Search results for: healthcare coordination

Authors: Amy Darwin, Claire Blacklock

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Background: Existing literature about delivering evidence-based mental health and psychosocial support (MHPSS) in emergency settings is limited. It is difficult to monitor and evaluate the approach to MHPSS in informal refugee camps such as ‘The Jungle’ in Calais, where there are multiple service providers and where the majority of providers are volunteers. AIM: To identify experiences of MHPSS delivery by service providers in an informal camp environment in Calais, France and describe MHPSS barriers and opportunities in this type of setting. Method: Qualitative semi-structured interviews were conducted with 13 individuals from different organisations offering MHPSS in Calais and analysed using conventional content analysis. Results: Unsafe, uncertain and unsanitary conditions in the camp meant MHPSS was difficult to implement, and such conditions contributed to the poor mental health of the residents. The majority of MHPSS was offered by volunteers who lacked resources and training, and there was no overall official camp leadership which meant care was poorly coordinated and monitored. Strong relationships existed between volunteers and camp residents, but volunteers felt frustrated that they could not deliver the kind of MHPSS that they felt residents required. Conclusion: While long-term volunteers had built supportive relationships with camp residents, lack of central coordination and leadership of MHPSS services and limited access to trained professionals made implementation of MHPSS problematic. Similarly, the camp lacked the necessary infrastructure to meet residents’ basic needs. Formal recognition of the camp, and clear central leadership were identified as necessary steps to improving MHPSS delivery.

Keywords: calais, mental health, refugees, the jungle, MHPSS

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Authors: Mohammad H. Yarmohammadian, Reza Safdari, Mahmoud Keyvanara, Nahid Tavakoli

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One of the greatest challenges in disaster and emergencies is patient tracking. The concept of tracking has different denotations. One of the meanings refers to tracking patients’ physical locations and the other meaning refers to tracking patients ‘medical needs during emergency services. The main goal of patient tracking is to provide patient safety during disaster and emergencies and manage the flow of patient and information in different locations. In most of cases, there are not sufficient and accurate data regarding the number of injuries, medical conditions and their accommodation and transference. The objective of the present study is to survey on patient tracking issue in natural disaster and emergencies. Methods: This was a narrative study in which the population was E-Journals and the electronic database such as PubMed, Proquest, Science direct, Elsevier, etc. Data was gathered by Extraction Form. All data were analyzed via content analysis. Results: In many countries there is no appropriate and rapid method for tracking patients and transferring victims after the occurrence of incidents. The absence of reliable data of patients’ transference and accommodation, even in the initial hours and days after the occurrence of disasters, and coordination for appropriate resource allocation, have faced challenges for evaluating needs and services challenges. Currently, most of emergency services are based on paper systems, while these systems do not act appropriately in great disasters and incidents and this issue causes information loss. Conclusion: Patient tracking system should update the location of patients or evacuees and information related to their states. Patients’ information should be accessible for authorized users to continue their treatment, accommodation and transference. Also it should include timely information of patients’ location as soon as they arrive somewhere and leave therein such a way that health care professionals can be able to provide patients’ proper medical treatment.

Keywords: patient tracking, challenges, disaster, emergency

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Authors: Johnson O. Adeogo, Ayodele S. Oluwole, O. Akinsanmi, Olawale J. Olaluyi

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In this 5G network, very high traffic density in densely populated areas, most especially in densely populated areas, is one of the key requirements. Radiation reduction becomes one of the major concerns to secure the future life of mobile network users in ultra-dense network areas using an improved coordinated multipoint technology. Coordinated Multi-Point (CoMP) is based on transmission and/or reception at multiple separated points with improved coordination among them to actively manage the interference for the users. Small cells have two major objectives: one, they provide good coverage and/or performance. Network users can maintain a good quality signal network by directly connecting to the cell. Two is using CoMP, which involves the use of multiple base stations (MBS) to cooperate by transmitting and/or receiving at the same time in order to reduce the possibility of electromagnetic radiation increase. Therefore, the influence of the screen guard with rubber condom on the mobile transceivers as one major piece of equipment radiating electromagnetic radiation was investigated by mobile network users amidst ultra-dense networks in 5g. The results were compared with the same mobile transceivers without screen guards and rubber condoms under the same network conditions. The 5 cm distance from the mobile transceivers was measured with the help of a ruler, and the intensity of Radio Frequency (RF) radiation was measured using an RF meter. The results show that the intensity of radiation from various mobile transceivers without screen guides and condoms was higher than the mobile transceivers with screen guides and condoms when call conversation was on at both ends.

Keywords: ultra-dense networks, mobile network users, 5g, coordinated multi-point.

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Authors: Sarah K. Amer, Walaa Alaa

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Epilepsy is an important cause of mortality and morbidity, according to WHO statistics. It is characterized by the presence of frequent seizures occurring more than 24 hours apart. Carbamazepine (CBZ) is considered first-line treatment for epilepsy. However, reports have shown that CBZ oral formulations failed to achieve optimum systemic delivery, minimize side effects, and enhance patient compliance. Besides, the literature has signified the lack of therapeutically efficient CBZ transdermal formulation and the urge for its existence owing to its ease and convenient method of application and highlighted capability to attain higher bioavailability and more extended-release profiles compared to conventional oral CBZ tablets. This work aims to prepare CBZ microspheres (MS) that are embedded in a transdermal gel containing Vitamin B to be co-delivered. MS were prepared by emulsion-solvent diffusion method using Eudragit S as core forming polymer and hydroxypropyl methylcellulose (HPMC) polymer. The MS appeared to be spherical and porous in nature, offering a large surface area and high entrapment efficiency of CBZ. The transdermal gel was prepared by solvent-evaporation technique using HPMC that, offered high entrapment efficiency and Eudragit S that provided an extended-release profile. Polyethylene glycol, Span 80 and Pyridoxine were also added. Data indicated that combinations of CBZ with pyridoxine can reduce epileptic seizures without affecting motor coordination. Extended-release profiles were evident for this system. The patches were furthermore tested for thickness, moisture content, folding endurance, spreadability and viscosity measurements. This novel pharmaceutical formulation would be of great influence on seizure control, offering better therapeutic effects.

