Search results for: healthcare facility
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2222

Search results for: healthcare facility

1022 The Doctor-Patient Interaction Experience Hierarchy Using Rasch Measurement Model Analysis

Authors: Wan Nur'ashiqin Wan Mohamad, Zarina Othman, Mohd Azman Abas, Azizah Ya'acob, Rozmel Abdul Latiff

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Effective doctor-patient interaction is vital to both doctor and patient relationship. It is the cornerstone of good practice and an integral quality of a healthcare institution. This paper presented the hierarchy of the communication elements in doctor-patient interaction during medical consultations in a medical centre in Malaysia. This study adapted The Picker Patient Experience Questionnaire (2002) to obtain the information from patients. The questionnaire survey was responded by 100 patients between the ages of 20 and 50. Data collected were analysed using Rasch Measurement Model to yield the hierarchy of the communication elements in doctor-patient interaction. The findings showed that the three highest ranking on the doctor-patient interaction were doctor’s treatment, important information delivery and patient satisfaction of doctor’s responses. The results are valuable in developing the framework for communication ethics of doctors.

Keywords: communication elements, doctor-patient interaction, hierarchy, Rasch measurement model

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1021 Knowledge and Practices on Waste Disposal Management Among Medical Technology Students at National University – Manila

Authors: John Peter Dacanay, Edison Ramos, Cristopher James Dicang

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Waste management is a global concern due to increasing waste production from changing consumption patterns and population growth. Proper waste disposal management is a critical aspect of public health and environmental protection. In the healthcare industry, medical waste is generated in large quantities, and if not disposed of properly, it poses a significant threat to human health and the environment. Efficient waste management conserves natural resources and prevents harm to human health, and implementing an effective waste management system can save human lives. The study aimed to assess the level of awareness and practices on waste disposal management, highlighting the understanding of proper disposal, potential hazards, and environmental implications among Medical Technology students. This would help to provide more recommendations for improving waste management practices in healthcare settings as well as for better waste management practices in educational institutions. From the collected data, a female of 21 years of age stands out among the respondents. With the frequency and percentage of medical technology students' knowledge of laboratory waste management being high, it indicates that all respondents demonstrated a solid understanding of proper disposal methods, regulations, risks, and handling procedures related to laboratory waste. That said, the findings emphasize the significance of education and awareness programs in equipping individuals involved in laboratory practices with the necessary knowledge to handle and dispose of hazardous and infectious waste properly. Most respondents demonstrate positive practices or are highly mannered in laboratory waste management, including proper segregation and disposal in designated containers. However, there are concerns about the occasional mixing of waste types, emphasizing the reiteration of proper waste segregation. Students show a strong commitment to using personal protective equipment and promptly cleaning up spills. Some students admit to improper disposal due to rushing, highlighting the importance of time management and safety prioritization. Overall, students follow protocols for hazardous waste disposal, indicating a responsible approach. The school's waste management system is perceived as adequate, but continuous assessment and improvement are necessary. Encouraging reporting of issues and concerns is crucial for ongoing improvement and risk mitigation. The analysis reveals a moderate positive relationship between the respondents' knowledge and practices regarding laboratory waste management. The statistically significant correlation with a p-value of 0.26 (p-value 0.05) suggests that individuals with higher levels of knowledge tend to exhibit better practices. These findings align with previous research emphasizing the pivotal role of knowledge in influencing individuals' behaviors and practices concerning laboratory waste management. When individuals possess a comprehensive understanding of proper procedures, regulations, and potential risks associated with laboratory waste, they are more inclined to adopt appropriate practices. Therefore, fostering knowledge through education and training is essential in promoting responsible and effective waste management in laboratory settings.

Keywords: waste disposal management, knowledge, attitude, practices

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1020 The Effectiveness of Online Learning in the Wisconsin Technical College System

