Search results for: nurses resilience

Authors: M. Deligianni, P. Voultsos, E. Tsamadou

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Background/Introduction: Moral distress is a common occurrence for health professionals working in neonatal critical care. Despite a growing number of critically ill neonatal and pediatric patients, only a few articles related to moral distress as experienced by neonatal physicians have been published over the last years. Objectives/Aims: The aim of this study was to define and identify barriers to and facilitators of moral distress based on the perceptions and experiences of neonatal physicians working in neonatal intensive care units (NICUs). This pilot study is a part of a larger nationwide project. Methods: A multicenter qualitative descriptive study using focus group methodology was conducted. In-depth interviews lasting 45 to 60 minutes were audio-recorded. Once data were transcribed, conventional content analysis was used to develop the definition and categories, as well as to identify the barriers to and facilitators of moral distress. Results: Participants defined moral distress broadly in the context of neonatal critical care. A wide variation of definitions was displayed. The physicians' responses to moral distress included different feelings and other situations. The overarching categories that emerged from the data were patient-related, family-related, and physician-related factors. Moreover, organizational factors may constitute major facilitators of moral distress among neonatal physicians in NICUs. Note, however, that moral distress may be regarded as an essential component to caring for neonates in critical care. The present study provides further insight into the moral distress experienced by physicians working in Greek NICUs. Discussion/Conclusions: Understanding how neonatal and pediatric critical care nurses define moral distress and what contributes to its development is foundational to developing targeted strategies for mitigating the prevalence of moral distress among neonate physicians in the context of NICUs.

Keywords: critical care, moral distress, neonatal physician, neonatal intensive care unit, NICU

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Authors: M. A. Brown, K. Hugill, D. Meredith

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Since the establishment of midwifery, as a professional identity in its own right, in the early years of the 20th century, midwifery-led models of childbirth have prevailed in many parts of the world. However, in many locations midwives’ scope of practice remains underdeveloped or absent. In Qatar, all births take place in hospital and are under the professional jurisdiction of obstetricians, predominately supported by internationally trained nurse-midwives and obstetric nurses. The strategic vision for health services in Qatar endorsed a desire to provide women with the ‘Best Care Always’ and the introduction of midwifery was seen as a way to achieve this. In 2015 the process of recruiting postgraduate educated Clinical Midwife Specialists from international sources began. The midwives were brought together to initiate an in hospital and community service transformation plan. This plan set out a series of wide-ranging actions to transform maternity and neonatal services to make care safer and give women more health choices. Change in any organization is a complex and dynamic process. This is made even more complex when multifaceted professional and cross cultural factors are involved. This presentation reports upon the motivations and challenges that exist and the progress around introducing a multicultural midwifery model of childbirth care in the state of Qatar. The paper examines and reflects upon the drivers and unique features of childbirth in the country. Despite accomplishments, progress still needs to be made in order to fully implement sustainable changes to further improve care and ensure women and neonates get the ‘Best Care Always’. The progress within the transformation plan highlights how midwifery may coexist with competing models of maternity care to create an innovative, eclectic and culturally sensitive paradigm that can best serve women and neonatal health needs.

Keywords: culture, managing change, midwifery, neonatal, service transformation plan

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Authors: Lakmali Anthony, Bushra Oathman, Anshini Jain, Raaj Chandra

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Introduction: Abscesses are traditionally treated by incision and drainage with the packing of the residual abscess cavity until healing. This method requires regular visits from community nurses for continuous wound packing upon discharge from the hospital and causes considerable patient discomfort. Whether abscess cavity packing offers any advantage over non-packing has not yet been adequately studied to the best of our knowledge. This study aims to determine if there are differences in clinical outcomes of time to healing, fistula formation and recurrence of abscess between abscess cavity packing vs. non-packing groups. Methods: This study was a single-center, single-blind, randomized controlled trial where patients were randomized into packing and non-packing arms. All patients over 18 years presenting to Eastern Health with an abscess requiring incision and drainage in the theatre were invited to participate. Those with underlying conditions that cause recurrent abscesses were excluded. Data were collected from December 2018 to April 2020. Results: There were 63 patients who had abscesses treated with incision and drainage that were enrolled in the study, 52 of which were suitable for analysis. Demographic characteristics were similar in both groups. The packing group had a significantly longer time to heal compared to the non-packing group. Rates of fistula formation and recurrence of abscess were low and there were no statistically significant differences between groups. The packing group had more patients with delayed healing (defined as >60 days) and required more follow-up visits compared to the non-packing group. Conclusion: This pilot study indicates that abscesses can not only be managed safely with incision and drainage alone without the need for continuous abscess cavity packing but also that non-packing may offer clinical benefits to patients with earlier healing of abscesses compared to continuous cavity packing.