Keywords: epilepsy, carbamazepine, pyridoxine, transdermal

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Authors: Maxwell Ladogo Abilla

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As evidence from the 2007–2008 and 2010 global food and financial crises revealed that food systems were under stress, the idea of sustainable food systems rose to prominence in the discussion of food security. The idea suggests moving away from a conception of food security that emphasizes production in favor of one that is more socially and environmentally conscious and interested in tackling a wide range of issues that have rendered the food system dysfunctional. This study evaluates the efforts made by international development organizations to increase food security in the area, taking into account the persistence of poverty and food insecurity in northern Ghana, utilizing the idea of sustainable food systems as the evaluation criterion. The study used triangulation to address the research questions by combining qualitative interview data with documentary analysis. To better comprehend the concept of sustainability, a variety of discourses and concepts are used, which results in the development of eight doable objectives for attaining sustainable food systems. The study finds that the food system in northern Ghana is unsustainable because of three kinds of barriers, with the practical objectives of developing sustainable food systems serving as the assessment criteria (natural, cultural and economic, and institutional). According to an evaluation of the World Food Programme's development support in northern Ghana, regional challenges to attaining sustainable food systems continue to be unaddressed by global development initiatives. Due to institutional constraints, WFP's interventions fell short of their promise. By demonstrating the need for development partners to enhance institutional efficiency and coordination, enable marginalized communities to access their rights, and prioritize agricultural irrigation in the area, the study makes a contribution to development policy and practice in northern Ghana.

Keywords: sustainable, food security, development, institutional

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Authors: Nuwan Karunarathna, Hemali Seneviratne

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Distribution Utilities inherently present electrical hazards for their workers in addition to the general public especially due to bare overhead lines spreading out over a large geographical area. Therefore, certain procedures such as; de-energization, verification of de-energization, isolation, lock-out tag-out and earthing are carried out to ensure safe working conditions when conducting maintenance work on de-energized overhead lines. However, measures must be taken to coordinate the above procedures and to ensure successful and accurate execution of those procedures. Issuing of 'Work Permits' is such a measure that is used by the Distribution Utility considered in this paper. Unfortunately, the Work Permit method adopted by the Distribution Utility concerned here has not been successful in creating the safe working conditions as expected which was evidenced by four (4) number of fatalities of workers due to electrocution occurred in the Distribution Utility from 2016 to 2018. Therefore, this paper attempts to identify deficiencies in the Work Permit method and related contributing factors through careful analysis of the four (4) fatalities and work place practices to rectify the short comings to prevent future incidents. The analysis shows that the present level of coordination between the 'Authorized Person' who issues the work permit and the 'Competent Person' who performs the actual work is grossly inadequate to achieve the intended safe working conditions. The paper identifies the need of active participation of a 'Control Person' who oversees the whole operation from a bird’s eye perspective and recommends further measures that are derived through the analysis of the fatalities to address the identified lapses in the current work permit system.

Keywords: authorized person, competent person, control person, de-energization, distribution utility, isolation, lock-out tag-out, overhead lines, work permit

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Authors: Celine Shi Ying Lee, Jong Jian Lee

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Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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Authors: Rehab F. Abdel-Rahman, Sally A. El Awdan, Rehab R. Hegazy, Dina F. Mansour, Hanan A. Ogaly, Marwan Abdelbaset

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Disorders of the cerebral circulation are the leading cause of numerous neurological and psychiatric illnesses. The transient middle cerebral artery occlusion model (MCAO) is considered to be a reliable and reproducible rodent model of cerebral ischemia. The purpose of the current study was to examine the neuroprotective effects of Crocus sativus (saffron) in a rat model of left middle cerebral artery MCAO. Male Wistar rats were anesthetized and subjected to 1 h of MCAO followed by 48 h reperfusion or sham surgery. One group of the ischemia operated animals was kept as left brain ischemia/reperfusion (I/R). Another 2 operated groups received saffron extract (100 or 200 mg/kg, i.p) four times (60 min before the surgery, during the surgery, and on days 1 and 2 after the occlusion). During the experiment, behavioral tests were performed. After 72 h the animals were euthanized and their left brain hemispheres were used in the biochemical, histopathological, and immunohistochemical studies. Saffron administration revealed an improvement in I/R-induced alteration of locomotor balance and coordination ability of rats. Moreover, saffron decreased the brain content of malondialdehyde, nitric oxide, brain natriuretic peptide and vascular endothelial growth factor with significant increase of reduced glutathione. Immunohistochemical evaluation of caspase-3 and Bax protein expression revealed reduction in I/R-enhanced apoptosis in saffron treated rats. In conclusion, saffron treatment decreases ischemic brain injury in association with inhibition of apoptotic and oxidative cell death in a dose dependent manner.

