Search results for: holistic healthcare

Authors: M. Graus, K. Westhoff, X. Xu

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The climate change causes a change in all aspects of society. While the expansion of renewable energies proceeds, industry could not be convinced based on general studies about the potential of demand side management to reinforce smart grid considerations in their operational business. In this article, a procedure model for a case-specific data-driven decision support for industrial energy management based on a holistic data analytics approach is presented. The model is executed on the example of the strategic decision problem, to integrate the aspect of renewable energies into industrial energy management. This question is induced due to considerations of changing the electricity contract model from a standard rate to volatile energy prices corresponding to the energy spot market which is increasingly more affected by renewable energies. The procedure model corresponds to a data analytics process consisting on a data model, analysis, simulation and optimization step. This procedure will help to quantify the potentials of sustainable production concepts based on the data from a factory. The model is validated with data from a printer in analogy to a simple production machine. The overall goal is to establish smart grid principles for industry via the transformation from knowledge-driven to data-driven decisions within manufacturing companies.

Keywords: data analytics, green production, industrial energy management, optimization, renewable energies, simulation

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Authors: Abi Miller, Eleanor Wilson, Claire Diver

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Background: UK Head and Neck Cancer incidence and prevalence were rising related to better treatment outcomes and changed demographics. More people of working-age now survive Head and Neck Cancer. For individuals, work provides income, purpose, and social connection. For society, work increases economic productivity and reduces welfare spending. In the UK, a cancer diagnosis is classed as a disability and more disabled people leave the workplace than non-disabled people. Limited evidence exists on return-to-work after Head and Neck Cancer, with no UK qualitative studies. Head and Neck Cancer survivors appear to return to work less when compared to other cancer survivors. This study aimed to explore the effects of Head and Neck Cancer disability on survivors’ return-to-work experience. Methodologies: This was an exploratory qualitative study using a critical realist approach to carry out semi-structured one-off interviews with Head and Neck Cancer survivors who had returned to work. Interviews were informed by an interview guide and carried out remotely by Microsoft Teams or telephone. Interviews were transcribed verbatim, pseudonyms allocated, and transcripts anonymized. Data were interpreted using Reflexive Thematic Analysis. Findings: Thirteen Head and Neck Cancer survivors aged between 41 -63 years participated in interviews. Three major themes were derived from the data: changed identity and meaning of work after Head and Neck Cancer, challenging and supportive work experiences and impact of healthcare professionals on return-to-work. Participants described visible physical appearance changes, speech and eating challenges, mental health difficulties and psycho-social shifts following Head and Neck Cancer. These factors affected workplace re-integration, ability to carry out work duties, and work relationships. Most participants experienced challenging work experiences, including stigmatizing workplace interactions and poor communication from managers or colleagues, which further affected participant confidence and mental health. Many participants experienced job change or loss, related both to Head and Neck Cancer and living through a pandemic. A minority of participants experienced strategies like phased return, which supported workplace re-integration. All participants, bar one, wanted conversations with healthcare professionals about return-to-work but perceived these conversations as absent. Conclusion: All participants found returning to work after Head and Neck Cancer to be a challenging experience. This appears to be impacted by participant physical, psychological, and functional disability following Head and Neck Cancer, work interaction and work context.

Keywords: disability, experience, head and neck cancer, qualitative, return-to-work