Authors: Julie Furst-Bowe

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Over the past decade, there has been significant growth in online courses and programs at all levels of education in the United States. This study explores the growth of online and blended (or hybrid) programs offered by the sixteen technical colleges in the Wisconsin Technical College System (WTCS). The WTCS provides education and training programs to more than 300,000 students each year in career clusters including agriculture, business, energy, information technology, healthcare, human services, manufacturing, and transportation. These programs range from short-term training programs that may lead to a certificate to two-year programs that lead to an associate degree. Students vary in age from high school students who are exploring career interests to employees who are seeking to gain additional skills or enter a new career. Because there is currently a shortage of skilled workers in nearly all sectors in the state of Wisconsin, it is critical that the WTCS is providing fully educated and trained graduates to fill workforce needs in a timely manner. For this study, information on online and blended programs for the past five years was collected from the WTCS, including types of programs, course and program enrollments, course completion rates, program completion rates, time to completion and graduate employment rates. The results of this study indicate that the number of online and blended courses and programs is continuing to increase each year. Online and blended programs are most commonly found in the business, human services, and information technology areas, and they are less commonly found in agriculture, healthcare, manufacturing, and transportation programs. Overall, course and program completion rates were higher for blended programs when compared to fully online programs. Students preferred the blended programs over the fully online programs. Overall, graduates were placed into related jobs at a rate of approximately 90 percent, although there was some variation in graduate placement rates by programs and by colleges. Differences in graduate employment rate appeared to be based on geography and sector as employers did not distinguish between graduates who had completed their programs via traditional, blended or fully online instruction. Recommendations include further exploration as to the reasons that blended courses and programs appear to be more effective than fully online courses and programs. It is also recommended that those program areas that are not using blended or online delivery methods, including agriculture, health, manufacturing and transportation, explore the use of these methods to make their courses and programs more accessible to students, particularly working adults. In some instances, colleges were partnering with specific companies to ensure that groups of employees were completing online coursework leading to a certificate or a degree. Those partnerships are to be encouraged in order for the state to continue to improve the skills of its workforce. Finally, it is recommended that specific colleges specialize in the delivery of specific programs using online technology since it is not bound by geographic considerations. This approach would take advantage of the strengths of the individual colleges and avoid unnecessary duplication.

Keywords: career and technical education, online learning, skills shortage, technical colleges

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1019 Survival Pattern of Under-five Mortality in High Focus States in India

Authors: Rahul Kumar

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Background: Under-FiveMortality Rate(U5MR)ofanationiswidelyacceptedandlong-standing indicators of well-beingofherchildren.They measuredtheprobability of dying before theageoffive(expressedper1000livebirths).TheU5MRisanappropriate indicator of the cumulative exposure totheriskofdeathduringthefirstfiveyearsoflife, and accepted globalindicator ofthehealthandsocioeconomicstatusofagiven population.Itisalsousefulforassessing theimpactofvariousintervention programmes aimed at improving child survival.Under-fivemortalitytrendsconstitutealeadingindicatorofthelevel ofchildhealthandoveralldevelopmentincountries. Objectives: The first aim of our research is to study the level, trends, and Pattern of Under-five mortality using different sources of data. The second objective is to examine the survival pattern of Under-five mortality by different background characteristics. Data Source and Methodology: SRS and NFHS data have been used forobservingthelevelandtrendofUnder-Five mortality rate. Kaplan Meier Estimate has been used to understand the survival Pattern of Under-five mortality. Result: WefindthatallmostallthestatesmadesomeprogressbyreducingU5MRin recent decades.During1992-93highestU5MR(per thousand live birth) was observed in Assam(142)followed by up(141),Odisha(131),MP(130),andBihar(127.5).While the least U5MR(perthousandlive birth)wasobservedinRajasthan(102). The highestU5MR(per thousandlive birth)isobservedinUP(78.1), followed by MP(64.9)and Chhattisgarh(63.7)which are far away from the national level(50). Among them, Uttarakhand(46.7)hadleastU5MR(perthousandlivebirth), followed by Odisha(48.6). TheU5MR(perthousandlivebirth)ofcombinedhighfocusstateis63.7whichisfar away fromthenationallevel(50). Weidentified thatthesurvivalprobability ofunder-fivechildrenfromadolescentmotherislessin comparisontootherchildrenbornby differentagegroupofmothers. thatduringneonatalperiodusually male mortality exceedsthefemale mortality butthisdifferentialreversedinthepostneonatalperiod. Astheirageincreasesand approachingtofiveyears,weidentifiedthatthesurvivalprobability ofbothsexdecreasesbut female’s survival probabilitydecrement is more than male as their ageincreases. The poorer children’s survival probability is minimum. Children using improved toilet facility has more survival probability throughout thefiveyearsthan who uses unimproved. The survival probability of children under five who got Full ANCis more than the survival probability of children under five who doesn’t get any ANC. Conclusions: Improvement of maternal education is an urgent need to improve their health seeking behavior and thus the health of their children. Awareness on reproductive health and environmental sanitation should be strengthened.

