Search results for: healthcare organisation

Authors: A. Alrasheed, I. Connerton

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Daily provision of high quality food and hygiene to patients is a challenging goal of the healthcare. In Saudi Arabia, matters related to food safety and hygiene are regulated by the Ministry of Health (MOH) and the Saudi Food and Drugs Authority (SFDA). The purpose of this research is to discuss the food safety management inconsistencies and flaws, in particular the ones related to Hazard Analysis and Critical Control Points (HACCP) in Riyadh’s MOH hospitals. As required by law, written HACCP regulations must be implemented, and food handlers need to receive the training accordingly. However, in Saudi hospitals, this is not a requirement, and the food handlers do not need to hold training certificates in food safety or HACCP. Nowadays, the matter of food safety and hygiene have become increasingly important since the decision makers want to align these regulations with the majority of the world and to implement HACCP fully and for this purpose, the SFDA was established. 

Keywords: food safety, patients, hospitals, HACCP, Saudi Arabia

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Authors: Johanida L. Etado

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The study determined the Administrative traits and capabilities of Mindanao State University Heads of office as perceived by their respondents. Specifically, this study attempted to find out: To get the primary data, a self- constructed survey questionnaire which was validated by a panel of experts, including the adviser. Most of the MSU head of office were aware of their duties and responsibilities as a manager. Considering their vast knowledge and expertise on the technical or task aspects of the job, it is not surprising that respondents perceived them to a high degree as work or task oriented. MSU head of office were knowledgeable and capable in performing field-specific, specialized tasks and enabling them to coordinate work, solve problems, communicate effectively, and also understand the big picture in light of the front-line work that must be performed. The significance of coaching or mentoring in this instance may be explained by the less number of Master’s or Doctorate degree holder among employees resulting to close supervision and mentorship of head of office towards the latter; Without comparison, interpersonal or human relation capabilities is a very effective way in dealing with people as it gives them the opportunity to influence their employees. In the case of MSU head of office, the best way of dealing with problematic employees is by establishing trust and allowing them to partake in the decision making even on setting organizational goals as it would make them feel part of the organization; Thus, it is recommended that the success of an organization depends largely with the effectiveness of the head of unit. In this case, being development oriented would mean encouraging both head officers & employees to know not only the technical know hoe of the organisation but also the visions, missions, goals & the latter’s aspirations to establish cooperation & harmonious working environment; hence, orientation & reorientation time to time would enable them to be more development oriented; With respect to human relations, effective interpersonal relationship between head of unit & employee is of paramount importance. In order to strengthen the relationship between the two, the management should establish an upward & downward communication where two parties will have to establish an open & transparent communication, either through verbal & non-verbal one.

Keywords: administrator, administrative traits, leadership traits, work orientation

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Authors: Julius Lenaerts, Ahmed Elsaadawy, Mohammed Bashir

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Background Sedated and paralyzed patients have an impaired blink reflex leading to ophthalmic complications such as conjunctivitis, epithelial defects, bacterial keratitis, and more. These are entirely preventable complications through regular eye care. Methods Patients at level 3 or above (intubated/paralyzed) care in the Intensive Care Unit (ICU) were reviewed between February and April. Data was pulled from Metavision and adherence was compared to Royal College of Ophthalmology (RCOphth) recommendations[4]. Using a multi-pronged approach through posters, individual teaching sessions and faculty teaching, we aimed to educate staff about eye care in the ICU. Patients were reaudited in the period July to August. Results Out of 40 patients, only 23% were assessed for eye care needs on admission compared to 77% after teaching; eye care was only delivered 59% of the time it was due, compared to 61%; 2.5% of patients had eyedrops prescribed compared to 41%. This shows an overall increase in meeting RCOphth standards. Key messages Eye care is an overlooked aspect of patient care in the ICU, associated with avoidable ocular complications. Healthcare staff need further rigorous education on the provision and importance of eye care to reduce avoidable complications.

Keywords: ICU, eye care, risk, QIP

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Authors: Alaa Abdellatif, Gabrièle Breda