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Hsiao-Lin Fang

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The Patient Self-Determination Act is based on the belief that each life is unique. The act regards each patient as an autonomous entity and explicitly protects the patient’s rights to know and make decisions and choices while ensuring that the patient’s wish for a peaceful end is granted. Even when the patient is unconscious and unable to express himself/herself, the patient’s self-determination and its exercise are still protected under the law. The act also ensures that healthcare professionals (HCPs) have a specific set of rules to follow and complete legal protection when their patients are unable to express themselves clearly. This report is about a 55-year-old female patient who weighed 110 kg and was diagnosed with acute type A aortic dissection. The case was that the patient suddenly felt backache and nausea during sleep before daybreak and was therefore transferred to this hospital from the original one. After the doctor explained the patient’s conditions, it was concluded that surgery was necessary. However, the patient’s family was immediately against the surgery after having heard its possible complications. Nevertheless, the patient was still willing to receive the surgery. Being at odds with her family, the patient decided to sign the surgery agreement herself and agreed to receive the two surgical procedures: (1) ascending aorta replacement and (2) innominate artery debranching. After the surgery, the patient did not regain consciousness and therefore received computed tomography scanning of the brain, which revealed false lumen involving proximal left common carotid artery, left subclavian artery and innominate artery, and severe compression of the true lumen with total/subtotal occlusion in the left common carotid artery. On the following day, the doctor discussed two further surgical procedures: (1) endografting for descending aorta and (2) endografting for left common carotid artery and subclavian artery with the family. However, as the patient’s postoperative recovery of consciousness only reached the level of stupor and her family had no intention of subsequent healthcare for the patient, the family made the joint decision three days later to have the endotracheal tube removed from the patient and let her die a natural death. Suggestion: An advance directive (AD) can be created beforehand. Once the patient is in a special clinical state (e.g., terminal illness, permanent vegetative state, etc.), the AD can determine whether to sustain the patient’s life through ‘medical intervention’ or to respect the patient’s rights to choose a peaceful end and receive palliative care. Through the expression of self-determination, it is possible to respect the patient’s medical practice autonomy and protect the patient’s dignity and right to a peaceful end, thereby respecting and supporting the patient’s decision. This also allows the three sides: the patient, the family and the medical team to understand the patient’s true wish in the process of advance care planning (ACP) and thereby promote harmony in the HCP-patient relationship.

Keywords: intensive care unit patient, cardiovascular surgery, self-determination, advance directive

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Authors: Muhammad Ali Tariq

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Grid-connected PV systems have drawn tremendous attention of researchers in the past recent years. The report elucidates the development of efficient and stable solar PV energy conversion systems after thorough analysis at various facets like PV module characteristics, its arrangement, power electronics and MPPT topologies, the stability of the grid, and economic viability over its lifetime. This report and feasibility study will try to bring all optimizing approaches and design calculations which are required for generating energy from BIPV and roof-mounted solar PV in a convenient, sustainable, and user-friendly way.

Keywords: building integrated photovoltaic system, grid integration, solar resource assessment, return on investment, multi MPPT-inverter, levelised cost of electricity

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Authors: Sarayu Agarwal

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This paper aims to teach English (secondary language) by bridging the understanding between the Regional language (primary language) and the English Language (secondary language). Here primary language is the one a person has learned from birth or within the critical period, while secondary language would be any other language one learns or speaks. The paper also focuses on evolving old teaching methods to a contemporary participatory model of learning and teaching. Pilot studies were conducted to gauge an understanding of student’s knowledge of the English language. Teachers and students were interviewed and their academic curriculum was assessed as a part of the initial study. Extensive literature study and design thinking principles were used to devise a solution to the problem. The objective is met using a holistic learning kit/card game to teach children word recognition, word pronunciation, word spelling and writing words. Implication of the paper is a noticeable improvement in the understanding and grasping of English language. With increasing usage and applicability of English as a second language (ESL) world over, the paper becomes relevant due to its easy replicability to any other primary or secondary language. Future scope of this paper would be transforming the idea of participatory learning into self-regulated learning methods. With the upcoming govt. learning centres in rural areas and provision of smart devices such as tablets, the development of the card games into digital applications seems very feasible.

Keywords: English as a second language, vocabulary-building card games, learning through gamification, rural education

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Authors: Klio Monokrousou, Maria Giannopoulou

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Urban areas, as they have been developed and operate today, are areas of accumulation of a significant amount of people and a large number of activities that generate desires and reasons for traveling. The territorial expansion of the cities as well as the need to preserve the importance of the central city areas lead to the continuous increase of transportation needs which in the limited urban space results in creating serious traffic and operational problems. The modern perception of urban planning is directed towards more holistic approaches and integrated policies that make it economically competitive, socially just and more environmentally friendly. Over the last 25 years, the goal of sustainable transport development has been central to the agenda of any plan or policy for the city. The modern planning of urban space takes into account the economic and social aspects of the city and the importance of the environment to sustainable urban development. In this context, the European Union promotes direct or indirect related interventions according to the cohesion and environmental policies; many countries even had the chance to actually test them. This paper is part of a wider research still in progress and it explores the methods and processes that have been developed towards this direction and presents a review and systematic presentation of this work. The ultimate purpose of this research is to effectively use this review to create a decision making methodological framework which can be the basis of a useful operational tool for sustainable urban planning.

