledge and skills. Teamwork is required to effectively reduce the costs.

Keywords: cost reduction, management, logistics, transportation

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Authors: H. J. Hong

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Sporting organizations are arguably responsible for encouraging high-performance athletes to balance their life and identity during their sporting career; sporting organizations can establish the motivational climate for high-performance athletes using athlete career development and management programs. The purpose of this article to provide an overview of career development and management programs in 20 countries and to examine the following seven features of the programs: (1) Which government-funded sporting organizations provide career development and management programs? (2) Which athletes are eligible to access the programs? (3) What are the aims and objectives of the programs? (4) What are the activities and content of the programs? (5) Who is responsible for the delivery of the programs within organizations (e.g., advisors, coordinators, service providers, counsellors, etc.)? (6) Do the sporting organizations have training and development programs for support services providers? and (7) Do the sporting organizations assess the programs in terms of the programs’ impact on high-performance athletes’ career development and management skills? Web-based data collection was conducted first. The author contacted the sporting organizations to clarify information as required by requesting further information via emails, international calls, video calls on Skype, and by visiting the sporting organizations and meeting with the practitioners (Fiji, Ireland, Korea, Scotland, Singapore, and Spain). By selecting comparable career development and management programs, the present study reviews programs across the world, identifying similarities, differences, and difficulties, so that sporting organizations and practitioners may enhance the quality of their programs. Since international comparisons of career development and management programs remain scarce, the findings deepen the knowledge of high-performance athletes’ career development, management, and transitions in the areas of organizational support programs.

Keywords: athletes' career development and management, athletes' psychological preparation, organizational support, sport career transition

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Authors: Nizar Ghali, Bernard Fortin, Guy Lacroix

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In Quebec, colonoscopies volumes have continued to rise in recent years in the absence of effective monitoring mechanism for the appropriateness and the quality of these exams. In 2010, November, Quebec Government introduced the colorectal cancer-screening program in the objective to control for volume and cost imperfection. This program is based on clinical standards and was initiated for first group of institutions. One year later, Government adds financial incentives for participants institutions. In this analysis, we want to assess for the causal effect of the two components of this program: clinical pathways and financial incentives. Especially we assess for the reform effect on healthcare quality and population health in the context that medical remuneration is not directly dependent on this additional funding offered by the program. We have data on admissions episodes and deaths for 8 years. We use multistate model analog to difference in difference approach to estimate reform effect on the transition probability between different states for each patient. Our results show that the reform reduced length of stay without deterioration in hospital mortality or readmission rate. In the other hand, the program contributed to decrease the hospitalization rate and a less invasive treatment approach for colorectal surgeries. This is a sign of healthcare quality and population health improvement. We demonstrate in this analysis that physicians’ behavior can be affected by both clinical standards and financial incentives even if offered to facilities.

Keywords: multi-state and multi-episode transition model, healthcare quality, length of stay, transition probability, difference in difference

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Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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Authors: Kari M. Solomon

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Companies with a culture accepting of change management and performance excellence are better suited to determine their sustainability performance and impacts. A mature corporate culture supportive of performance excellence is better positioned to integrate sustainability management tools into their standard business strategy. Companies use various sustainability management tools and reporting standards to communicate levels of sustainability performance to their stakeholders, more often focusing on shareholders and investors. A research gap remains in understanding how companies adapt business excellence models to define corporate sustainability performance. A content analysis of medium-sized enterprises using corporate sustainability reports and business excellence models reveals the challenges and opportunities of reporting sustainability performance in the context of organizational excellence. The outcomes of this content analysis contribute knowledge on the resources needed for companies to build sustainability performance management systems integral to existing management systems. The findings of this research inform academic research areas of corporate sustainability performance, the business community contributing to sustainable development initiatives, and integrating sustainable development issues into business excellence models. There are potential research links between sustainability performance management and the alignment of the United Nations Sustainable Development Goals (UN SDGs) when organizations promote a culture of performance or business excellence.