Keywords: abscess packing, subcutaneous, perianal, pilonidal

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Authors: Changaiz Khan

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Pakistan has the highest rates of maternal mortality in South Asia. From the year 2000 to 2017 the global rate of maternal mortality has decreased up to 39 %. In the context of South Asia, it has decreased by 59% since 2000s. Pakistan has also reduced the rate of maternal mortality, but there is a difference on the provincial level. According to the report of the National Institute of Population Studies (NIPS) conducted in 2020, the MMR in Balochistan has crossed the ratio of most of the South Asian countries, i.e., 298 maternal deaths per 100,000 live births. In comparison, the province of Punjab has the lowest maternal mortality rate i.e. 157 deaths (per 100,000 live births). The rate of maternal mortality is much higher in Balochistan as compared to the other provinces. This research is aimed to discuss the supply side barriers and utilization of maternal healthcare services in the District Gwadar. Likert scale survey method has been used to collect data from the Healthcare Professionals from hospitals -private and government- and the maternal healthcare receiver, that is patient. Semi-structured interviews of healthcare professionals such as doctors, nurses, and Lab technicians have also been conducted. It has been found in this research study that the hospitals in Gwadar district are lagging behind in providing modern maternal healthcare to women due to the lack of staff training, medicine supply, and Laboratories. Moreover, the system of the lady health worker is also not catering to the needs of the women in District Gwadar. It has been recommended in the study that first of all the government should fulfill the supply of the medicine in the hospital. Secondly, the government should open laboratories in the hospitals. Thirdly, the government should increase the funding of the government hospital and the allocation of lady health workers in District Gwadar, Balochistan should be increased.

Keywords: maternal mortality, neonatal, postnatal, supply barriers, patients, healthcare professionals, laboratory, medical supply, training

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Authors: Abdelrahman Elsehsah, Abdelazim Negm, Eid Ashour, Mohamed Elsahabi

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Water resources management is a critical field that encompasses the planning, development, conservation, and allocation of water resources to meet societal needs while ensuring environmental sustainability. This paper reviews the key concepts and challenges in water resources management, emphasizing the significance of a holistic approach that integrates social, economic, and environmental factors. Traditional water management practices, characterized by supply-oriented strategies and centralized control, are increasingly inadequate in addressing contemporary challenges such as water scarcity, climate change impacts, and ecosystem degradation. Emerging technologies, particularly machine learning and remote sensing, offer innovative solutions to enhance decision-making processes in water management. Machine learning algorithms facilitate accurate water demand forecasting, quality monitoring, and leak detection, while remote sensing technologies provide vital data for assessing water availability and quality. This review highlights the need for integrated water management strategies that leverage these technologies to promote sustainable practices and foster resilience in water systems. Future research should focus on improving data quality, accessibility, and the integration of diverse datasets to optimize the benefits of these technological advancements.

Keywords: water resources management, water scarcity, climate change, machine learning, remote sensing, water quality, water governance, sustainable practices, ecosystem management

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Authors: Mattia Testuzza

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Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

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Authors: Ande Nesmith

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There is an ongoing shortage of foster parents worldwide to take on a growing population of children in need of out-of-home care. Currently, resources are primarily aimed at recruitment rather than retention. Retention rates are extraordinarily low, especially in the first two years of fostering. Qualitative interviews with 19 foster parents averaging 20 years of service provided insight into the challenges they faced and how they overcame them. Thematic analysis of interview transcripts identified sources of stress and resiliency. Key stressors included lack of support and responsiveness from the children’s social workers, false maltreatment allegations, and secondary trauma from children’s destructive behaviors and emotional dysregulation. Resilient parents connected with other foster parents for support, engaged in creative problem-solving, recognized that positive feedback from children usually arrives years later, and through training, understood the neurobiological impact of trauma on child behavior. Recommendations include coordinating communication between the foster parent licensing agency social workers and the children’s social workers, creating foster parent support networks and mentoring, and continuous training on trauma including effective parenting strategies. Research is needed to determine whether these resilience indicators in fact lead to long-term retention. Policies should include a mechanism to develop a cohesive line of communication and connection between foster parents and the children’s social workers as well as their respective agencies.

Keywords: foster care stability, foster parent burnout, foster parent resiliency, foster parent retention, trauma-informed fostering

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Authors: M. Adamczak-Retecka, O. Hołub-Śniadach

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Dangerous of climate change is now global problem and as such has a strategic priority also for the European Union. Europe and European citizens try to do their best to cut greenhouse gas emissions, moreover they substantially encourage other nations and regions to follow the same way. The European Commission and a number of Member States have developed adaptation strategies in order to help strengthen EU's resilience to the inevitable impacts of climate change. The EU has long been a driving force in international negotiations on climate change and was instrumental in the development of the UN Framework Convention on Climate Change. As the world's leading donor of development aid, the EU also provides substantial funding to help developing countries tackle climate change problem. Global warming influences human health, biodiversity, ecosystems but also many social and economic sectors. The aim of this paper is to focus on impact of claimant change on for food security. Food security challenges are directly related to globalization, climate change. It means that current and future food policy is exposed to all cross-cutting and that must be linked with environmental and climate targets, which supposed to be achieved. In the 7th EAP —The new general Union Environment Action Program to 2020, called “Living well, within the limits of our planet” EU has agreed to step up its efforts to protect natural capital, stimulate resource efficient, low carbon growth and innovation, and safeguard people’s health and wellbeing– while respecting the Earth’s natural limits.