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Background. Advanced therapy medicinal products (ATMPs) are innovative therapies that mainly target orphan diseases and high unmet medical needs. ATMP includes gene therapy medicinal products (GTMP), somatic cell therapy medicinal products (CTMP), and tissue-engineered therapies (TEP). Since legislation opened the way in 2007, 25 ATMPs have been approved in the EU, which is about the same amount as the U.S. Food and Drug Administration. However, not all of the ATMPs that have been approved have successfully reached the market and retained their approval. Objectives. We aim to understand all the factors limiting the market access to very promising therapies in a systemic approach, to be able to overcome these problems, in the future, with scientific, regulatory and commercial innovations. Further to recent reviews that focus either on specific countries, products, or dimensions, we will address all the challenges faced by ATMP development today. Methodology. We used mixed methods and a multi-level approach for data collection. First, we performed an updated academic literature review on ATMP development and their scientific and market access challenges (papers published between 2018 and April 2023). Second, we analyzed industry feedback from cell and gene therapy webinars and white papers published by providers and pharmaceutical industries. Finally, we established a comparative analysis of the regulatory guidelines published by EMA and the FDA for ATMP approval. Results: The main challenges in bringing these therapies to market are the high development costs. Developing ATMPs is expensive due to the need for specialized manufacturing processes. Furthermore, the regulatory pathways for ATMPs are often complex and can vary between countries, making it challenging to obtain approval and ensure compliance with different regulations. As a result of the high costs associated with ATMPs, challenges in obtaining reimbursement from healthcare payers lead to limited patient access to these treatments. ATMPs are often developed for orphan diseases, which means that the patient population is limited for clinical trials which can make it challenging to demonstrate their safety and efficacy. In addition, the complex manufacturing processes required for ATMPs can make it challenging to scale up production to meet demand, which can limit their availability and increase costs. Finally, ATMPs face safety and efficacy challenges: dangerous adverse events of these therapies like toxicity related to the use of viral vectors or cell therapy, starting material and donor-related aspects. Conclusion. As a result of our mixed method analysis, we found that ATMPs face a number of challenges in their development, regulatory approval, and commercialization and that addressing these challenges requires collaboration between industry, regulators, healthcare providers, and patient groups. This first analysis will help us to address, for each challenge, proper and innovative solution(s) in order to increase the number of ATMPs approved and reach the patients

Keywords: advanced therapy medicinal products (ATMPs), product development, market access, innovation

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Authors: Alina M. Udall, Judith de Groot, Simon de Jong, Avi Shankar

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There are many ways in which environmentally significant behavior can be explained. Dominant psychological theories, namely, the theory of planned behavior, the norm-activation theory, its extension, the value-belief-norm theory, and the theory of habit do not explain large parts of environmentally significant behaviors. A new and rapidly growing approach is to focus on how consumer’s identities predict environmentally significant behavior. Identity may be relevant because consumers have many identities that are assumed to guide their behavior. Therefore, we assume that many identities will guide environmentally significant behavior. Many identities can be relevant for environmentally significant behavior. In reviewing the literature, over 200 identities have been studied making it difficult to establish the key identities for explaining environmentally significant behavior. Therefore, this paper first aims to establish the key identities previously used for explaining environmentally significant behavior. Second, the aim is to test which key identities explain environmentally significant behavior. To address the aims, an online survey study (n = 578) is conducted. First, the exploratory factor analysis reveals 15 identity factors. The identity factors are namely, environmentally concerned identity, anti-environmental self-identity, environmental place identity, connectedness with nature identity, green space visitor identity, active ethical identity, carbon off-setter identity, thoughtful self-identity, close community identity, anti-carbon off-setter identity, environmental group member identity, national identity, identification with developed countries, cyclist identity, and thoughtful organisation identity. Furthermore, to help researchers understand and operationalize the identities, the article provides theoretical definitions for each of the identities, in line with identity theory, social identity theory, and place identity theory. Second, the hierarchical regression shows only 10 factors significantly uniquely explain the variance in environmentally significant behavior. In order of predictive power the identities are namely, environmentally concerned identity, anti-environmental self-identity, thoughtful self-identity, environmental group member identity, anti-carbon off-setter identity, carbon off-setter identity, connectedness with nature identity, national identity, and green space visitor identity. The identities explain over 60% of the variance in environmentally significant behavior, a large effect size. Based on this finding, the article reveals a new, theoretical framework showing the key identities explaining environmentally significant behavior, to help improve and align the field.

Keywords: environmentally significant behavior, factor analysis, place identity, social identity

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Authors: Swati Minz, Pradeep Munda, Ranchi Jharkhand

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Women of today’s era are well educated and they are best and proficient at their skills that are key to success anywhere. Government played a major role in uplifting women in Indian society. Through all these efforts Indian women decided to move forward and started choosing career path which was itself a challenge in their life. The people in the society had a very hatred feeling for the women who chose a career and moved forward. Women in today’s times have achieved a lot but in reality they have to still travel a long way. Women started leaving the secured domains of their home and moved out, but a harsh, cruel, exploitative world awaits them, where women have to prove their talent against the world who see women as merely vassals of producing children. In spite all modernisation, a woman has her limits and emerges to claim traditional male space, juggling with many family problems and multiple roles to excel at a level that would have been perceived as impossible a generation ago. Still a woman in India is storming traditional male fields. Even the occupation which had male monopoly life defense services, merchant navy, administrative or police services, these are the best examples for women now. If these women are taken under consideration they never had any issues while fighting a battle ,or trying to encroach into the men’s world ,but rather, they adopts themselves in the situation and are good ,trying to justify their roles and proving themselves. The last few decades there have been noticed an enormous growth in levels of education, confidence and the most importantly, ambition noticed towards in women, who all are striving their rights and claiming a dignified place in the society. Previously women were educated for the sake to get married and start new family but nowadays they utilize their skill productively. Since the time after independence, considering both women in India in general and women in Jharkhand in particular has played a very prominent role in all walks of life including the professions. Any success and achievement in any organisation depends on their contribution as well. Due to these consequences, there has always been a need to study and focus light on issues affecting women professionals, empowerment and their work life balance.

