Search results for: healthcare reform

Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: hospital, light fidelity, Li-Fi, medical devices, security

Procedia PDF Downloads 94

Authors: Mehtap Öztürk, Adem Öğüt, Emine Öğüt

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Leader member exchange is considered as relationship-based approach to leadership. The focal point of this theory is that effective leadership processes occur when leaders and followers are able to develop mature leadership relationships and thus gain access to a variety of benefits these relationships bring. In this context, it can be claimed that the quality of leader member exchange appears to have a strong affect on perceived organizational support and reduce turnover intention. The purpose of this study is to determine the relationship between the levels of leader member exchange, perceived organizational support and turnover intention on the employees of a health institution operating in the province of Konya. A field study based on survey method on 134 physicians who are employees of a health institution operating in the mentioned sample. In accordance with this purpose, it has been observed that there is a negative and statistically significant relationship between leader member exchange and turnover intention. Furthermore, it has been also realized that there is a negative and statistically significant relationship between perceived organizational support and turnover intention.

Keywords: leader member exchange, perceived organizational support, social exchange theory, turnover intention

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Authors: Jian Yu

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Carbo dioxide (CO2) from fossil fuel combustion is a prime green-house gas emission. It can be mitigated by microalgae through conventional photosynthesis. The algal oil is a feedstock of biodiesel, a carbon neutral liquid fuel for transportation. The conventional CO2 fixation, however, is quite slow and affected by the intermittent solar irradiation. It is also a technical challenge to reform the bio-oil into a drop-in liquid fuel that can be directly used in the modern combustion engines with expected performance. Here, an artificial photosynthesis system is presented to produce a biopolyester and liquid fuels from CO2, water, and solar power. In this green process, solar energy is captured using photovoltaic modules and converted into hydrogen as a stable energy source via water electrolysis. The solar hydrogen is then used to fix CO2 by Cupriavidus necator, a hydrogen-oxidizing bacterium. Under the autotrophic conditions, CO2 was reduced to glyceraldehyde-3-phosphate (G3P) that is further utilized for cell growth and biosynthesis of polyhydroxybutyrate (PHB). The maximum cell growth rate reached 10.1 g L-1 day-1, about 25 times faster than that of a typical bio-oil-producing microalga (Neochloris Oleoabundans) under stable indoor conditions. With nitrogen nutrient limitation, a large portion of the reduced carbon is stored in PHB (C4H6O2)n, accounting for 50-60% of dry cell mass. PHB is a biodegradable thermoplastic that can find a variety of environmentally friendly applications. It is also a platform material from which small chemicals can be derived. At a high temperature (240 - 290 oC), the biopolyester is degraded into crotonic acid (C4H6O2). On a solid phosphoric acid catalyst, PHB is deoxygenated via decarboxylation into a hydrocarbon oil (C6-C18) at 240 oC or so. Aromatics and alkenes are the major compounds, depending on the reaction conditions. A gasoline-grade liquid fuel (77 wt% oil) and a biodiesel-grade fuel (23 wt% oil) were obtained from the hydrocarbon oil via distillation. The formation routes of hydrocarbon oil from crotonic acid, the major PHB degradation intermediate, are revealed and discussed. This work shows a novel green process from which biodegradable plastics and high-grade liquid fuels can be directly produced from carbon dioxide, water and solar power. The productivity of the green polyester (5.3 g L-1 d-1) is much higher than that of microalgal oil (0.13 g L-1 d-1). Other technical merits of the new green process may include continuous operation under intermittent solar irradiation and convenient scale up in outdoor.

Keywords: bioplastics, carbon dioxide fixation, drop-in liquid fuels, green process

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Authors: Yiqi Zhu, Jean Francois Trani, Rameez Ulhassan

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Extreme weather phenomena increased by 46% between 2007 and 2017 and have become more intense with the rise in global average temperatures. This increased intensity of climate variations often induces humanitarian crises and particularly affects vulnerable populations in low- and middle-income countries (LMICs). Expectant and lactating mothers are among the most vulnerable groups. Pakistan ranks 10th among the most affected countries by climate disasters. In 2022, monsoon floods submerged a third of the country, causing the loss of 1,500 lives. Approximately 650,000 expectant and lactating mothers faced systematic stress from climatic disasters. Our study used participatory methods to investigate the systematic impact of climatic disasters on maternal health. In March 2023, we conducted six Group Model Building (GMB) workshops with healthcare workers, fathers, and mothers separately in two of the most affected areas in Pakistan. This study was approved by the Islamic Relief Research Review Board. GMB workshops consist of three sessions. In the first session, participants discussed the factors that impact maternal health. After identifying the factors, they discussed the connections among them and explored the system structures that collectively impact maternal health. Based on the discussion, a causal loop diagram (CLD) was created. Finally, participants discussed action ideas that could improve the system to enhance maternal health. Based on our discussions and the causal loop diagram, we identified interconnected factors at the family, community, and policy levels. Mothers and children are directly impacted by three interrelated factors: food insecurity, unstable housing, and lack of income. These factors create a reinforcing cycle that negatively affects both mothers and newborns. After the flood, many mothers were unable to produce sufficient breastmilk due to their health status. Without breastmilk and sufficient food for complementary feeding, babies tend to get sick in damp and unhygienic environments resulting from temporary or unstable housing. When parents take care of sick children, they miss out on income-generating opportunities. At the community level, the lack of access to clean water and sanitation (WASH) and maternal healthcare further worsens the situation. Structural failures such as a lack of safety nets and programs associated with flood preparedness make families increasingly vulnerable with each disaster. Several families reported that they had not fully recovered from a flood that occurred ten years ago, and this latest disaster destroyed their lives again. Although over twenty non-profit organizations are working in these villages, few of them provide sustainable support. Therefore, participants called for systemic changes in response to the increasing frequency of climate disasters. The study reveals the systematic vulnerabilities of mothers and children after climatic disasters. The most vulnerable populations are often affected the most by climate change. Collaborative efforts are required to improve water and forest management, strengthen public infrastructure, increase access to WASH, and gradually build climate-resilient communities. Governments, non-governmental organizations, and the community should work together to develop and implement effective strategies to prevent, mitigate, and adapt to climate change and its impacts.