Keywords: climate change, food security, sustainable food consumption, climate governance

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Authors: Ali Reza Ghanbarnezhad Ghazvini, Seyyed Hamid Reza Mosayyebi

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In recent years, an earthquake has occurred approximately every five years in certain regions of Iran. To mitigate the impact of these seismic events, it is crucial to identify and thoroughly assess the vulnerability of buildings and infrastructure, ensuring their safety through principled reinforcement. By adopting new methods of risk assessment, we can effectively reduce the potential risks associated with future earthquakes. In our research, we have observed that the coefficient of behavior in the fourth chapter is 1.65 for the initial structure and 1.72 for the Superframe structure. This indicates that the Superframe structure can enhance the strength of the main structural members by approximately 10% through the utilization of super beams. Furthermore, based on the comparative analysis between the two structures conducted in this study, we have successfully designed a stronger structure with minimal changes in the coefficient of behavior. Additionally, this design has allowed for greater energy dissipation during seismic events, further enhancing the structure's resilience to earthquakes. By comprehensively examining and reinforcing the vulnerability of buildings and infrastructure, along with implementing advanced risk assessment techniques, we can significantly reduce casualties and damages caused by earthquakes in Iran. The findings of this study offer valuable insights for civil engineering professionals in the field of structural engineering, aiding them in designing safer and more resilient structures.

Keywords: modal pushover analysis, response modification factor, high-strength concrete, concrete shear walls, high-rise building

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Authors: Danielle Preziuso, Kamila Kazimierczuk, Annalise Stein, Bethel Tarekegne

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Coastal communities experience a variety of distinct socioeconomic, technical, and environmental vulnerabilities, all of which accrue heightened risk with increasingly frequent and severe climate change impacts. Marine renewable energy (MRE) offers a potential solution for mitigating coastal community vulnerabilities, especially water-energy dependencies while delivering promising co-benefits such as increased resilience and more sustainable energy outcomes. This paper explores coastal community vulnerabilities and service dependencies based on the local drivers that create them, with attention to climate change impacts and how they catalyze water-energy unmet needs in these communities. We examine the vulnerabilities through the lens of coastal Tribal communities (i.e., the Makah Tribe, the Kenaitze Tribe, Quinault Nation), as indigenous communities often face compounded impacts of technical, economic, and environmental vulnerabilities due to their underlying socio-demographic inequalities. We offer an environmental and energy justice indicators framework to understand how these vulnerabilities disproportionately manifest and impact the most vulnerable community members, and we subsequently utilize the framework to inform a weighted decision matrix tool that compares the viability of MRE-based alternative energy futures in addressing these vulnerabilities. The framework and complementary tool highlight opportunities for future MRE research and pilot demonstrations that directly respond to the vulnerabilities of coastal communities.

Keywords: coastal communities, decision matrix, energy equity, energy vulnerability, marine energy, service dependency

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Authors: Sarinra Thongmee, Krittaporn Prakobsaeng, Adithep Mingsuan, Chanyapak Polkhet, Supattra Wongsuk

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The purposes of this research and developmentwasto develop and evaluation of the clinical nursingpractice guideline (CNPG) for the prevention infection during intubation in patient with suspected or confirmedCOVID-19 patient. This study was developed by using the evidencebased practice model of Soukup (2000) asa conceptual framework. The study consisted of 4 steps: 1) situational analysis of intubation service in patientswith confirmed COVID-19; 2) development of the CNPG; 3) apply the NPG to trial; and 4) evaluation of the CNPG. The sample consisted of 52 nurse anesthetists and 25 infected or suspected COVID-19 patients. The research instrument consisted of 1) the CNPG, which was developed by the researchers; 2) the nurses anesthetist opinion questionnaire to the guideline; 3) the evaluation practice form; and 4) the nurse anesthetist knowledge test on nursing care of patients infected with COVID-19. Data were analyzed by using descriptive statistics, and Wilcoxon matched-pairs signed rank test. The results revealed this developed CNPG consists of 4 sections: 1)the CNPG for airborne precautions2) the preparation of anesthetic and intubation equipments3) the roles and duties of the intubation team, 4) the guidelines for intubation in suspected or confirmed COVID-19 patients. The results of CNPG use found that 1)the provider: using NPG in providers revealed that nurse anesthetist had a higher mean of knowledge scores than before using CNPG statistically significant at the 0.05 level (p<0.01) and able to follow the NPG 100% inall activities. The anesthetic team was not infected with COVID-19 from intubation outside the operating room. 2)the client: the patient was safe, with no complications from intubation. Summary CNPG to prevent infection during reintubation of suspected or confirmedCOVID-19patient was appropriate and applicable to practice.