Keywords: under-five mortality, survival pattern, ANC, trend

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1018 Examining the Impact of De-Escalation Training among Emergency Department Nurses

Authors: Jonathan D. Recchi

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Introduction: Workplace violence is a major concern for nurses throughout the United States and is a rising occupational health hazard that has been exacerbated by both the Covid-19 pandemic and increasing patient and family member incivility. De-escalation training has been found to be an evidence-based tool for emergency department nurses to help avoid or mitigate high-risk situations that could lead to workplace violence. Many healthcare organizations either do not provide de-escalation training to their staff or only provide it sparingly, such as during new employee orientation. There is limited research in the literature on the psychological benefits of de-escalation training. Purpose: The purpose of this study is to determine if there are psychological and organizational advantages to providing emergency department nurses with de-escalation training. Equipping emergency department nurses with skills that are essential to de-escalate violent or potentially violent patients may help prevent physical, mental, and/or psychological damage to the nurse because of violence and/or threatening acts. The hypothesis is that providing de-scalation training to emergency department nurses will lead to increased nurse confidence in dealing with aggressive patients, increased resiliency, increased professional quality of life, and increased intention to stay with their current organization. This study aims to show that organizations would benefit from providing de-escalation training to all nurses operating in high-risk areas on a regular basis. Significance: Showing psychological benefits to providing evidence-based de-escalation training can provide healthcare organizations with the ability to retain a more resilient and prepared workforce. Method: This study uses a pre-experimental cross-sectional pre-/post-test design using a convenience sample of emergency department registered nurses employed across Jefferson Health Northeast (Jefferson Torresdale, Jefferson Bucks, and Jefferson Frankford. Inclusion criteria include registered nurses who work full or part-time, with 51% or more of their clinical time spent in direct clinical care. Excluded from participation are registered nurses in orientation, per-diem nurses, temporary and/or travel nurses, nurses who spend less than 51% of their time in direct patient care, and nurses who have received de-escalation training within the past two years. This study uses the Connor-Davidson Resilience Scale 10 (CD-RISC-10), the Clinician Confidence in Coping with Patient Aggression Scale, the Press Ganey Intention To Stay question, and the Professional Quality of Life Scale. Results: A Paired t-Test will be used to analyze the mean scores of the three scales and one question pre and post-intervention to determine if there is a statistically significant difference in RN resiliency, confidence in coping with patient aggression, intention to stay, and professional quality of life. Discussion and Conclusions: Upon completion, the outcomes of this intervention will show the importance of providing evidence-based de-escalation training to all nurses operating within the emergency department.

Keywords: de-escalation, nursing, emergency department, workplace violence

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1017 Body Farming in India and Asia

Authors: Yogesh Kumar, Adarsh Kumar

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A body farm is a research facility where research is done on forensic investigation and medico-legal disciplines like forensic entomology, forensic pathology, forensic anthropology, forensic archaeology, and related areas of forensic veterinary. All the research is done to collect data on the rate of decomposition (animal and human) and forensically important insects to assist in crime detection. The data collected is used by forensic pathologists, forensic experts, and other experts for the investigation of crime cases and further research. The research work includes different conditions of a dead body like fresh, bloating, decay, dry, and skeleton, and data on local insects which depends on the climatic conditions of the local areas of that country. Therefore, it is the need of time to collect appropriate data in managed conditions with a proper set-up in every country. Hence, it is the duty of the scientific community of every country to establish/propose such facilities for justice and social management. The body farms are also used for training of police, military, investigative dogs, and other agencies. At present, only four countries viz. U.S., Australia, Canada, and Netherlands have body farms and related facilities in organised manner. There is no body farm in Asia also. In India, we have been trying to establish a body farm in A&N Islands that is near Singapore, Malaysia, and some other Asian countries. In view of the above, it becomes imperative to discuss the matter with Asian countries to collect the data on decomposition in a proper manner by establishing a body farm. We can also share the data, knowledge, and expertise to collaborate with one another to make such facilities better and have good scientific relations to promote science and explore ways of investigation at the world level.

