Search results for: electronic health records (ehrs)

Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

Procedia PDF Downloads 191

Authors: Daniel F. Bohorquez, Luis M. Agudelo, Henry H. León

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Heart rate variability (HRV) is defined as the temporary variation between heartbeats or RR intervals (distance between R waves in an electrocardiographic signal). This distance is currently a recognized biomarker. With the analysis of the distance, it is possible to assess the sympathetic and parasympathetic nervous systems. These systems are responsible for the regulation of the cardiac muscle. The analysis allows health specialists and researchers to diagnose various pathologies based on this variation. For the acquisition and analysis of HRV taken from a cardiac electrical signal, electronic equipment and analysis software that work independently are currently used. This complicates and delays the process of interpretation and diagnosis. With this delay, the health condition of patients can be put at greater risk. This can lead to an untimely treatment. This document presents a single portable device capable of acquiring electrocardiographic signals and calculating a total of 19 HRV metrics. This reduces the time required, resulting in a timelier intervention. The device has an electrocardiographic signal acquisition card attached to a microcontroller capable of transmitting the cardiac signal wirelessly to a mobile device. In addition, a mobile application was designed to analyze the cardiac waveform. The device calculates the RR and different metrics. The application allows a user to visualize in real-time the cardiac signal and the 19 metrics. The information is exported to a cloud database for remote analysis. The study was performed under controlled conditions in the simulated hospital of the Universidad de la Sabana, Colombia. A total of 60 signals were acquired and analyzed. The device was compared against two reference systems. The results show a strong level of correlation (r > 0.95, p < 0.05) between the 19 metrics compared. Therefore, the use of the portable system evaluated in clinical scenarios controlled by medical specialists and researchers is recommended for the evaluation of the condition of the cardiac system.

Keywords: biological signal análisis, heart rate variability (HRV), HRV metrics, mobile app, portable device.

Procedia PDF Downloads 184

Authors: K. N. Dinesh Babu

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In this paper, the protection of a complicated bus arrangement with a dual bus coupler and bus sectionalizer using low impedance differential protection applicable for very high voltages like 220kV and 400kV is discussed. In many power generation stations, several operational procedures are implemented to utilize the transfer bus as the main bus and to facilitate the maintenance of circuit breakers and current transformers (in each section) without shutting down the bay(s). Owing to this fact, the complications in operational philosophy have thrown challenges for the bus bar protection implementation. Many bus topologies allow any one of the main buses available in the station to be used as an auxiliary bus. In such a system, pre-defined precautions and procedures are made as guidelines, which are followed before assigning any bus as an auxiliary bus. The procedure involves shifting of links, changing rotary switches, insertion of test block, and so on, thereby causing unreliable operation. This kind of unreliable operation or inadvertent procedural lapse may result in the isolation of the bus bar from the grid due to the unpredictable operation of the bus bar protection relay, which is a commonly occurring phenomenon due to manual mistakes. With the sophisticated configuration and implementation of logic in modern intelligent electronic devices, the operator is free to select the transfer arrangement without sacrificing the protection required by a bus differential system for a reliable operation, and labor-intensive processes are completely eliminated. This paper deals with the procedure to test the security logic for such special scenarios using Megger make SMRT, bus bar protection relay to assure system stability and get rid of all the specific operational precautions/procedure.

Keywords: bus bar protection, by-pass isolator, blind spot, breaker failure, intelligent electronic device, end fault, bus unification, directional principle, zones of protection, breaker re-trip, under voltage security, smart megger relay tester

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Authors: Saeed Ullah Jan, Shaukat Ullah

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Purpose of the study: The main theme of this study is to explore the information literacy skills of the law practitioners in Khyber Pakhtunkhwa-Pakistan under the heading "Information Literacy Skills of Legal Practitioners in Khyber Pakhtunkhwa-Pakistan: An Empirical Study." Research Method and Procedure: To conduct this quantitative study, the simple random sample approach is used. An adapted questionnaire is distributed among 254 lawyers of Dera Ismail Khan through personal visits and electronic means. The data collected is analyzed through SPSS (Statistical Package for Social Sciences) software. Delimitations of the study: The study is delimited to the southern district of Khyber Pakhtunkhwa: Dera Ismael Khan. Key Findings: Most of the lawyers of District Dera Ismail Khan of Khyber Pakhtunkhwa can recognize and understand the needed information. A large number of lawyers are capable of presenting information in both written and electronic forms. They are not comfortable with different legal databases and using various searching and keyword techniques. They have less knowledge of Boolean operators for locating online information. Conclusion and Recommendations: Efforts should be made to arrange refresher courses and training workshops on the utilization of different legal databases and different search techniques for retrieval of information sources. This practice will enhance the information literacy skills of lawyers, which will ultimately result in a better legal system in Pakistan. Practical implication(s): The findings of the study will motivate the policymakers and authorities of legal forums to restructure the information literacy programs to fulfill the lawyers' information needs. Contribution to the knowledge: No significant work has been done on the lawyers' information literacy skills in Khyber Pakhtunkhwa-Pakistan. It will bring a clear picture of the information literacy skills of law practitioners and address the problems faced by them during the seeking process.