Keywords: methods, sustainable urban development, urban mobility, methodological framework

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Authors: Jami Wang, Brian Kao, Davin Agustines

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COVID-19 highlighted the active discrimination against the Asian American population easily seen through media, social tension, and increased crimes against the specific population. It is well known that long-term racism can also have a large impact on both emotional and psychological well-being. However, the healthcare disparity during this time also revealed how the Asian American community lacked the research data, political support, and medical infrastructure for this particular population. During a time when Asian American fear for safety with decreasing mental health, telepsychiatry is particularly promising. COVID-19 demonstrated how well psychiatry could integrate with telemedicine, with psychiatry being the second most utilized telemedicine visits. However, the Asian American community did not utilize the telepsychiatry resources as much as other groups. Because of this, we wanted to understand why the patient population who was affected the most by COVID-19 mentally did not seek out care. To do this, we decided to study the top top telepsychiatry platforms. The current top telepsychiatry companies in the United States include Teladoc and BetterHelp. In the Teladoc mental health sector, they only had 4 available languages (English, Spanish, French, and Danis,) with none of them being an Asian language. In a similar manner, Teladoc’s top competitor in the telepsychiatry space, BetterHelp, only listed a total of 3 Asian languages, including Mandarin, Japanese, and Malaysian. However, this is still a short list considering they have over 20 languages available. The shortage of available physicians that speak multiple languages is concerning, as it could be difficult for the Asian American community to relate with. There are limited mental health resources that cater to their likely cultural needs, further exacerbating the structural racism and institutional barriers to appropriate care. It is important to note that these companies do provide interpreters to comply with the nondiscrimination and language assistance federal law. However, interactions with an interpreter are not only more time-consuming but also less personal than talking directly with a physician. Psychiatry is the field that emphasizes interpersonal relationships. The trust between a physician and the patient is critical in developing patient rapport to guide in better understanding the clinical picture and treating the patient appropriately. The language barrier creates an additional barrier between the physician and patient. Because Asian Americans are one of the largest growing patient population bases, these telehealth companies have much to gain by catering to the Asian American market. Without providing adequate access to bilingual and bicultural physicians, the current system will only further exacerbate the growing disparity. The healthcare community and telehealth companies need to recognize that the Asian American population is a severely underserved population in mental health and has much to gain from telepsychiatry. The lack of language is one of many reasons why there is a disparity for Asian Americans in the mental health space.

Keywords: telemedicine, psychiatry, Asian American, disparity

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Authors: Rabson Banda

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This abstract delves into the transformative journey of Rabson Banda, a visionary leader in Zambia who has harnessed the power of photovoice, mental fitness, and entrepreneurship to combat substance use disorders in the face of limited job opportunities in Africa. Rabson's personal battle with alcohol-induced disorder serves as the foundation for his pioneering work in establishing Elevated Initiatives, a grassroots organization dedicated to empowering individuals struggling with addiction through innovative approaches. Through the lens of photovoice, Rabson Banda amplifies the voices of those affected by substance abuse, providing a platform for self-expression and healing. By intertwining mental fitness techniques and entrepreneurial skills, he equips individuals with the tools needed to break free from the cycle of addiction and chart a new path toward holistic wellness and economic independence. Rabson Banda's story embodies resilience, hope, and the unwavering belief in the transformative power of community-driven initiatives. His work not only addresses the immediate challenges of substance use disorders but also addresses the root causes of addiction by advocating for increased job opportunities and economic empowerment in Zambia and across Africa for decent job creation and Entrepreneurship: A Lived Experience of Alcohol-Induced Disorder and Recovery in Zambia.

Keywords: mental fitness, entrepreneurship, photovoice, descent jobs

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Authors: D. Garg, S. Luthra, A. Haleem

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Due to growing concern about environmental and social consequences throughout the world, a need has been felt to incorporate sustainability concepts in conventional manufacturing. This paper is an attempt to identify and evaluate drivers in implementing sustainable manufacturing in Indian context. Nine possible drivers for successful implementation of sustainable manufacturing have been identified from extensive review. Further, Decision Making Trial and Evaluation Laboratory (DEMATEL) approach has been utilized to evaluate and categorize these identified drivers for implementing sustainable manufacturing in to the cause and effect groups. Five drivers (Societal Pressure and Public Concerns; Regulations and Government Policies; Top Management Involvement, Commitment and Support; Effective Strategies and Activities towards Socially Responsible Manufacturing and Market Trends) have been categorized into the cause group and four drivers (Holistic View in Manufacturing Systems; Supplier Participation; Building Sustainable culture in Organization; and Corporate Image and Benefits) have been categorized into the effect group. “Societal Pressure and Public Concerns” has been found the most critical driver and “Corporate Image and Benefits” as least critical or the most easily influenced driver to implementing sustainable manufacturing in Indian context. This paper may surely help practitioners in better understanding of these drivers and their priorities towards effective implementation of sustainable manufacturing.