Keywords: body farm, rate of decomposition, forensically important flies, time since death

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1016 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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1015 Knowledge, Attitude, Practice and Contributing Factors on Menstrual Hygiene Among High School Students, Ethiopia: Cross-Sectional Study

Authors: Getnet Gedefaw, Fentanesh Endalew, Bitewush Azmeraw, Bethelhem Walelign, Eyob Shitie

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Introduction: The issue of menstrual hygiene is often overlooked and has not been sufficiently addressed in the fields of reproductive health in low and middle-income countries. Inadequate menstrual hygiene practices can increase the risk of various infectious and chronic obstetric and gynaecological complications for girls and adolescents. Hence, this study seeks to investigate the knowledge, attitudes, and practices related to menstrual hygiene, along with the factors influencing them, among high school students. Methods: A facility based cross-sectional study was conducted involving a total of 423 study subjects. A systematic random sampling technique was utilized. Data was entered and analyzed through Epi data 3.1 and SPSS 22, respectively. Both univariable and multivariable logistic regression models were employed. A p-value of less than 0.05 was considered statistically significant. Results: This study revealed that 365(89.2%), 200(48.9%) and 196(47.9%) of the study participants have good knowledge, good practice, and good attitudes about menstrual hygiene, respectively. Being higher grade students (grade 10) [AOR=3.96, 95% CI =2.0-7.8] and having good practice of menstrual hygiene (AOR=2.52, 95% CI= 1.26-5) had a positive association with menstrual hygiene knowledge. Whereas maternal education level (AOR=1.86, 95% CI=1.18-2.9) and being a grade 10 student (AOR=2.3, 95% CI=1.48-3.56) were associated factors for practising menstrual hygiene. Additionally, being higher grade students (AOR=1.9, 95% CI=1.2-2.8), age ≥18 years (AOR=1.67, 95% CI=1.09-2.55) were statistically and positively associated with the attitude of menstrual hygiene. Conclusion: The study findings indicated that the knowledge of the study participants regarding menstrual hygiene was high, while their attitudes and practices towards menstrual hygiene were low. It is suggested that raising awareness among reproductive health groups and educating their families and parents could potentially lead to a positive change in their poor practices and attitudes towards menstrual hygiene.

Keywords: menstrual hygiene, menstruation, students, reproductive health

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1014 Hepatitis B Vaccination Status and Its Determinants among Primary Health Care Workers in Northwest Pakistan

Authors: Mohammad Tahir Yousafzai, Rubina Qasim

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We assessed Hepatitis B vaccination and its determinants among health care workers (HCW) in Northwest Pakistan. HCWs from both public and private clinics were interviewed about hepatitis B vaccination, socio-demographic, hepatitis B virus transmission modes, disease threat and benefits of vaccination. Logistic regression was performed. Hepatitis B vaccination was 40% (Qualified Physicians: 86% and non-qualified Dispensers:16%). Being Qualified Physician (Adj. OR 26.6; 95%CI 9.3-73.2), Non-qualified Physician (Adj.OR 1.9; 95%CI 0.8-4.6), qualified Dispensers (Adj. OR 3.6; 95%CI 1.3-9.5) compared to non-qualified Dispensers, working in public clinics (Adj. OR 2.5; 95%CI 1.1-5.7) compared to private, perceived disease threat after exposure to blood and body fluids (Adj. OR 1.1; 95%CI 1.1-1.2) and perceived benefits of vaccination (Adj. OR 1.1; 95%CI 1.1-1.2) were significant predictors of hepatitis B vaccination. Improved perception of disease threat and benefits of vaccination and qualification of HCWs are associated with hepatitis B vaccination.

Keywords: Hepatitis B vaccine, immunization, healthcare workers, primary health

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1013 Collaborative Learning Aspect for Training Hip and Knee Joint Anatomy

Authors: Nasir Mustafa

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One of the prerequisites required for an efficient diagnosis in a medical practice is to have a strong command of both functional and clinical anatomy. In this study, we introduce a new collaborative approach to the effective teaching of the knee and hip joints. In the present teaching model, anatomists, orthopedists and physical therapists present the anatomy of the hip and knee joints in small groups. Courses for the hip and knee joints were scheduled during the early stages of the medical curriculum. Students of nursing and physical therapy were grouped together to sensitize to the importance of a collaborative effort. The study results clearly demonstrate that nursing students and physical therapy students appreciated this teaching approach. The collaborative approach further proved to be a suitable method to teach both functional and clinical anatomy of the hip and knee joints. Aside from this training, a collaborative approach between medical students and physical therapy students was also successful for a healthcare organization.

