Search results for: holistic healthcare

Authors: R. Schweighoffer, N. Nagy, E. Reeves, B. Liebig

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Due to aging populations, the need for seamless palliative care provision is of central interest for western societies. An essential aspect of palliative care delivery is the quality of collaboration amongst palliative care providers. Therefore, the current research is based on Bainbridge’s conceptual framework, which provides an outline for the evaluation of palliative care provision. This study is the first one to investigate the predictive validity of spatial distribution on the quantity of interaction amongst various palliative care providers. Furthermore, based on the familiarity principle, we examine whether the extent of collaboration influences the perceived quality of collaboration among palliative care providers in urban versus rural areas of Switzerland. Based on a population-representative survey of Swiss palliative care providers, the results of the current study show that professionals in densely populated areas report higher absolute numbers of interactions and are more satisfied with their collaborative practice. This indicates that palliative care providers who work in urban areas are better embedded into networks than their counterparts in more rural areas. The findings are especially important, considering that efficient collaboration is a prerequisite to achieve satisfactory patient outcomes. Conclusively, measures should be taken to foster collaboration in weakly interconnected palliative care networks.

Keywords: collaboration, healthcare networks, palliative care, Switzerland

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Authors: Natalie Delia

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This academic paper investigates the transformative potential of incorporating alternative ways of knowing within the framework of Critical Studies departments. Traditional academic paradigms often prioritize empirical evidence and established methodologies, potentially limiting the scope of critical inquiry. In response to this, our research seeks to illuminate the benefits and challenges associated with integrating alternative epistemologies, such as indigenous knowledge systems, artistic expressions, and experiential narratives. Drawing upon a comprehensive review of literature and case studies, we examine how alternative ways of knowing can enrich and diversify the intellectual landscape of Critical Studies departments. By embracing perspectives that extend beyond conventional boundaries, departments may foster a more inclusive and holistic understanding of critical issues. Additionally, we explore the potential impact on pedagogical approaches, suggesting that alternative ways of knowing can stimulate alternative way of teaching methods and enhance student engagement. Our investigation also delves into the institutional and cultural shifts necessary to support the integration of alternative epistemologies within academic settings. We address concerns related to validation, legitimacy, and the potential clash with established norms, offering insights into fostering an environment that encourages intellectual pluralism. Furthermore, the paper considers the implications for interdisciplinary collaboration and the potential for cultivating a more responsive and socially engaged scholarship. By encouraging a synthesis of diverse perspectives, Critical Studies departments may be better equipped to address the complexities of contemporary issues, encouraging a dynamic and evolving field of study. In conclusion, this paper advocates for a paradigm shift within Critical Studies departments towards a more inclusive and expansive approach to knowledge production. By embracing alternative ways of knowing, departments have the opportunity to not only diversify their intellectual landscape but also to contribute meaningfully to broader societal dialogues, addressing pressing issues with renewed depth and insight.

Keywords: critical studies, alternative ways of knowing, academic department, Wallerstein

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Authors: Abdi Omar Shuriye

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A social business is a business designed to address socio-economic problems to enhance the welfare of the communities involved. Lately, social business, with its focus on innovative ideas, is capturing the interest of educational institutions, governments, and non-governmental organizations. Social business uses a business model to achieve a social goal, and in the last few decades, the idea of imbuing social business into the education system of higher learning institutions has spurred much excitement. This is due to the belief that it will lead to job creation and increased social resilience. One of the higher learning institutions which have invested immensely in the idea is Albukhari International University; it is a private education institution, on a state-of-the-art campus, providing an advantageous learning ecosystem. The niche area of this institution is social business, and it graduates job creators, not job seekers; this Malaysian institution is unique and one of its kind. The objective of this paper is to develop a work plan, direction, and milestone as well as the focus area for the infusion of social business into higher learning institutions with special reference to Al-Bukhari International University. The purpose is to develop a prototype and model full-scale to enable higher learning education institutions to construct the desired curriculum fermented with social business. With this model, major predicaments faced by these institutions could be overcome. The paper sets forth an educational plan and will spell out the basic tenets of social business, focusing on the nature and implementational aspects of the curriculum. It will also evaluate the mechanisms applied by these educational institutions. Currently, since research in this area remains scarce, institutions adopt the process of experimenting with various methods to find the best way to reach the desired result on the matter. The author is of the opinion that social business in education is the main tool to educate holistic future leaders; hence educational institutions should inspire students in the classroom to start up their own businesses by adopting creative and proactive teaching methods. This proposed model is a contribution in that direction.