Keywords: drivers, decision making trial and evaluation laboratory (DEMATEL), India, sustainable manufacturing

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Authors: T. Esteves, S. Mesquita, A. Santos, A. Campina, C. Costa-Lobo

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The theme regarding the differentiation of high-performance athletes has always aroused curiosity and fascination, becoming a target for study, especially in the social and human sciences. It was from the 60's and 70's that the concern for the study of the excellence of athletes that showed indices of high performance in sports began to arise. From the 1990s, it became possible to specify the mental competencies and psychological characteristics associated with Olympic athletes with high levels of success. Several studies considered that well-structured pre-competitive and competitive routines and plans were predictors of sports success. Likewise, the high levels of motivation, commitment and concentration; the high levels of self-confidence and optimism; the presence of effective coping strategies to deal with distractions and unexpected situations or events; adequate regulation of activation and anxiety; the establishment and formulation of objectives; and mental visualization and practice were determinants in the manifestation of excellence in these athletes. As such, the promotion of these cognitive abilities has been emphasized in the good performance of the athletes. With the objective of implementing cognitive stimulation programs to meet the specific needs of talented athletes, together with pedagogical activities to promote educational strategies and promote interpersonal relationships, this communication systematizes a proposal for a psychopedagogical service to promote cognitive abilities in competitive athletes, SPAC, to implement in a Portuguese soccer team. This service will be based on a holistic vision in order to promote talent.

Keywords: athletes, cognitive abilities, high competition, psycho-pedagogical service

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Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.

Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate

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Authors: Farah Al Zaabi, Sarah Amrani

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Complex regional pain syndrome (CRPS) is a chronic pain condition that develops in an extremity following a fracture, soft tissue injury, or surgery. It is a neuropathic pain disorder that is accompanied by the characteristic skin manifestations that are needed for the diagnosis. We report the case of a 30 year old male, who has findings consistent with CRPS and has been followed for over two years by multiple specialties within the healthcare system without obtaining a diagnosis. The symptoms he presented with were treated based on the specialty he was seeing, rather than unified and recognized as a single disease process. Our case highlights the complexity of chronic pain, which can sometimes present with skin manifestations, and the importance of involving a pain specialist early for both the medical and physical recovery of CRPS patients.

Keywords: complex regional pain syndrome, chronic pain, skin changes of CRPS, dermatological manifestions of CRPS

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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Authors: Aisha Maroof

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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.

Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment

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Authors: Samuel Oludayo Alamu, Seong Lee

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The need for generating energy from biomass in an efficient way as well as maximizing the yield of total energy from the thermal conversion process has been a major concern for researchers. A holistic approach which involves the combination of First law of thermodynamics (FLT) and the second law of thermodynamics (SLT) is required for conducting an effective assessment of an energy plant since FLT analysis alone fails to identify the quality of the dissipated energy and how much work potential is available. The overall purpose of this study is to investigate the exergy analysis of direct combustion of poultry waste being converted to energy with a handful of environmental assessment of the conversion processes in order to maximize thermal efficiency. The exergy analysis around the shell and tube heat exchanger (STHE) was investigated primarily by varying the operating parameters for different tube shapes and flow direction, and an exergy model was obtained from estimations of the higher heating value and standard entropy of poultry waste from the elemental compositions. The STHE was designed and fabricated by Lee Research Group at Morgan State University. The analysis conducted on theSTHE using the flue gas temperature entering and exiting show that only about one-third of the energy input to the STHE was available to do work with an overall efficiency of 13.8%, while a huge amount was lost to the surrounding. By recirculating the flue gas, the exergy efficiency of the combustion system can be maximized with a greater reduction in the amount of exergy loss.