Keywords: climatic disasters, maternal health, Pakistan, systematic impact, flood, disaster relief.

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Authors: Safoin Aktaou, Aya Al Masri, Kamel Guerchouche, Malorie Martin, Fouad Maaloul

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Introduction: In the ‘Magnetic Resonance Imaging (MRI)’ department, all workers involved in preparing the patient, setting it up, tunnel cleaning, etc. are likely to be exposed to ‘ElectroMagnetic fields (EMF)’ emitted by the MRI device. Exposure to EMF can cause adverse radio-biological effects to workers. The purpose of this study is to propose an organizational process to manage and control EMF risks. Materials and methods: The study was conducted at seven MRI departments using machines with 1.5 and 3 Tesla magnetic fields. We assessed the exposure of each one by measuring the two electromagnetic fields (static and dynamic) at different distances from the MRI machine both inside and around the examination room. Measurement values were compared with British and American references (those of the UK's ‘Medicines and Healthcare Regulatory Agency (MHRA)’ and the ‘American Radiology Society (ACR)’). Results: Following the results of EMF measurements and their comparison with the recommendations of learned societies, a zoning system that adapts to needs of different MRI services across the country has been proposed. In effect, three risk areas have been identified within the MRI services. This has led to the development of a good practice guide related to the magnetic protection of MRI workers. Conclusion: The guide established by our study is a standard that allows MRI workers to protect themselves against the risk of electromagnetic fields.

Keywords: comparison with international references, measurement of electromagnetic fields, magnetic protection of workers, magnetic resonance imaging

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Authors: Jawad Taheri

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This paper investigates the impact of foreign aid-funded development projects on corruption perception in Afghanistan, utilizing instrumental variable (IV) approaches in regression analysis setting. Seven sub-categories of development projects are examined in order to have a glance over comparative usefulness of each project. The study incorporates natural disaster indicators as exogenous variables to mitigate endogeneity concerns and control variables. The findings reveal significant associations between certain types of projects and corruption perception. Road and bridge construction, irrigation, and agriculture projects are found to decrease corruption perception, fostering optimism and trust within affected communities. Mosque construction and healthcare initiatives aligned with religious beliefs also contribute to reduced corruption perception. However, drinking water projects are associated with increased corruption perception, highlighting potential challenges in their implementation. The study emphasizes the importance of well-implemented projects, cultural contexts, and effective governance in mitigating corruption and fostering trust within communities. These findings contribute to a refined understanding of the relationship between development projects and corruption perception in Afghanistan.

Keywords: foreign aid, development projects, corruption perception, Afghanistan, instrumental variable analysis, survey of Afghan people (SAP), natural disasters, exogenous variation

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Authors: David Lynch, Jake Madden

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There exists a body of literature that reports on the many benefits of partnerships between universities and schools, especially in terms of teaching improvement and school reform. This is because such partnerships can build significant teaching capital, by deepening and expanding the skillsets and mindsets needed to create the connections that support ongoing and embedded teacher professional development and career goals. At the same time, this literature is critical of such initiatives when the partnership outcomes are short- term or one-sided, misaligned to fundamental problems, and not expressly focused on building the desired teaching capabilities. In response to this situation, research conducted by Professor David Lynch and his TeachLab research team, has begun to shed light on the strengths and limitations of school/university partnerships, via the identification of key conceptual elements that appear to act as critical partnership success factors. These elements are theorised as an inter-play between professional knowledge acquisition, readiness, talent management and organisational structure. However, knowledge of how these elements are established, and how they manifest within the school and its teaching workforce as an overall system, remains incomplete. Therefore, research designed to more clearly delineate these elements in relation to their impact on school/university partnerships is thus required. It is within this context that this paper reports on the development and testing of a Professional Learning (PL) model for schools and their teachers that incorporates school-university research partnering within a systematic, whole-of-school PL strategy that is underpinned and structured by a micro-credentialing (MC) regime. MC involves learning a narrow-focused certificate (a micro-credential) in a specific topic area (e.g., 'How to Differentiate Instruction for English as a second language Students') and embedded in the teacher’s day-to-day teaching work. The use of MC is viewed as important to the efficacy and sustainability of teacher PL because it (1) provides an evidence-based framework for teacher learning, (2) has the ability to promote teacher social capital and (3) engender lifelong learning in keeping professional skills current in an embedded and seamless to work manner. The associated research is centred on a primary school in Australia (P-6) that acted as an arena to co-develop, test/investigate and report on outcomes for teacher PL that uses MC to support a whole-of-school partnership with a university.

Keywords: teaching improvement, teacher professional learning, talent management, education partnerships, school-university research

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Authors: Jinyan Li, Simon Fong, Raymond Wong, Mohammed Sabah, Fiaidhi Jinan

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Clinical data analysis and forecasting have make great contributions to disease control, prevention and detection. However, such data usually suffer from highly unbalanced samples in class distributions. In this paper, we target at the binary imbalanced dataset, where the positive samples take up only the minority. We investigate two different meta-heuristic algorithms, particle swarm optimization and bat-inspired algorithm, and combine both of them with the synthetic minority over-sampling technique (SMOTE) for processing the datasets. One approach is to process the full dataset as a whole. The other is to split up the dataset and adaptively process it one segment at a time. The experimental results reveal that while the performance improvements obtained by the former methods are not scalable to larger data scales, the later one, which we call Adaptive Swarm Balancing Algorithms, leads to significant efficiency and effectiveness improvements on large datasets. We also find it more consistent with the practice of the typical large imbalanced medical datasets. We further use the meta-heuristic algorithms to optimize two key parameters of SMOTE. Leading to more credible performances of the classifier, and shortening the running time compared with the brute-force method.