Keywords: clinical nursing practice guideline, prevention of infection, endotracheal intubation, COVID-19

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Authors: Joanna Apps, Elena Markova

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Concepts of the ideal mother and ideal mothering are disseminated through familial experiences, religious and cultural depictions of mothers and the national media. In recent years social media can also be added to the channels by which mothers and motherhood are socially constructed. However, the gulf between these depictions, -or in the case of social media ‘self-curations’ - of motherhood and lived experience has never been wider, particularly for women in disadvantaged or difficult circumstances. We report on a study of four lone mothers who were living with one or more of the following: limiting long term illness, large families, in temporary accommodation and on low incomes. The mothers were interviewed 3 times and invited to take a series of photos reflecting their lives in between each of the interviews. These photographs were used to ground the interviews in lived experience and as stimuli to discuss how the images within them compared to portrayals of mothers and motherhood that participants were exposed to on social media. The objectives of the study were to explore how mothers construct their identity in challenging and disadvantaged circumstances; to consider what their photographs of everyday life tell us about their experiences and understand the impact idealised images of motherhood have on real mothers in difficult circumstances. The results suggested that the mothers both strived to adhere to certain ideals of motherhood and acknowledged elements of these as partially or wholly impossible to achieve. The lack of depictions, in both national and social media, of motherhood that corresponded with their lived experience inhibited the mothers’ use of social media. Other themes included: lack of control, frustration and strain; and parental pride, love, humour, resilience, and hope.

Keywords: motherhood, social media, photography, poverty

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Authors: Elizelle Juaneé Cilliers

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The green hype is becoming stronger within various disciplines, modern practices and academic thinking, enforced by concepts such as eco-health, eco-tourism, eco-cities, and eco-engineering. There is currently also an expanded scientific understanding regarding the value and benefits relating to green infrastructure, for both communities and their host cities, linked to broader sustainability and resilience thinking. The integration and implementation of green infrastructure as part of spatial planning approaches and municipal planning, are, however, more complex, especially in South Africa, inflated by limitations of budgets and human resources, development pressures, inequities in terms of green space availability and political legacies of the past. The prevailing approach to spatial planning is further contributing to complexity, linked to misguided perceptions of the function and value of green infrastructure. As such, green spaces are often considered a luxury, and green infrastructure a costly alternative, resulting in green networks being susceptible to land-use changes and under-prioritized in local authority decision-making. Spatial planning, in this sense, may well be a valuable tool to realise the green agenda, encapsulating various initiatives of sustainability as provided by a range of disciplines. This paper aims to clarify the importance and value of green infrastructure planning as a component of spatial planning approaches, in order to inform and encourage local authorities to embed sustainability thinking into city planning and decision-making approaches. It reflects on the decisive role of land-use management to guide the green agenda and refers to some recent planning initiatives. Lastly, it calls for trans-disciplinary planning approaches to build a case towards green(er) cities.

Keywords: green infrastructure, spatial planning, transdisciplinary, integrative

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Authors: Jessica Lynne Hicksted

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Disability discrimination is a long-standing issue that, despite protections, continues to result in unemployment, underemployment, and lack of advancement for disabled persons. Visible stigma is researched substantially; however, less is known about the impact of stigma associated with identities that can be concealed. Although researchers have investigated this issue, currently there is no tool to measure this phenomenon. The purpose of this quantitative study was to create and validate a new tool to measure stigma associated with invisible disabilities. The study is grounded by Roberts’ conceptual model of professional image construction integrating social identity, impression management, and organizational behavior; Meisenbach’s stigma management communication theory addressing the vulnerabilities and resilience to stigma communication by focusing on how individuals encounter and react to perceived stigmas; and Kelley and Michela’s causal attribution theory. Participants included 1,412 adults in the United States 18 years or older currently employed or who have been employed within the last 5 years. Confirmatory factor analysis of the new Workplace Invisible Disabilities Experience scale showed excellent fit of the factor structure to the data, X₂/df = 1.855, CFI = .955, RMSEA = .045, p = .0001. The scale has three subscales, Ableism, Advocacy, and Acceptance, with excellent internal consistency reliability. Total score, Advocacy, and Acceptance were associated with intention to disclose. Implications for positive social change include helping organizations to understand the extent of invisible disability stigma that can help improve workplace performance and satisfaction.

Keywords: invisible disabilities, accommodations, acceptance, social change, workplace inclusion

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Authors: Nuno M. Pereira

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In the last thirty years, European cities have been addressing global climate change and its local impacts by implementing mitigation and adaptation strategies. Lisbon Downtown is no exception with 10 plans under implementation since 2010 with completion scheduled for 2030 valued 1 billion euros of public investment. However, the gap between mitigation and adaptation strategies is not yet sufficiently studied alongside with its nuances- vulnerability and risk mitigation, resilience and adaptation. In Lisbon Downtown, these plans are being implemented separately, therefore compromising the effectiveness of public investment. The research reviewed the common ground of mitigation and adaptation strategies of the theoretical framework and analyzed the current urban development actions in Lisbon Downtown in order to identify potential conflicts and synergies. The empirical fieldwork supported by a sounding board of experts has been developed during two years and the results suggest that the largest public investment in Lisbon on flooding mitigation will conflict with the new Cruise ship terminal and old Downton building stock, therefore increasing risk and vulnerability factors. The study concludes that the Lisbon Downtown blue infrastructure plan should be redesigned in some areas in a trans- disciplinary and holistic approach and that the current theoretical framework on climate change should focus more on mitigation and adaptation synergies articulating the gray, blue and green infrastructures, combining old knowledge tested by resilient communities and new knowledge emerging from the digital era.