Keywords: information literacy-Pakistan, infromation literacy-lawyers, information literacy-lawyers-KP, law practitioners-Pakistan

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Authors: Ntandazo Dlatu, Benjamin Longo-Mbenza, Andre Renzaho, Ruffin Appalata, Yolande Yvonne Valeria Matoumona Mavoungou, Mbenza Ben Longo, Kenneth Ekoru, Blaise Makoso, Gedeon Longo Longo

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Background: The gap between complexities related to the integration of Tuberculosis /HIV control and evidence-based knowledge motivated the initiation of the study. Therefore, the objective of this study was to explore correlations between national TB management guidelines, multiple deprivation indexes, quantiles, components and levels of Tuberculosis control programme using mathematical modeling in rural O.R. Tambo District Health Facilities, South Africa. Methods: The study design used mixed secondary data analysis and cross-sectional analysis between 2009 and 2013 across O.R Tambo District, Eastern Cape, South Africa using univariate/ bivariate analysis, linear multiple regression models, and multivariate discriminant analysis. Health inequalities indicators and component of an impediment to the tuberculosis control programme were evaluated. Results: In total, 62 400 records for TB notification were analyzed for the period 2009-2013. There was a significant but negative between Financial Year Expenditure (r= -0.894; P= 0.041) Seropositive HIV status(r= -0.979; P= 0.004), Population Density (r = -0.881; P= 0.048) and the number of TB defaulter in all TB cases. It was shown unsuccessful control of TB management program through correlations between numbers of new PTB smear positive, TB defaulter new smear-positive, TB failure all TB, Pulmonary Tuberculosis case finding index and deprivation-concentration-dispersion index. It was shown successful TB program control through significant and negative associations between declining numbers of death in co-infection of HIV and TB, TB deaths all TB and SMIAD gradient/ deprivation-concentration-dispersion index. The multivariate linear model was summarized by unadjusted r of 96%, adjusted R2 of 95 %, Standard Error of estimate of 0.110, R2 changed of 0.959 and significance for variance change for P=0.004 to explain the prediction of TB defaulter in all TB with equation y= 8.558-0.979 x number of HIV seropositive. After adjusting for confounding factors (PTB case finding the index, TB defaulter new smear-positive, TB death in all TB, TB defaulter all TB, and TB failure in all TB). The HIV and TB death, as well as new PTB smear positive, were identified as the most important, significant, and independent indicator to discriminate most deprived deprivation index far from other deprivation quintiles 2-5 using discriminant analysis. Conclusion: Elimination of poverty such as overcrowding, lack of sanitation and environment of highest burden of HIV might end the TB threat in O.R Tambo District, Eastern Cape, South Africa. Furthermore, ongoing adequate budget comprehensive, holistic and collaborative initiative towards Sustainable Developmental Goals (SDGs) is necessary for complete elimination of TB in poor O.R Tambo District.

Keywords: tuberculosis, HIV/AIDS, success, failure, control program, health inequalities, South Africa

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Authors: Ahmad Jawad Fardin

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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.

Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan

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Authors: E. M. Mhlongo, E. Lutge

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In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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Authors: Thomas A. Fuller

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Over the past fifteen years, virtual schooling has been introduced and implemented in varying degrees throughout the public education system in the United States. It is possible in some states for students to voluntarily take all of their course load online, without ever having to step in a classroom. Experts foresee a dramatic rise in the number of courses taken online by public school students in the United States, with some predicting that by 2019 as many as 50% of public high school courses will be delivered online. This electronic delivery of public education offers tremendous potential to the scientific community because it calls for innovation and is funded by public school revenue. Public accountability provides a ready supply of statistical data for measuring the progress of virtual schools as they are implemented into the public school arena. This allows for a survey of the current use of virtual schooling through examination of past statistical data, as well as forecasting forward for future years based upon this past data. Virtual schooling is on the rise in the United States, but its growth has been tempered by practical problems of implementation. The greatest and best use of virtual schooling thus far has been to supplement the courses offered by public schools (e.g., offering unique language courses, elective courses, and games-based math and science courses). The weaknesses of virtual schooling lay in the problematic accountability in allowing students to take courses online at home and the lack of supportive infrastructure in the public school arena. Virtual schooling holds great promise for the public school education system in the United States, as well as the scientific community. Online courses allow students access to a much greater catalog of courses than is offered through classroom instruction in their local public school. This promising sector needs assistance from the scientific community in implementing new pedagogical methodologies.