Keywords: caspase-3, cerebral ischemia, Crocus sativus, rats, vascular endothelial growth factor

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Authors: Rohtash

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Academically, the concept of Justice in the literature is vast, and theories are voluminous and definitions are numerous but it is very difficult to define. Through the ages, justice has been evolving and developing reasoning that how individuals and communities do the right thing that is just and fair to all in that society. Justice is a relative and dynamic concept, not absolute one. It is different in different societies based on their morality and ethics. The idea of justice cannot arise from a single morality but interaction of competing moralities and contending perspectives. Justice is the conditional and circumstantial term. Therefore, justice takes different meanings in different contexts. Justice is the application of the Laws. It is a values-based concept in order to protect the rights and liberties of the people. It is a socially created concept that has no physical reality. It exists in society on the basis of the spirit of sharing by the communities and members of society. The conception of justice in society or among communities and individuals is based on their social coordination. It can be effective only when people’s judgments are based on collective reasoning. Their behavior is shaped by social values, norms and laws. People must accept, share and respect the set of principles for delivering justice. Thus justice can be a reasonable solution to conflicts and to coordinate behavior in society. The subject matter of distributive justice is the Public Good and societal resources that should be evenly distributed among the different sections of society on the principles developed and established by the State through legislation, public policy and Executive orders. The Socioeconomic transformation of the society is adopted by the constitution within the limit of its morality and gives a new dimension to transformative justice. Therefore, both Procedural and Transformative justice is part of Distributive justice. Distributive justice is purely an economic phenomenon. It concerns the allocation of resources among the communities and individuals. The subject matter of distributive justice is the distribution of rights, responsibilities, burdens and benefits in society on the basis of the capacity and capability of individuals.

Keywords: distributive justice, constitutionalism, institutionalism, constitutional morality

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Authors: Temilola Akinbolade, Bukola Okunade, Karounwi Okunade

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Leadership is a subject of direction. Direction entails ensuring that employees carryout the jobs assigned to them. In order to direct subordinates, a manager must lead, motivate, communicate and ensure effective co-ordination of activities so that enterprise objectives are achieved. The purpose of the study was to find out the impact of Leadership Styles on Employees Performance, Study of Wema Bank Plc. Leadership has been described as a tool used in influencing people in order to willingly get a particular or task done. The importance of leadership is followership. That is the willingness of people to follow what makes a person a leader. A sample size of 150 was systematically selected from the study population using the statistical packages for Social Science (SPSS) formula. Based on this, questionnaire was designed and administered. Out of the 105 copies of the questionnaire administered. 150 were recovered, 45 were discarded for improper filling and mutilation while the remaining 105 were used for statistical analysis. Chi-square was employed in testing the hypothesis. The following findings were discovered in the course of the study: how leadership enhances employee’s performance, 85.7% of the respondents were in agreement. Also how implementation of workers social welfare packages enhance the employees performance. 88.6 percent of the respondents in agreement. Over the years, some leadership styles adopted by managers and administrators have an impact on the level of employee’s performance in workplace and this has led to the inefficient and ineffective attainment of organizational goals and objectives. Due to the inability of employees to perform to set standard, this research work will also indicate some ways through which high employee performance will be attained most especially with regards to the leadership style adopted by the management that is managers and administrators. It was also discovered that collective intelligence of employees leads to high employee’s performance 82.9 percent of the respondent in agreement.

Keywords: leadership, employees, performance, banking sector

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Authors: Prem Bahadur Giri

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The nationalization of forests during the early 1960s had become counterproductive for the conservation of forests in Nepal. Realizing this fact, the Government of Nepal initiated a paradigm shift from a government-controlled forestry system to people’s direct participation in managing forestry, conceptualizing a community forest approach in the early 1980s. The community forestry approach is expected to promote sustainable forest management, restoring degraded forests to enhance the forest condition on the one hand, and on the other, improvement of livelihoods, particularly of low-income people and forest-dependent communities, as well as promoting community ownership of a forest. As a result, the establishment of community forests started and had taken faster momentum in Nepal. Of the total land in Nepal, forest occupies 6.5 million hectares which are around 45 percent of the forest area. Of the total forest area, 1.8 million hectares have been handed over to community management. A total of 19,361 ‘community forest users groups’ are already created to manage the community forest. To streamline the governance of community forests, the enactment of ‘The Forest Act 1993’ provides a clear legal basis for managing community forests in Nepal. This article is based on an in-depth study taking the case of Tarpakha Community Forest (TCF) located in Siranchok Rural Municipality of Gorkha District in Nepal. It mainly discusses the extent to which the TCF is able to achieve the twin objectives of this community forest for catalyzing socio-economic improvement of the targeted community and conservation of the forest. The primary information was generated through in-depth interviews along with group discussions with members, the management committee, and other relevant stakeholders. The findings reveal that there is a significant improvement in the regeneration of the forest and also changes in the socio-economic status of the local community. However, coordination with local municipalities and forest governing entities is still weak.

Keywords: community forest, socio-economic benefit, sustainable forest management, Nepal

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Authors: Carole A. South-Winter

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Research-based learning gives students the opportunity to experience problems that require critical thinking and idea development. The skills they gain in working through these problems 'hands-on,' develop into attributes that benefit their careers in the professional field. The partnerships developed between students and industries give advantages to both sides. The students gain knowledge and skills that will increase their likelihood of success in the future and the industries are given research on new advancements that will give them a competitive advantage in their given field of work. The future of these partnerships is dependent on the success of current programs, enabling the enhancement and improvement of the research efforts. Once more students can complete research, there will be an increase in reliability of the results for each industry. The overall goal is to continue the support for research-based learning and the partnerships formed between students and industries.