Keywords: business excellence, corporate sustainability, performance excellence, sustainability performance

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Authors: Ana Karaman, Dmitriy Gaevoy

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Successful and effective governing boards play an essential role in higher education by providing essential oversight and helping to steer the direction of an institution while creating and maintaining a thriving culture of stewardship. A well-functioning board can also help mitigate conflicts of interest, ensure responsible use of an organization's assets, and maintain institutional transparency. However, boards’ functions in higher education are inhibited by the presence of information asymmetry between the board and management. Board members typically have little specific knowledge about the business side of the higher education, in general, and an institution under their oversight in particular. As a result, boards often must rely on the discretion of the institutional upper administration as to what type of pertinent information being disclosed to the board. The phenomenon of information asymmetry is not unique to the higher education and has been studied previously in the context of both corporate and non-for-profit boards. Various board characteristics have been analyzed with respect to mitigating the information asymmetry between an organizational board and management. For example, it has been argued that such board characteristics as its greater size, independence, and a higher proportion of female members tend to reduce information asymmetry by raising levels of information disclosure and organizational transparency. This paper explores the phenomenon of information asymmetry between boards and management in the context of higher education. In our analysis, we propose a heat map of information asymmetry based on the categories of board competencies in higher education. The proposed heat map is based on the assessment of potential risks to both the boards and its institutions. It employs an assumption that a potential risk created by the presence of information asymmetry varies in its magnitude across various areas of boards’ competencies. Then, we explore the role of board members’ training in mitigating information asymmetry between the boards and the management by increasing the level of information disclosure and enhancing transparency in management communication with the boards. The paper seeks to demonstrate how appropriate training can provide board members with an adequate preparation to request a sufficient level of information disclose and transparency by arming them with knowledge of what questions to ask of the management.

Keywords: higher education, governing boards information asymmetry, board competencies, board training

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Authors: Genevieve Lim, Arthur Shelley, Dongcheol Heo

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Abstract—Mobile technologies can enhance the learning process as it enables social engagement around concepts beyond the classroom and the curriculum. Early results in this ongoing research is showing that when learning interventions are designed specifically to generate new insights, mobile devices support regulated learning and encourage learners to collaborate, socialize and co-create new knowledge. As students navigate across the space and time boundaries, the fundamental social nature of learning transforms into mobile computer supported collaborative learning (mCSCL). The metacognitive interaction in mCSCL via mobile applications reflects the regulation of learning among the students. These metacognitive experiences whether self-, co- or shared-regulated are significant to the learning outcomes. Despite some insightful empirical studies, there has not yet been significant research that investigates the actual practice and processes of the new knowledge co-creation. This leads to question as to whether mobile learning provides a new channel to leverage learning? Alternatively, does mobile interaction create new types of learning experiences and how do these experiences co-create new knowledge. The purpose of this research is to explore these questions and seek evidence to support one or the other. This paper addresses these questions from the students’ perspective to understand how students interact when constructing knowledge in mCSCL and how students’ self-regulated learning (SRL) strategies support the co-creation of new knowledge in mCSCL. A pilot study has been conducted among international undergraduates to understand students’ perspective of mobile learning and concurrently develops a definition in an appropriate context. Using classroom action research (CAR) with multiple case studies, this study is being carried out in a private university in Thailand to narrow the research gaps in mCSCL and SRL. The findings will allow teachers to see the importance of social interaction for meaningful student engagement and envisage learning outcomes from a knowledge management perspective and what role mobile devices can play in these. The findings will signify important indicators for academics to rethink what is to be learned and how it should be learned. Ultimately, the study will bring new light into the co-creation of new knowledge in a social interactive learning environment and challenges teachers to embrace the 21st century of learning with mobile technologies to deepen and extend learning opportunities.