Keywords: Imbalanced dataset, meta-heuristic algorithm, SMOTE, big data

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Authors: H. Moalla, A. Frikha

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Multi-criteria decision aid methods consider decision problems where numerous alternatives are evaluated on several criteria. These methods are used to deal with perfect information. However, in practice, it is obvious that this information requirement is too much strict. In fact, the imperfect data provided by more or less reliable decision makers usually affect decision results since any decision is closely linked to the quality and availability of information. In this paper, a PROMETHEE-BELIEF approach is proposed to help multi-criteria decisions based on incomplete information. This approach solves problems with incomplete decision matrix and unknown weights within PROMETHEE method. On the base of belief function theory, our approach first determines the distributions of belief masses based on PROMETHEE’s net flows and then calculates weights. Subsequently, it aggregates the distribution masses associated to each criterion using Murphy’s modified combination rule in order to infer a global belief structure. The final action ranking is obtained via pignistic probability transformation. A case study of real-world application concerning the location of a waste treatment center from healthcare activities with infectious risk in the center of Tunisia is studied to illustrate the detailed process of the BELIEF-PROMETHEE approach.

Keywords: belief function theory, incomplete information, multiple criteria analysis, PROMETHEE method

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Authors: Malarvizhi Selvaraj, Paul Fergus, Andy Shaw

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Uterine contractions produced during labour have the potential to damage the foetus by diminishing the maternal blood flow to the placenta. In order to observe this phenomenon labour and delivery are routinely monitored using cardiotocography monitors. An obstetrician usually makes the diagnosis of foetus hypoxia by interpreting cardiotocography recordings. However, cardiotocography capture and interpretation is time-consuming and subjective, often lead to misclassification that causes damage to the foetus and unnecessary caesarean section. Both of these have a high impact on the foetus and the cost to the national healthcare services. Automatic detection of foetal heart rate may be an objective solution to help to reduce unnecessary medical interventions, as reported in several studies. This paper aim is to provide a system for better identification and interpretation of abnormalities of the fetal heart rate using RStudio. An open dataset of 552 Intrapartum recordings has been filtered with 0.034 Hz filters in an attempt to remove noise while keeping as much of the discriminative data as possible. Features were chosen following an extensive literature review, which concluded with FIGO features such as acceleration, deceleration, mean, variance and standard derivation. The five features were extracted from 552 recordings. Using these features, recordings will be classified either normal or abnormal. If the recording is abnormal, it has got more chances of hypoxia.

Keywords: cardiotocography, foetus, intrapartum, hypoxia

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Authors: Aya Salama

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Digital Twin is an emerging research topic that attracted researchers in the last decade. It is used in many fields, such as smart manufacturing and smart healthcare because it saves time and money. It is usually related to other technologies such as Data Mining, Artificial Intelligence, and Machine Learning. However, Human digital twin (HDT), in specific, is still a novel idea that still needs to prove its feasibility. HDT expands the idea of Digital Twin to human beings, which are living beings and different from the inanimate physical entities. The goal of this research was to create a Human digital twin that is responsible for real-time human replies automation by simulating human behavior. For this reason, clustering, supervised classification, topic extraction, and sentiment analysis were studied in this paper. The feasibility of the HDT for personal replies generation on social messaging applications was proved in this work. The overall accuracy of the proposed approach in this paper was 63% which is a very promising result that can open the way for researchers to expand the idea of HDT. This was achieved by using Random Forest for clustering the question data base and matching new questions. K-nearest neighbor was also applied for sentiment analysis.

Keywords: human digital twin, sentiment analysis, topic extraction, supervised machine learning, unsupervised machine learning, classification, clustering

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Authors: Yufeng Wu, Yifan Gu, Bin Li, Wei Wang

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Resource recycling process contains a subsystem with interactions of three dimensions including coupling allocation of primary and secondary resources, responsibility coordination of stakeholders in forward and reverse supply chains, and trans-boundary transfer of hidden resource and environmental responsibilities between regions. Overlap or lack of responsibilities is easy to appear at the intersection of the three management dimensions. It is urgent to make an overall design of the policy system for recycling resources. From theoretical perspective, this paper analyzes the unique external differences of resource and environment in various dimensions and explores the reason why the effects of trans-dimensional policies are strongly correlated. Taking the example of the copper resources contained in the waste electrical and electronic equipment, this paper constructs reduction effect accounting model of resources recycling and set four trans-dimensional policy scenarios including resources tax and environmental tax reform of the raw and secondary resources, application of extended producer responsibility system, promotion of clean development mechanism, and strict entry barriers of imported wastes. In these ways, the paper simulates the impact effect of resources recycling process on resource deduction and emission reduction of waste water and gas, and constructs trans-dimensional policy mix scenario through integrating dominant strategy. The results show that combined application of various dimensional policies can achieve incentive compatibility and the trans-dimensional policy mix scenario can reach a better effect. Compared with baseline scenario, this scenario will increase 91.06% copper resources reduction effect and improve emission reduction of waste water and gas by eight times from 2010 to 2030. This paper further analyzes the development orientation of policies in various dimension. In resource dimension, the combined application of compulsory, market and authentication methods should be promoted to improve the use ratio of secondary resources. In supply chain dimension, resource value, residual functional value and potential information value contained in waste products should be fully excavated to construct a circular business system. In regional dimension, it should give full play to the comparative advantages of manufacturing power to improve China’s voice in resource recycling in the world.