Keywords: global healthcare, industry partnerships, research-driven decisions, short-term study abroad

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Authors: Armine Vahanyan

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Humanity has been still coping with the new COVID-19 pandemic. Healthcare providers, economists, psychologists, and other specialists speak about the impact of the virus on different spheres of our life. In the list of similar discussions, the impact of pandemics on global education is of utmost importance. Ideally, providing quality education services should be crucial, and the ways education programs are being adapted will determine the success or failure of the service providers. The paper aims to summarize the research touching upon the current situation of higher education in Armenia. The research includes data from official reports, surveys among education leads, faculty, and students, as well as personal observations and consideration. Through descriptive analysis, the findings of the research are being presented from various aspects. Interim results of the research unveiled two major issues in the sector of higher education in Armenia. On the one hand, the entire compulsory digitization of instruction, assessment, and grading has evoked serious gaps related to the lack of technical competencies. There is an urgent need for professional development programs that will address most of the concerns due to the shift to the online instruction mode. On the other hand, online teaching and learning require revision and adaptation of the existing curricula. Given that the content of certain programs may not be compromised, the teaching methods, the assignments, and evaluation require profound transformation, which will still be in line with course learning outcomes and student learning outcomes. The given paper focuses on the ways the mentioned issues are being addressed in Armenia. The extent of commitment for changes and adaptability to the new situation varies from the government-funded and private universities. In particular, the paper compares and contrasts activities and measures taken at the Armenian State Pedagogical University and the American University of Armenia. Thus, the Pedagogical University focused on the use of Google Classroom as the only means for teaching and learning as well as adopted the compulsory synchronous instruction mode. The American University, on the contrary, kept practicing the academic freedom, enabling both synchronous and asynchronous instruction modes, ensuring alignment of the course learning outcomes and student learning outcomes. The State University utilized the assignments and assessment, which would work for the on-campus instruction mode, while the American university employed a variety of assignments applicable for online teaching mode. The latter has suggested the utilization of multiple apps, internet sources, and online library access for a better online instant. Discussions with faculty through online forums and/or professional development workshops also facilitate restructuring and adaptation of the courses. Finally, the paper will synthesize the results of the undertaken research and will outline the e-learning perspectives and opportunities boosted by the known devastating healthcare issue.

Keywords: assessment, compulsory digitization of education services, online teaching, instruction mode, program restructuring

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Authors: Anat Keller

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Given that macro-prudential supervision is a relatively new policy area and its empirical and analytical research are still in their infancy, its theoretical foundations are also lagging behind. This paper contributes to the developing discussion on effective legal and institutional macroprudential supervision frameworks. In the first part of the paper, it is argued that effectiveness as a key benchmark poses some challenges in the context of macroprudential supervision such as the difficulty in proving causality between supervisory actions and the achievement of the supervisor’s mission. The paper suggests that effectiveness in the macroprudential context should, therefore, be assessed at the supervisory decision-making process (to be differentiated from the supervisory outcomes). The second part of the essay examines whether insights from behavioural economics can point to biases in the macroprudential decision-making process. These biases include, inter alia, preference bias, groupthink bias and inaction bias. It is argued that these biases are exacerbated in the multilateral setting of the macroprudential supervision framework in the EU. The paper then examines how legal and institutional frameworks should be designed to acknowledge and perhaps contain these identified biases. The paper suggests that the effectiveness of macroprudential policy will largely depend on the existence of clear and robust transparency and accountability arrangements. Accountability arrangements can be used as a vehicle for identifying and addressing potential biases in the macro-prudential framework, in particular, inaction bias. Inclusiveness of the public in the supervisory process in the form of transparency and awareness of the logic behind policy decisions may assist in minimising their potential unpopularity thus promoting their effectiveness. Furthermore, a governance structure which facilitates coordination of the macroprudential supervisor with other policymakers and incorporates outside perspectives and opinions could ‘break-down’ groupthink bias as well as inaction bias.

Keywords: behavioural economics and biases, effectiveness of macroprudential supervision, legal and institutional macroprudential frameworks, macroprudential decision-making process

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Authors: Cameron Wilson, Megan Hanrahan, Katie Brittain, Riona McArdle, Alison Keogh, Lynn Rochester

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Background: The loss of mobility and functional dependence is a significant marker in the progression of neurodegenerative diseases such as Parkinson’s Disease (PD). Pharmacological, surgical, and therapeutic treatments are available that can help in the management and amelioration of PD symptoms; however, these only prolong more severe symptoms. Accordingly, ensuring people with PD can maintain independence and a healthy wellbeing are essential in establishing an effective treatment option for those afflicted. Existing literature reviews have examined experiences in engaging with PD treatment options and the impact of PD on independence and wellbeing. Although, the literature fails to explore the influence of treatment options on independence and wellbeing and therefore misses what people value in their treatment. This review is the first that synthesises the impact of mobility-related treatments on independence and wellbeing in people with PD and their carers, offering recommendations to clinical practice and provides a conceptual framework (in development) for future research and practice. Objectives: To explore the impact of mobility-related treatment (both pharmacological and non-pharmacological) on the independence and wellbeing of people with PD and their carers. To propose a conceptual framework to patients, carers and clinicians which captures the qualities people with PD value as part of their treatment. Methods: We performed a critical interpretive synthesis of qualitative evidence, searching six databases for reports that explored the impact of mobility-related treatments (both drug and non-pharmacological) on independence and wellbeing in Parkinson’s Disease. The types of treatments included medication (Levodopa and Amantadine), dance classes, Deep-Brain Stimulation, aquatic therapies, physical rehabilitation, balance training and foetal transplantation. Data was extracted, and quality was assessed using an adapted version of the NICE Quality Appraisal Tool Appendix H before being synthesised according to the critical interpretive synthesis framework and meta-ethnography process. Results: From 2301 records, 28 were eligible. Experiences and impact of treatment pathway on independence and wellbeing was similar across all types of treatments and are described by five inter-related themes: (i) desire to maintain independence, (ii) treatment as a social experience during and after, (iii) medication to strengthen emotional health, (iv) recognising physical capacity and (v) emphasising the personal journey of Parkinson’s treatments. Conclusion: There is a complex and inter-related experience and effect of PD treatments common across all types of treatment. The proposed conceptual framework (in development) provides patients, carers, and clinicians recommendations to personalise the delivery of PD treatment, thereby potentially improving adherence and effectiveness. This work is vital to disseminate as PD treatment transitions from subjective and clinically captured assessments to a more personalised process supplemented using wearable technology.