Keywords: social business, curriculum, skills, university

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Authors: Komal K., Cleary F., Wells J S.G., Bennett L

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Smart fabric garments enable various monitoring applications across sectors such as healthcare, sports and fitness, and the military. Healthcare smart garments monitoring EEG, EMG, and ECG rely on the use of electrodes (dry or wet). However, such electrodes, when used for long-term monitoring, can cause discomfort and skin irritation for the wearer because of their inflexible structure and weight. Ongoing research has been investigating textile-based electrodes (textrodes) in order to provide more comfortable and usable fabric-based electrodes capable of providing intuitive biopotential monitoring. Progress has been made in this space, but they still face a critical design challenge in maintaining consistent skin contact, which directly impacts signal quality. Furthermore, there is a lack of an ISO-based testing framework to validate the electrode design and assess its ability to achieve enhanced performance, strength, usability, and durability. This study proposes the development and evaluation of an ISO-compliant testing framework for standard 2D and advanced 3D embroidered textrodes designs that have a unique structure in order to establish enhanced skin contact for the wearer. This testing framework leverages ISO standards: ISO 13934-1:2013 for tensile and zone-wise strength tests; ISO 13937-2 for tear tests; and ISO 6330 for washing, validating the textrode's performance, a necessity for wearables health parameter monitoring applications. Five textrodes (C1-C5) were designed using EPC win digitization software. Varying patterns such as running stitches, lock stitches, back-to-back stitches, and moss stitches were used to create various embroidered tetrodes samples using Madeira HC12 conductive thread with a resistivity of 100 ohm/m. The textrode designs were then fabricated using a ZSK technical embroidery machine. A comparative analysis was conducted based on a series of laboratory tests adhering to ISO compliance requirements. Tests focusing on the application of strain were applied to the textrodes, and these included: (1) analysis of the electrode's overall surface area strength; (2) assessment of the robustness of the textrodes boundaries; and (3) the assignment of fault test zones to each textrode, where vertical and horizontal slits of 3mm were applied to evaluate the performance of textrodes and its durability. Specific ISO-compliant tests linked to washing were conducted multiple times on each textrode sample to assess both mechanical and chemical damage. Additionally, abrasion and pilling tests were performed to evaluate mechanical damage on the surface of the textrodes and to compare it with the washing test. Finally, the textrodes were assessed based on morphological and surface resistance changes. Results demonstrate that textrode C4, featuring a 3-D layered structure consisting of foam, fabric, and conductive thread layers, significantly enhances skin-electrode contact for biopotential recording. The inclusion of a 3D foam layer was particularly effective in maintaining the shape of the electrode during strain tests, making it the top-performing textrode sample. Therefore, the layered 3D design structure of textrode C4 ranks highest when tested for durability, reusability, and washability. The ISO testing framework established in this study will support future research, validating the durability and reliability of textrodes for a wide range of applications.

Keywords: smart fabric, textrodes, testing framework, ISO compliant

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Authors: Eyasu Markos Woldesemayat, Paolo Vincenzo Genovese

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In recent years with an increase in the concentration of Green House Gases (GHG), Climate Change (CC) externalities are mounting, regardless of governments, are scrambling to implement mitigation and adaptation measures. With multiple social, economic and environmental benefits, Green Infrastructure (GI) has evolved as a highly valuable policy tool to promote sustainable development and smart growth by meeting multiple objectives towards quality of life. However, despite the wide range of benefits, it's uptake in African cities such as Addis Ababa is very low due to several constraining factors. This study, through content analysis and key informant interviews, examined barriers for the uptake of GI among spatial planners in Addis Ababa. Added to this, the study has revealed that the spatial planners had insufficient knowledge about GI planning principles such as multi-functionality, integration, and connectivity, and multiscale. The practice of implementing these holistic principles in urban spatial planning is phenomenally nonexistent. The findings also revealed 20 barriers categorized under four themes, i.e., institutional, socio-cultural, resource, and cognitive barriers. Similarly, it was identified that institutional barriers (0.756), socio-cultural barriers (0.730), cognitive barriers (0.700) and resource barriers (0.642), respectively, are the foremost impending factors for the promotion of GI in Addis Ababa. It was realized that resource barriers were the least constraining factor for enshrining the GI uptake in the city. Strategies to hasten the adoption of GI in the city mainly focus on improving political will, harmonization sectorial plans, improve spatial planning and implementation practice, prioritization of GI in all planning activities, enforcement of environmental laws, introducing collaborative GI governance, creating strong and stable institutions and raising awareness on the need to conserve environment and CC externalities through education and outreach mechanisms.