Keywords: resource recycling, trans-dimension, policy design, incentive compatibility, life cycle

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Authors: Eish Sharma

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Literature around Mathematics education suggests that democratic attitudes can be strengthened through teaching and learning Mathematics. Furthermore, connections between critical education and Mathematics education are observed in the light of critical pedagogy to locate Critical Mathematics Education (CME) as the theoretical framework. Critical pedagogy applied to Mathematics education is identified as one of the key themes subsumed under Critical Mathematics Education. Through the application of critical pedagogy in mathematics, unequal power relations and social injustice can be identified, analyzed, and challenged. The research question is: have educational policies in India viewed the role of critical pedagogy applied to mathematics education (i.e., critical mathematics education) to ensure social justice as an educational aim? The National Curriculum Framework (NCF), 2005 upholds education for democracy and the role of mathematics education in facilitating the same. More than this, NCF 2005 rests on Critical Pedagogy Framework and it recommends that critical pedagogy must be practiced in all dimensions of school education. NCF 2005 visualizes critical pedagogy for social sciences as well as sciences, stating that the science curriculum, including mathematics, must be used as an “instrument for achieving social change to reduce the divide based on economic class, gender, caste, religion, and the region”. Furthermore, the implementation of NCF 2005 led to a reform in the syllabus and textbooks in school mathematics at the national level, and critical pedagogy was applied to mathematics textbooks at the primary level. This intervention led to ethnomathematics and critical mathematics education in the school curriculum in India for the first time at the national level. In October 2022, the Ministry of Education launched the National Curriculum Framework for Foundational Stage (NCF-FS), developed in light of the National Education Policy, 2020, for children in the three to eight years age group. I want to find out whether critical pedagogy-based education and critical pedagogy-based mathematics education are carried forward in NCF 2022. To find this, an argument analysis of specific sections of the National Curriculum Framework 2022 document needs to be executed. Des Gasper suggests two tables: The first table contains four columns, namely, text component, comments on meanings, possible reformulation of the same text, and identified conclusions and assumptions (both stated and unstated). This table is for understanding the components and meanings of the text and is based on Scriven’s model for understanding the components and meanings of words in the text. The second table contains four columns i.e., claim identified, given data, warrant, and stated qualifier/rebuttal. This table is for describing the structure of the argument, how and how well the components fit together and is called ‘George Table diagram based on Toulmin-Bunn Model’.

Keywords: critical mathematics education, critical pedagogy, social justice, etnomathematics

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Authors: Stela Papa, Klementina Puto, Migena Pllaha

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HCV is a hepatotropic RNA virus, transmitted primarily via the blood route, which causes progressive disease such as chronic hepatitis, liver cirrhosis, or hepatocellular carcinoma. HCV nowadays is a global healthcare problem. A variety of immunoassays including old and new technologies are being applied to detect HCV in our country. These methods include Immunochromatography assays (ICA), Fluorescence immunoassay (FIA), Enzyme linked fluorescent assay (ELFA), and Enzyme linked immunosorbent assay (ELISA) to detect HCV antibodies in blood serum, which lately is being slowly replaced by more sensitive methods such as rapid automated analyzer chemiluminescence immunoassay (CLIA). The aim of this study is to estimate HCV infection in carriers and chronic acute patients and to evaluate the use of new diagnostic methods. This study was realized from September 2016 to May 2018. During this study period, 2913 patients were analyzed for the presence of HCV by taking samples from their blood serum. The immunoassays performed were ICA, FIA, ELFA, ELISA, and CLIA assays. Concluding, 82% of patients taken in this study, resulted infected with HCV. Diagnostic methods in clinical laboratories are crucial in the early stages of infection, in the management of chronic hepatitis and in the treatment of patients during their disease.

Keywords: CLIA, ELISA, Hepatitis C virus, immunoassay

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Authors: Yang Chen, Lili Fu

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Promoting urban regeneration in existing areas has been elevated to a national strategy in China. In this context, because of the multidimensional sustainable effect through the intensive use of land, mixed-use development has become an important objective for high-quality urban regeneration in the inner city. However, in the long period of time since China's reform and opening up, the "unbalanced phenomenon" of mixed-use development in China's inner cities has been very serious. On the one hand, the excessive focus on certain individual spaces has led to an increase in the level of mixed-use development in some areas, substantially ahead of others, resulting in a growing gap between different parts of the inner city; On the other hand, the excessive focus on a one-dimensional element of the spatial organization of mixed-use development, such as the enhancement of functional mix or spatial capacity, has led to a lagging phenomenon or neglect in the construction of other dimensional elements, such as pedestrian permeability, green environmental quality, social inclusion, etc. This phenomenon is particularly evident in the central area of the inner city, and it clearly runs counter to the need for sustainable development in China's new era. Therefore, a rational qualitative and quantitative analysis of the "unbalanced phenomenon" will help to identify the problem and provide a basis for the formulation of relevant optimization plans in the future. This paper builds a dynamic evaluation method of mixed-use development based on a meta-dimensional model and then uses spatial evolution analysis and spatial consistency analysis with ArcGIS software to reveal the "unbalanced phenomenon " in over the past 40 years of the central city area in Nanjing, a China’s typical city facing regeneration. This study result finds that, compared to the increase in functional mix and capacity, the dimensions of residential space mix, public service facility mix, pedestrian permeability, and greenness in Nanjing's city central area showed different degrees of lagging improvement, and the unbalanced development problems in each part of the city center are different, so the governance and planning plan for future mixed-use development needs to fully address these problems. The research methodology of this paper provides a tool for comprehensive dynamic identification of mixed-use development level’s change, and the results deepen the knowledge of the evolution of mixed-use development patterns in China’s inner cities and provide a reference basis for future regeneration practices.

Keywords: mixed-use development, unbalanced phenomenon, the meta-dimensional model, over the past 40 years of Nanjing, China

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Authors: Shalitha Jayasekara, Saluk Bawantha, Dinithi Anupama, Isuru Gunarathne, Pradeepa Bandara, Hansi De Silva

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Dogs have been known as "man's best friend" for generations, providing friendship and loyalty to their human counterparts. However, due to people's busy lives, they are unaware of the ailments that can affect their pets. However, in recent years, mobile technologies have had a significant impact on our lives, and with technological improvements, a rule-based expert system allows the end-user to enable new types of healthcare systems. The advent of Android OS-based smartphones with more user-friendly interfaces and lower pricing opens new possibilities for continuous monitoring of pets' health conditions, such as healthy dogs, dangerous ingestions, and swallowed objects. The proposed ‘Best Bark’ Dog care and owner consultation system is a mobile application for dog owners. Four main components for dog owners were implemented after a questionnaire was distributed to the target group of audience and the findings were evaluated. The proposed applications are widely used to provide health and clinical support to dog owners, including suggesting exercise and diet plans and answering queries about their dogs. Additionally, after the owner uploads a photo of the dog, the application provides immediate feedback and a description of the dog's skin disease.