Keywords: parkinson's disease, medication, treatment, dance, review, healthcare, delivery, levodopa, social, emotional, psychological, personalised healthcare

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Authors: Jianghua Chen

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Sustainable urban development requires the coordination of economic growth and resource environment, and industrial transformation and upgrading is the key link. Based on the decoupling theory and the improved decoupling decomposition model, the quantitative evaluation and comprehensive analysis of the degree of decoupling between resource consumption and economic development in Jiangsu Province are carried out by utilizing the data related to resource consumption and economic growth of the secondary and tertiary industries in Jiangsu Province from 2013 to 2018, so as to explore the sustainable development path of industrial transformation in Jiangsu Province. The results show that from the decoupling status, the degree of decoupling of economic development of the secondary industry to the required coke resources, water resources and human resources is gradually deepening, and the decoupling index of economic development of the tertiary industry to the required water resources is fluctuating; from the perspective of the driving factors, the technological effect is the main driving factor for decoupling the economic growth of Jiangsu Province to the resources, and the structural effect has a significant impact on the driving index of the decoupling of economic growth of the secondary and tertiary industries to the consumption of resources in Jiangsu Province. In terms of driving factors, the technology effect is the main driving factor for economic growth in Jiangsu Province to realize decoupling of resources, while the structural effect is the main driving factor for economic growth in Jiangsu Province's second and third industries to realize decoupling of resources. Finally, we discuss the difficulties of industrial transformation and layout faced by Jiangsu Province at present.

Keywords: resource consumption, economic growth, industrial transformation, decoupling theory

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Authors: Mahmoud Ashraf Farouk

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Shipping transportation is the foremost imperative mode of transportation in universal coordination. At display, more than 2/3 of the full worldwide exchange volume accounts for shipping transportation. Ships are utilized as an implies of marine transportation, introducing large-power diesel motors with exhaust containing nitrogen oxide NOx, sulfur oxide SOx, carbo di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO which are the most dangerous contaminants found in exhaust gas from ships. Ships radiating a large amount of exhaust gases have become a significant cause of pollution in the air in coastal areas, harbors and oceans. Therefore, IMO (the International Maritime Organization) has established rules to reduce this emission. This experiment shows the measurement of the exhaust gases emitted from the Aida IV ship's main engine using marine diesel oil fuel (MDO). The measurement is taken by the Sensonic2000 device on 85% load, which is the main sailing load. Moreover, the paper studies different emission reduction technologies as an alternative fuel, which as liquefied natural gas (LNG) applied to the system and reduction technology which is represented as selective catalytic reduction technology added to the marine diesel oil system (MDO+SCR). The experiment calculated the amount of nitrogen oxide NOx, sulfur oxide SOx, carbon-di-oxide CO₂, particular matter PM10, hydrocarbon HC and carbon mono-oxide CO because they have the most effect on the environment. The reduction technologies are applied on the same ship engine with the same load. Finally, the study found that MDO+SCR is the more efficient technology for the Aida IV ship as a training and supply ship due to low consumption and no need to modify the engine. Just add the SCR system to the exhaust line, which is easy and cheapest. Moreover, the differences between them in the emission are not so big.

Keywords: marine, emissions, reduction, shipping

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Authors: K. J. Sannapapamma, H. Malligawad Lokanath, Sakeena Naikwadi

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Eco-friendly textiles are gaining importance among the consumers and textile manufacturers in the healthcare sector due to increased environmental pollution which leads to several health and environmental hazards. Hence, the research was designed to cultivate and develop the organic cotton knit, to prepare and characterize the Vetiver oil microcapsules for textile finishing and to access the wash durability of finished knits. The cotton SAHANA variety grown under organic production systems was processed and spun into 30 single yarn dyed with four natural colorants (Arecanut slurry, Eucalyptus leaves, Pomegranate rind and Indigo) and eco dyed yarn was further used for development of single jersy knitted fabric. Vetiveria zizanioides is an aromatic grass which is being traditionally used in medicine and perfumery. Vetiver essential oil was used for preparation of microcapsules by interfacial polymerization technique subjected to Gas Chromatography Mass Spectrometry (GCMS), Fourier Transform Infrared Spectroscopy (FTIR), Thermo Gravimetric Analyzer (TGA) and Scanning Electron Microscope (SEM) for characterization of microcapsules. The knitted fabric was finished with vetiver oil microcapsules by exhaust and pad dry cure methods. The finished organic knit was assessed for laundering on antimicrobial efficiency and aroma intensity. GCMS spectral analysis showed that, diethyl phthalate (28%) was the major compound found in vetiver oil followed by isoaromadendrene epoxide (7.72%), beta-vetivenene (6.92%), solavetivone (5.58%), aromadenderene, azulene and khusimol. Bioassay explained that, the vetiver oil and diluted vetiver oil possessed greater zone of inhibition against S. aureus and E. coli than the coconut oil. FTRI spectra of vetiver oil and microcapsules possessed similar peaks viz., C-H, C=C & C꞊O stretching and additionally oil microcapsules possessed the peak of 3331.24 cm^-1 at 91.14 transmittance was attributed to N-H stretches. TGA of oil microcapsules revealed that, there was a minimum weight loss (5.835%) recorded at 467.09°C compared to vetiver oil i.e., -3.026% at the temperature of 396.24°C. The shape of the microcapsules was regular and round, some were spherical in shape and few were rounded by small aggregates. Irrespective of methods of application, organic cotton knits finished with microcapsules by pad dry cure method showed maximum zone of inhibition compared to knits finished by exhaust method against S. aureus and E. coli. The antimicrobial activity of the finished samples was subjected to multiple washing which indicated that knits finished with pad dry cure method showed a zone of inhibition even after 20^th wash and better aroma retention compared to knits finished with the exhaust method of application. Further, the group of respondents rated that the 5^th washed samples had the greater aroma intensity in both the methods than the other samples. Thus, the vetiver microencapsulated organic cotton knits are free from hazardous chemicals and have multi-functional properties that can be suitable for medical and healthcare textiles.