Keywords: adaptation, climate change, conflict, Lisbon Downtown, mitigation, synergy

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Authors: Gaurav Kumar Sinha

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The oil and gas industry is a critical component of the global economy, relying heavily on industrial control systems (ICS) to manage and monitor operations. However, these systems are increasingly becoming targets for cyber-attacks, posing significant risks to operational continuity, safety, and environmental integrity. This paper explores comprehensive cybersecurity strategies for protecting oil and gas industrial control systems. It delves into the unique vulnerabilities of ICS in this sector, including outdated legacy systems, integration with IT networks, and the increased connectivity brought by the Industrial Internet of Things (IIoT). We propose a multi-layered defense approach that includes the implementation of robust network security protocols, regular system updates and patch management, advanced threat detection and response mechanisms, and stringent access control measures. We illustrate the effectiveness of these strategies in mitigating cyber risks and ensuring the resilient and secure operation of oil and gas industrial control systems. The findings underscore the necessity for a proactive and adaptive cybersecurity framework to safeguard critical infrastructure in the face of evolving cyber threats.

Keywords: cybersecurity, industrial control systems, oil and gas, cyber-attacks, network security, IoT, threat detection, system updates, patch management, access control, cybersecurity awareness, critical infrastructure, resilience, cyber threats, legacy systems, IT integration, multi-layered defense, operational continuity, safety, environmental integrity

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Authors: Thanom Kaeniam

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ST-Elevation Myocardial Infarction (STEMI) is a state of sudden death of the heart muscle due to sudden blockage of the artery. STEMI patients are usually in critical condition and with a potential opportunity for sudden death. Therefore, management guidelines for safety in caring and referring STEMI patients are needed. The objective of this developmental research was to assess the effectiveness of using the guidelines for caring and referring STEMI patients at the Accident and Emergency Department of Songkhla Hospital. The subjects of the study were 22 nurses in the emergency room, and doctors on duty in the accident and emergency room selected using purposive sampling with inclusion criteria. The research instruments were the guidelines for caring and referring STEMI patients, and record forms for the effectiveness of using the guidelines for caring and referring STEMI patients (a general record form for STEMI patients, a record form for SK administering, a referring record form for PCI, and a record form for dead patient in the accident and emergency room and during referring). The instruments were tested for content validity by three experts, and the reliability was tested using Kuder-Richardson 20 (KR20). The descriptive statistic employed was the percentage. The outcomes of using the guidelines for caring and referring ST Elevation Myocardial Infarction (STEMI) Patients at the Accident and Emergency Department revealed that before using the guidelines in 2009, 2010, and 2011, there were 84, 73, and 138 STEMI patients receiving services at the accident and emergency room, of which, only 9, 32, and 48 patients were referred for PCI/SK medications, or 10.74; 43.84; and 34.78 percent, and the death rates were 10.71; 10.95; and 11.59 percent, respectively. However, after the use of the guidelines in 2012, 2013, and 2014, there were 97, 77, and 57 patients, of which, the increases to 77, 72, and 55 patients were referred for PCI /SK medications or 79.37; 93.51; and 96.49 percent, and the death rates were reduced to 10.30; 6.49; and 1.76 percent, respectively. The results of the study revealed that the use of the guidelines for caring and referring STEMI patients at the Accident and Emergency Department increased the effectiveness and quality of nursing, especially in terms of SK medication, caring and referring patients for PCI to reduce the death rate.

Keywords: outcomes, guidelines for caring, referring, myocardial infarction, STEMI

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Authors: Salman Naseer

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One of the main challenges of operating a smart city (SC) is collecting the massive data generated from multiple data sources (DS) and to transmit them to the control units (CU) for further data processing and analysis. These ever-increasing data demands require not only more and more capacity of the transmission channels but also results in resource over-provision to meet the resilience requirements, thus the unavoidable waste because of the data fluctuations throughout the day. In addition, the high energy consumption (EC) and carbon discharges from these data transmissions posing serious issues to the environment we live in. Therefore, to overcome the issues of intensive EC and carbon emissions (CE) of massive data dissemination in Smart Cities, we propose an energy efficient and carbon reduction approach by utilizing the daily mobility of the existing vehicles as an alternative communications channel to accommodate the data dissemination in smart cities. To illustrate the effectiveness and efficiency of our approach, we take the Auckland City in New Zealand as an example, assuming massive data generated by various sources geographically scattered throughout the Auckland region to the control centres located in city centre. The numerical results show that our proposed approach can provide up to 5 times lower delay as transferring the large volume of data by utilizing the existing daily vehicles’ mobility than the conventional transmission network. Moreover, our proposed approach offers about 30% less EC and CE than that of conventional network transmission approach.