Keywords: Convolution Neural Networks, Artificial Neural Networks, Knowledgebase, Sentimental Analysis.

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Authors: Hussain Darraj

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Background: Healthcare workers, especially nurses, are subjected to a great risk of psychological stress, mostly moral distress. Therefore, it is crucial to address moral distress in nurses. Objectives: The aim of this study is to study the extent of moral distress among hospital nurses in Jazan. Methods: This study used a cross-sectional study design, which included 419 nurses from Jazan hospitals. A questionnaire was used to measure moral distress and its related factors. Results: The average total score for moral distress among the study participants is 134.14, with a standard deviation of 53.94. Moreover, the current study findings indicate that those over the age of 35 years who work as nurse managers, working in critical departments, have the intention to leave a position, have received ethical training or workshops, have provided care for COVID-19 cases, or work in a department with staff shortages are associated with the experience of higher-level moral stress. Conclusion: Nurses are recommended to be provided with ongoing education and resources in order to reduce moral distress and create a positive work atmosphere for nurses. Moreover, the current study sheds light on the importance of organizational support to provide enough resources and staffing in order to reduce moral distress among nurses. Further research is needed to focus on other health professionals and moral distress. Moreover, future studies are also required to explore the strategies to reduce moral distress levels among nurses.

Keywords: moral distress, Jazan, nurses, hospital

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Authors: Claire Song

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Background: TikTok is an emerging social media platform creating an outlet for nurses to express and communicate their nursing experiences and stress related to nursing. Purpose: This study investigates the lived experiences of nursing burnout shared on TikTok. Method: The cross-sectional content analysis examines the video content, format, type, and quantitative indicators, including the number of likes and comments. Results: A total of 35 videos and 18616 comments were examined, published between November 2020 and May 2023. Combined, these 35 videos received 24859 comments and 1159669 of likes. Most of the videos included nurses, and 12 included nurses in professional attire. Three videos included interviewers in the video, but the rest of the videos were self-recorded. Four themes of nurses’ burnout experiences were identified: 1) high-intensity work environment, 2) negative internal perception, 3) culture of nursing work, and 4) poor teamwork experience. Conclusion: This study explored the description of nurses’ burnout experiences via a creative platform. Social media, such as TikTok, is a valuable outlet for healthcare providers to express and share their experiences. Future research might consider using the social media platform to explore coping strategies and resilience in nurses who experienced burnout.

Keywords: burnout, emotional wellbeing, nursing, social media

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Authors: Aditya Karade, Sharada Falane, Dhananjay Deshmukh, Vijaykumar Mantri

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Brain tumors pose a significant challenge in healthcare due to their complex nature and impact on patient outcomes. The application of deep learning (DL) algorithms in medical imaging have shown promise in accurate and efficient brain tumour detection. This paper explores the performance of various pre-trained DL models ResNet50, Xception, InceptionV3, EfficientNetB0, DenseNet121, NASNetMobile, VGG19, VGG16, and MobileNet on a brain tumour dataset sourced from Figshare. The dataset consists of MRI scans categorizing different types of brain tumours, including meningioma, pituitary, glioma, and no tumour. The study involves a comprehensive evaluation of these models’ accuracy and effectiveness in classifying brain tumour images. Data preprocessing, augmentation, and finetuning techniques are employed to optimize model performance. Among the evaluated deep learning models for brain tumour detection, ResNet50 emerges as the top performer with an accuracy of 98.86%. Following closely is Xception, exhibiting a strong accuracy of 97.33%. These models showcase robust capabilities in accurately classifying brain tumour images. On the other end of the spectrum, VGG16 trails with the lowest accuracy at 89.02%.

Keywords: brain tumour, MRI image, detecting and classifying tumour, pre-trained models, transfer learning, image segmentation, data augmentation

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Authors: Mohammad Tahir Yousafzai, Amna Rehana Siddiqui, Naveed Zafar Janjua

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We assessed the frequency and predictors of sharp injuries (SIs) among health care workers (HCWs) at first level care facilities (FLCF) in rural Pakistan. HCWs working at public clinic (PC), privately owned licensed practitioners’ clinic (LPC) and non-licensed practitioners’ clinic (NLC) were interviewed on universal precautions (UPs) and constructs of health belief model (HBM) to assess their association with SIs through negative-binomial regression. From 365 clinics, 485 HCWs were interviewed. Overall annual rate of Sis was 192/100 HCWs/year; 78/100 HCWs among licensed prescribers, 191/100 HCWs among non-licensed prescribers, 248/100 HCWs among qualified assistants, and 321/100 HCWs among non-qualified assistants. Increasing knowledge score about bloodborne pathogens (BBPs) transmission (rate-ratio (RR): 0.93; 95%CI: 0.89–0.96), fewer years of work experience, being a non-licensed prescriber (RR: 2.02; 95%CI: 1.36–2.98) licensed (RR: 2.86; 9%CI: 1.81–4.51) or non-licensed assistant (RR: 2.78; 95%CI: 1.72–4.47) compared to a licensed prescriber, perceived barriers (RR: 1.06;95%CI: 1.03–1.08), and compliance with UPs scores (RR: 0.93; 95%CI: 0.87–0.97) were significant predictors of SIs. Improved knowledge about BBPs, compliance with UPs and reduced barriers to follow UPs could reduce SIs to HCWs.

