Search results for: holistic healthcare

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

Abstract:

Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

Procedia PDF Downloads 144

Authors: Brandtner Patrick, Staberhofer Franz

Abstract:

Logistics and Supply Chain Management are of crucial importance for organisational success. In the era of Digitalization, several implications and improvement potentials for these domains arise, which at the same time could lead to decreased competitiveness and could endanger long-term company success if ignored or neglected. However, empirical research on the issue of Digitalization and benefits purported to it by practitioners is scarce and mainly focused on single technologies or separate, isolated Supply Chain blocks as e.g. distribution logistics or procurement only. The current paper applies a holistic focus group approach to elaborate practitioner use cases at the nexus of the concepts of Supply Chain Management (SCM) and Digitalization. In the course of three focus group workshops with over 45 participants from more than 20 organisations, a comprehensive set of benefit entitlements and areas for improvement in terms of applying digitalization to SCM is developed. The main results of the paper indicate the relevance of Digitalization being realized in practice. In the form of seventeen concrete research action fields, the benefit entitlements are aggregated and transformed into potential starting points for future research projects in this area. The main contribution of this paper is an empirically grounded basis for future research projects and an overview of actual research action fields from practitioners’ point of view.

Keywords: digital supply chain, digital transformation, supply chain management, value networks

Procedia PDF Downloads 153

Authors: Elaheh Ezami, Behzad Mohammadian, Elham Aznab

Abstract:

Health service design will need to change due to bringing in new digital health tools. This highlights the importance of innovation in adopting Health Information Technology (HIT). It can be argued that innovation in the health sector correlates with entrepreneurship. Various reasons exist for health entrepreneurs to advocate increased investment in HIT to compensate for shortcomings in the health sector and improve the quality of healthcare. Furthermore, every innovative program presents challenges and motivations for entrepreneurs that may distract or encourage the adoption of technology. Our study used a systematic literature review to identify relevant articles that defined the frustrations and promotions of using health information technology in organizations or enterprises. A meta-analysis of the articles was conducted to identify the factors driving or pulling entrepreneurs to use HIT.

Keywords: health information technology, health entrepreneurship, health enterprise, health entrepreneurs' innovation

Procedia PDF Downloads 99

Authors: Mihika Shivkumar, Krishna Kumar, C. Perisamy

Abstract:

3D printing is a method of manufacturing wherein materials, such as plastic or metal, are deposited in layers one on top of the other to produce a three dimensional object. 3D printing is most commonly associated with creating engineering prototypes. However, its applications in the field of human health care have been frequently disregarded. Medical applications for 3D printing are expanding rapidly and are envisaged to revolutionize health care. Medical applications for 3D printing, both present and its potential, can be categorized broadly, including: creation of customized prosthetics tissue and organ fabrication; creation of implants, and anatomical models and pharmaceutical research regarding drug dosage forms. This piece breaks down bioprinting in the healthcare sector. It focuses on the better subtle elements of every particular point, including how 3D printing functions in the present, its impediments, and future applications in the health care sector.

Keywords: bio-printing, prototype, drug delivery, organ regeneration

Procedia PDF Downloads 262

Authors: Berit Johannessen

Abstract:

Introduction: Depression and dementia are the two most common psychiatric disorders of older people. The use of antidepressants does not always have the desired effect and serious side effects are common. Aroma therapists claim that the essential oil of Bergamot has an antidepressant effect. Aromatherapy is defined as holistic or complementary medicine and is rarely used in the Norwegian public health service, but in recent years, there has been an increasing interest in, and use of complementary and alternative therapies (CAM) in the Norwegian population, and aromatherapy is one of the most widely used. Focus for this study: How do nurses experience the use of Bergamot essential oil for patients suffering from dementia and depression? Method: Action research study including 12 patients and 8 nurses. The patients were strategically selected by the nurses and were given Bergamot in a fan diffuser every day for 12 weeks. The patients' mood and behavior patterns were reported daily and the nurse`s experiences were reported weekly. Individual interviews with the nurses were conducted at the end of the project. Results: The nurses reported that bergamot had positive impact on patients mood and wellbeing, and was considered as an effective method for six patients, four had uncertain effect and two had no effect. They also reported less use of medication and that the fan diffusers were easy and pleasant to administer. They found the use of natural remedies as Bergamot inspiring and wanted to learn more about aromatherapy and its use in nursing. Some were disturbed by the smell and some had to deal with critical and negative colleagues. Conclusion: Nurses experienced aromatherapy using bergamot oil in fan diffusers as a simple and useful procedure for patients suffering from dementia and depression. The effects were varying. Further research is needed.