Keywords: smart city, delay tolerant network, infrastructure offloading, opportunistic network, vehicular mobility, energy consumption, carbon emission

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Priya Nambisan, Lien B. Nguyen

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Women participate extensively in the healthcare field, professionally (as physicians, nurses, dietitians, etc.) as well as informally (as caregivers at home). This provides them with a better understanding of the health needs of people. Women are also in the forefront of using social media and other mobile health related apps. Further, many health mobile apps are specifically designed for women users. All of these indicate the potential for women to be successful entrepreneurs in healthcare, especially, in the area of mobile health app development. However, extant research in entrepreneurship has paid limited attention to women entrepreneurship in healthcare. The objective of this study is to determine the key factors that shape the intentions and actions of women entrepreneurs with regard to their entrepreneurial pursuits in the healthcare field. Specifically, the study advances several hypotheses that relate key variables such as personal skills and capabilities, experience, support from institutions and family, and perceptions regarding entrepreneurship to individual intentions and actions regarding entrepreneurship (specifically, in the area of mobile apps). The study research model will be validated using survey data collected from potential women entrepreneurs in the healthcare field – students in the area of health informatics and engineering. The questionnaire-based survey relates to woman respondents’ intention to become entrepreneurs in healthcare and the key factors (independent variables) that may facilitate or inhibit their entrepreneurial intentions and pursuits. The survey data collection is currently ongoing. We also plan to conduct semi-structured interviews with around 10-15 women entrepreneurs who are currently developing mobile apps to understand the key issues and challenges that they face in this area. This is an exploratory study and as such our goal is to combine the findings from the regression analysis of the survey data and that from the content analysis of the interview data to inform on future research on women entrepreneurship in healthcare. The study findings will hold important policy implications, specifically for the development of new programs and initiatives to promote women entrepreneurship, particularly in healthcare and technology areas.

Keywords: women entrepreneurship, healthcare, mobile apps, health apps

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Authors: Walter M. Millanzi, Stephen M. Kibusi

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Background: Currently, there has been a progressive shortage not only to the number but also the quality of medical practitioners for the most of nursing. Despite that, those who are present exhibit unethical and illegal practices, under standard care and malpractices. The concern is raised in the ways they are prepared, or there might be something missing in nursing curricula or how it is delivered. There is a need for transforming or testing new teaching modalities to enhance competent health workforces. Objective: to investigate the Effect of Facilitation in a Problem-based Environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. Methods: quasi-experimental study (quantitative research approach). A purposive sampling technique was employed to select institutions and achieving a sample size of 401 participants (interventional = 134 and control = 267). Self-administered semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentations. Results: The pre-post test results between groups indicated noticeably significant change on metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p < 0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p < 0.01). A FPBE teaching pedagogy, was observed to be effective on the metacognition (AOR = 1.603, p < 0.05), SDL (OR = 1.729, p < 0.05) and Intrinsic motivation in learning (AOR = 1.720, p < 0.05) against conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p > 0.05) and Amotivation (AOR = 0.538, p > 0.05). Conclusion and recommendation: FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students. Nursing curricula developers should incorporate it to produce 21st century competent and qualified nurses.

Keywords: facilitation, metacognition, motivation, self-directed

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Authors: Hiroko Komatsu, Kaori Yagasaki

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Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

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Authors: Harumi Katayama, Mina Suzuki, Taeko Muramatsu, Yui Shimogawa, Yoshimi Mizushima, Mitsuo Hiramatsu, Kimitsugu Nakamura, Takeshi Suzue

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Purpose: There are very often footbaths in the hot-spring area as culture from old days in Japan. This culture moderately supported mental and physical health among people. In Japanese hospitals, nurses provide footbath for severe patients to mental comfortable. However, there are only a few evidences effect of footbath for mental comfortable. In this presentation, we show the effect of stress relief of the footbath using biomarker among 35 college students in volunteer. Methods: The experiment was designed in two groups of the footbath group and the simple relaxation group randomly. As mental load, Kraepelin test was given to the students beforehand. Ultra-weak chemiluminescence (UCL) in saliva and self-administered liner scale measurable emotional state were measured on four times concurrently; there is before and after the mental load, after the stress relief, and 30 minutes after the stress relief. The scale that measured emotional state was consisted of 7 factors; there is excitement, relaxation, vigorous, fatigue, tension, calm, and sleepiness with 22 items. ANOVA was calculated effect of the footbath for stress relief. Results: The level of UCL (photons/100sec) was significantly increased in response on both groups after mental load. After the two types of stress relief, UCL (photons/100sec) of footbath group was significantly decreased compared to simple relaxation group. Score of sleepiness and relaxation were significantly increased after the stress relief in the footbath group than the simple relaxation group. However, score of excitement, vigorous, tension, and calm were exhibit the same degree of decrease after the stress relief on both group. Conclusion: It was suggested that salivary UCL may be a sensitive biomarker for mild stress relief as nursing care. In the future, we will measure using UCL to evaluate as stress relief for inpatients, outpatients, or general public as the subjects.