Keywords: exhaust and pad dry cure finishing, interfacial polymerization, organic cotton knits, vetiver oil microcapsules

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Authors: Shuqi Zhang

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Federated learning allows users to participate in collaborative model training without sending data to third-party servers, reducing the risk of user data privacy leakage, and is widely used in smart finance and smart healthcare. However, the distributed architecture design of federation learning itself and the existence of secure aggregation protocols make it inherently vulnerable to backdoor attacks. To solve this problem, the federated learning backdoor defense framework FLEX based on group aggregation, cluster analysis, and neuron pruning is proposed, and inter-compatibility with secure aggregation protocols is achieved. The good performance of FLEX is verified by building a horizontal federated learning framework on the CIFAR-10 dataset for experiments, which achieves 98% success rate of backdoor detection and reduces the success rate of backdoor tasks to 0% ~ 10%.

Keywords: federated learning, secure aggregation, backdoor attack, cluster analysis, neuron pruning

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Authors: Rogelio Portillo Vélez, Eduardo Vázquez-Santacruz, Mariano Gamboa-Zúñiga

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In this paper a new mechanical architecture design of a multi functional robot bed, is presented. The importance of this design relies on the fact that in next years the need of assistive devices development will increase in such way that elderly patients will use this kind of devices. This mechanical design implies following specific mechanisms which attend Mexican hospital requirements. This design is the base of next step of this kind of development given that it shows all technical details of the mechanical systems which are needed in order to construct the bed. This is first hospital bed design which could responds to the Latin America hospital requirements. We have obtained these hospital requirements using our diagnosis methodology [14]. From these results we have designed the mechanical system. This is the mechanical base of the hospital robotic bed which is being developed in our robotics laboratory. It will be useful in different hospital environments for elderly and disabled patients.

Keywords: assistive robotics, methodology, feasibility analysis, robotics, operational feasibility, assistive technology, viability analysis matrix, social impact

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Authors: Amna I. Shibeika, Batoul Y. Hittini, Tasneem B. Abd Bakri

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Regulation and integration of public policy, economy, insurance industry, education, and construction stakeholders are the main contributors to achieve sustainable development. Building environmental assessment methods were introduced in the field to address issues such as global warming and conservation of natural resources. In the UAE, Estidama framework with its associated Pearl Building Rating System (PBRS) has been introduced in 2010 to address and spread sustainability practices within the country’s fast-growing built environment. Based on literature review of relevant studies investigating different project characteristics that influence sustainability outcomes, this paper presents a conceptual framework for understanding the adoption of PBRS in UAE projects. The framework also draws on Diffusion of Innovations theory to address the questions of how the assessment method is chosen in the first place and what is the impact of PBRS on the multi-disciplinary design and construction processes. The study highlights the mandatory nature of the adoption of PBRS for government buildings as well as imbedding Estidama principles within Abu Dhabi building codes as key factors for raising awareness about sustainable practices. Moreover, several project-related elements are addressed to understand their relationship with the adoption process, including project team collaboration; communication and coordination; levels of commitment and engagement; and the involvement of key actors as sustainability champions. This conceptualization of the adoption of PBRS in UAE projects contributes to the growing literature on the adoption of energy assessment tools and addresses the UAE vision is to be at the forefront of innovative sustainable development by 2021.

Keywords: adoption, building assessment, design management, innovation, sustainability

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Authors: Rishi Agarwal

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Digital twins are emerging as a strong technology used to imitate and monitor physical objects digitally in real time across sectors. It is not only dealing with the digital space, but it is also actuating responses in the physical space in response to the digital space processing like storage, modeling, learning, simulation, and prediction. This paper explores the application of digital twins for enhancing physical security in retail stores. The retail sector still relies on outdated physical security practices like manual monitoring and metal detectors, which are insufficient for modern needs. There is a lack of real-time data and system integration, leading to ineffective emergency response and preventative measures. As retail automation increases, new digital frameworks must control safety without human intervention. To address this, the paper proposes implementing an intelligent digital twin framework. This collects diverse data streams from in-store sensors, surveillance, external sources, and customer devices and then Advanced analytics and simulations enable real-time monitoring, incident prediction, automated emergency procedures, and stakeholder coordination. Overall, the digital twin improves physical security through automation, adaptability, and comprehensive data sharing. The paper also analyzes the pros and cons of implementation of this technology through an Emerging Technology Analysis Canvas that analyzes different aspects of this technology through both narrow and wide lenses to help decision makers in their decision of implementing this technology. On a broader scale, this showcases the value of digital twins in transforming legacy systems across sectors and how data sharing can create a safer world for both retail store customers and owners.