Keywords: aromatherapy, bergamot, dementia, depression

Procedia PDF Downloads 240

Authors: Ruth Green, Samantha Milton, Rinal Desai

Abstract:

Background/Aims: Eye pain/swelling/redness is a common presentation to Barnet General Hospital (a district general hospital), pediatric emergency department, and is managed by both the pediatric and emergency teams. The management of each child differs dramatically depending on the healthcare professional who reviews them. There also appears to be confusion in diagnosis between periorbital cellulitis, pre-septal cellulitis, and orbital cellulitis. Pre septal cellulitis refers to an inflammation of the eyelids and soft tissue anterior to the orbital septum. In contrast, orbital cellulitis is a serious, rapidly progressive infection of soft tissues located posterior to the orbital septum. Pre-septal cellulitis is more prevalent and less serious than orbital cellulitis, although it may be part of a continuous spectrum if untreated. Pre-septal cellulitis should there be diagnosed and treated urgently to prevent spread to the septum. For the purpose of the audit, the term periorbital cellulitis has been used as an umbrella term for all spectrums of this infection. The audit aimed to look at, how as a whole, the department is diagnosing and managing orbital and pre-septal cellulitis. Gold Standard: Patients of the same age and diagnosis should be treated with the same medication, advice, and follow-up. Method: Data was collected retrospectively from pediatric patients ( < 18years) who attended the emergency department from June 2019 to February 2020 who had been coded as pre-septal cellulitis, periorbital cellulitis, orbital cellulitis, or eye pain/swelling/redness. Demographics, signs and symptoms, management, and follow-up were recorded for all patients with any of the diagnoses of pre-septal, periorbital, or orbital cellulitis. A Microsoft Excel spreadsheet was used to record the anonymised data. Results: There were vast discrepancies in the diagnosis, management, and follow-up of patients with periorbital cellulitis. Conclusion/Discussion: The audit concluded there is no uniform approach to managing periorbital cellulitis in Barnet General Hospital Paediatric Emergency Department. Healthcare professionals misdiagnosed conjunctivitis as periorbital cellulitis, and adequate steps did not appear to be documented on excluding red flag signs and symptoms of patients presenting. There was no consistency in follow-up, with some patients having timely phone reviews or clinical reviews for mild symptoms. Advice given by the staff was appropriate, and patients did return when symptoms got worse and were treated accordingly. Plan: Given the inconsistency, a gold standard care pathway or local easily accessible clinical guideline can be developed to help with the diagnosis and management of periorbital cellulitis. Along with this, a teaching session can be carried out for the staff of the pediatric team and emergency department to disseminate the teaching. Following the introduction of a guideline and teaching sessions, patients notes can be re-reviewed to check improvement in patient care.

Keywords: periorbital cellulitis, preseptal cellulitis, orbital cellulitis, erythematous eyelid

Procedia PDF Downloads 115

Authors: Guangtong Xu, Yi He

Abstract:

Like most historic and cultural cities in China, the historic urban area of Jingmen city is facing a typical spatial problem of fragmentation and fuzzification. This study focuses on exploring a method for evaluating the existing values of historic urban area based on spatial prototype, a concept introduced into urban morphology from 'Archetype' in architectural typology. As the spatial elements and built-up relationship of historic city, spatial prototype has habitual structural characteristics and formal modulus. It is the inherent logic and order rules behind the scattered historic environment, providing a clue to understand the spatial characteristics and a basis for guiding the construction and conservation in historic urban areas. Three criteria, the resolution of historical elements, the completeness of historical structure and the renewal potential of associated land, were selected to construct the integrated assessment system. These three dimensions are linked to the spatial prototype and its constituent elements, as well as the transformation relationship in ancient and present day. The results showed that historic urban areas have changed from a holistic city to different existing types dominated by their historic structure elements. It is necessary to improve the pertinence of planning strategies and develop diversified management measures in the conservation scope of historic urban area. Moreover, a constructive-conservation strategy should be put forward to enhance the integrity of historic urban area based on the trace of spatial prototype and evaluation results.

Keywords: constructive conservation, existing value, historic urban area, spatial prototype

Procedia PDF Downloads 152

Authors: Bu Kyung Park

Abstract:

Background: The survival rate of pediatric cancer patients has been increased. Thus, the needs of long-term management and follow-up education after discharge continue to grow. Purpose: The purpose of this study was to explore the experiences of pediatric cancer patients and their families from first diagnosis to returning their social life. The ultimate goal of this study was to assess which information and intervention did pediatric cancer patients and their families required and needed, so that this could provide fundamental information for developing educational content of web-based intervention program for pediatric cancer patients. Research Approach: This study was based on a descriptive qualitative research design using semi-structured focus group interview. Participants: Twelve pediatric cancer patients and 12 family members participated in a total six focus group interview sessions. Methods: All interviews were audiotaped after obtaining participants’ approval. The recordings were transcribed. Qualitative Content analysis using the inductive coding approach was performed on the transcriptions by three coders. Findings: Eighteen categories emerged from the six main themes: 1) Information needs, 2) Support system, 3) Barriers to treatment, 4) Facilitators to treatment, 5) Return to social life, 6) Healthcare system issues. Each theme had both pediatric cancer patients’ codes and their family members’ codes. Patients and family members had high information needs through the whole process of treatment, not only the first diagnosis but also after completion of treatment. Hospitals provided basic information on chemo therapy, medication, and various examinations. However, they were more likely to rely on information from other patients and families by word of mouth. Participants’ information needs were different according to their treatment stage (e.g., first admitted patients versus cancer survivors returning to their social life). Even newly diagnosed patients worried about social adjustment after completion of all treatment, such as return to school and diet and physical activity at home. Most family members had unpleasant experiences while they were admitted in hospitals and concerned about healthcare system issues, such as medical error and patient safety. Conclusions: In conclusion, pediatric cancer patients and their family members wanted information source which can provide tailored information based on their needs. Different information needs with patients and their family members based on their diagnosis, progress, stage of treatment were identified. Findings from this study will be used to develop a patient-centered online health intervention program for pediatric cancer patients. Pediatric cancer patients and their family members had variety fields of education needs and soak the information from various sources. Web-based health intervention program for them is required to satisfy their inquiries to provide reliable information.

Keywords: focus group interview, family caregivers, pediatric cancer patients, qualitative content analysis

Procedia PDF Downloads 176

Authors: Teresa Azevedo PerdicoúLis, Paulo Lopes Dos Santos

Abstract:

The conceptualisation of the problem of network optimisation as a noncooperative game sets up a holistic interactive approach that brings together different network features (e.g., com-pressor stations, sources, and pipelines, in the gas context) where the optimisation objectives are different, and a single optimisation procedure becomes possible without having to feed results from diverse software packages into each other. A mathematical model of this type, where independent entities take action, offers the ideal modularity and subsequent problem decomposition in view to design a decentralised algorithm to optimise the operation and management of the network. In a game framework, compressor stations and sources are under-stood as players which communicate through network connectivity constraints–the pipeline model. That is, in a scheme similar to tatonnementˆ, the players appoint their best settings and then interact to check for network feasibility. The devolved degree of network unfeasibility informs the players about the ’quality’ of their settings, and this two-phase iterative scheme is repeated until a global optimum is obtained. Due to network transients, its optimisation needs to be assessed at different points of the control interval. For this reason, the proposed approach to optimisation has two stages: (i) the first stage computes along the period of optimisation in order to fulfil the requirement just mentioned; (ii) the second stage is initialised with the solution found by the problem computed at the first stage, and computes in the end of the period of optimisation to rectify the solution found at the first stage. The liability of the proposed scheme is proven correct on an abstract prototype and three example networks.

Keywords: connectivity matrix, gas network optimisation, large-scale, noncooperative game, system decomposition

Procedia PDF Downloads 140

Authors: Nicolas Haber

Abstract:

The study addresses the design process of integrated product-service offerings as a measure of answering environmental sustainability concerns by replacing stand-alone physical artefacts with comprehensive solutions relying on functional results rather than conventional product sales. However, views regarding this transformation are dissimilar and differentiated: The study discusses the importance and requirements of product-service systems before analysing the theoretical studies accomplished in the extent of their design and development processes. Based on this, a framework, built on a design science approach, is proposed, where the distinct approaches from the literature are merged towards a unified structure serving as a generic methodology to designing product-service systems. Each stage of this model is then developed to present a holistic design proposal called the Functional Engineered Product-Service System (FEPSS) model. Product-service systems are portrayed as customisable solutions tailored to specific settings and defined circumstances. Moreover, the approaches adopted to guide the design process are diversified. A thorough analysis of the design strategies and development processes however, allowed the extraction of a design backbone, valid to varied situations and contexts whether they are product-oriented, use-oriented or result-oriented. The goal is to guide manufacturers towards an eased adoption of these integrated offerings, given their inherited environmental benefits, by proposing a robust all-purpose design process.