Keywords: women, work life balance, work empowerment, career, struggle, society, challenges, family, society, achievement

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Authors: Paveenapat Nithitantiwat, Kwanjai Pataipakaipet

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The purpose of this research was to study the happiness level of nursing students, Boromarajonani College of nursing, Ratchaburi, Thailand. A purposive sampling of 652 first to four-year nursing students was used. This research is descriptive research. The instruments were questionnaires that developed by the researcher. It included the demographic data and nursing student’s perception about healthcare, safety, life security, family, proud of oneself, education and activities, dormitories and environment in college, and how to improve their happiness. Frequencies, percentage, mean, and T-test is used to analysis the data. The results of the research have shown that family and moral value was an important thing in nursing student’s life. In addition, the mean of the happiness level was a high level. The first year nursing students had the higher mean score of the happiness level than the fourth year, second year, and the third year, respectively. Therefore, nursing students would realize that the important things in their life are family and Buddhism’s teaching. In addition, dharma is guideline how to be both academic achievements and successful in life.

Keywords: happiness, nursing students, nursing students’ perceptions, bachelor program

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Authors: Erico R. Carmona, Lucas Hernandez-Saravia, Aliro Villacorta, Felipe Carevic

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Tailings and electronic waste (e-waste) are an important source of global contamination. Chile is one of Organisation for Economic Co-operation and Development (OECD) member countries that least recycled this kind of industrial waste, reaching only 3% of the total. Tailings and e-waste recycling offers a valuable tool to minimize the increasing accumulation of waste, supplement the scarcity of some raw materials and to obtain economic benefits through the commercialization of these. It should be noted that this type of industrial waste is an important source of valuable metals, such as copper, which allow generating new business and added value through its transformation into new materials with advanced physical and biological properties. In this sense, the development of nanotechnology has led to the creation of nanomaterials with multiple applications given their unique physicochemical properties. Among others, copper nanoparticles (CuNPs) have gained great interest due to their optical, catalytic, conductive properties, and particularly because of their broad-spectrum antimicrobial activity. There are different synthesis methods of copper nanoparticles; however, green synthesis is one of the most promising methodologies, since it is simple, low-cost, ecological, and generates stable nanoparticles, which makes it a promising methodology for scaling up. Currently, there are few initiatives that involve the development of methods for the recovery and transformation of copper from waste to produce nanoparticles with new properties and better technological benefits. Thus, the objective of this work is to show preliminary data about the develop a sustainable transformation process of tailings and e-waste that allows obtaining a copper-based nanotechnological product with potential antimicrobial applications. For this, samples of tailings and e-waste collected from Tarapacá and Antofagasta region of northern Chile were used to recover copper through efficient, ecological, and low-cost alkaline hydrometallurgical treatments, which to allow obtaining copper with a high degree of purity. On the other hand, the transformation process from recycled copper to a nanomaterial was carried out through a green synthesis approach by using vegetal organic residue extracts that allows obtaining CuNPs following methodologies previously reported by authors. Initial physical characterization with UV-Vis, FTIR, AFM, and TEM methodologies will be reported for CuNPs synthesized.

Keywords: nanomaterials, industrial waste, chile, recycling

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Authors: Colin David La Grange, Lisa Frost Ramsay

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Hydrogen sulphide (H2S) is a minor component of landfill gas, but significant in its distinct odorous quality and its association with landfill-related community complaints. The World Health Organisation (WHO) provides two guidelines for H2S: a health guideline at 150 µg/m3 on a 24-hour average, and a nuisance guideline at 7 µg/m3 on a 30-minute average. Albeit a practical distinction for impact assessment, this paper highlights the danger of the apparent dualism between nuisance and health impact, particularly when it is used to dismiss community concerns of perceived health impacts at low concentrations of H2S, as in the case of a community battle against the impacts of a landfill in Shongweni, KwaZulu-Natal, South Africa. Here community members reported, using a community developed mobile phone application, a range of health symptoms that coincided with, or occurred subsequent to, odour events and localised H2S peaks. Local doctors also documented increased visits for symptoms of respiratory distress, eye and skin irritation, and stress after such odour events. Objectively measured H2S and other pollutant concentrations during these events, however, remained below WHO health guidelines. This case study highlights the importance of the physiological link between the experience of environmental nuisance and overall health and wellbeing, showing these to be less distinct than the WHO guidelines would suggest. The potential mechanisms of impact of an odorous plume, with key constituents at concentrations below traditional health thresholds, on psychologically and/or physiologically sensitised individuals are described. In the case of psychological sensitisation, previously documented mechanisms such as aversive conditioning and odour-triggered panic are relevant. Physiological sensitisation to environmental pollutants, evident as a seemingly disproportionate physical (allergy-type) response to either low concentrations or a short duration exposure of a toxin or toxins, remains extensively examined but still not well understood. The links between a heightened sensitivity to toxic compounds, accumulation of some compounds in the body, and a pre-existing or associated immunological stress disorder are presented as a possible explanation.