Keywords: virtual schools, online classroom, electronic delivery, technological innovation

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Authors: Yahaya Lasiele Alabi, Odebode Aminat Adeola

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Attitudes of health personnel usually influence the speed of recovery. It is essential that professional counsellors investigate the attitude of health personnel toward patients. In view of this, this study examined attitudes of health personnel towards patients as expressed by literate adults in Ilorin metropolis, Kwara State. The study also examined the influence of gender, age, and educational qualification on the respondents’ views. A self designed instrument tittled ‘Attitude of Health Personnel towards Patients Questionnaire (AHPPQ)’ was used to collect data from six hundred respondents, who were selected through a two-stage sampling procedure. Four research questions were constructed while three null hypotheses were formulated and tested using t-test and ANOVA at 0.05 alpha level. The findings of the study showed that literate adults in Ilorin metropolis expressed that health personnel have negative attitude towards patients. It was also found out that there was no significant difference in the attitude of health personnel towards Patients as expressed by literate adults in Ilorin metropolis on the basis of gender, age, and educational qualification. Based on the findings of this study, recommendations were made that Government should formulate policies and laws that will promote disposition of positive attitudes toward patients by health personnel. Health Counsellors should be employed and involved in organisation of seminars and workshops from time to time in order to encourage health personnel to interract positively with patients.

Keywords: attitude, health personnel, patients, Kwara State

Procedia PDF Downloads 571

Authors: Sabo Elizabeth

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Electronic learning is increasingly popular learning approach in higher educational institutions due to vast growth of internet technology. This approach is important in human capital development. An investigation of open distance and e-learning facilities and information need by open and distance learning students was carried out in Jalingo, Nigeria. Structured questionnaires were administered to 70 registered ODL students of the NOUN. Information sourced from the respondents covered demographic, economic and institutional variables. Data collected for demographic variables were computed as frequency count and percentages. Assessment of the effectiveness of ODL facilities and information need among open and distance learning students was computed on a three or four point Likert Rating Scale. Findings indicated that there are more men compared to women. A large proportion of the respondents are married and there are more matured students in ODL compared to the youth. A high proportion of the ODL students obtained qualifications higher than the secondary school certificate. The proportion of computer literate ODL students was high, and large number of the students does not own a laptop computer. Inadequate e -books and reference materials, internet gadgets and inadequate books (hard copies) and reference material are factors that limit utilization of e-learning facilities in the study areas. Inadequate computer facilities and power back up caused inconveniences and delay in administering and use of e learning facilities. To a high extent, open and distance learning students needed information on university time table and schedule of activities, availability and access to books (hard and e-books) and reference materials. The respondents emphasized that contact with course coordinators via internet will provide a better learning and academic performance.

Keywords: open and distance learning, information required, electronic books, internet gadgets, Likert scale test

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Authors: Merve Nur Güven Biçer

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Conductive inks are used extensively in electronic devices like sensors, batteries, photovoltaic devices, antennae, and organic light-emitting diodes. These inks are typically made from silver. Wearable technology is another industry that requires inks to be flexible. The aim of this study is the fabrication of low-temperature silver paste by synthesis long silver nanowires.

Keywords: silver ink, conductive ink, low temperature conductive ink, silver nanowire

Procedia PDF Downloads 188

Authors: Jennis Delina Giles, Nimesha Liyanage, Damindi Senadheera, Dilan Randima, Kushnara Suriyawansa

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Mental health is essential during childhood, adolescence, and adulthood. Mental health issues can influence one's thoughts, disposition, and conduct. A record number of mental health problems are caused by a global pandemic. Prevention of mental disease is vital for both children and adults. We desired to develop a web application for those with mental health difficulties. This web application will provide group chat, discussion, a community feed, and counseling services. The community feed function provides information regarding scheduled conversation space meetings, and the counselor uploads uplifting thoughts and tales of patients who received proper care and overcame mental health issues. Community feed can filter content based on user preferences. The mental health system for adults and adolescents will be updated. The community feed delivers relevant and instructive postings, links, and images so that service recipients can benefit from other platform features and receive encouraging words to assist them in overcoming mental health difficulties.

Keywords: bio medical, mental helath care, empower youths & adults, counselling

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Authors: Jalalludin Abdul Malek, Zurinah Tahir

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When the Multimedia Super Corridor (MSC) was launched in 1995, it became the catalyst for the implementation of the intelligent city concept, an area that covers about 15 x 50 kilometres from Kuala Lumpur City Centre (KLCC), Putrajaya and Kuala Lumpur International Airport (KLIA). The concept of intelligent city means that the city has an advanced infrastructure and infostructure such as information technology, advanced telecommunication systems, electronic technology and mechanical technology to be utilized for the development of urban elements such as industries, health, services, transportation and communications. For example, the Golden Triangle of Kuala Lumpur has also many intelligent buildings developed by the private sector such as the KLCC Tower to implement the intelligent city concept. Consequently, the intelligent buildings in the Golden Triangle can be linked directly to the Putrajaya Intelligent City and Cyberjaya Intelligent City within the confines of the MSC. However, the reality of the situation is that there are not many intelligent buildings within the Golden Triangle Kuala Lumpur scope which can be considered of high-standard intelligent buildings as referred to by the Intelligence Quotient (IQ) building standard. This increases the need to implement the real ‘intelligent city’ concept. This paper aims to show the strengths and weaknesses of the intelligent buildings in the Golden Triangle by taking into account aspects of 'intelligence' in the areas of technology and infrastructure of buildings.