Keywords: digital twin, retail store safety, digital twin in retail, digital twin for physical safety

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Authors: Natina Roberts, Hanhee Lee

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The existing and emerging refugee research reports unfavorable resettlement outcomes in multiple domains. The proposed paper highlights trends in refugee research in which empirical studies investigate resettlement of former refugees from individual and culturally homogeneous perspectives. The proposed paper then aims to examine the reality of the lived experience of resettlement from family and cross-cultural viewpoints. Proponents for this focus include the United Nations High Commissioner for Refugees (UNHCR). The UNHCR is responsible for leading resettlement efforts for refugees through the durable solutions of repatriation, local integration and resettlement. Life experiences with refugee families, and a report of literary findings on former refugee resettlement from various cultural backgrounds – that highlight similarities and differences among various ethnic groups, will be discussed. The proposed paper is expected to frame underrepresented refugee perspectives, and review policy implications in healthcare, education, and public support systems.

Keywords: refugee, cross-cultural, families, resettlement policy

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Authors: Chander Shekhar, Jeetendra Yadav, Shaziya Allarakha

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Hypertension has been described as an 'iceberg disease' as those who suffered are ignored and hence usually seek healthcare services at a very late stage. It is estimated that more than 2 million Indians are suffering from hypertensive heart disease that contributed to above 0.13 million deaths in 2016. The paper study aims to know the prevalence of Hypertension in India and its variation by socioeconomic backgrounds and to find out risk factors discriminating hypertension with special emphasis on consumption of tobacco and alcohol among men aged 15-54 years in India. The paper uses NFHS (2015-16) data. The paper used binary logistic regression and discriminant analysis to find significant predictors and discriminants of interest. The prevalence of hypertension was 16.5% in the study population. The results suggest that consumption of alcohol and tobacco are significant discriminant characteristics in carrying hypertension irrespective of what socioeconomic background characteristic he possesses.

Keywords: hypertention, alcohol, tobacco, discriminant

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Authors: Jeelka Ray

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Survey of the papers revealed that there is no practical design available for packaging machine based on Embedded system, so the need arose for the development of the prototype model. In this paper, author has worked on the development of an ARM7 based Embedded Controller for controlling the sequence of packaging machine. The unit is made user friendly with TFT and Touch Screen implementing human machine interface (HMI). The different system components are briefly discussed, followed by a description of the overall design. The major functions which involve bag forming, sealing temperature control, fault detection, alarm, animated view on the home screen when the machine is working as per different parameters set makes the machine performance more successful. LPC2478 ARM 7 Embedded Microcontroller controls the coordination of individual control function modules. In back gone days, these machines were manufactured with mechanical fittings. Later on, the electronic system replaced them. With the help of ongoing technologies, these mechanical systems were controlled electronically using Microprocessors. These became the backbone of the system which became a cause for the updating technologies in which the control was handed over to the Microcontrollers with Servo drives for accurate positioning of the material. This helped to maintain the quality of the products. Including all, RS 485 MODBUS Communication technology is used for synchronizing AC Drive & Servo Drive. These all concepts are operated either manually or through a Graphical User Interface. Automatic tuning of heaters, sealers and their temperature is controlled using Proportional, Integral and Derivation loops. In the upcoming latest technological world, the practical implementation of the above mentioned concepts is really important to be in the user friendly environment. Real time model is implemented and tested on the actual machine and received fruitful results.

Keywords: packaging machine, embedded system, ARM 7, micro controller, HMI, TFT, touch screen, PID

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Authors: Maureen Kamau, Gulnaz Mohamoud, Adelaide Lusambili, Njeri Nyanja

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Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. These multiple chronic conditions are managed with polypharmacy. Polypharmacy has numerous adverse effects including non-adherence, poor compliance to the various medications, reduced appetite, and risk of fall. Studies on polypharmacy and ageing are few and poorly understood especially in low and middle - income countries. The aim of this study was to explore the knowledge, attitudes and beliefs of older people towards polypharmacy. A qualitative study of 15 patients aged 60 years and above, taking more than five medications per day were conducted at the Aga Khan University using Semi-structured in-depth interviews. Three interviews were pilot interviews, and data analysis was performed on 12 interviews. Data were analyzed using NVIVO 12 software. A thematic qualitative analysis was carried out guided by Braun and Clarke (2006) framework. Themes identified; - knowledge of their co-morbidities and of the medication that older persons take, sources of information about medicines, and storage of the medication, experiences and attitudes of older patients towards polypharmacy both positive and negative, older peoples beliefs and their coping mechanisms with polypharmacy. The study participants had good knowledge on their multiple co-morbidities, and on the medication they took. The patients had positive attitudes towards medication as it enhanced their health and well-being, and enabled them to perform their activities of daily living. There was a strong belief among older patients that the medications were necessary for their health. All these factors enhanced compliance to the multiple medication. However, some older patients had negative attitudes due to the pill burden, side effects of the medication, and stigma associated with being ill. Cost of healthcare was a concern, with most of the patients interviewed relying on insurance to cover the cost of their medication. Older patients had accepted that the medication they were prescribed were necessary for their health, as it enabled them to complete their activities of daily living. Some concerns about the side effects of the medication arose, and brought about the need for patient education that would ensure that the patients are aware of the medications they take, and potential side effects. The effect that the COVID 19 pandemic had in the healthcare of the older patients was evident by the number of the older patients avoided coming to the hospital during the period of the pandemic. The relationship with the primary care physician and the older patients is an important one, especially in LMICs such as Kenya, as many of the older patients trusted the doctors wholeheartedly to make the best decision about their health and about their medication. Prescription review is important to avoid the use of potentially inappropriate medication.