Keywords: mobile computer supported collaborative learning, mobile instant messaging, mobile learning, new knowledge co-creation, self-regulated learning

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Authors: Nana Benma Osei

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Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

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Authors: Jiashu Shen

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This study aims at exploring the characteristics of sexual knowledge, attitudes, and behaviors of Chinese college students from the 'one-child' families compared with those with siblings. This study utilized the data from the 'National College Student Survey on Sexual and Reproductive Health 2019'. Multiple logistic regression analyses were used to assess the association between the 'only-child' and their sexual knowledge, sexual attitudes, sexual behaviors, and risky sexual behaviors (RSB) stratified by sex and home regions, respectively. Compared with students with siblings, the 'only-child' students scored higher in sex-related knowledge (only-child students: 4.49 ± 2.28, students with siblings: 3.60 ± 2.27). Stronger associations between only-child and more liberal sexual attitudes were found in urban areas, including the approval of premarital sexual intercourse (OR: 1.51, 95% CI: 1.50-1.65) and multiple sexual partners (OR: 1.85, 95% CI: 1.72-1.99). For risky sexual behaviors, being only-child is more likely to use condoms in first sexual intercourse, especially among male students (OR: 0.68, 95% CI: 0.58-0.80). Only-child students are more likely to have more sexual knowledge, more liberal sexual attitude, and less risky sexual behavior. Further health policy and sex education should focus more on students with siblings.

Keywords: attitudes and behaviors, only-child students, sexual knowledge, students with siblings

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Authors: Shu-Ching Chiu, Shu-Fang Chang

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The World Health Organization (WHO) has been actively developing intervention programs to deal with geriatric frailty. In its White Paper on Healthcare Policy 2020, the Department of Health, Bureau of Health Promotion proposed that active aging and the prevention of disability are essential for elderly people to maintain good health. The paper recommended five main policies relevant to this objective, one of which is the prevention of frailty and disability. Scholars have proposed a number of different criteria to diagnose and assess frailty; no consistent or normative standard of measurement is currently available. In addition, many methods of assessment are recursive, which can easily result in recall bias. Due to the relationship between frailty and physical fitness with regard to co-morbidity, it is important that academics optimize the criteria used to assess frailty by objectively evaluating the physical fitness of senior citizens. This study used a review of the literature to identify fitness indicators suitable for measuring frailty in the elderly. This study recommends that measurement criteria be integrated to produce an optimized predictive value for frailty score. Healthcare professionals could use this data to detect frailty at an early stage and provide appropriate care to prevent further debilitation and increase longevity.

Keywords: frailty, aging, physical fitness, optimized criteria, healthcare

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Authors: Lucia Varra, Marzia Timolo

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The interest of scholars towards corporate sustainability has strengthened in recent years in parallel with the growing need to undertake paths of cultural and organizational change, as a way for greater competitiveness and stakeholders’ satisfaction. In fact, studies on the business sustainability, while on the one hand have integrated the three dimensions of sustainability that existed for some time in the economic approaches (economic, environmental and social dimensions), on the other hand did not give rise to an organic construct that puts together the aspects of strategic management with corporate social responsibility and even less with the organizational issues. Therefore some important questions remain open: Which organizational structure and which operational mechanisms are coherent or propitious to a sustainability strategy? Existing studies appear to be fragmented, although some aspects have shared importance: knowledge management, human resource, management, leadership, innovation, etc. The construction of a model of sustainable organization that supports the sustainability strategy no longer seems to be postponed, as is its connection with the main practices of measuring corporate social responsibility performance. The paper aims to identify the organizational characteristics of a sustainable corporate. To this end, from a theoretical point of view the work examines the main existing literary contributions and, from a practical point of view, it presents a business case referring to a service organization that for years has undertaken the sustainability strategy. This paper is divided into two parts: the first part concerns a review of the main articles on the strategic management topic and the main organizational issues raised by the literature, such as knowledge management, leadership, innovation, etc.; later, a modeling of the main variables examined by scholars and an integration of these with the international measurement standards of CSR is proposed. In the second part, using the methodology of the case study company, the hypotheses and the structure of the proposed model that aims to integrate the strategic issues with the organizational aspects and measurement of sustainability performance, are applied to an Italian company, which has some organizational and human resource management interventions are in place to align strategic decisions with the structure and operating mechanisms of the structure. The case presented supports the hypotheses of the model.

Keywords: CSR, strategic management, sustainable leadership, sustainable human resource management, sustainable organization

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