Keywords: intelligent city concepts, intelligent building, Golden Triangle, Kuala Lumpur

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Authors: Michael Daly

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Background/Aims: The interplay of childhood self-control and early life social background in predicting adult health is currently unclear. We drew on rich data from two large nationally representative cohort studies to test whether individual differences in childhood self-control may: (i) buffer the health impact of social disadvantage, (ii) act as a mediating pathway underlying the emergence of health disparities, or (iii) compensate for the health consequences of socioeconomic disadvantage across the lifespan. Methods: We examined data from over 25,000 participants from the British Cohort Study (BCS) and the National Child Development Study (NCDS). Child self-control was teacher-rated at age 10 in the BCS and ages 7/11 in the NCDS. The Early life social disadvantage was indexed using measures of parental education, occupational prestige, and housing characteristics (i.e. housing tenure, home crowding). A range of health outcomes was examined: the presence of chronic conditions, whether illnesses were limiting, physiological dysregulation (gauged by clinical indicators), mortality, and perceptions of pain, psychological distress, and general health. Results: Childhood self-control and social disadvantage predicted each measure of adult health, with similar strength on average. An examination of mediating factors showed that adult smoking, obesity, and socioeconomic status explained the majority of these linkages. There was no systematic evidence that self-control moderated the health consequences of early social disadvantage and limited evidence that self-control acted as a key pathway from disadvantage to later health. Conclusions: Childhood self-control predicts adult health and may compensate for early life social disadvantage by shaping adult health behaviour and social status.

Keywords: personality and health, social disadvantage, health psychology, life-course development

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Authors: Haya Salah, Srinivas Sharan

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Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.

Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time

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Authors: Sananda Mukherjee, Nandini Lakshmikantha

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Films are considered as the most influential form of mass media. To attract audience films are made on various themes and issues which are assumed to have an impact on the behavioural pattern of the society. Among the various issues that have been bothering Indian society, health is primary. Thus it is important and interesting to study how health is being projected in Bollywood which is largely considered by the world as Indian cinema. This study tries to focus its attention on some select popular movies made in the recent decade and will try to analyse its content and significance of the same with the contemporary Indian society. It is evident that some of the movies made projecting health issues have earned good box office revenues, but have they been successful in making the public understand the significance of health issues they have been trying to project, is an interesting area to understand.

Keywords: box office, health issues, Indian cinema, social awareness

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Authors: Tanya L. Patimeteeporn, Murali D. Nair

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There is a wide range of literature that suggests the factors that prevent Asian American families from utilizing mental health services. These factors arise from a combination of cultural perceptions of mental illness, and methods of treating them without the use of a mental health professional. Due to the increased awareness of Asian Americans’ stigmatization to mental health, there has been an effort to create culturally competent interventions for Asian American families that would reduce opposition to mental health services. Assessment of the effectiveness of these interventions reveals practices that integrate traditional healing methods with psychoeducation are more likely to promote receptiveness of mental health services by Asian American families. The documentary in this review, demonstrates these traditional healing methods from various ethnic enclaves in Los Angeles. In addition, mental health professionals who provide these interventions to Asian American families need to consider culture-bound syndromes and the various Asian health philosophies and belief systems in order to provide a culturally sensitive holistic treatment for their clients. However, because the literature on these interventions is limited, there is a need for a larger body of evidence to accurately assess the effectiveness of these culturally competent psychoeducation interventions.

Keywords: Asian American, cultural boundaries, intervention, mental health stigma, psychoeducation, traditional healing

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Pippa Sipanoun, Jo Wray, Kate Oulton, Faith Gibson