Keywords: polypharmacy, older patients, multiple chronic conditions, Kenya, Africa, qualitative study, indepth interviews, primary care

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Authors: Maria Luiza Fulga, Georgeta Truca, Mihaela Alexandru, Andriescu Mariana, Crin Marcean

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The significance of nursing as a subject in the post-secondary healthcare curriculum is a major. We aimed to enable our students to assess the patient's risk, to establish prevention measures and to adapt to a specific learning context, in order to acquire the skills and abilities necessary for the nursing profession. In order to achieve these objectives, during the three years of study, teachers put an emphasis on acquiring communication skills, because in our country after the first cycle of hospital accreditation concluded in 2016, the National Authority for Quality of Health Management has introduced the criteria for the implementation and application of the nursing process according to the accreditation standards. According to these requirements, the nurse has to carry out the nursing assessment, based on communication as a distinct component, so that they can identify nursing diagnoses and implement the nursing plan. In this respect, we, the teachers, have refocused, by approaching various teaching strategies and preparing students for the real context of learning and applying what they learn. In the educational process, the tutors in the hospitals have an important role to play in acquiring professional skills. Students perform their activity in the hospital in accordance with the curriculum, in order to verify the practical applicability of the theoretical knowledge acquired in the school classes and also have the opportunity to acquire their skills in a real learning context. In clinical education, the student nurse learns in the middle of a guidance team which includes a practice tutor, who is a nurse that takes responsibility for the practical/clinical learning of the students in their field of activity. In achieving this objective, the tutor's abilities involve pedagogical knowledge, knowledge for the good of the individual and nursing theory, in order to be able to guide clinical practice in accordance with current requirements. The aim of this study is to find out the students’ confidence level in practice tutors in hospitals, the students’ degree of satisfaction in the pedagogical skills of the tutors and the practical applicability of the theoretical knowledge. In this study, we used as a method of investigation a student satisfaction questionnaire regarding the clinical practice in the hospital and the sample of the survey consisted of 100 students aged between 20 and 50 years, from the first, second and third year groups, with the General Nurse specialty (nurses responsible for general care), from 'Fundeni' Healthcare Post-Secondary School, Bucharest, Romania. Following the analysis of the data provided, we arrived the conclusion that the hospital tutor needs to improve his/her pedagogical skills, the knowledge of nursing diagnostics, and the implementation of the nursing plan, so that the applicability of the theoretical notions would be increased. Future plans include the pedagogical training of the medical staff, as well as updating the knowledge needed to implement the nursing process in order to meet current requirements.

Keywords: clinical training, nursing process, pedagogical skills, tutor

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Authors: Nihayatul Munaa, Nyoman A. Damayanti

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This study seeks to understand what factors might influence a patient’s perception of health care under national health insurance in early implementation. In Indonesia, National Health Insurance was first implemented in 2014 and planned to achieve universal health coverage by 2019. However, the little understanding of this new policy lead to increase of complaint in hospital as a health care provider. This is a observational descriptive study with cross sectional design method. Data was collected through in-depth interview with 96 patient from Jemursari Islamic Hospital of Surabaya (Rumah Sakit Islam Jemursari Surabaya) who participate in National Health Insurance. Subject was selected by simple random sampling. The findings demonstrated that from five categories, 82,3% patient was satisfied in reliability aspect and 85,4% in assurance aspect, while in tangible, responsiveness and empathy aspect > 90% patient was satisfied. Meanwhile, in Indonesia, the minimum service standard of healthcare of patient satisfaction is 90%.

Keywords: patient’s satisfaction, national health insurance, hospital, complaint

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Authors: Sepinoud Hamedi

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The ponder points to observationally look at the impact of carbon-neutrality approaches on the key assets required for Industry 4.0 driven savvy fabricating and how these assets can give a economical competitive advantage. The hypothetical system is coordinates with the regulation hypothesis and the resource-based see (RBV). The observational strategy is utilized for collecting information through studies and assist covariance-based auxiliary condition modeling is utilized to test the theories. Discoveries demonstrate that carbon–neutral-based government arrangements have a more grounded impact on unmistakable assets and human aptitudes than intangible assets related to Industry 4.0 driven shrewd fabricating. Moment, carbon–neutral arrangement arrangement with the firm’s maintainability destinations plays a directing impact on the relationship between carbon–neutral-based government arrangements and assets (substantial, intangible assets and human abilities) for Industry 4.0 driven shrewd fabricating. Finally, the three assets (substantial, intangible assets and human abilities) for Industry 4.0 driven savvy fabricating play a basic part in creating firms’ carbon–neutral capability and assist improving operational execution. Administrative suggestions incorporate venture in progressed advanced innovations, creating a solid mentality among workers and supply chain partners, and planning preparing programs for upgrading shrewd fabricating execution to create carbon-neutrality capability. This think about proposes a crossover hypothesis within the setting of carbon nonpartisanship by coordination institutional theory and RBV. Typically the primary think about that looks at the impact of carbon neutrality-based government arrangements on crucial Industry 4.0-driven savvy fabricating assets and the circuitous impact on carbon nonpartisanship capability and operational execution.

Keywords: carbon, industry 4.0, neutrality, RBV, nonpartisanship

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Authors: Arslan Murtaza

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RFID (Radio Frequency Identification) and WSN (Wireless sensor network) are two significant wireless technologies that have extensive diversity of applications and provide limitless forthcoming potentials. RFID is used to identify existence and location of objects whereas WSN is used to intellect and monitor the environment. Incorporating RFID with WSN not only provides identity and location of an object but also provides information regarding the condition of the object carrying the sensors enabled RFID tag. It can be widely used in stock management, asset tracking, asset counting, security, military, environmental monitoring and forecasting, healthcare, intelligent home, intelligent transport vehicles, warehouse management, and precision agriculture. This assessment presents a brief introduction of RFID, WSN, and integration of WSN and RFID, and then applications related to both RFID and WSN. This assessment also deliberates status of the projects on RFID technology carried out in different computing group projects to be taken on WSN and RFID technology.

Keywords: wireless sensor network, RFID, embedded sensor, Wi-Fi, Bluetooth, integration, time saving, cost efficient

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