Keywords: exergy analysis, shell and tube heat exchanger, thermodynamics, combustion system, thermal efficiency

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Haruka Ando

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Undernutrition of children is a critical issue, especially for people in the remote areas of the Republic of Djibouti, since household food insecurity, inadequate child caring and feeding, unhealthy environment and lack of clean water, as well as insufficient maternal and child healthcare, are underlying causes which affect. Nomadic pastoralists living in the Dikhil region (Dikhil) are socio-economically and geographically more vulnerable due to displacement, which in turn worsens the situation of child stunting. A high prevalence of inappropriate complementary feeding among pastoral mothers might be a significant barrier to child growth. This study aims to identify health promotion intervention strategies that would support an increase in optimal complementary feeding among pastoral mothers of children aged 6-23 months in Dikhil. There are four objectives; to explore and to understand the existing practice of complementary feeding among pastoral mothers in Dikhil; to identify the barriers in appropriate complementary feeding among the mothers; to critically explore and analyse the strategies for an increase in complementary feeding among the mothers; to make pragmatic recommendations to address the barriers in Djibouti. This is an in-depth study utilizing a conceptual framework, the behaviour change wheel, to analyse the determinants of complementary feeding and categorize health promotion interventions for increasing optimal complementary feeding among pastoral mothers living in Dikhil. The analytical tool was utilized to appraise the strategies to mitigate the selected barriers against optimal complementary feeding. The data sources were secondary literature from both published and unpublished sources. The literature was systematically collected. The findings of the determinants including the barriers of optimal complementary feeding were identified: heavy household workload, caring for multiple children under five, lack of education, cultural norms and traditional eating habits, lack of husbands' support, poverty and food insecurity, lack of clean water, low media coverage, insufficient health services on complementary feeding, fear, poor personal hygiene, and mothers' low decision-making ability and lack of motivation for food choice. To mitigate selected barriers of optimal complementary feeding, four intervention strategies based on interpersonal communication at the community-level were chosen: scaling up mothers' support groups, nutrition education, grandmother-inclusive approach, and training for complementary feeding counseling. The strategies were appraised through the criteria of effectiveness and feasibility. Scaling up mothers' support groups could be the best approach. Mid-term and long-term recommendations are suggested based on the situation analysis and appraisal of intervention strategies. Mid-term recommendations include complementary feeding promotion interventions are integrated into the healthcare service providing system in Dikhil, and donor agencies advocate and lobby the Ministry of Health Djibouti (MoHD) to increase budgetary allocation on complementary feeding promotion to implement interventions at a community level. Moreover, the recommendations include a community health management team in Dikhil training healthcare workers and mother support groups by using complementary feeding communication guidelines and monitors behaviour change of pastoral mothers and health outcome of their children. Long-term recommendations are the MoHD develops complementary feeding guidelines to cover sector-wide collaboration for multi-sectoral related barriers.

Keywords: Afar, child food, child nutrition, complementary feeding, complementary food, developing countries, Djibouti, East Africa, hard-to-reach areas, Horn of Africa, nomad, pastoral, rural area, Somali, Sub-Saharan Africa

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Authors: Parsa Mahdavi, M. Amin Hariri-Ardebili

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The development of accurate machine learning and deep learning models traditionally demands hands-on expertise and a solid background to fine-tune hyperparameters. With the continuous expansion of datasets in various scientific and engineering domains, researchers increasingly turn to machine learning methods to unveil hidden insights that may elude classic regression techniques. This surge in adoption raises concerns about the adequacy of the resultant meta-models and, consequently, the interpretation of the findings. In response to these challenges, automated machine learning (AutoML) emerges as a promising solution, aiming to construct machine learning models with minimal intervention or guidance from human experts. AutoML encompasses crucial stages such as data preparation, feature engineering, hyperparameter optimization, and neural architecture search. This paper provides a comprehensive overview of the principles underpinning AutoML, surveying several widely-used AutoML platforms. Additionally, the paper offers a glimpse into the application of AutoML on various engineering datasets. By comparing these results with those obtained through classical machine learning methods, the paper quantifies the uncertainties inherent in the application of a single ML model versus the holistic approach provided by AutoML. These examples showcase the efficacy of AutoML in extracting meaningful patterns and insights, emphasizing its potential to revolutionize the way we approach and analyze complex datasets.