Keywords: hip and knee joint anatomy, collaborative, Anatomy teaching, Nursing students, Physiotherapy students

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1012 Openness to Linguistic and Value Diversity as a Key Factor in the Development of a Learning Community

Authors: Caterina Calicchio, Talia Sbardella

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The ability to move through geographical and symbolic spaces is key for building new nodes and social relationships. Especially in the framework of language learning, accepting and valuing diversity can help to create a constructive atmosphere of cooperation, innovation, and creativity. Thus, it is important to outline the stages of forming a learning community, focusing on the characteristics that can favor its development. It is known that elements like curiosity and motivation are significant for individual language learning; hence, the study attempts to investigate how factors like openness to diversity and cultural immersion could improve Italian learning and teaching. This paper aims to indicate the factors that could be significant for the development of a Learning Community by presenting a case study on a course on Italian as a second language for beginners: first, the theoretical matrices underlying social learning will be outlined. Secondly, a quantitative study will be described based on an adaptation of the openness to diversity and some insights psychometric scale questionnaire developed at the Umbra Institute. The questionnaire was delivered to 52 American college students with open-ended and closed-ended questions. Students were asked to specify their level of agreement to a set of statements on a six-point Likert scale ranging from (1) Strongly disagree to (6) Strongly agree. The data has been analyzed with a quantitative and qualitative method and has been represented in a pie chart and in a histogram. Moreover, mean and frequency have been calculated. The research findings demonstrate that openness to diversity and challenge enhances cross-cutting skills such as intercultural and communicative competence: through cultural immersion and the facility of speaking with locals, the participants have been able to develop their own Italian L2 language community. The goal is to share with the scientific community some insights to trace possible future lines of research.

Keywords: Italian as second language, language learning, learning community, openness to diversity

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1011 Assessing Sustainability Dimensions of Transportation as a Critical Infrastructure: Jordan as a Case Study

Authors: Malak M. Shatnawi

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Infrastructure is the fundamental facility that plays an important part in socio-economic development for modern societies, if such sector is well planned, managed by decision makers in a way that is compatible with the population growth, safety, and national security needs; it will enrich progress, prosperity, awareness, social and economic welfare for any country. Infrastructure is the most important aspect of life because it can provide materials, products, and services that will improve and facilitate living conditions and maintain sustainability at the same time, and in order to study critical infrastructure, in general, we must think sustainability. Otherwise there will be a significant gap. The planning processes for sustainability include urban infrastructure and public transportation are considered the most important sectors for economic development for both developed and developing countries as they are linked to the civilizational and urban development, meanwhile, choosing the appropriate transportation mode that will provide a good level of service, and increase the satisfaction of the potential users is a difficult task. This research paper tries to assess where is Jordan located vs. each transportation sustainability dimensions in aspects related to social, economic and environmental dimensions based on (Zietsman et al. 2006) adopted model for sustainability transportation infrastructure. Measures of performance indicators for each dimensional goal were traced and supported with needed data, figures and statistical findings. The study uses analytical, descriptive style and methodology based on different references and previous studies from secondary data sources to support the case. Recommendations for enhancing sustainability were concluded, and future reform directions were proposed which can be applied to Jordan and generalized for other developing countries with similar circumstances.

Keywords: infrastructure transportation sustainability, economic, social, environmental

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1010 Scheduling Jobs with Stochastic Processing Times or Due Dates on a Server to Minimize the Number of Tardy Jobs

Authors: H. M. Soroush

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The problem of scheduling products and services for on-time deliveries is of paramount importance in today’s competitive environments. It arises in many manufacturing and service organizations where it is desirable to complete jobs (products or services) with different weights (penalties) on or before their due dates. In such environments, schedules should frequently decide whether to schedule a job based on its processing time, due-date, and the penalty for tardy delivery to improve the system performance. For example, it is common to measure the weighted number of late jobs or the percentage of on-time shipments to evaluate the performance of a semiconductor production facility or an automobile assembly line. In this paper, we address the problem of scheduling a set of jobs on a server where processing times or due-dates of jobs are random variables and fixed weights (penalties) are imposed on the jobs’ late deliveries. The goal is to find the schedule that minimizes the expected weighted number of tardy jobs. The problem is NP-hard to solve; however, we explore three scenarios of the problem wherein: (i) both processing times and due-dates are stochastic; (ii) processing times are stochastic and due-dates are deterministic; and (iii) processing times are deterministic and due-dates are stochastic. We prove that special cases of these scenarios are solvable optimally in polynomial time, and introduce efficient heuristic methods for the general cases. Our computational results show that the heuristics perform well in yielding either optimal or near optimal sequences. The results also demonstrate that the stochasticity of processing times or due-dates can affect scheduling decisions. Moreover, the proposed problem is general in the sense that its special cases reduce to some new and some classical stochastic single machine models.