Keywords: functional product, integrated product-service offerings, product-service systems, sustainable design

Procedia PDF Downloads 282

Authors: Dalia Suša Vugec

Abstract:

Business process management (BPM) is widely used approach focused on designing, mapping, changing, managing and analyzing business processes of an organization, which eventually leads to better performance and derives many other benefits. Since every organization strives to improve its performance in order to be sustainable and to remain competitive on the market in long-term period, numerous organizations are nowadays adopting and implementing BPM. However, not all organizations are equally successful in that. One of the ways of measuring BPM success is by measuring its maturity by calculating Process Performance Index (PPI) using ten BPM success factors. Still, although BPM is a holistic concept, organizational culture is not taken into consideration in calculating PPI. Hence, aim of this paper is twofold; first, it aims to explore and analyze the current state of BPM success factors within the big organizations from Slovenia, Croatia, and Austria and second, it aims to analyze the structure of organizational culture within the observed companies, focusing on the link with BPM success factors as well. The presented study is based on the results of the questionnaire conducted as the part of the PROSPER project (IP-2014-09-3729) and financed by Croatian Science Foundation. The results of the questionnaire reveal differences in the achieved levels of BPM success factors and therefore BPM maturity in total between the three observed countries. Moreover, the structure of organizational culture across three countries also differs. This paper discusses the revealed differences between countries as well as the link between organizational culture and BPM success factors.

Keywords: business process management, BPM maturity, BPM success factors, organizational culture, process performance index

Procedia PDF Downloads 108

Authors: Olubiyi Johnson Ezekiel

Abstract:

Basic science curriculum is an on-going effort towards developing the potential of manner to produce individuals in a holistic and integrated person, who are intellectually, spiritually, emotionally and physically balanced and harmonious. The main focus of this study is to determine the relationship between students’ achievement in junior school certificate examination (JSCE) and senior school basic science achievement test (SSBSAT) on the basis of all the components of basic science. The study employed the descriptive research of the survey type and utilized junior school certificate examination and senior school basic science achievement test(r = .87) scores as instruments. The data collected were subjected to Pearson product moment correlation, Spearman rank correlation, regression analysis and analysis of variance. The result of the finding revealed that the mean effects of the achievement in all the components of basic science on SSBSAT are significantly different from zero. Based on the results of the findings, it was concluded that the relationship between students’ achievement in JSCE and SSBSAT was weak and to achieve a unit increase in the students’ achievement in the SSBSAT when other subjects are held constant, we have to increase the learning of: -physics by 0.081 units; -chemistry by 0.072 units; -biology by 0.025 units and general knowledge by 0.097 units. It was recommended among others, that general knowledge aspect of basic science should be included in either physics or chemistry aspect of basic science.

Keywords: basic science curriculum, students’ achievement, science test, secondary school students

Procedia PDF Downloads 433

Authors: Md. Shakhawat Ullah Chowdhury

Abstract:

Mobile school is an innovative methodology in non-formal education to increase access to education for children during conflict through theatre for education for appropriate basic education to children during conflict. The continuous exposure to harsh environments and the nature of the lifestyles of children in conflict make them vulnerable. However, the mobile school initiative takes into consideration the mobile lifestyle of children in conflict. Schools are provided considering the pocket area of the street children with portable chalkboards, tin of books and materials as communities move. Teaching is multi-grade to ensure all children in the community benefit. The established mobile schools, while focused on basic literacy and numeracy skills according to traditions of the communities. The school teachers are selected by the community and trained by a theatre activist. These teachers continue to live and move with the community and provide continuous education for children in conflict. The model proposed a holistic team work to deliver education focused services to the street children’s pocket area where the team is mobile. The team consists of three members –an educator (theatre worker), a psychological counsellor and paramedics. The mobile team is responsible to educate street children and also play dramas which specially produce on the basis of national curriculum and awareness issues for street children. Children enjoy play and learn about life skills and basic literacy and numeracy skills which may be a pillar of humanitarian aid during conflict.

Keywords: vulnerable, children in conflict, mobile schooling, child-friendly

Procedia PDF Downloads 416

Authors: Amanda Madden

Abstract:

The purpose of this research was to identify students understanding of well-being and perceptions of the effective components of school-based well-being programs they have participated in during their time in secondary school. With one in four adolescents suffering from some form of mental health disorder, which has the potential to directly impact their academic ability, schools have moved towards a more holistic approach to education, resulting in the growth of school-based well-being programs. There is limited research on the effectiveness of school-based well-being programs, with fewer studies examining students’ perspectives on their well-being. A mixed-method design was utilized, framed by a social constructivist methodology. Quantitative data was collected through a researcher-developed self-report survey, and qualitative data were collected through one-on-one interviews and a semi-structured focus group undertaken with Year 12 students from three independent co-educational schools in Western Australia. Preliminary findings indicate that participants have experienced a minimal impact, either positively or negatively, on their well-being from school-based well-being programs. The data detailed that adolescents consider happiness, positive attitude, good physical health, balance, emotional fulfillment and confidence components of well-being. The findings also highlighted sports, positive family relationships, positive friendships, and pets positively enhanced well-being. This research suggests that researchers and educational leaders should consider students’ understanding of well-being in the development of school-based well-being assessments and interventions. Students are the recipients of school-based well-being programs and are best placed to inform what they will and will not respond to in the determination of appropriate well-being content.