Keywords: bio-marker, footbath, Japan, stress relief

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Authors: Huang Chiung Chiu

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This article is about the nursing experience of assisting an outpatient with premature menopause, osteoporosis and sarcopenia through a multi-discipline care model. The nursing period is from September 22nd, 2020, to December 7th, 2020, collecting data through interviews with the patient, observation, and physical assessment. It was found that the main health problems were insufficient nutrition, less physical need, insomnia, and potentially dangerous falls. As an outpatient nurse, the author observed that in recent years, the age group of women with premature menopause, osteoporosis and sarcopenia had shifted downward. Integrated multi-disciplinary interventions were provided upon the initial diagnosis of osteoporosis and sarcopenia. Under the outpatient care setting, the collaborative team works between the doctors, nutritionists, osteoporosis educators, rehabilitates, physical therapists and other specialized teams were applied to provide individualized, integrated multi-disciplinary care. Through empathy and the establishment of attentive care, companionship and trust, we discussed care plans and treatment guidelines with the case, providing accurate, complete disease information and feedback education to strengthen the patient’s knowledge and motivation for exercise. Nursing guidance regarding the dietary nutrition and adjustment of daily routine was provided to increase the self-care ability, improve the health problems of muscle weakness and insomnia, and prevent falls. For patients with postmenopausal osteoporosis and sarcopenia, it is recommended that the nurses coordinate the multi-discipline integrated care model, adjust patients’ lifestyle and diet, and establish a regular exercise plan so that the cases can be evaluated holistically to improve the quality of care and physical and mental comfort.

Keywords: multi-discipline care model, premature menopause, osteoporosis, sarcopenia, insomnia

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Authors: Kathryn Strachan, Sameer Otoom, Amal AL-Gallaf, Ahmed Al Ansari

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Introduction: Introducing a reliable method to select graduates for an award in higher education can be challenging but is not impossible. Multisource feedback (MSF) is a popular assessment tool that relies on evaluations of different groups of people, including physicians and non-physicians. It is useful for assessing several domains, including professionalism, communication and collaboration and may be useful for selecting the best interns to receive a University award. Methods: 16 graduates responded to an invitation to participate in the student award, which was conducted by the Royal College of Surgeons of Ireland-Bahrain Medical University of Bahrain (RCSI Bahrain) using the MSF process. Five individuals from the following categories rated each participant: physicians, nurses, and fellow students. RCSI Bahrain graduates were assessed in the following domains; professionalism, communication, and collaboration. Mean and standard deviation were calculated and the award was given to the graduate who scored the highest among his/her colleagues. Cronbach’s coefficient was used to determine the questionnaire’s internal consistency and reliability. Factor analysis was conducted to examine for the construct validity. Results: 16 graduates participated in the RCSI-Bahrain interns’ award based on the MSF process, giving us a 16.5% response rate. The instrument was found to be suitable for factor analysis and showed 3 factor solutions representing 79.3% of the total variance. Reliability analysis using Cronbach’s α reliability of internal consistency indicated that the full scale of the instrument had high internal consistency (Cronbach’s α 0.98). Conclusion: This study found the MSF process to be reliable and valid for selecting the best graduates for the interns’ awards. However, the low response rates may suggest that the process is not feasible for allowing the majority of the students to participate in the selection process. Further research studies may be required to support the feasibility of the MSF process in selecting graduates for the university award.

Keywords: MSF, RCSI, validity, Bahrain

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Authors: S. Karthikeyan, Naveen Bindra

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Introduction: To update ourselves and understand the concept of latest electronic formats available for Health care providers and how it could be used and developed as per standards. The idea is to correlate between the patients Manual Medical Records keeping and maintaining patients Electronic Information in a Health care setup in this world. Furthermore this stands with adapting to the right technology depending upon the organization and improve our quality and quantity of Healthcare providing skills. Objective: The concept and theory is to explain the terms of Electronic Medical Record (EMR), Electronic Health Record (EHR) and Personal Health Record (PHR) and selecting the best technical among the available Electronic sources and software before implementing. It is to guide and make sure the technology used by the end users without any doubts and difficulties. The idea is to evaluate is to admire the uses and barriers of EMR-EHR-PHR. Aim and Scope: The target is to achieve the health care providers like Physicians, Nurses, Therapists, Medical Bill reimbursements, Insurances and Government to assess the patient’s information on easy and systematic manner without diluting the confidentiality of patient’s information. Method: Health Information Technology can be implemented with the help of Organisations providing with legal guidelines and help to stand by the health care provider. The main objective is to select the correct embedded and affordable database management software and generating large-scale data. The parallel need is to know how the latest software available in the market. Conclusion: The question lies here is implementing the Electronic information system with healthcare providers and organisation. The clinicians are the main users of the technology and manage us to ‘go paperless’. The fact is that day today changing technologically is very sound and up to date. Basically the idea is to tell how to store the data electronically safe and secure. All three exemplifies the fact that an electronic format has its own benefit as well as barriers.

Keywords: medical records, digital records, health information, electronic record system

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Authors: Atefeh Kalantari

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The increase in population and energy consumption has caused environmental crises such as the energy crisis, increased pollution, and climate change, all of which have resulted in a decline in the quality of life, especially in urban environments. Iran is one of the developing countries which faces several challenges concerning energy use and environmental sustainability such as air pollution, climate change, and energy security. On the other hand, due to its favorable geographic characteristics, Iran has diverse and accessible renewable sources, which provide appropriate substitutes to reduce dependence on fossil fuels. Sustainable development programs and post-carbon cities rely on implementing energy policies in different sectors of society, particularly, the built environment sector is one of the main ones responsible for energy consumption and carbon emissions for cities. Because of this, several advancements and programs are being implemented to promote energy efficiency for urban planning, and city experts, like others, are looking for solutions to deal with these problems. Among the solutions provided for this purpose, low-carbon design can be mentioned. Among the different scales, the neighborhood can be mentioned as a suitable scale for applying the principles and solutions of low-carbon urban design; Because the neighborhood as a "building unit of the city" includes elements and flows that all affect the number of CO2 emissions. The article aims to provide criteria for designing a low-carbon and carbon-free neighborhood through descriptive methods and secondary data analysis. The ultimate goal is to promote energy efficiency and create a more resilient and livable environment for local residents.