Keywords: immunological stress disorder, landfill odour, odour nuisance, odour sensitisation, toxin accumulation

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Authors: P. S. Surya Meghana, K. Lingeshwaran, C. Kannan, V. Raghavendran, C. Priya

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One of the most basic and powerful tools in all of science and medicine is the light microscope, the fundamental device for laboratory as well as research purposes. With the improving technology, the need for portable, economic and user-friendly instruments is in high demand. The conventional microscope fails to live up to the emerging trend. Also, adequate access to healthcare is not widely available, especially in developing countries. The most basic step towards the curing of a malady is the diagnosis of the disease itself. The main aim of this paper is to diagnose Malaria with the most common device, cell phones, which prove to be the immediate solution for most of the modern day needs with the development of wireless infrastructure allowing to compute and communicate on the move. This opened up the opportunity to develop novel imaging, sensing, and diagnostics platforms using mobile phones as an underlying platform to address the global demand for accurate, sensitive, cost-effective, and field-portable measurement devices for use in remote and resource-limited settings around the world.

Keywords: cellular, hand-held, health care, image processing, malarial parasites, microscope

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Authors: Areej Makeineldein Mustafa

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The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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Authors: Tarek M. Alguhane, Ayman H. Khalil, Nour M. Fayed, Ayman M. Ismail

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Early, pre-code, reinforced concrete structures present undetermined resistance to earthquakes. This situation is particularly unacceptable in the case of essential structures, such as healthcare structures and pilgrims' houses. Among these, existing old RC building in Madinah is seismically evaluated with and without infill wall and their dynamic characteristics are compared with measured values in the field using ambient vibration measurements (AVM). After, updating the mathematical models for this building with the experimental results, three dimensional pushover analysis (Nonlinear static analysis) was carried out using SAP 2000 software incorporating inelastic material properties for concrete, infill and steel. The purpose of this analysis is to evaluate the expected performance of structural systems by estimating, strength and deformation demands in design, and comparing these demands to available capacities at the performance levels of interest. The results are summarized and discussed.

Keywords: seismic assessment, pushover analysis ambient vibration, modal update

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Authors: Partha Pratim Kalita

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As sound can be converted to light, light can also be deduced to sound. There are technologies to convert light to sound, but there are not many technologies related to the field where sound can be converted to a distinct vibrational sequence of light. Like the laws under which the principles of sound work, there are principles for the light to become quantum in nature. Thus, as we move from sound to the subtler aspects of light, we are moving from 3D to 5D. Either we will be making technologies of 3D in today’s world, or we will be really interested in making technologies of the 5D, depends on our understanding of how quantum 5D works. Right now, the entire world is talking about quantum, which is about the nature and behavior of subatomic particles, which is 5D. In practice, they are using metals and machines based on atomic structures. If we talk of quantum without taking note of the technologies of 5D and beyond, we will only be reinterpreting relative theories in the name of quantum. This paper, therefore, will explore the possibilities of moving towards quantum in its real essence with the Shoonya ecosystem (zero-point energy). In this context, the author shall highlight certain working models developed by him, which are currently in discussion with the Indian government.

Keywords: quantum mechanics, quantum technologies, healthcare, shoonya ecosystem, energy, human consciousness

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Authors: Ronit Chakraborty, Sugata Banerji

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There has been a marked increase in the reported prevalence of Autism Spectrum Disorder (ASD) among children in the US over the past two decades. This research has analyzed the growth in state-level ASD prevalence against 45 different potentially explanatory factors, including socio-economic, demographic, healthcare, public policy, and political factors. The goal was to understand if these factors have adequate predictive power in modeling the differential growth in ASD prevalence across various states and if they do, which factors are the most influential. The key findings of this study include (1) the confirmation that the chosen feature set has considerable power in predicting the growth in ASD prevalence, (2) the identification of the most influential predictive factors, (3) given the nature of the most influential predictive variables, an indication that a considerable portion of the reported ASD prevalence differentials across states could be attributable to over and under diagnosis, and (4) identification of Florida as a key outlier state pointing to a potential under-diagnosis of ASD there.

Keywords: autism spectrum disorder, clustering, machine learning, predictive modeling

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Authors: Haitham Assiri, Priyadarsi Nanda

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The world is gradually entering the fourth industrial revolution. E-Government services are scaling government operations across the globe. However, as promising as an e-Government system would be, it is also susceptible to malicious attacks if not properly secured. This study found out that, in Saudi Arabia, the e-Government website, Yesser is vulnerable to external attacks. Obviously, this can lead to a breach of data integrity and privacy. In this paper, a Systematic Literature Review was conducted to explore possible ways the Kingdom of Saudi Arabia can take necessary measures to strengthen its e-Government system using Blockchain. Blockchain is one of the emerging technologies shaping the world through its applications in finance, elections, healthcare, etc. It secures systems and brings more transparency. A total of 28 papers were selected for this SLR, and 19 of the papers significantly showed that blockchain could enhance the security and privacy of Saudi’s e-government system. Other papers also concluded that blockchain is effective, albeit with the integration of other technologies like IoT, AI and big data. These papers have been analysed to sieve out the findings and set the stage for future research into the subject.