Keywords: automated machine learning, uncertainty, engineering dataset, regression

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Lilia Edit Aparicio Pico, Paulo Cesar Coronado Sánchez, Roberto Ferro Escobar

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This paper presents the implementation of telemedicine services for physiotherapy, occupational therapy, and speech therapy rehabilitation, utilizing telebroadcasting of audiovisual content to enhance comprehensive patient recovery in rural areas of San Vicente del Caguán municipality, characterized by high levels of social conflict in Colombia. The region faces challenges such as dysfunctional problems, physical rehabilitation needs, and a high prevalence of hearing diseases, leading to neglect and substandard health services. Limited access to healthcare due to communication barriers and transportation difficulties exacerbates these issues. To address these challenges, a research initiative was undertaken to leverage information and communication technologies (ICTs) to improve healthcare quality and accessibility for this vulnerable population. The primary objective was to develop a tele-rehabilitation system to provide asynchronous online therapies and teleconsultation services for patient follow-up during the recovery process. The project comprises two components: Communication systems and human development. A technological component involving the establishment of a wireless network connecting rural centers and the development of a mobile application for video-based therapy delivery. Communications systems will be provided by a radio link that utilizes internet provided by the Colombian government, located in the municipality of San Vicente del Caguán to connect two rural centers (Pozos and Tres Esquinas) and a mobile application for managing videos for asynchronous broadcasting in sidewalks and patients' homes. This component constitutes an operational model integrating information and telecommunications technologies. The second component involves pedagogical and human development. The primary focus is on the patient, where performance indicators and the efficiency of therapy support were evaluated for the assessment and monitoring of telerehabilitation results in physical, occupational, and speech therapy. They wanted to implement a wireless network to ensure audiovisual content transmission for tele-rehabilitation, design audiovisual content for tele-rehabilitation based on services provided by the ESE Hospital San Rafael in physiotherapy, occupational therapy, and speech therapy, develop a software application for fixed and mobile devices enabling access to tele-rehabilitation audiovisual content for healthcare personnel and patients and finally to evaluate the technological solution's contribution to the ESE Hospital San Rafael community. The research comprised four phases: wireless network implementation, audiovisual content design, software application development, and evaluation of the technological solution's impact. Key findings include the successful implementation of virtual teletherapy, both synchronously and asynchronously, and the assessment of technological performance indicators, patient evolution, timeliness, acceptance, and service quality of tele-rehabilitation therapies. The study demonstrated improved service coverage, increased care supply, enhanced access to timely therapies for patients, and positive acceptance of teletherapy modalities. Additionally, the project generated new knowledge for potential replication in other regions and proposed strategies for short- and medium-term improvement of service quality and care indicators

Keywords: e-health, medical informatics, telemedicine, telerehabilitation, virtual therapy

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Authors: Weidong Xia, Malgorzata Kolotylo, Xuan Tan

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This study examines the key factors that influence general practitioners’ learning and transfer of specialized arthritis knowledge and self-care techniques to patients during normal patient visits. Drawing on the theory of planed behavior and using matched survey data collected from general practitioners before and after training sessions provided by specialized orthopedic physicians, the study suggests that the general practitioner’s intention to use and transfer learned knowledge was influenced mainly by intrinsic motivation, organizational learning culture and absorptive capacity, but was not influenced by extrinsic motivation. The results provide both theoretical and practical implications.

Keywords: empirical study, healthcare knowledge management, patient self-care, physician knowledge transfer

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Authors: Chao Sima, Shanaz Ghandhi, Sally A. Amundson, Michael L. Bittner, David J. Brenner

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In a large-scale radiologic emergency, potentially affected population need to be triaged efficiently using various biomarkers where personal dosimeters are not likely worn by the individuals. It has long been established that radiation injury can be estimated effectively using panels of genetic biomarkers. Furthermore, the rate of radiation, in addition to dose of radiation, plays a major role in determining biological responses. Therefore, a better and more accurate triage involves estimating both the dose level of the exposure and the length of time of that exposure. To that end, a large in vivo study was carried out on mice with internal emitter caesium-137 (¹³⁷Cs). Four different injection doses of ¹³⁷Cs were used: 157.5 μCi, 191 μCi, 214.5μCi, and 259 μCi. Cohorts of 6~7 mice from the control arm and each of the dose levels were sacrificed, and blood was collected 2, 3, 5, 7 and 14 days after injection for microarray RNA gene expression analysis. Using a generalized linear model with penalized maximum likelihood, a panel of 244 genes was established and both the doses of injection and the number of days after injection were accurately predicted for all 155 subjects using this panel. This has proven that microarray gene expression can be used effectively in radiation biodosimetry in predicting both the dose levels and the length of exposure time, which provides a more holistic view on radiation exposure and helps improving radiation damage assessment and treatment.