Keywords: health belief model, sharp injuries, needle stick injuries, healthcare workers

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Authors: Stefano Fantin

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The present analysis outcomes from the research undertaken in the course of the European-funded project EUNITY, which targets the gaps in research and development on cybersecurity and privacy between Europe and Japan. Under these auspices, the research presents a study on the policy approach of Japan, the EU and a number of Member States of the Union with regard to the handling and discovery of software vulnerabilities, with the aim of identifying methodological differences and similarities. This research builds upon a functional comparative analysis of both public policies and legal instruments from the identified jurisdictions. The result of this analysis is based on semi-structured interviews with EUNITY partners, as well as by the participation of the researcher to a recent report from the Center for EU Policy Study on software vulnerability. The European Union presents a rather fragmented legal framework on software vulnerabilities. The presence of a number of different legislations at the EU level (including Network and Information Security Directive, Critical Infrastructure Directive, Directive on the Attacks at Information Systems and the Proposal for a Cybersecurity Act) with no clear focus on such a subject makes it difficult for both national governments and end-users (software owners, researchers and private citizens) to gain a clear understanding of the Union’s approach. Additionally, the current data protection reform package (general data protection regulation), seems to create legal uncertainty around security research. To date, at the member states level, a few efforts towards transparent practices have been made, namely by the Netherlands, France, and Latvia. This research will explain what policy approach such countries have taken. Japan has started implementing a coordinated vulnerability disclosure policy in 2004. To date, two amendments can be registered on the framework (2014 and 2017). The framework is furthermore complemented by a series of instruments allowing researchers to disclose responsibly any new discovery. However, the policy has started to lose its efficiency due to a significant increase in reports made to the authority in charge. To conclude, the research conducted reveals two asymmetric policy approaches, time-wise and content-wise. The analysis therein will, therefore, conclude with a series of policy recommendations based on the lessons learned from both regions, towards a common approach to the security of European and Japanese markets, industries and citizens.

Keywords: cybersecurity, vulnerability, European Union, Japan

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Authors: Jawaher Bakheet Almudarra

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The Saudi Arabian educational system shared the philosophical principles, in its foundation, which concentrated on the achievement of goals, thereby taking up authoritative styles of leadership. However, organisations are beginning to be more liberal in today’s environment than in the 1940s and 1950s, and appealing to emotional intelligence as a tool and skill are needed for effective leadership. In the Saudi Arabian case, such developments are characterised by changes such as that of the educational supervisor having the role redefined to that of a director. This review tracks several parts: the first section helps western reader to understand the subtleties, complexities, and intricacies of the Saudi Arabia education system and its approach to leadership system of education, history, culture and political contribution. This can lead to the larger extent understand if emotional intelligence is a provocation for better leadership of Saudi Arabian education sector or not. The second part is the growth of educational supervision in Saudi Arabia, focusing on the education system, and evaluates the impact of emotional intelligence as a necessary skill in leadership. The third section looks at emotions and emotional intelligence, gender roles, and contributions by emotional intelligence in the education system. The education system of Saudi Arabia has undergone significant transformation. To fully understand the current climate of Saudi Arabia, it is essential to review this process of transformation in terms of the historical, cultural, political and social positions and transformations. Over the years, the education system in Saudi Arabia has undergone significant metamorphosis. The Saudi government has instituted a wide range of reforms in an attempt to improve education standards and outcomes, facilitate improvements and ensure that high standards of education standards are upheld to keep pace with the global environment and knowledge economy. Leadership itself has become an increasingly prominent aspect of educational reform worldwide. Emotional intelligence is often considered a significant aspect of leadership, but it is in its early stages in Saudi Arabia. Its recognition and adoption may improve leadership practices, particularly among educational supervisors and contribute to national and international understandings of leadership in Saudi Arabia. Studying leadership in the Saudi Arabian context is imperative as the new generation of leaders need to cultivate pertinent skills that will allow them to become fundamentally and positively involved in the regions’ decision making processes in order to impact the progression of the Saudi Arabian education system. Understanding leadership in the education context will allow for suitable inculcation of leadership skills. These skills include goal-setting, sound decision-making as well as problem-solving within the education system of Saudi Arabia.

Keywords: educational supervision, educational administration, emotional intelligence, educational leadership

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Authors: Anasuya Ghosh, Subhramoy Chaudhury

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During routine cadaveric dissection at gross anatomy lab of our institution, a radial artery was found with unusual origin and superficial course. Normally the radial artery takes its origin as one of the terminal branches of brachial artery at the level of the neck of radius. It usually lies along the lateral border of fore arm deep to the brachioradialis muscle. While dissecting a 72-year-old Caucasian female cadaver, it was found that the right sided radial artery originated from the upper part of brachial artery of arm, 2 cm below the lower border of teres major muscle, from the lateral aspect of brachial artery. Then the radial artery superficially crossed the brachial artery and median nerve from lateral to medial direction and rested superficially at the cubital fossa. Embryologically, it can be explained as a failure of disappearance, or abnormal persistence of some insignificant embryonic vessels may give rise to this kind of vascular anomalies. As radial artery is one of the most important upper limb arteries, its variation and related complications are clinically significant. This unusual origin and course of radial artery should be kept in mind by all healthcare providers including surgeons and radiologists during routine venipuncture, orthopedic and plastic surgeries of arm, coronary angiographic procedures in radial approach etc. to prevent unwanted complications.

Keywords: brachial artery anomalies, brachio-radial artery, high origin radial artery, superficial radial artery

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Authors: Fadzayi M.Maruza

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The conversation about diversity in the African academy focuses on the need for an international and ethnically diverse population of scholars and students. Operationalising the concept of cognitive diversity offers us an opportunity to broaden our conception of who can know and who can proclaim knowledge by availing new understandings of what knowledge is and how it is made. Limited attention is paid to the value of diversity generated by cognitive disabilities in the African academy. The inclusion of persons with minds labelled disabled in African academia requires an epistemology of disability to reform the still dominant notion of the expert and scholar as an able-bodied and hyper-rational in African academia. This review wants to explore how cognitive disabilities have been represented in higher education research in Africa or has the African academy reinforced ignorance by promoting an able-bodied academia. The review aims to tackle its exploratory objective by using Malcom Tights framework. The main questions this paper would focus on are: (I)What are the major disability themes and concerns discussed in the disability-related articles? (II)What are the major methods or methodologies used to address the topic in the papers? (III)What are the levels of analysis the papers focus on? (IV)How do higher education researchers define and represent cognitive disabilities in higher education research in Africa? To answer the exploratory questions that are aimed at mapping the disability-related higher education research landscape, Malcolm Tights’ framework is seen as most appropriate. In addition to a thematic categorization, that shall be made after reviewing of published empirical studies on disability in African higher education from the period 2010 – 2017. A synthesis of the findings and implications of African disability studies relating to students with cognitive disabilities in the African Academy will be provided using the categories suggested by Tight as a benchmark. Data for the proposed work shall be taken from well-reputed higher education journals between 2010 and 2017.Using the keyword ‘Disability’ in the titles, abstracts and keywords section of journal articles, a selection of disability-focused higher education articles shall be compiled for analysis regarding cognitive disability. It has to be noted as a limitation that the word Disability might not be sufficient to investigate the topic for there can be many more specific disabilities concerns the researchers would discuss. Therefore, the paper is only intended to give a bird’s eye view of cognitive disability in higher education research and therefore is not comprehensive. The paper is expected to shed some light for me, as a beginning researcher, and other researchers like myself as to what has been the focus of higher education researchers about cognitive disability in the African academy. Keywords: Cognitive diversity, cognitive disability, disability, higher education.