Keywords: blockchain, data integrity, e-government, security threats

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Authors: Ram Sharan Mehta

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Continuing changes in health and social care policy and practice have affected and changed the way in which nursing is practiced. One of the greatest challenges facing nursing today is to build on the essence of nursing as a caring profession whilst incorporating new technologies, ideas and approaches to future healthcare. The objective of this study was to find out the socio-demographic characteristics of the M.Sc. Nursing students and calculate the association between specialty subjects, caste, age group, and residence with SLC division, BN/BSN division, entrance score, and total nursing experience. Descriptive cross-sectional study design was used to conduct the study among all the 25 M.Sc. Nursing students studying at BPKIHS in 2012. Most of the students (56%) were of age group of 25-30 years, completed his academic courses with first division and succeeded in entrance test in first attempt (96%). Based on the results, it can conclude that most of the subjects were of young age, having high score achievers in SLC, I.Sc., CN, BN/BSN and Entrance test. The demographic characteristics do not influence in the academic scores of the students.

Keywords: profile, postgraduate nursing students, Nepal, influence

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Authors: Jocelyn Jones, Louise Southalan, Lindey Andrews, Mandy Wilson, Emma Vieira, Jackie Oakley, Dorothy Bagshaw, Alice V. Brown, Patrick Egan, Duc Dau, Lucy Spanswick

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Working with people experiencing homelessness requires careful use of methods that support them to comfortably share their experiences. This is particularly important for Aboriginal and Torres Strait Islander peoples, the traditional owners of Australia, who have experienced intergenerational and compounding trauma since colonisation. Aboriginal cultures regularly experience research fatigue and distrust in research’s potential for impact. They often view research as an extraction -a process of taking the knowledge that empowers the research team and its institution, rather than benefiting those being researched. Through a partnership between an Aboriginal Community Controlled Organisation and a university research institute, we conducted a community-driven research project with 70-90 Aboriginal people experiencing homelessness in Perth, Western Australia. The project aimed to listen to and advocate for the voices of those who are experiencing homelessness, guided by the Aboriginal community. In consultation with Aboriginal Elders, we selected methods that are considered culturally safe, including those who would prefer to express their experiences creatively. This led us to run a series of Photovoice workshops -an established method that supports people to share their experiences through photography. This method treats participants as experts and is regularly used with marginalised groups across the world. We detail our experience and lessons in using Photovoice with Aboriginal community members experiencing homelessness. This includes the ways the method needed to be moulded to community needs and driven by their individual choices, such as being dynamic in the length of time participants would spend with us, how we would introduce the method to them, and providing support workers for participants when taking photos. We also discuss lessons in establishing and retaining engagement and how the method was successful in supporting participants to comfortably share their stories. Finally, we outline the insights into homelessness that the method offered, including highlighting the difficulty experienced by participants in transitioning from homelessness to accommodation and the diversity of hopes people who have experienced homelessness have for the future.

Keywords: Aboriginal and Torres Strait Islander peoples, photovoice, homelessness, community-led research

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Authors: Sabrina Neururer, Marco Schweitzer, Werner Hackl, Bernhard Tilg, Patrick Raudaschl, Andreas Huber, Bernhard Pfeifer

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History and the current outbreak of Covid-19 have shown the deadly potential of infectious diseases. However, infectious diseases also have a serious impact on areas other than health and healthcare, such as the economy or social life. These areas are strongly codependent. Therefore, disease control measures, such as social distancing, quarantines, curfews, or lockdowns, have to be adopted in a very considerate manner. Infectious disease modeling can support policy and decision-makers with adequate information regarding the dynamics of the pandemic and therefore assist in planning and enforcing appropriate measures that will prevent the healthcare system from collapsing. In this work, an agent-based simulation package named “survival” for simulating infectious diseases is presented. A special focus is put on SARS-Cov-2. The presented simulation package was used in Austria to model the SARS-Cov-2 outbreak from the beginning of 2020. Agent-based modeling is a relatively recent modeling approach. Since our world is getting more and more complex, the complexity of the underlying systems is also increasing. The development of tools and frameworks and increasing computational power advance the application of agent-based models. For parametrizing the presented model, different data sources, such as known infections, wastewater virus load, blood donor antibodies, circulating virus variants and the used capacity for hospitalization, as well as the availability of medical materials like ventilators, were integrated with a database system and used. The simulation result of the model was used for predicting the dynamics and the possible outcomes and was used by the health authorities to decide on the measures to be taken in order to control the pandemic situation. The survival package was implemented in the programming language Java and the analytics were performed with R Studio. During the first run in March 2020, the simulation showed that without measures other than individual personal behavior and appropriate medication, the death toll would have been about 27 million people worldwide within the first year. The model predicted the hospitalization rates (standard and intensive care) for Tyrol and South Tyrol with an accuracy of about 1.5% average error. They were calculated to provide 10-days forecasts. The state government and the hospitals were provided with the 10-days models to support their decision-making. This ensured that standard care was maintained for as long as possible without restrictions. Furthermore, various measures were estimated and thereafter enforced. Among other things, communities were quarantined based on the calculations while, in accordance with the calculations, the curfews for the entire population were reduced. With this framework, which is used in the national crisis team of the Austrian province of Tyrol, a very accurate model could be created on the federal state level as well as on the district and municipal level, which was able to provide decision-makers with a solid information basis. This framework can be transferred to various infectious diseases and thus can be used as a basis for future monitoring.