Keywords: wellbeing, school based wellbeing, adolescents, wellbeing interventions

Procedia PDF Downloads 60

Authors: Ilham Zaidi, P. Sankara Sarma, Quazi Taufique Ahmed, V. Raman Kutty, Khalid Umer Khayyam, Gurpreet Singh, Abhishek Royal

Abstract:

Introduction: Tuberculosis is a global public health emergency, but it is particularly acute in India, which has the world's highest tuberculosis burden. Due to overpopulation, lack of sanitation, malnutrition, low living standards, and poor socioeconomic status, among other factors, it is India's most common infectious disease. The long period of treatment is one of the main reasons for considering it as a public health emergency. Consequently, there is an increase in patient noncompliance, which leads to treatment failure, adverse treatment outcomes, and deaths. This could lead to the growth of anti-TB drug resistance. According to the WHO, approximately 558 thousand new cases of Multi-Drug Resistance Tuberculosis were diagnosed worldwide, with 8.5 percent developed Extensively Drug Resistance Tuberculosis. Methodology: This study is a program-based cross-sectional descriptive survey of adult tuberculosis patients enrolled in the Delhi-based Revised National Tuberculosis Program. The study setting was 27 NTEP districts of Delhi. (N=65,893) and Sample size- was 200; the sampling method which is used in the study was the systemic random sampling method. Results: Most of the demographic factors (age, gender, residence, and family type) were not significantly associated with adherence; marital status was found statistically significant with the treatment compliance. Hesitation while telling people about the disease and motivation to strictly follow drug schedule by healthcare workers were other factors where a significant association with drug adherence was observed. The study findings also suggest that provision of food, minimal financial and other moral support from family, counseling, discussion and politeness by healthcare providers might also facilitate adherence. Discussion and Conclusions: For TB treatment, adherence, age, sex, socioeconomic status, types of accommodations, malnutrition, and personal hygiene should all be considered; similar results were observed in previous studies. In the care of TB patients, DOTS services, health workers, and family support play a significant role. According to the country's National Strategic Plan, the Indian government has set a goal of eliminating tuberculosis by 2025 and patients' compliance with TB care and treatment adherence is very crucial to achieve this aim. A cohort study will be able to give a better understanding of factors associated with adherence since this study may have missed some defaulters who were absconding and could not be reached. Important Terms: RNTCP, NTEP, DOTS, DS-TB, DR-TB, RR-TB, MDR-TB, XDR-TB, Treatment failure, Treatment relapse, Treatment adherence.

Keywords: treatment adherence, treatment relapse, treatment failure, drug resistance tuberculosis

Procedia PDF Downloads 189

Authors: Ju-Chun Chien

Abstract:

Rapid aging and depopulation could lead to serious problems, including workforce shortages and health expenditure costs. The current and predicted future LTC workforce shortages could be a real threat to Taiwan’s society. By means of comparison of data from 144 nursing aide trainees and 727 general public, the main purpose of the present study was to determine whether there were any notable differences between the two groups toward engaging in LTC services. Moreover, this study focused on recognizing the attributes of the general public who had the willingness to take LTC jobs but continue to ride the fence. A self-developed questionnaire was designed based on Ajzen’s Theory of Planned Behavior model. After conducting exploratory factor analysis (EFA) and reliability analysis, the questionnaire was a reliable and valid instrument for both nursing aide trainees and the general public. The main results were as follows: Firstly, nearly 70% of nursing aide trainees showed interest in LTC jobs. Most of them were middle-aged female (M = 46.85, SD = 9.31), had a high school diploma or lower, had unrelated work experience in healthcare, and were mostly unemployed. The most common reason for attending the LTC training program was to gain skills in a particular field. The second most common reason was to obtain the license. The third and fourth reasons were to be interested in caring for people and to increase income. The three major reasons that might push them to leave LTC jobs were physical exhaustion, payment is bad, and being looked down on. Secondly, the variables that best-predicted nursing aide trainees’ intention to engage in LTC services were having personal willingness, perceived behavior control, with high school diploma or lower, and supported from family and friends. Finally, only 11.80% of the general public reported having interest in LTC jobs (the disapproval rating was 50% for the general public). In comparison to nursing aide trainees who showed interest in LTC settings, 64.8% of the new workforce for LTC among the general public was male and had an associate degree, 54.8% had relevant healthcare experience, 67.1% was currently employed, and they were younger (M = 32.19, SD = 13.19) and unmarried (66.3%). Furthermore, the most commonly reason for the new workforce to engage in LTC jobs were to gain skills in a particular field. The second priority was to be interested in caring for people. The third and fourth most reasons were to give back to society and to increase income, respectively. The top five most commonly reasons for the new workforce to quitting LTC jobs were listed as follows: physical exhaustion, being looked down on, excessive working hours, payment is bad, and excessive job stress.