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Background: With rapidly evolving digital health innovation, there is a need for digital health transformation that is accessible and sustainable, that demonstrates utility for all stakeholders while maintaining data safety. Great Ormond Street Hospital for Children aimed to future-proof the hospital by transitioning to an electronic patient record (EPR) system with a tethered patient portal (MyGOSH) in April 2019. MyGOSH patient portal enables patients 12 years or older (with their parent's consent) to access their digital health data. This includes access to results, documentation, and appointments that facilitate communication with their care team. As part of the Going Digital Study conducted between 2018-2021, data were collected from a sample of all relevant stakeholders before and after EPR and MyGOSH implementation. Data collection reach was wide and included the hospital legal and ethics teams. Aims: This study aims to understand the ethical and legal implications of young people and their parents accessing their digital health data. Methods: A focus group was conducted. Recruited participants were members of the Great Ormond Street Hospital Paediatric Bioethics Centre. Participants included expert and lay members from the Committee from a variety of professional or academic disciplines. Written informed consent was provided by all participants (n=7). The focus group was recorded, transcribed verbatim, and analyzed using thematic analysis. Results: Six themes were identified: access, competence and capacity - granting access to the system; inequalities in access resulting in inequities; burden, uncertainty and responding to change - managing expectations; documenting, risks and data safety; engagement, empowerment and understanding – how to use and manage personal information; legal considerations and obligations. Discussion: If healthcare professionals are to empower young people to be more engaged in their care, the importance of including them in decisions about their health is paramount, especially when they are approaching the age of becoming the consenter for treatment. Complexities exist in assessing competence or capacity when granting system access, when disclosing sensitive information, and maintaining confidentiality. Difficulties are also present in managing clinician burden, managing user expectations whilst providing an equitable service, and data management that meets professional and legal requirements. Conclusion: EPR and tethered-portal implementation at Great Ormond Street Hospital for Children was not only timely, due to the need for a rapid transition to remote consultations during the COVID-19 pandemic, which would not have been possible had EPR/MyGOSH not been implemented, but also integral to the digital health revolution required in healthcare today. This study is highly relevant in understanding the complexities around young people and their parents accessing their digital health data and, although the focus of this research related to portal use and access, the findings translate to young people in the wider digital health context. Ongoing support is required for all relevant stakeholders following MyGOSH patient portal implementation to navigate the ethical and legal complexities. Continued commitment is needed to balance the benefits and burdens, promote inclusion and equity, and ensure portal utility for patient benefit, whilst maintaining an individualized approach to care.

Keywords: patient portal, young people and their parents, ethical, legal

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Authors: Mert Kıranç, Ekrem Duman, Murat Özbilen

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In order to achieve new product development (NPD) activities on time and within budgetary constraints, the NPD managers need a well-designed methodology. This study intends to create an integrated project management methodology for the ones who focus on new product development projects. In the scope of the study, four different management systems are combined. These systems are called as 'Schedule-oriented Stage-Gate Method, Risk Management, Change Management and Earned Value Management'. New product development term is quite common in many different industries such as defense industry, construction, health care/dental, higher education, fast moving consumer goods, white goods, electronic devices, marketing and advertising and software development. All product manufacturers run against each other’s for introducing a new product to the market. In order to achieve to produce a more competitive product in the market, an optimum project management methodology is chosen, and this methodology is adapted to company culture. The right methodology helps the company to present perfect product to the customers at the right time. The benefits of proposed methodology are discussed as an application by a company. As a result, how the integrated methodology improves the efficiency and how it achieves the success of the project are unfolded.

Keywords: project, project management, management methodology, new product development, risk management, change management, earned value, stage-gate

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Authors: Aarthi Mariappan, Janani Selvaraj, P. B. Harathi, M. Prashanthi Devi

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Anthropogenic modification of the urban environment has largely increased in the recent years in order to sustain the growing human population. Intense industrial activity, permanent and high traffic on the roads, a developed subterranean infrastructure network, land use patterns are just some specific characteristics. Every day, the urban environment is polluted by more or less toxic emissions, organic or metals wastes discharged from specific activities such as industrial, commercial, municipal. When these eventually deposit into the soil, the physical and chemical properties of the surrounding soil is changed, transforming it into a human exposure indicator. Metals are non-degradable and occur cumulative in soil due to regular deposits are a result of permanent human activity. Due to this, metals are a contaminant factor for soil when persistent over a long period of time and a possible danger for inhabitant’s health on prolonged exposure. Metals accumulated in contaminated soil may be transferred to humans directly, by inhaling the dust raised from top soil, or by ingesting, or by dermal contact and indirectly, through plants and animals grown on contaminated soil and used for food. Some metals, like Cu, Mn, Zn, are beneficial for human’s health and represent a danger only if their concentration is above permissible levels, but other metals, like Pb, As, Cd, Hg, are toxic even at trace level causing gastrointestinal and lung cancers. In urban areas, metals can be emitted from a wide variety of sources like industrial, residential, commercial activities. Our study interrogates the spatial distribution of heavy metals in soil in relation to their permissible levels and their association with the health risk to the urban population in Coimbatore, India. Coimbatore region is a high cancer risk zone and case records of gastro intestinal and respiratory cancer patients were collected from hospitals and geocoded in ArcGIS10.1. The data of patients pertaining to the urban limits were retained and checked for their diseases history based on their diagnosis and treatment. A disease map of cancer was prepared to show the disease distribution. It has been observed that in our study area Cr, Pb, As, Fe and Mg exceeded their permissible levels in the soil. Using spatial overlay analysis a relationship between environmental exposure to these potentially toxic elements in soil and cancer distribution in Coimbatore district was established to show areas of cancer risk. Through this, our study throws light on the impact of prolonged exposure to soil contamination in soil in the urban zones, thereby exploring the possibility to detect cancer risk zones and to create awareness among the exposed groups on cancer risk.