Keywords: number of late jobs, scheduling, single server, stochastic

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1009 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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1008 Measuring Hazard Analysis and Critical Control Points Implementation in Riyadh Hospitals

Authors: A. Alrasheed, I. Connerton

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

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

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1007 Mitigation of Wind Loads on a Building Using Small Wind Turbines

Authors: Arindam Chowdhury, Andres Tremante, Mohammadtaghi Moravej, Bodhisatta Hajra, Ioannis Zisis, Peter Irwin

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Extreme wind events, such as hurricanes, have caused significant damage to buildings, resulting in losses worth millions of dollars. The roof of a building is most vulnerable to wind-induced damage due to the high suctions experienced by the roof in extreme wind conditions. Wind turbines fitted to buildings can help generate energy, but to our knowledge, their application to wind load mitigation is not well known. This paper presents results from an experimental study to assess the effect of small wind turbines (developed and patented by the first and second authors) on the wind loads on a low rise building roof. The tests were carried out for an open terrain at the Wall of Wind (WOW) experimental facility at Florida International University (FIU), Miami, Florida, USA, for three cases – bare roof, roof fitted with wind turbines placed closer to the roof edges, and roof with wind turbines placed away from the roof edges. Results clearly indicate that the presence of the wind turbines reduced the mean and peak pressure coefficients (less suction) on the roof when compared to the bare deck case. Furthermore, the peak pressure coefficients were found to be lower (less suction) when the wind turbines were placed closer to the roof, than away from the roof. Flow visualization studies using smoke and gravel clearly showed that the presence of the turbines disrupted the formation of vortices formed by cornering winds, thereby reducing roof suctions and preventing lift off of roof coverings. This study shows that the wind turbines besides generating wind energy, can be used for mitigating wind induced damage to the building roof. Future research must be directed towards understanding the effect of these wind turbines on other roof geometries (e.g. hip/gable) in different terrain conditions.

Keywords: wall of wind, wind loads, wind turbine, building

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1006 Groundwater Treatment of Thailand's Mae Moh Lignite Mine

Authors: A. Laksanayothin, W. Ariyawong

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Mae Moh Lignite Mine is the largest open-pit mine in Thailand. The mine serves coal to the power plant about 16 million tons per year. This amount of coal can produce electricity accounting for about 10% of Nation’s electric power generation. The mining area of Mae Moh Mine is about 28 km2. At present, the deepest area of the pit is about 280 m from ground level (+40 m. MSL) and in the future the depth of the pit can reach 520 m from ground level (-200 m.MSL). As the size of the pit is quite large, the stability of the pit is seriously important. Furthermore, the preliminary drilling and extended drilling in year 1989-1996 had found high pressure aquifer under the pit. As a result, the pressure of the underground water has to be released in order to control mine pit stability. The study by the consulting experts later found that 3-5 million m3 per year of the underground water is needed to be de-watered for the safety of mining. However, the quality of this discharged water should meet the standard. Therefore, the ground water treatment facility has been implemented, aiming to reduce the amount of naturally contaminated Arsenic (As) in discharged water lower than the standard limit of 10 ppb. The treatment system consists of coagulation and filtration process. The main components include rapid mixing tanks, slow mixing tanks, sedimentation tank, thickener tank and sludge drying bed. The treatment process uses 40% FeCl3 as a coagulant. The FeCl3 will adsorb with As(V), forming floc particles and separating from the water as precipitate. After that, the sludge is dried in the sand bed and then be disposed in the secured land fill. Since 2011, the treatment plant of 12,000 m3/day has been efficiently operated. The average removal efficiency of the process is about 95%.