Keywords: climate change, low-carbon urban design, carbon-free neighborhood, resilience

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Authors: Ida Fatimawati Adi Badiozaman, Augustus Raymond Segar

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The Covid-19 pandemic transformed teaching contexts at an unprecedented level. Although studies have focused mainly on its impact on students, little is known about how emergency online teaching affects faculty members in higher education. Given that the pandemic has robbed teachers of opportunities for adequate preparation, it is vital to understand how teaching competencies were perceived in the crisis-response transition to online teaching and learning (OTL). Therefore, the study explores how academics perceive their readiness for OTL and what competencies were perceived to be central. Therefore, through a mixed-methods design, the study first explores through a survey how academics perceive their readiness for OTL and what competencies were perceived to be central. Emerging trends from the quantitative data of 330 academics (three public and three private Higher learning institutions) led to the formulation of interview guides for the subsequent qualitative phase. The authors use critical sensemaking (CSM) to analyse interviews with twenty-two teachers (n = 22) (three public; three private HEs) toward understanding the interconnected layers of influences they draw from as they make sense of their teaching competence. The sensemaking process reframed competence and readiness in that agentic competency emerged as crucial in shaping resilience and adaptability during the transition to OTL. The findings also highlight professional learningcriticalto teacher competence: course design, communication, time management, technological competence, and identity (re)construction. The findings highlight opportunities for strategic orientation to change during crisis. Implications for pedagogy and policy are discussed.

Keywords: online teaching, pedagogical competence, agentic competence, agency, technological competence

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Authors: Olivier Chaigneau, Damianos Oikonomidis, Marie-Cecile Delmas

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GAMBAS (Galileo Advanced features for the Maritime domain: Breakthrough Applications for Safety and security) is a project funded by the European Space Program Agency (EUSPA) aiming at identifying the search-and-rescue and ship security alert system needs for maritime users (including operators and fishing stakeholders) and developing operational concepts to answer these needs. The general objective of the GAMBAS project is to support the deployment of Galileo exclusive features in the maritime domain in order to improve safety and security at sea, detection of illegal activities and associated surveillance means, resilience to natural and human-induced emergency situations, and develop, integrate, demonstrate, standardize and disseminate these new associated capabilities. The project aims to demonstrate: improvement of the SAR (Search And Rescue) and SSAS (Ship Security Alert System) detection and response to maritime distress through the integration of new features into the beacon for SSAS in terms of cost optimization, user-friendly aspects, integration of Galileo and OS NMA (Open Service Navigation Message Authentication) reception for improved authenticated localization performance and reliability, and at sea triggering capabilities, optimization of the responsiveness of RCCs (Rescue Co-ordination Centre) towards the distress situations affecting vessels, the adaptation of the MCCs (Mission Control Center) and MEOLUT (Medium Earth Orbit Local User Terminal) to the data distribution of SSAS alerts.

Keywords: Galileo new advanced features, maritime, safety, security

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Authors: Szu-Mei Hsiao

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Many nurses have concerns about the difficulties of providing spiritual care for ethnic-Chinese patients and family members within their cultural context. This is due to a lack of knowledge and training. Most family caregivers are female. There has been little research exploring the potential impact of Chinese cultural values on the spiritual distress of couple dyadic participants in Taiwan. This study explores the spiritual issues of Taiwanese women coping with their husband’s advanced cancer during palliative care to death. Qualitative multiple case studies were used. Data was collected through participant observation and in-depth face-to-face interviews. Transcribed interview data was analyzed by using qualitative content analysis. Three couples were recruited from a community-based rural hospital in Taiwan where the husbands were hospitalized in a medical ward. Four spiritual distress themes emerged from the analysis: (1) A personal conflict in trying to come to terms with love and forgiveness; the inability to forgive their husband’s mistakes; and, lack of their family’s love and support. (2) A feeling of hopelessness due to advanced cancer, such as a feeling of disappointment in their destiny and karma, including expressing doubt on survival. (3) A feeling of uncertainty in facing death peacefully, such as fear of facing the unknown world; and, (4) A feeling of doubt causing them to question the meaning and values in their lives. This research has shown that caregivers needed family support, friends, social welfare, and the help of their religion to meet their spiritual needs in coping within the final stages of life and death. The findings of this study could assist health professionals to detect the spiritual distress of ethnic-Chinese patients and caregivers in the context of their cultural or religious background as early as possible.

Keywords: advanced cancer, Buddhism, Confucianism, Taoism, qualitative research, spiritual distress

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