Keywords: soil contamination, cancer risk, spatial analysis, India

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Authors: Anshu Gupta, Charu Gupta

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Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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Authors: Kimberly Tasha Jiayi Tang, Changqing Lin, Zhe Wang, Tze-Wai Wong, Md. Shakhaoat Hossain, Jian Yu, Alexis Lau

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Hong Kong has practiced a risk-based Air Quality Health Index (AQHI) system that sums hospitalization risks associated with short-term exposure to air pollu-tants. As an air pollution risk communication tool, it informs the public about the current air quality, anchoring around the World Health Organization's (WHO) 2005 Air Quality Guidelines (AQGs). Given the WHO's recent update in 2021, assessing how Hong Kong’s air quality risk communication can be en-hanced using these updated guidelines is essential. Hong Kong’s AQHI is lim-ited by solely focusing on short-term health risks, which could lead the public to underestimate cumulative health impacts. Therefore, we propose the intro-duction of a composite AQHI that reports both long-term and short-term health risks. Additionally, the WHO interim targets will be considered as anchor points for various health risk categories. Furthermore, with the increasing ozone levels in Hong Kong and Southern China due to improved NOx mitigation measures, it has been a challenging task in balancing health protection against climate mitigation. However, our findings present a promising outlook. Despite the rise in ozone levels, the combined health risks in Hong Kong and Guang-dong have seen a decline, largely due to reductions in NO2 and PM concentra-tions, both having significant health implications. By shifting from a concentra-tion-based approach to a health risk-based system like the AQHI, our study highlights the prospective of harmonizing health protection and climate mitiga-tion goals. This health-focused framework suggests that rigorous NOx controls can effective-ly serve both objectives in parallel.

Keywords: air quality management, air quality health index, health risk management, air pollution

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Authors: Jesus Carretero, Mario Vasile, Javier Garcia-Blas, Felix Garcia-Carballeira

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Supporting cross-border secure and reliable exchange of data and documents and to promote data interoperability is critical for Europe to enhance sector (like eFinance, eJustice and eHealth). This work presents the status and results of the European Project MADE, a Research Project funded by Connecting Europe facility Programme, to provide secure e-invoicing and e-document exchange systems among Europe countries in compliance with the eIDAS Regulation (Regulation EU 910/2014 on electronic identification and trust services). The main goal of MADE is to develop six new AS4 Access Points and SMP in Europe to provide secure document exchanges using the eDelivery DSI (Digital Service Infrastructure) amongst both private and public entities. Moreover, the project demonstrates the feasibility and interest of the solution provided by providing several months of interoperability among the providers of the six partners in different EU countries. To achieve those goals, we have followed a methodology setting first a common background for requirements in the partner countries and the European regulations. Then, the partners have implemented access points in each country, including their service metadata publisher (SMP), to allow the access to their clients to the pan-European network. Finally, we have setup interoperability tests with the other access points of the consortium. The tests will include the use of each entity production-ready Information Systems that process the data to confirm all steps of the data exchange. For the access points, we have chosen AS4 instead of other existing alternatives because it supports multiple payloads, native web services, pulling facilities, lightweight client implementations, modern crypto algorithms, and more authentication types, like username-password and X.509 authentication and SAML authentication. The main contribution of MADE project is to open the path for European companies to use eDelivery services with cross-border exchange of electronic documents following PEPPOL (Pan-European Public Procurement Online) based on the e-SENS AS4 Profile. It also includes the development/integration of new components, integration of new and existing logging and traceability solutions and maintenance tool support for PKI. Moreover, we have found that most companies are still not ready to support those profiles. Thus further efforts will be needed to promote this technology into the companies. The consortium includes the following 9 partners. From them, 2 are research institutions: University Carlos III of Madrid (Coordinator), and Universidad Politecnica de Valencia. The other 7 (EDICOM, BIZbrains, Officient, Aksesspunkt Norge, eConnect, LMT group, Unimaze) are private entities specialized in secure delivery of electronic documents and information integration brokerage in their respective countries. To achieve cross-border operativity, they will include AS4 and SMP services in their platforms according to the EU Core Service Platform. Made project is instrumental to test the feasibility of cross-border documents eDelivery in Europe. If successful, not only einvoices, but many other types of documents will be securely exchanged through Europe. It will be the base to extend the network to the whole Europe. This project has been funded under the Connecting Europe Facility Agreement number: INEA/CEF/ICT/A2016/1278042. Action No: 2016-EU-IA-0063.