Keywords: arsenic, coagulant, ferric chloride, groundwater, lignite, coal mine

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1005 A Quality Improvement Project on Eye Care in the Intensive Care Unit

Authors: Julius Lenaerts, Ahmed Elsaadawy, Mohammed Bashir

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

Keywords: ICU, eye care, risk, QIP

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1004 Scientific and Regulatory Challenges of Advanced Therapy Medicinal Products

Authors: Alaa Abdellatif, Gabrièle Breda

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

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

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1003 Impact of Map Generalization in Spatial Analysis

Authors: Lin Li, P. G. R. N. I. Pussella

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When representing spatial data and their attributes on different types of maps, the scale plays a key role in the process of map generalization. The process is consisted with two main operators such as selection and omission. Once some data were selected, they would undergo of several geometrical changing processes such as elimination, simplification, smoothing, exaggeration, displacement, aggregation and size reduction. As a result of these operations at different levels of data, the geometry of the spatial features such as length, sinuosity, orientation, perimeter and area would be altered. This would be worst in the case of preparation of small scale maps, since the cartographer has not enough space to represent all the features on the map. What the GIS users do is when they wanted to analyze a set of spatial data; they retrieve a data set and does the analysis part without considering very important characteristics such as the scale, the purpose of the map and the degree of generalization. Further, the GIS users use and compare different maps with different degrees of generalization. Sometimes, GIS users are going beyond the scale of the source map using zoom in facility and violate the basic cartographic rule 'it is not suitable to create a larger scale map using a smaller scale map'. In the study, the effect of map generalization for GIS analysis would be discussed as the main objective. It was used three digital maps with different scales such as 1:10000, 1:50000 and 1:250000 which were prepared by the Survey Department of Sri Lanka, the National Mapping Agency of Sri Lanka. It was used common features which were on above three maps and an overlay analysis was done by repeating the data with different combinations. Road data, River data and Land use data sets were used for the study. A simple model, to find the best place for a wild life park, was used to identify the effects. The results show remarkable effects on different degrees of generalization processes. It can see that different locations with different geometries were received as the outputs from this analysis. The study suggests that there should be reasonable methods to overcome this effect. It can be recommended that, as a solution, it would be very reasonable to take all the data sets into a common scale and do the analysis part.

Keywords: generalization, GIS, scales, spatial analysis

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1002 Happiness of Undergraduate Nursing Students, College of Nursing, Ratchaburi, Thailand

Authors: Paveenapat Nithitantiwat, Kwanjai Pataipakaipet

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

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

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1001 Linkages of Environment with the Health Condition of Poor Women and Children in the Urban Areas of India

Authors: Barsharani Maharana

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India is the country that shelters the largest number of poor. One of the major areas of concern in India is the unsatisfactory situation of the poor in social developmental and health parameters, not only in rural areas which are partly devoid of the facilities but also in the urban areas where the facilities are insufficient to provide services of a satisfactory quality. Objectives: 1) to examine the association between the environmental condition and health condition among poor women in urban areas. 2) to find out the significance of the effect of environment on the child health among the poor children. 3) to present the scenario of poor among highly urbanized and less urbanized states with respect to the health and environment. Data: data from National Family Health survey-3 and census are used to fulfill the objectives. Methodology: In this study, the standard of living condition of people living in urban areas is computed by taking some household characteristics and assets. People possessing low standard of living are considered as poor. Bivariate and multivariate analysis are employed to examine the effect of environment on poor women and children. A geographical information system is used to present the health and environmental condition of poor in highly and less urbanized states. Results: The findings reveal that the poor women who are not accessed to improved source of water, and sanitation facility are facing more health problems. Children who are living in a dirty environment and are not accessed to improved source of drinking water, among them prevalence of diarrhea and fever is found to be high. As well, the health condition of poor in highly urbanized states is dreadful. Policy implications: Government should emphasize on the implementation of programs regarding the improvement in the infrastructural facilities and health care treatment of urban poor.