Keywords: modelling, simulation, agent-based, SARS-Cov-2, COVID-19

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Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Teresa Kupczyk, Selçuk Mustafa Özcan, Joanna Kubicka

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The paper presents results of specialist literature analysis concerning learning outcomes and student satisfaction as a factor of the necessary change in the Polish higher education system. The objective of the empirical research was to determine students’ assessment of learning outcomes, satisfaction of their expectations, as well as their satisfaction with lectures and practical classes held in the traditional form, e-learning and video-conference. The assessment concerned effectiveness of time spent at classes, usefulness of the delivered knowledge, instructors’ preparation and teaching skills, application of tools, studies curriculum, its adaptation to students’ needs and labour market, as well as studying conditions. Self-assessment of learning outcomes was confronted with assessment by lecturers. The indirect objective of the research was also to identify how students assessed their activity and commitment in acquisition of knowledge and their discipline in achieving education goals. It was analysed how the studies held affected the students’ willingness to improve their skills and assessment of their perspectives at the labour market. To capture the changes underway, the research was held at the beginning, during and after completion of the studies. The study group included 86 students of two editions of full-time studies majoring in Management and specialising in “Mega-event organisation”. The studies were held within the EU-funded project entitled “Responding to challenges of new markets – innovative managerial education”. The results obtained were analysed statistically. Average results and standard deviations were calculated. In order to describe differences between the studied variables present during the process of studies, as well as considering the respondents’ gender, t-Student test for independent samples was performed with the IBM SPSS Statistics 21.0 software package. Correlations between variables were identified by calculation of Pearson and Spearman correlation coefficients. Research results suggest necessity to introduce some changes in the teaching system applied at Polish higher education institutions, not only considering the obtained outcomes, but also impact on students’ willingness to improve their qualifications constantly, improved self-assessment among students and their opportunities at the labour market.

Keywords: higher education, learning outcomes, students, change

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Authors: David Parmenter, Brian Millar

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Obstructive sleep apnoea is a common condition which is generally under-diagnosed. Poorly managed obstructive sleep apnoea carries serious health risks and can greatly impact on the sufferer's quality of life. This publication covers the aetiology, symptoms, and treatment of sleep apnoea. The treatment of Obstructive Sleep Apnoea is an emerging field, and the useful role of the Dental Team is relatively unknown, therefor this paper will highlight the role of the dental team in its treatment. The concept of mandibular advancement appliances, along with the clinical and laboratory stages for constructing them, are documented. It is the hope of the author that this publication will educate healthcare professionals on the role of dental practitioners in the multidisciplinary team for treating sleep apnoea. Objective: Individuals should be more aware of the demographic of patients at risk of sleep apnoea, how it is diagnosed and which group of sleep apnoea patients are suitable to refer for mandibular appliance therapy. Individuals should also be aware of what a mandibular advancement appliance is and how it helps treat obstructive sleep apnoea.

Keywords: sleep apnoea, snoring, sleep appliances, mandibular advancement appliance

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Authors: Adebisi A. Sunday, Babajide Adeokin

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The persistent rise in farm theft in rural region of Nigeria is attributed to the lack of adequate and effective policing in the regions; thus, this brought about the inevitable introduction of native charms on farmlands as a means of fortification of harvests against theft in Ayetoro community. The use of charm by farmers as security on farmlands is a traditional crime control mechanism that is largely based on unwritten laws which greatly influenced the lives of people, and their attitudes toward the society. This research presents a qualitative sociological study on how native charms are deployed by farmers for protection against theft. The study investigated the various types of charms that are employed as security measures among farmers in Ayetoro community and the rationale behind the use of these mechanisms as farm security. The study utilized qualitative method to gather data in the research process. Under the qualitative method, in-depth interview method was adopted to generate a robust and detailed data from the respondents. Also the data generated were analysed qualitatively using thematic content analysis and simple description which was preceded by transcription of data from the recorder. It was revealed that amidst numerous charms known, two major charms are used on farmlands as a measure of social control in Ayetoro community, Ogun state South West Nigeria. Furthermore, the result of this study showed that, the desire for safekeeping of harvest from pilferers and the heavy punishments dispense on offenders by native charms are the reasons why farmers deploy charms on their farms. In addition, findings revealed that the adoption of these charms for protection has improved yields among farmers in the community because the safety of harvest has been made possible by virtue of the presence of various charms in the farm lands. Therefore, based on the findings of this study, it is recommended that such measures should be recognized in mainstream social control mechanisms in the fight against crime in Nigeria and the rest of the world. Lastly, native charms could be installed in all social and cooperate organisation and position of authority to prevent theft of valuables and things hold with utmost importance.