Keywords: cognitive disability, cognitive diversity, disability, higher education

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Authors: Rami S. Alasmari, Abdullah Al Zahrani, Hattan A. Hassani, Hattan A. Hassani, Nawwaf A. Almalky, Abdullah F. Bokhari, Alwalied A. Hafez

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Diabetes mellitus type 2 (DMT2) is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood, thus, the aim of this study is to determine whether diabetes is an independent risk factor for falls in elderly. In this observational cross-sectional study, 309 diabetic patients aged 60 or more who visited the primary healthcare centers of the Ministry of National Guard Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, Semi-structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used. The mean age of the participants was estimated to be 68.5 (SD:7.4) years. Among the participants, 48.2% experienced falling before, and 63.1% of them suffered falls in the past 12-months. The results showed that gait problems were independently associated with a higher likelihood of fall among the elderly patients (OR = 1.98, 95%CI, 1.08 to 3.62, p = 0.026. This paper suggests that diabetes mellitus is an independent fall risk factor among elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.

Keywords: diabetes, fall, elderly, risk factors

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Authors: Tery Nehemia Nugraha Joseph, J. D. P. Wisnubroto

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Thyroid cancer is a healthcare problem with high morbidity and mortality. Follicular adenoma and follicular carcinoma are thyroid tumors from the thyroid follicular cells differentiation with a microfollicular pattern that consists of follicular cuboidal cells. vascular endothelial growth factor (VEGF) is a potent and powerful mitogen for endothelial cells and increases vascular permeability. Therefore, due to an increase in thyroid-stimulating hormone (TSH), VEGF production is activated in the thyroid that leads to the end of mitogenic TSH stimulation and initiation of angiogenesis. The differences in VEGF levels in the follicular carcinoma of thyroid tissue with follicular adenoma thyroid can be used as a basis in differentiating the two types of neoplasms. This study aims to analyze VEGF in the serum so that it can be used to differentiate the types of thyroid carcinoma before surgery. This study uses a cross-sectional research design. Samples were carried out by taking serum samples, and the VEGF levels were calculated. Data were analyzed using the Mann-Whitney test. The results found a significant difference between VEGF levels in the follicular carcinoma thyroid group and VEGF levels in the follicular adenoma thyroid group with a value of p = 0.007 (p < 0.05). The results obtained are 560,427 ± 160,506 ng/mL in the type of follicular carcinoma thyroid and 320.943 ± 134.573 ng/mL in the type of follicular adenoma thyroid. VEGF levels between follicular adenoma and follicular carcinoma are different. VEGF levels are higher in follicular carcinoma thyroid than follicular adenoma thyroid.

Keywords: follicular adenoma thyroid, follicular carcinoma thyroid, thyroid, VEGF

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Authors: Yaara Shilo

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Early childhood education and care (ECEC)in Israel has undergone extensive reform and now requires daycare centers to meet internationally recognized professional standards. Since 1948, one of the aims of childcare facilities was to enable women’s participation in the workforce.A 1965 law grouped daycare centers for young children with facilities for the elderly and for disabled persons under the same authority. In the 1970’s, ECEC leaders sought to change childcare from proprietary to educational facilities. From 1976 deliberations in the Knesset regarding appropriate attribution of ECEC frameworks resulted in their being moved to various authorities that supported women’s employment: Ministries of Finance, Industry, and Commerce, as well as the Welfare Department. Prior to 2018, 75% of infants and toddlers in institutional care were in unlicensed and unsupervised settings. Legislative processes accompanied the conceptual change to an eventual appropriate attribution of ECEC frameworks. Position papers over the past two decades resulted in recommendations for standards conforming to OECD regulations. Simultaneous incidents of child abuse, some resulting in death, riveted public attention to the need for adequate government supervision, accelerating the legislative process. Appropriate care for very young children must center on quality interactions with caregivers, thus requiring adequate staff training. Finally, in 2018 a law was passed stipulating standards for staff training, proper facilities, child-adult ratios, and safety measures. The Ariav commission expanded training to caregivers for ages 0-3. Transfer of the ECEC to the Ministry of Education ensured establishment of basic training. Groundwork created by new legislation initiated professional development of EC educators for ages 0-3. This process should raise salaries and bolster the system’s ability to attract quality employees. In 2022 responsibility for ECEC ages 0-3 was transferred from the Ministry of Finance to the Ministry of Education, shifting emphasis from proprietary care to professional considerations focusing on wellbeing and early childhood education. The recent revolutionary changes in ECEC point to a new age in the care and education of Israel’s youngest citizens. Implementation of international standards, adequate training, and professionalization of the workforce focus on the child’s needs.