Keywords: caesium-137, gene expression microarray, multivariate responses prediction, radiation biodosimetry

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Authors: Jake Gonzalez, Tommy Dang

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This paper proposes a temporal graph approach to visualize and analyze the evolution of gene relationships and nomenclature over time. An interactive web-based tool implements this temporal graph, enabling researchers to traverse a timeline and observe coupled dynamics in network topology and naming conventions. Analysis of a real human genomic dataset reveals the emergence of densely interconnected functional modules over time, representing groups of genes involved in key biological processes. For example, the antimicrobial peptide DEFA1A3 shows increased connections to related alpha-defensins involved in infection response. Tracking degree and betweenness centrality shifts over timeline iterations also quantitatively highlight the reprioritization of certain genes’ topological importance as knowledge advances. Examination of the CNR1 gene encoding the cannabinoid receptor CB1 demonstrates changing synonymous relationships and consolidating naming patterns over time, reflecting its unique functional role discovery. The integrated framework interconnecting these topological and nomenclature dynamics provides richer contextual insights compared to isolated analysis methods. Overall, this temporal graph approach enables a more holistic study of knowledge evolution to elucidate complex biology.

Keywords: temporal graph, gene relationships, nomenclature evolution, interactive visualization, biological insights

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Authors: J. Luché-Thayer, C. Perronne, C. Meseko

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We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent

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Authors: Ryadi Adityavarman

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The study is an analysis by using the postcolonial theoretical lens on the search for a distinctive architectural identity by architect Maclaine Pont in Indonesia in the early twentieth century. Influenced by progressive architectural thinking and enlightened humanism at the time, Pont applied the fundamental principles of Structural Rationalism by using a creative combination of traditional Indonesian architectural typology and innovative structural application. The interpretive design strategy also celebrated creative use of local building materials with sensible tropical climate design response. Moreover, his holistic architectural scheme, including inclusion of local custom of building construction, represents the notion of Gesamkunstwerk. By using such hybrid strategy, Maclaine Pont intended to preserve the essential cultural identity and vernacular architecture of the indigenous. The study will chronologically investigate the evolution of Structural Rationalism architecture philosophy of Viollet-le-Duc to Hendrik Berlage’s influential design thinking in the Dutch modern architecture, and subsequently to the Maclaine Pont’s innovative design in Indonesia. Consequently, the morphology analysis on his exemplary design works of ITB campus (1923) and Pohsarang Church (1936) is to understand the evolutionary influence of Structural Rationalism theory. The postmodern analysis method is to highlight the validity of Pont’s idea in the contemporary Indonesian architecture within the culture of globalism era.

Keywords: Indonesian modern architecture, postcolonial, structural rationalism, critical regionalism

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Authors: Avishkar Gawade, Omkar Bansode, Ketan Bhambure, Bhargav Deore

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In recent year wide range of business intelligence technology have been applied to different area in order to support decision making process BI enables extraction of knowledge from data store. BI tools usually used in public health field for financial and administrative purposes.BI uses a dashboard in presentation stage to deliver information to information to end users.In this paper,we intend to analyze some open source BI tools on the market and their applicability in the clinical sphere taking into consideration the general characteristics of the clinical environment.A pervasive BI platform was developed using a real case in order to prove the tool viability.Analysis of various BI Tools in done with the help of several parameters such as data security,data integration,data quality reporting and anlaytics,performance,scalability and cost effectivesness.

Keywords: CDSS, EHR, business intelliegence, tools

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Authors: Monique de Ritter, Annemieke Roobeek