Keywords: long-term care services, nursing aide trainees, Taiwanese people, theory of planned behavior

Procedia PDF Downloads 145

Authors: Pablo Cardozo Herrera

Abstract:

In a dynamic market of Information Technology (IT) Service and with high quality demands and high performance requirements in decreasing costs, it is imperative that IT companies invest organizational effort in order to increase the effectiveness of their Information Technology Service Management (ITSM) processes through the improvement of ITSM project management and through solid support to the strategic decision-making process of IT directors. In this article, the author presents an analysis of common issues of IT companies around the world, with strategic needs of information unmet that provoke their ITSM processes and projects management that do not achieve the effectiveness and efficiency expected of their results. In response to the issues raised, the author proposes a framework consisting of an innovative theoretical framework model of ITSM management and a technological solution aligned to the Information Technology Infrastructure Library (ITIL) good practices guidance and ISO/IEC 20000-1 requirements. The article describes a research that proves the proposed framework is able to integrate, manage and coordinate in a holistic way, measurable and auditable, all ITSM processes and projects of IT organization and utilize the effectiveness assessment achieved for their strategic decision-making process increasing the process maturity level and improving the capacity of an efficient management.

Keywords: innovation in IT services, ITSM processes, ITIL and ISO/IEC 20000-1, IT service management, IT service excellence

Procedia PDF Downloads 380

Authors: Bindu Shrestha, Sudarshan R. Tiwari, Sushil B. Bajracharya

Abstract:

Urban household cooking fuel choice is highly influenced by human behavior and energy culture parameters such as cognitive norms, material culture and practices. Although these parameters have a leading role in Kathmandu for cleaner households, they are not incorporated in the city’s energy policy. This paper aims to identify trade-offs to transform resident behavior in cooking pattern towards cleaner technology from the questionnaire survey, observation, mapping, interview, and quantitative analysis. The analysis recommends implementing a Collaborative Cultural Model (CCM) for changing impact on the neighborhood from the policy level. The results showed that each household produces 439.56 kg of carbon emission each year and 20 percent used unclean technology due to low-income level. Residents who used liquefied petroleum gas (LPG) as their cooking fuel suffered from an energy crisis every year that has created fuel hoarding, which ultimately creates more energy demand and carbon exposure. In conclusion, the carbon emission can be reduced by improving the residents’ energy consumption culture. It recommended the city to use holistic action of changing habits as soft power of collaboration in two-way participation approach within residents, private sectors, and government to change their energy culture and behavior in policy level.

Keywords: energy consumption pattern, collaborative cultural model, energy culture, fuel stacking

Procedia PDF Downloads 126

Authors: Badr Eddine Lebrouhi, Melissa Lopez Viveros, Silvia De Los Santos, Kolthoum Missaoui, Pamela Ramirez Vidal

Abstract:

Since the Paris Climate Agreement, numerous countries, including France, have committed to achieving carbon neutrality by 2050 by enhancing renewable energy capacity and decarbonizing various sectors, including aviation. In this way, the Occitanie region aspires to become a renewable energy pioneer and has focused on Toulouse's Blagnac airport—a prominent hub characterized by high-energy demands. As part of a holistic strategy to reduce the airport's energy dependency, green hydrogen has emerged as a promising alternative fuel, offering the potential to significantly enhance aviation's environmental sustainability. This study assesses the technical and economic aspects of green hydrogen production, particularly its potential to replace fossil kerosene in aviation at Toulouse-Blagnac airport. It analyzes future liquid hydrogen fuel demand, calculates energy requirements for electrolysis and liquefaction, considers diverse renewable energy scenarios, and assesses the Levelized Cost of Hydrogen (LCOH) for economic viability. The research also projects LCOH evolution from 2023 to 2050, offering a comprehensive view of green hydrogen's feasibility as a sustainable aviation fuel, aligning with the region's renewable energy and sustainable aviation objectives.

Keywords: Toulouse-Blagnac Airport, green hydrogen, aviation decarbonization, electrolysis, renewable energy, technical-economic feasibility

Procedia PDF Downloads 48

Authors: A. A. AlRasheed, A. Atkins, R. Campion

Abstract:

This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: knowledge management, improvements, visualisation, workflow

Procedia PDF Downloads 259

Authors: Jo Parsons, Cath Grimley, Debra Bick, Sarah Hillman, Louise Clarke, Helen Atherton

Abstract:

The problem: Vaccinations are routinely offered to pregnant women in the UK for influenza (flu), pertussis (whooping cough), and COVID-19, yet the uptake of these vaccinations in pregnancy remains low. Pregnant women are at increased risk of hospitalisation, morbidity, and mortality from these preventable illnesses, which can also expose their unborn babies to an increased risk of serious complications, including in utero death. This research aims to explore how pregnant women feel about vaccinations offered during pregnancy (flu, whooping cough, and COVID-19), particularly following the COVID-19 pandemic. It also aims to examine factors influencing women’s decisions about vaccinations during pregnancy and how they feel about their health and vulnerabilities to illness arising from the COVID-19 pandemic. The approach: This is a qualitative study involving semi-structured interviews with pregnant women and midwives in the UK. Interviews with pregnant women explored their views since the COVID-19 pandemic about vaccinations offered during pregnancy and whether the pandemic has influenced perceptions of vulnerability to illness in pregnant women. Interviews with midwives explored vaccination discussions they routinely have with pregnant women and identified some of the barriers to vaccination that pregnant women discuss with them. Pregnant women were recruited via participating hospitals and community groups. Midwives were recruited via participating hospitals and midwife-specific social media groups. All interviews were conducted remotely (using telephone or Microsoft Teams) and analysed using thematic analysis. Findings: 43 pregnant women and 16 midwives were recruited and interviewed. The findings presented will focus on data from pregnant women. Pregnant women reported a wide range of views and vaccination behaviour, and identified several factors influencing their decision whether to accept vaccinations or not. These included internal factors (comprised of beliefs about susceptibility to illness, perceptions of immunity, fear, and feelings of responsibility), other influences (including visibility of illness and external influences such as healthcare professional recommendations), vaccination-related factors (comprised of beliefs about effectiveness and safety of vaccinations, availability and accessibility of vaccinations and preferences for alternative forms of protection to vaccination) and COVID-19 specific factors (including COVID-19 vaccinations and COVID-19 specific influences). Implications: Findings identified some of the factors that affect pregnant women’s decisions when deciding to have a vaccination or not and how these decisions have been influenced by COVID-19. Findings highlight areas where healthcare professional advice needs to focus, such as the provision of information about the increased vulnerability to illnesses during pregnancy and consideration of opportunistic vaccination at hospital appointments to maximise uptake of vaccinations during pregnancy. Findings of this study will inform the development of an intervention to increase vaccination uptake amongst pregnant women.

Keywords: vaccination, pregnancy, qualitative, interviews, COVID-19

Procedia PDF Downloads 79

Authors: Zahra Hamedani, Ebrahim Solgi, Henry Skates, Gillian Isoardi

Abstract:

Daylighting plays a pivotal role in promoting productivity and user satisfaction in office spaces. There is an ongoing trend in designing office buildings with a high proportion of glazing which relatively increases the risk of high visual discomfort. Providing a more realistic lighting analysis can be of high value at the early stages of building design when necessary changes can be made at a very low cost. This holistic approach can be achieved by incorporating subjective evaluation and user behaviour in computer simulation and provide a comprehensive lighting analysis. In this research, a detailed computer simulation model has been made using Radiance and Daysim. Afterwards, this model was validated by measurements and user feedback. The case study building is the school of science at Griffith University, Gold Coast, Queensland, which features highly glazed office spaces. In this paper, the visual comfort predicted by the model is compared with a preliminary survey of the building users to evaluate how user behaviour such as desk position, orientation selection, and user movement caused by daylight changes and other visual variations can inform perceptions of visual comfort. This work supports preliminary design analysis of visual comfort incorporating the effects of gaze shift patterns and views with the goal of designing effective layout for office spaces.

Keywords: lighting simulation, office buildings, user behaviour, validation, visual comfort

Procedia PDF Downloads 197

Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

Abstract:

Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

Procedia PDF Downloads 86

Authors: Han Guan Chew, Keith Yong Ngee Ng, Shan-Wei Fan

Abstract:

In Singapore, talent retention is one of the most persistent and real issue companies have to grapple with due to the tight labour market. Being resource-scarce, Singapore depends solely on its talented pool of high quality human resource to sustain its competitive advantage in the global economy. But the complex and multifaceted nature of turnover phenomenon makes the prescription of effective talent retention strategies in such a competitive labour market very challenging, especially when it comes to monetary incentives, companies struggle to answer the question of “How much is enough?” By examining the interactive effects of perceived alternative employment opportunities, annual salary and satisfaction with compensation on the turnover intention of 102 Singapore Professionals, Managers, Executives and Technicians (PMET) through correlation analyses and multiple regressions, important insights into the psyche of the Singapore talent pool can be drawn. It is found that annual salary influence turnover intention indirectly through mediation and moderation effects on PMET’s satisfaction on compensation. PMET are also found to be heavily swayed by better external opportunities. This implies that talent retention strategies should not adopt a purely monetary based blanket approach but rather a comprehensive and holistic one that considers the dynamics of prevailing market conditions.