Keywords: Ayetoro, farm theft, mechanism, native charms, Pilferer

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Authors: Caroline Selai, Sushrut Jadhav

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Background: University College London (UCL), the first secular university in England to admit students regardless of their religion and gender, has nearly 29,000 students of which approximately 30% are international students. The UCL Cultural Consultation Service (CCS) for staff and students is a unique service that provides assistance to staff and students experiencing challenges in their teaching, enabling, support work or studies which they believe may have a cultural component. The service provides one-to-one and group consultations, lectures, seminars, ‘grand rounds’, interactive workshops and bespoke interventions. Data: This paper presents a content analysis of CCS referrals over the last 36 months. We focus on the experience of international students, many of whom experience not only a challenge to their academic identity but also a profound challenge to their personal cultural identity. We also present 3 vignettes to illustrate how students interpret, accept, contest and resist changes in their cultural and academic identity. Discussion: This paper highlights (i) how students from collectivist cultures attempt to assimilate within an individualistic, highly competitive western university that is bound by its own institutional norms; (ii) problems in negotiating challenges at the interface of culture and gender (iii) the impact of culturally different hierarchies of power, discrimination and authority and (iv) the significance of earlier traumatic and kinship conflicts. Many international students’ social identities are shaped by their cultural and family scripts. A large number have been taught that their teachers are to be revered and their teachings unchallenged. This is at odds with quintessential goal of the western university to encourage healthy scepticism and hone students’ critical thinking skills. Conclusions: Pupil-teacher ‘cultural transference’ and shifts in cultural academic identities of students underscore critical aspects of developmental and learning challenges for students. Staff-student cultural conflict requires a broader, systemic analysis of students, staff and the wider organisation. Our findings challenge Eurocentric psychodynamic concepts such as the nature of parent-child relationship in Western Europe. We argue for a broader, more inclusive approach to develop both effective pedagogic skills in euro-american academic institutions and culturally- appropriate psychodynamic theory to underpin counselling international students.

Keywords: academic identity, cultural transference, cultural consultation in higher education, cultural formulation, cultural identity.

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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Authors: Rachel S. Chang, Samuel P. Massion, Alan Z. Grusky, Heather A. Ridinger

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Introduction Health advocacy is defined as activities that improve access to care, utilize resources, address health disparities, and influence health policy. Advocacy is increasingly being recognized as a critical component of a physician’s role, as understanding social determinants of health and improving patient care are important aspects within the American Medical Association’s Health Systems Science framework. However, despite this growing prominence, educational interventions that address advocacy topics are limited and variable across medical school curricula. Furthermore, few recent studies have evaluated attitudes toward health advocacy among physicians-in-training in the United States. This study examines medical student attitudes towards health advocacy, along with perceived knowledge, ability, and current level of engagement with health advocacy during their clerkships. Methods This study employed a cross-sectional survey design using a single anonymous, self-report questionnaire to all second-year medical students at Vanderbilt University School of Medicine (n=96) in December 2020 during clerkship rotations. The survey had 27 items with 5-point Likert scale (15), multiple choice (11), and free response questions (1). Descriptive statistics and thematic analysis were utilized to analyze responses. The study was approved by the Vanderbilt University Institutional Review Board. Results There was an 88% response rate among second-year clerkship medical students. A majority (83%) agreed that formal training in health advocacy should be a mandatory part of the medical student curriculum Likewise, 83% of respondents felt that acting as a health advocate or patients should be part of their role as a clerkship student. However, a minority (25%) felt adequately prepared. While 72% of respondents felt able to identify a psychosocial need, 18% felt confident navigating the healthcare system and only 9% felt able to connect a patient to a psychosocial resource to fill that gap. 44% of respondents regularly contributed to conversations with their medical teams when discussing patients’ social needs, such as housing insecurity, financial insecurity, or legal needs. On average, respondents reported successfully connecting patients to psychosocial resources 1-2 times per 8-week clerkship block. Barriers to participating in health advocacy included perceived time constraints, lack of awareness of resources, lower emphasis among medical teams, and scarce involvement with social work teams. Conclusions In this single-institutional study, second-year medical students on clerkships recognize the importance of advocating for patients and support advocacy training within their medical school curriculum. However, their perceived lack of ability to navigate the healthcare system and connect patients to psychosocial resources, result in students feeling unprepared to advocate as effectively as they hoped during their clerkship rotations. Our results support the ongoing need to equip medical students with training and resources necessary for them to effectively act as advocates for patients.

Keywords: clerkships, medical students, patient advocacy, social medicine

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Authors: Murad Almadani, Khalil Abu-Hantash, Xinyu Wang, Herbert Jelinek, Kinda Khalaf

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Gait analysis is used by healthcare professionals as a tool to gain a better understanding of the movement impairment and track progress. In most circumstances, monitoring patients in their real-life environments with low-cost equipment such as cameras and wearable sensors is more important. Inertial sensors, on the other hand, cannot provide enough information on angular dynamics. This research offers a method for tracking 2D joint coordinates using cutting-edge vision algorithms and a single RGB camera. We provide an end-to-end comprehensive deep learning pipeline for marker-less gait parameter estimation, which, to our knowledge, has never been done before. To make our pipeline function in real-time for real-world applications, we leverage the AlphaPose human posture prediction model and a deep learning transformer. We tested our approach on the well-known GPJATK dataset, which produces promising results.