Keywords: security, e-delivery, e-invoicing, e-delivery, e-document exchange, trust

Procedia PDF Downloads 265

Authors: Ahmet Koyuncu, Abdullah Berkan Erdogmus, Orkun Dogu, Sinan Uygur

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Thermoelectric modules are integrated to electronic components to keep their temperature in specific values in electronic cooling applications. They can be used in different ambient temperatures. The cold side temperatures of thermoelectric modules depend on their hot side temperatures, operation currents, and heat loads. Performance curves of thermoelectric modules are given at most two different hot surface temperatures in product catalogs. Characteristic properties are required to select appropriate thermoelectric modules in thermal design phase of projects. Generally, manufacturers do not provide characteristic material property values of thermoelectric modules to customers for confidentiality. Common commercial software applied like ANSYS ICEPAK, FloEFD, etc., include thermoelectric modules in their libraries. Therefore, they can be easily used to predict the effect of thermoelectric usage in thermal design. Some software requires only the performance values in different temperatures. However, others like ICEPAK require three temperature-dependent equations for material properties (Seebeck coefficient (α), electrical resistivity (β), and thermal conductivity (γ)). Since the number and the variety of thermoelectric modules are limited in this software, definitions of characteristic material properties of thermoelectric modules could be required. In this manuscript, the method of derivation of characteristic material properties from the datasheet of thermoelectric modules is presented. Material characteristics were estimated from two different performance curves by experimentally and numerically in this study. Numerical calculations are accomplished in ICEPAK by using a thermoelectric module exists in the ICEPAK library. A new experimental setup was established to perform experimental study. Because of similar results of numerical and experimental studies, it can be said that proposed equations are approved. This approximation can be suggested for the analysis includes different type or brand of TEC modules.

Keywords: electrical resistivity, material characteristics, thermal conductivity, thermoelectric coolers, seebeck coefficient

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Authors: Florian Tille, Heide Weishaar, Bernhard Gibis, Susanne Schnitzer

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Introduction: The quality of patient-doctor communication and of written health information is central to organizational health literacy (HL). Whether patients understand their doctors’ explanations and textual material on health, however, is understudied. This study identifies the overall levels of patient understanding of health information and its associations with patients’ social characteristics in outpatient health care in Germany. Materials & Methods: This analysis draws on data collected via a 2017 national health survey with a sample of 6,105 adults. Quality of communication was measured for consultations with general practitioners (GPs) and specialists (SPs) via the Ask Me 3 program questions, and through a question on written health material. Correlations with social characteristics were explored employing bivariate and multivariate logistic regression analyses. Results: Over 90% of all respondents reported that they had understood their doctors’ explanations during the last consultation. Failed understanding was strongly correlated with patients’ very poor health (Odds Ratio [OR]: 5.19; 95% confidence interval [CI]: 2.23–12.10; ref. excellent/very good health), current health problem (OR: 6.54, CI: 1.70–25.12; ref. preventive examination) and age 65 years and above (OR: 2.97, CI: 1.10–8.00; ref. 18 to 34 years). Fewer patients answered they understood written material well (86.7% for las visit at GP, 89.7% at SP). Understanding written material poorly was highly associated with basic education (OR: 4.20, CI: 2.76–6.39; ref. higher education) and 65 years old and above (OR: 2.66, CI: 1.43–4.96). Discussion: Overall ratings of oral patient-doctor communication and written communication of health information are high. Yet, a considerable share of patients reports not-understanding their doctors and poor understanding of the written health-related material. Interventions that can contribute to improving organizational HL in outpatient care in Germany include HL training for doctors, reducing system barriers to easily-accessible health information for patients and combining oral and written health communication means. Conclusion: This work adds to the study of organizational HL in Germany. To increase patient understanding of health-relevant information and thereby possibly reduce health disparities, meeting the communication needs especially of persons in different age groups, with basic education and in very poor health is suggested.

Keywords: health survey, organizational health literacy, patient-doctor communication, social characteristics, outpatient care, Ask Me 3

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Authors: Jae-Hyuk Hyun, Dong-Sung Bae, Jea-Sun Lee

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The COVID-19 pandemic emphasized the benefits of natural green space on mental health in pandemic situations. The effects of greenspace on reducing mental health disorder are detected, but limitations impede highlighting the overall effectiveness of greenspace on mental health to be valid and significant. Therefore, this study aims to comprehensively and quantitatively analyze the effectiveness and significance of greenspace in reducing mental disorders after the COVID-19 outbreak. This study adopted a systematic review to select adequate, necessary studies with significant associations between greenspace and mental health after COVID-19. Meta-analysis is performed using the selected studies for calculating and analyzing the combined effect size of greenspace on reducing mental disorder, difference of effect size in various factors of greenspace or mental health, and variables’ effects on greenspace or mental health. Also, a correlation test using MQRS and effect size is performed to determine significant correlations of factors in greenspace and mental health. The analysis confirmed the combined effect size of the association between greenspace and mental health to be interpreted as large enough (medium effect size, 0.565). Various factors consisting of greenspace or mental health had considerable effect sizes, with heterogeneity existing between studies of different greenspace and mental health aspects (subgroups). A significant correlation between factors in greenspace and mental health was identified, with correlations satisfying both reliability and effectiveness used for suggesting necessary greenspace policies with mental health benefits during the pandemic situation. Different variables of the study period, female proportion, and mean age significantly affected certain factors of greenspace or mental health, while the increase in effects of greenspace on mental health was detected as the COVID-19 period continued. Also, the regional heterogeneity of effects on the association between greenspace and mental health is recognized in all factors consisting of greenspace and mental health except for the visitation of greenspace. In conclusion, valid and significant effects were detected in various associations between greenspace and mental health. Based on the results of this study, conducting elaborate research and establishing adequate and necessary greenspace policies and strategies are recommended to effectively benefit the mental health of citizens in future pandemic situations.