Keywords: environment, urban poor, health, sanitation

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1000 Mobile Microscope for the Detection of Pathogenic Cells Using Image Processing

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

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

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

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999 Audit Management of Constipation According to National Institute for Health and Care Excellence Guideline

Authors: Areej Makeineldein Mustafa

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

Keywords: constipation, elderly, management, patient

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998 Seismic Assessment of Old Existing RC Buildings In Madinah with Masonry Infilled Using Ambient Vibration Measurements

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

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

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

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997 Simultaneous Removal of Phosphate and Ammonium from Eutrophic Water Using Dolochar Based Media Filter

Authors: Prangya Ranjan Rout, Rajesh Roshan Dash, Puspendu Bhunia

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With the aim of enhancing the nutrient (ammonium and phosphate) removal from eutrophic wastewater with reduced cost, a novel media based multistage bio filter with drop aeration facility was developed in this work. The bio filter was packed with a discarded sponge iron industry by product, ‘dolochar’ primarily to remove phosphate via physicochemical approach. In the multi stage bio-filter drop, aeration was achieved by the process of percolation of the gravity-fed wastewater through the filter media and dropping down of wastewater from stage to stage. Ammonium present in wastewater got adsorbed by the filter media and biomass grown on the filter media and subsequently, got converted to nitrate through biological nitrification in the aerobic condition, as realized by drop aeration. The performance of the bio-filter in treating real eutrophic wastewater was monitored for a period of about 2 months. The influent phosphate concentration was in the range of 16-19 mg/L, and ammonium concentration was in the range of 65-78 mg/L. The average nutrient removal efficiency observed during the study period were 95.2% for phosphate and 88.7% for ammonium, with mean final effluent concentration of 0.91, and 8.74 mg/L, respectively. Furthermore, the subsequent release of nutrient from the saturated filter media, after completion of treatment process has been undertaken in this study and thin layer funnel analytical test results reveal the slow nutrient release nature of spent dolochar, thereby, recommending its potential agricultural application. Thus, the bio-filter displays immense prospective for treating real eutrophic wastewater, significantly decreasing the level of nutrients and keeping the effluent nutrient concentrations at par with the permissible limit and more importantly, facilitating the conversion of the waste materials into usable ones.

Keywords: ammonium removal, phosphate removal, multi-stage bio-filter, dolochar

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996 Quantum Technologies, the Practical Challenges to It, and Ideas to Build an Inclusive Quantum Platform, Shoonya Ecosystem (Zero-Point Energy)

Authors: Partha Pratim Kalita

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

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

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995 Musharakah Mutanaqisah Partnership as a Tool for House Financing, Its Sustainability and Issues

Authors: Imran Mehboob Shaikh, Kamaruzaman Noordin

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Musharakah Mutanaqisah or Diminishing Partnership is a derivative of Musharakah contract, which is used by Islamic banks for housing finance facility. Most of the banks offer housing finance based on the concept of Musharakah Mutanaqisah, apart from few which still offer housing finance using BBA, Tawarruq (commodity Murabahah) and Istisna. This research attempts to compare the practice of DP housing finance offered in Malaysia. This paper will further look into challenges in Musharakah Mutanaqisah practice and its sustainability as a mortgage product. In practice there are certain issues related to Musharakah Mutanaqisah also known as Musharakah al Muntaiah bi tamlik, widely accepted and mostly used for housing finance by the Islamic banks. In Malaysia, it is in transforming stage from Bay bithamman Ajil, which is mostly used for housing finance in ASEAN region i.e., Malaysia, Indonesia and Brunei. In order to conduct this study, a discussion was carried out with few researchers who had worked on the topic previously and some Islamic bank officers attached to a full-fledged Islamic bank in Malaysia. Apart from that previous literature on Musharakah Mutanaqisah was also reviewed and various books, as well as online data, was considered for this study, and websites of different Islamic banks with information for Diminishing partnership, home financing were retrieved. This paper will highlight issues surrounding Diminishing Partnership contract and its conformity to Maqasid al Shariah (objectives of Shariah). Diminishing Partnership is widely accepted in different parts of the world and is mostly used for housing finance. The future prospect of DP is believed to be affirmative. As the product is a better substitute for BBA and most of the Islamic banks around the world have utilized their housing portfolio using the contract but at the same time, there are certain issues that need to be overcome. Even though Islamic banks are striving to sustain and compete the conventional banks but securing the customers from Gharar and other issues should be the primary objective of Islamic financial institutions.

Keywords: BBA, home financing, musharakah mutanaqisah, tawarruq

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994 A Machine Learning-Based Analysis of Autism Prevalence Rates across US States against Multiple Potential Explanatory Variables

Authors: Ronit Chakraborty, Sugata Banerji

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

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

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993 Blockchain in Saudi E-Government: A Systematic Literature Review

Authors: Haitham Assiri, Priyadarsi Nanda

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

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

Procedia PDF Downloads 239