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This study takes a holistic multi-layered systems approach on entrepreneurship, innovation, and sustainability. Concretely we looked how mission driven entrepreneurs (level 1) employ new business models and launch innovative products and/or ideas in their enterprises, which are (level 2) operating in entrepreneurial ecosystems (level 3), and how these in turn may generate higher level sustainable change (level 4). We employed a qualitative grounded research approach in which our aim is to contribute to theory. Fourteen in-depth semi-structured interviews were conducted with mission driven entrepreneurs in the Netherlands in which their individual drives, business models, and ecosystems were discussed. Interview transcripts were systematically coded and analysed and the ecosystems were visually mapped. Most important patterns include 1) entrepreneurs have a clear sustainable mission and regard this mission as de raison d’être of their enterprise; 2) entrepreneurs employ new business models with a focus on collaboration for innovation; the business model supports or enhances the sustainable mission of the enterprise, 3) entrepreneurs collaborate in ecosystems in which a) they also regard suppliers as partners for innovation and clients as ambassadors for the sustainable mission, b) would like to improve their relationships with financial institutions as they are in the entrepreneurs’ perspective often lagging behind with their innovative ideas and models, c) they collaborate for knowledge and innovation with several parties, d) personal informal connections are very important, and e) in which the higher sustainable mission is not a point of competition but of collaboration.

Keywords: sustainability, entrepreneurship, innovation, ecosystem, business models

Procedia PDF Downloads 353

Authors: Priyadharshini Ahrumugam

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Cooperative groups through much research have been recognized to churn remarkable achievements instead of solitary or individualistic efforts. Based on Johnson and Johnson’s model of cooperative learning, the five key components of cooperation are positive interdependence, face-to-face promotive interaction, individual accountability, social skills and group processing. In 2011, the Malaysian Ministry of Higher Education (MOHE) introduced the Holistic Student Development policy with the aim to develop morally sound individuals equipped with lifelong learning skills. The Community Service project was included in the improvement initiative. The purpose of this study is to assess the relationship of team-based learning in facilitating particularly students’ positive interdependence and face-to-face promotive interaction. The research methods involve in-depth interviews with the team leaders and selected team members, and a content analysis of the undergraduate students’ reflective journals. A significant positive relationship was found between students’ progressive outlook towards teamwork and the highlighted two components. The key findings show that students have gained in their individual learning and work results through teamwork and interaction with other students. The inclusion of Community Service as a MOHE subject resonates with cooperative learning methods that enhances supportive relationships and develops students’ social skills together with their professional skills.

Keywords: community service, cooperative learning, positive interdependence, teamwork

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Authors: Kedar J. Mahadeshwar

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Concept introduction: This paper talks about how an innovative cloud based analytics enabled solution that could address a major industry challenge that is approaching all of us globally faster than what one would think. The world of supply chain for drugs and devices is changing today at a rapid speed. In the US, the Drug Supply Chain Security Act (DSCSA) is a new law for Tracing, Verification and Serialization phasing in starting Jan 1, 2015 for manufacturers, repackagers, wholesalers and pharmacies / clinics. Similarly we are seeing pressures building up in Europe, China and many countries that would require an absolute traceability of every drug and device end to end. Companies (both manufacturers and distributors) can use this opportunity not only to be compliant but to differentiate themselves over competition. And moreover a country such as UAE can be the leader in coming up with a global solution that brings innovation in this industry. Problem definition and timing: The problem of counterfeit drug market, recognized by FDA, causes billions of dollars loss every year. Even in UAE, the concerns over prevalence of counterfeit drugs, which enter through ports such as Dubai remains a big concern, as per UAE pharma and healthcare report, Q1 2015. Distribution of drugs and devices involves multiple processes and systems that do not talk to each other. Consumer confidence is at risk due to this lack of traceability and any leading provider is at risk of losing its reputation. Globally there is an increasing pressure by government and regulatory bodies to trace serial numbers and lot numbers of every drug and medical devices throughout a supply chain. Though many of large corporations use some form of ERP (enterprise resource planning) software, it is far from having a capability to trace a lot and serial number beyond the enterprise and making this information easily available real time. Solution: The solution here talks about a service provider that allows all subscribers to take advantage of this service. The solution allows a service provider regardless of its physical location, to host this cloud based traceability and analytics solution of millions of distribution transactions that capture lots of each drug and device. The solution platform will capture a movement of every medical device and drug end to end from its manufacturer to a hospital or a doctor through a series of distributor or retail network. The platform also provides advanced analytics solution to do some intelligent reporting online. Why Dubai? Opportunity exists with huge investment done in Dubai healthcare city also with using technology and infrastructure to attract more FDI to provide such a service. UAE and countries similar will be facing this pressure from regulators globally in near future. But more interestingly, Dubai can attract such innovators/companies to run and host such a cloud based solution and become a hub of such traceability globally.

Keywords: cloud, pharmaceutical, supply chain, tracking

Procedia PDF Downloads 515