Keywords: greenspace, natural environment, mental health, mental disorder, COVID-19, pandemic, systematic review, meta-analysis

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Authors: Mirjana Dokmanovic

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The main topic of this paper is the analysis of the presence of gender stereotypes in the media content in the Republic of Serbia with respect to the state commitments to eliminate discrimination against women. The research methodology included the analysis of the media content of six daily newspapers and two magazines on the date of 28 December 2015 and the analysis of the reality TV show programs in 2015 from gender perspective. The methods of the research has also included a desk research and a qualitative analysis of the available data, statistics, policy papers, studies, and reports produced by the government, the Ministry of Culture and Information, the Regulatory Body for Electronic Media, the Press Council, the associations of media professionals, the independent human rights bodies, and civil society organizations (CSOs). As a State Signatory to the Convention on the Elimination of All Forms of Discrimination against Women, the Republic of Serbia has adopted numerous measures in this field, including the Law on Equality between Sexes and the national gender equality strategies. Special attention has been paid to eliminating gender stereotypes and prejudices in the media content and portraying of women. This practice has been forbidden by the Law on Electronic Media, the Law on Public Information and Media, the Law on Public Service Broadcasting and the Bylaw on the Protection of Human Rights in the Provision of Media Services. Despite these commitments, there has not been achieved progress regarding eliminating gender stereotypes in the media content. The research indicates that the media perpetuate traditional gender roles and patriarchal patterns. Female politicians, entrepreneurs, academics, scientists, and engineers have been very rarely portrayed in the media. On the other side, women are in their focus as celebrities, singers, and actresses. Women are underrepresented in the pages related to politics and economy, while they are mostly present in the cover stories related to show-business, health care, family and household matters. Women are three times more than men identified on the basis of their family status, as mothers, wives, daughters, etc. Hate speech, misogyny, and violence against women are often present in the reality TV shows. The abuse of women and their bodies in advertising is still widely present. The cases of domestic violence are still presented with sensationalism, although there has been achieved progress in portraying victims of domestic violence with respect and dignity. The issues related to gender equality and the position of the vulnerable groups of women, such as Roma women or rural women, are not visible in the media. This research, as well as warnings of women’s CSOs and independent human rights bodies, indicates the necessity to implement legal and policy measures in this field consistently and with due diligence. The aim of the paper is to contribute eliminating gender stereotypes in the media content and advancing gender equality.

Keywords: discrimination against women, gender roles, gender stereotypes, media, misogyny, portraying women in the media, prejudices against women, Republic of Serbia

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Authors: Hong Wu, Naiji Lu, Chenguang Wang, Xinming Tu

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This article analyzes the causal effects of informal care, mental health, and physical health on falls and other accidents (e.g. traffic accidents) among elderly people. To purge potential reversal causal effects, e.g., past accidents induce more future informal care, we use two-stage least squares to identify the impacts. By using longitudinal data from a representative national China Health and retirement longitudinal study of people aged 45 and older in China, our findings indicate that informal care decreases while poor health conditions increase the occurrence of accidents. We also find heterogeneous impacts on the occurrence of accidents, varying by gender, urban status, and past accident history. Our findings suggest the following three policy implications. First, policy makers who aim to decrease accidents should take informal care to elders into account. Second, ease of birth policy and postponed retirement policy are urgent to meet the demand of informal care. Third, medical policies should attach great importance to not only physical health but also mental health of elderly parents especially for older people with accident history.

Keywords: accident, China, fall, informal care, mental health, physical health

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Authors: Lenka Jesonkova, Frantisek Bozek

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Trihalogenmethanes (THMs) are disinfection byproducts with non-carcinogenic and genotoxic effects. The contamination of 6 sites close to the water treatment plant has been monitored in second largest city of the Czech Republic. Health risk assessment including both non-carcinogenic and genotoxic risk for long term exposition was realized using the critical concentrations. Concentrations of trihalogenmethanes met national standards in all samples. Risk assessment proved that health risks from trihalogenmethanes are acceptable on each site.

Keywords: drinking water, health risk assessment, trihalogenmethanes, water pollution

Procedia PDF Downloads 520