Keywords: gait analysis, human pose estimation, deep learning, real time gait estimation, AlphaPose, transformer

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Authors: Oluwaseun Adeleke, Grace Amarachi Omenife, Jennifer Adebambo, Mopelola Raji, Anthony Nwala, Mogbonjubade Adesulure

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Introduction: The incorporation of digital technology in healthcare systems is instrumental in transforming the delivery, management, and overall experience of healthcare and holds the potential to scale up access through over 200 million active mobile phones used in Nigeria. Digital tools enable increased access to care, stronger client engagement, progress in research and data-driven insights, and more effective promotion of self-care and do-it-yourself practices. The Delivering Innovation in Self-Care (DISC) project 2021 has played a pivotal role in granting women greater autonomy over their sexual and reproductive health (SRH) through a variety of approaches, including information and training to self-inject contraception (DMPA-SC). To optimize its outcomes, the project also leverages digital technology platforms like social media: Facebook, Instagram, and Meet Tina (Chatbot) via WhatsApp, Customer Relationship Management (CRM) applications Freshworks, and Viamo. Methodology: The project has been successful at optimizing in-person digital cyberspace interaction to sensitize individuals effectively about self-injection and provide linkages to SI services. This platform employs the Freshworks CRM software application, along with specially trained personnel known as Cyber IPC Agents and DHIS calling centers. Integration of Freshworks CRM software with social media allows a direct connection with clients to address emerging issues, schedule follow-ups, send reminders to improve compliance with self-injection schedules, enhance the overall user experience for self-injection (SI) clients, and generate comprehensive reports and analytics on client interactions. Interaction covers a range of topics, including – How to use SI, learning more about SI, side-effects and its management, accessing services, fertility, ovulation, other family planning methods, inquiries related to Sexual Reproductive Health as well as uses an address log to connect them with nearby facilities or online pharmaceuticals. Results: Between the months of March to September, a total of 5,403 engagements were recorded. Among these, 4,685 were satisfactorily resolved. Since the program's inception, digital advertising has created 233,633,075 impressions, reached 12,715,582 persons, and resulted in 3,394,048 clicks. Conclusion: Leveraging digital technology has proven to be an invaluable tool in client management and improving client experience. The use of Cyber technology has enabled the successful development and maintenance of client relationships, which have been effective at providing support, facilitating delivery and compliance with DMPA-SC self-injection services, and ensuring overall client satisfaction. Concurrently, providing qualitative data, including user experience feedback, has enabled the derivation of crucial insights that inform the decision-making process and guide in normalizing self-care behavior.

Keywords: selfcare, DMPA-SC self-injection, digital technology, cyber technology, freshworks CRM software

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Authors: Khalid Ishola Bello

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Many religions and cultures believe in the existence of invisible beings who co-exist with man on earth. Muslims, for example, believe in malaikah (Angel) and jinn (demon), who have their source of creation from light and flame, respectively. Jinn, according to Islamic texts, possesses unique characteristics which give them an advantage over the man. Invisibility, transforming into or taking possession of another being are parts of advantages jinn have above man. Hence, jinn can attack man and truncate his well-being by causing malfunction of his physiological and psychological realms, which may go beyond physical health care. It is on this background that this paper aims to articulate the possibility of a demonic attack on human health and the care processes recommended by Islam to heal and restore well-being of the victim. Through analysis of the inductive, deductive, and historical approaches, the process of ruqyah (healing method based on recitation of the Qur’an) and hijamah (cupping) therapies shall be analyzed. The finding shows the efficacy of Islamic remedies to demonic possession, which usually complicates health challenges in the care of man. This alternative approach is therefore recommended for holistic health care since physical health care cannot fix spiritual health challenges.

Keywords: wellbeing, healthcare, demonic possession, cupping, jinn

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Authors: Priyesh Kumar Singh, S. K. Sharma, Sanjay Verma, C. Samuel

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Supplier Relationship Management (SRM), is strategic planning and managing of all interactions with suppliers to maximize its value. Its application varies from construction industries to healthcare system and investment banks to aviation industries. Several buyer-supplier relationship models, as well as supplier selection and evaluation strategies, have been documented by many academicians and researchers. In this paper, through a comprehensive literature review of over 30 published papers, different theoretical models, empirical data and conclusions were analysed relating to SRM to find its role in establishing better supplier relationships. These journal articles were searched by using the keyword “supplier relationship management,” in databases of Mendeley Library, ProQuest, EBSCO and Google Scholar. This paper reviews the academic literature on different relationship models, supplier evaluation, and selection strategies to discuss its implications in different situations. It also describes the dominant factors responsible for buyer-supplier relationships such trust and power. Finally, conclusions have been drawn which can be validated by various researchers and can help practitioners in industries.

Keywords: supplier relationship management, supplier performance, supplier evaluation, supplier selection strategies

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