Keywords: policy, early childhood, care and education, daycare, development

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Authors: Mirza Mujtaba Baig

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Artificial Intelligence (AI) is evolving rapidly, and one of the areas in which this field has influenced is automation. The automobile, healthcare, education, and robotic industries deploy AI technologies constantly, and the automation of tasks is beneficial to allow time for knowledge-based tasks and also introduce convenience to everyday human endeavors. The paper reviews the challenges faced with the current implementations of autonomous self-driving cars by exploring the machine learning, robotics, and artificial intelligence techniques employed for the development of this innovation. The controversy surrounding the development and deployment of autonomous machines, e.g., vehicles, begs the need for the exploration of the configuration of the programming modules. This paper seeks to add to the body of knowledge of research assisting researchers in decreasing the inconsistencies in current programming modules. Blockchain is a technology of which applications are mostly found within the domains of financial, pharmaceutical, manufacturing, and artificial intelligence. The registering of events in a secured manner as well as applying external algorithms required for the data analytics are especially helpful for integrating, adapting, maintaining, and extending to new domains, especially predictive analytics applications.

Keywords: artificial intelligence, automation, big data, self-driving cars, machine learning, neural networking algorithm, blockchain, business intelligence

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Authors: Erni Agustin, Zendy Prameswari

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The Law Number 1 Year 1974 on Marriage was issued by Indonesian Government to replace the old marriage law stipulated in Burgerlijk Wetboek inherited from the Dutch colonial. The Law defines marriage as both physical and mental bond between a man and a woman as husband and wife with the purpose to form a harmonious family based on deity. Marriage shall be conducted when determined requirements are met based on the Law. Article 7 of the Law Number 1 Year 1974 stipulates the minimum age requirement to enter into marriage, which is 19 years for men and 16 years for women. This stipulation is made to make the marriage achieve the true goal to form a happy, eternal and prosperous family. It is expected at that age, each party has a mature soul and physic. However, it is possible for those who have not reached the age to enter into marriage if there is a dispensation granted by the courts or other official designated by the parents of each party in the marriage. As many other countries in the world, Indonesia has serious problems linked with the child or underage marriage. Indonesia is one of the countries with the highest absolute numbers of child marriage. In 2012, a judicial review was filed to the Constitutional Court against the provisions of the minimum age limit in the Law Number 1 Year 1974 on Marriage. The appeal was filed in order to raise the limit of minimum age for women from 16 years to be 18 years. However, the Constitutional Court considered that the provisions on the minimum age in the Law Number 1 Year 1974 on Marriage is constitutional. At the international level, Indonesia has participated in the formulation of variety of international human rights instrument which have an impact on children, and is a party to a number of them. Indonesia ratified the CRC through Presidential Decree of the Republic of Indonesia Number 36 Year 1990 on 5 September 1990. This paper attempts to analyze three main issues. Firstly, it will scrutinize the ratio legis of the stipulation on minimum age requirement to enter into marriage in the Law Number 1 Year 1974 on Marriage. Secondly, it will discuss the conformity of Indonesian marriage law to the principles and provisions on the CRC. Last, this paper will elaborate the legal measures shall be taken to strengthen the legal protection for children against child marriage. This paper is a doctrinal research using statute, conceptual and historical approaches. This study argues that The Law-making of Indonesian marriage law influenced by religious values that live in Indonesia. With regard to the conformity of Indonesian marriage law with the CRC, Indonesia is facing the issue of the compatibility of its respective national law with the CRC. Therefore, the legal measures that have to be taken are to review and amend the Indonesian Marriage Law to provide better protection for the children against underage marriage.

Keywords: child marriage, children’s rights, indonesian marriage law, underage marriage

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Authors: Subhash Nerella, Ziyuan Guan, Azra Bihorac, Parisa Rashidi

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Intensive care units (ICUs) provide care to critically ill patients in severe and life-threatening conditions. However, patient monitoring in the ICU is limited by the time and resource constraints imposed on healthcare providers. Many critical care indices such as mobility are still manually assessed, which can be subjective, prone to human errors, and lack granularity. Other important aspects, such as environmental factors, are not monitored at all. For example, critically ill patients often experience circadian disruptions due to the absence of effective environmental “timekeepers” such as the light/dark cycle and the systemic effect of acute illness on chronobiologic markers. Although the occurrence of delirium is associated with circadian disruption risk factors, these factors are not routinely monitored in the ICU. Hence, there is a critical unmet need to develop systems for precise and real-time assessment through novel enabling technologies. We have developed the mobility and circadian disruption quantification system (Mobi-DiQ) by augmenting biomarker and clinical data with pervasive sensing data to generate mobility and circadian cues related to mobility, nightly disruptions, and light and noise exposure. We hypothesize that Mobi-DiQ can provide accurate mobility and circadian cues that correlate with bedside clinical mobility assessments and circadian biomarkers, ultimately important for delirium risk assessment and prevention. The collected multimodal dataset consists of depth images, Electromyography (EMG) data, patient extremity movement captured by accelerometers, ambient light levels, Sound Pressure Level (SPL), and indoor air quality measured by volatile organic compounds, and the equivalent CO₂ concentration. For delirium risk assessment, the system recognizes mobility cues (axial body movement features and body key points) and circadian cues, including nightly disruptions, ambient SPL, and light intensity, as well as other environmental factors such as indoor air quality. The Mobi-DiQ system consists of three major components: the pervasive sensing system, a data storage and analysis server, and a data annotation system. For data collection, six local pervasive sensing systems were deployed, including a local computer and sensors. A video recording tool with graphical user interface (GUI) developed in python was used to capture depth image frames for analyzing patient mobility. All sensor data is encrypted, then automatically uploaded to the Mobi-DiQ server through a secured VPN connection. Several data pipelines are developed to automate the data transfer, curation, and data preparation for annotation and model training. The data curation and post-processing are performed on the server. A custom secure annotation tool with GUI was developed to annotate depth activity data. The annotation tool is linked to the MongoDB database to record the data annotation and to provide summarization. Docker containers are also utilized to manage services and pipelines running on the server in an isolated manner. The processed clinical data and annotations are used to train and develop real-time pervasive sensing systems to augment clinical decision-making and promote targeted interventions. In the future, we intend to evaluate our system as a clinical implementation trial, as well as to refine and validate it by using other data sources, including neurological data obtained through continuous electroencephalography (EEG).

Keywords: deep learning, delirium, healthcare, pervasive sensing

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