Keywords: employee turnover, high performers, knowledge workers, perceived alternative employment opportunities salary, satisfaction on compensation, Singapore PMET, talent retention

Procedia PDF Downloads 275

Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

Abstract:

Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

Procedia PDF Downloads 402

Authors: Mimi Roy, Sriroop Chaudhuri

Abstract:

Sustainable water supply is among the basic needs for human development, especially in the rural areas of the developing nations where safe water supply and basic sanitation infrastructure is direly needed. In light of the above, we propose a simple methodology to develop a composite water sustainability index (WSI) to assess the collective performance of the existing rural water supply services (RWSS) in India over time. The WSI will be computed by summarizing the details of all the different varieties of water supply schemes presently available in India comprising of 40 liters per capita per day (lpcd), 55 lpcd, and piped water supply (PWS) per household. The WSI will be computed annually, between 2010 and 2016, to elucidate changes in holistic RWSS performances. Results will be integrated within a robust geospatial framework to identify the ‘hotspots’ (states/districts) which have persistent issues over adequate RWSS coverage and warrant spatially-optimized policy reforms in future to address sustainable human development. Dataset will be obtained from the National Rural Drinking Water Program (NRDWP), operating under the aegis of the Ministry of Drinking Water and Sanitation (MoDWS), at state/district/block levels to offer the authorities a cross-sectional view of RWSS at different levels of administrative hierarchy. Due to simplistic design, complemented by spatio-temporal cartograms, similar approaches can also be adopted in other parts of the world where RWSS need a thorough appraisal.

Keywords: rural water supply services, piped water supply, sustainability, composite index, spatial, drinking water

Procedia PDF Downloads 287

Authors: Arnab Adhikari, Arnab Bisi

Abstract:

Since the inception, the fashion apparel supply chain is facing the problem of high demand uncertainty. Often the demand volatility compels the corresponding supply chain member to incur substantial holding cost and opportunity cost in case of the overproduction and the underproduction scenario, respectively. It leads to an uncoordinated fashion apparel supply chain. There exist several scholarly works to achieve coordination in the fashion apparel supply chain by employing the different contracts such as the buyback contract, the revenue sharing contract, the option contract, and so on. Specially, the application of option contract in the apparel industry becomes prevalent with the changing global scenario. Exploration of existing literature related to the option contract reveals that most of the research works concentrate on the one direction demand adjustment i.e. either to match the demand upwards or downwards. Here, we present a holistic approach to coordinate a dyadic fashion apparel supply chain comprising one manufacturer and one retailer with the help of bidirectional option contract. We show a combination of wholesale price contract and bidirectional option contract can coordinate the under expanded supply chain. We also propose a framework that captures the variation of the apparel retailer’s order quantity and the apparel manufacturer’s production quantity with the changing exercise price for the different ranges of the option price. We analytically explore that corresponding cost parameters of the supply chain members along with the nature of demand distribution play an instrumental role in the coordination as well as the retailer’s ordering decision.

Keywords: fashion apparel supply chain, supply chain coordination, wholesale price contract, bidirectional option contract

Procedia PDF Downloads 433

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

Abstract:

Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

Procedia PDF Downloads 358

Authors: Jurijs Salijevs, Katrina Bolocko

Abstract:

The integration of artificial intelligence and neural networks has significantly changed full-body imaging and high-resolution 3D mapping systems, and this paper reviews research in these areas. With an emphasis on their use in the early identification of melanoma and other disorders, the goal is to give a wide perspective on the current status and potential future of these medical imaging technologies. Authors also examine methodologies such as machine learning and deep learning, seeking to identify efficient procedures that enhance diagnostic capabilities through the analysis of 3D body scans. This work aims to encourage further research and technological development to harness the full potential of AI in disease diagnosis.

Keywords: artificial intelligence, neural networks, 3D scan, body scan, 3D mapping system, healthcare

Procedia PDF Downloads 83

Authors: Dessy Arumsari, Ais Assana Athqiya, Mulyaminingrum

Abstract:

Healthcare in remote areas is one of the major concerns in Indonesia. Building hospitals in a nation of 18.000 islands with a larger-than-life bureaucracy and problems with corruption, a critical shortage of qualified medical professionals and well-heeled patients resigned to traveling abroad for health care is a hard feat to accomplish. To assuring that all populations have access to appropriate and cost-effective care, a new solution to tackle this problem is with the presence of RV Car Clinic. This car has a concept such as a walking hospital that provides health facilities inside it. All of the health professionals who work in RV Car Clinic will do the rotation for a year in order to the equitable distribution of health workers. We need to advocate the policy makers to help realize RV Car Clinic in remote areas. Health services can be disseminated by the present of RV Car Clinic. Summarily, the local communities can get cost effectively because RV Car Clinic will come to their place and serve the health services.

Keywords: health policy, health professional, remote areas, RV Car Clinic

Procedia PDF Downloads 277