Keywords: Addis Ababa, climate change, green infrastructure, spatial planning, spatial planners

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Authors: Hoang Vo Thi Minh, Duyen Nguyen Thi Phuong, Gerardo Van Halsema

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As one of the deltas which is extremely vulnerable to climate change, the Mekong Delta, Vietnam is facing many challenges that need to be addressed in strategic and holistic ways. In this study scope, a strategic delta planning is recently considered as a new vision of Adaptive Delta Management for the Mekong Delta. In Adaptive Delta Management, Room for the Rivers (RftR) has been formulated as a typical innovation, which is currently in need of careful consideration for implementing in the Mekong Delta’s planning process. This study then attempts to investigate the roles and analyze sociological aspects of the RftR as potential strategic 'soft' measure, in upstream of Hau River in An Phu district, An Giang province, especially in terms of its so-called multifunctions. The study applied social science approach embedded with a few qualitative methods including in-depth interviews and questionnaire distribution and conjoint analysis as a quantitative approach. The former mainly aims at gaining the local community’s perceptions about the RftR solution. The latter tries to gain farmers’ willingness to accept (WTA) with regard to their level of preference towards the three selected solutions which are considered as strategic plans for sustainably developing the MD. Qualitative data analysis shows that, farmers perceive RftR as very useful for their livelihoods due to its multifunctions as well as in terms of water management. The quantitative results illustrated that respondents expressed their WTAs on RftR as 84. 240 thousand VND / year. Amongst the three solutions that are analysed within this study (Floating rice for upper delta, Room for the Rivers for the Middle, and Shrimp-Mangrove integration for the coastal delta), RfrR was ranked as second preference from respondents. This result is not exactly reflecting the real values of these three mentioned solutions but showing a tendency that can be seen as a reference for the decision-makers in delta planning processes.

Keywords: strategic delta planning, room for the River, farmers’ perception, willingness-to-accept, local livelihoods

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Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

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Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

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Authors: Ilona Ivova Anachkova

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The analogy between the artist and the shaman as both being practitioners that more easily recognize and explore spiritual matters, and thus contribute to the society in a unique way has been implied in both Modernity and Postmodernity. The Romantic conception of the shaman as a great artist who helps common men see and understand messages of a higher consciousness has been employed throughout Modernity and is active even now. This paper deconstructs the term ‘shaman’ in the metaphorical analogy ‘artist – shaman’ that was developed more fully in Modernity in different artistic and scientific discourses. The shaman is a figure that to a certain extent adequately reflects the late modern and postmodern holistic views on the world. Such views aim at distancing from traditional religious and overly rationalistic discourses. However, the term ‘shaman’ can be well substituted by other concepts such as the priest, for example. The concept ‘shaman’ is based on modern ethnographic and historical investigations. Its later philosophical, psychological and artistic appropriations designate the role of the artist as a spiritual and cultural leader. However, the artist and the shaman are not fully interchangeable terms. The figure of the shaman in ‘primitive’ societies has performed many social functions that are now delegated to different institutions and positions. The shaman incorporates the functions of a judge, a healer. He is a link to divine entities. He is the creative, aspiring human being that has heightened sensitivity to the world in both its spiritual and material aspects. Building the metaphorical analogy between the shaman and the artist comes in many ways. Both are seen as healers of the society, having propensity towards connection to spiritual entities, or being more inclined to creativity than others. The ‘shaman’ however is a fashionable word for a spiritual person used perhaps because of the anti-traditionalist religious modern and postmodern views. The figure of the priest is associated with a too rational, theoretical and detached attitude towards spiritual matters, while the practices of the shaman and the artist are considered engaged with spirituality on a deeper existential level. The term ‘shaman’ however does not have priority of other words/figures that can explore and deploy spiritual aspects of reality. Having substituted the term ‘shaman’ in the pair ‘artist as a shaman’ with ‘the priest’ or literally ‘anybody,' we witness destruction of spiritual hierarchies and come to the view that everybody is responsible for their own spiritual and creative evolution.

Keywords: artist as a shaman, creativity, extended theory of art, functions of art, priest as an artist

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Authors: Vivienne Cloude C. Bersabe, Nuelle Anne Castro, Christy P. Gonzales, Nathalie Ann D. Ocbo, Araceli Chuwaley C. Padcayan, Michelle Gaile Lianne S. Peralta, Cecile A. Perez, Eiden Mae A. Roque, Frances Bea S. Sabaten, Korina Louise A. Saculles, Jada Kristen O. Taska, Jose Reinhard C. Laoingco, Don Leonardo N. Dacumos

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The rationale of the study: Since discussion about sexuality is considered taboo in the Filipino culture, provision of quality holistic care often lacks sexuality aspect. This research was conducted to highlight the need for nurses to incorporate sexuality in their care of older adults. Research Objectives: To measure the levels of older adults’ sexual desire, sexual behavior, and sexual intimacy and relate them to sex, living arrangement, educational level, and presence of chronic illness, whether with or without treatment. Methods: This study is of quantitative descriptive design that utilized purposive sampling. 400 older adults of Baguio City participated. The study used a 30 point researcher-made questionnaire, one-on-one interview and focused group discussion to gather data. Data were treated using weighted mean, t-test, F-test, and Scheffe's test. Results and Conclusions: The overall findings revealed that Filipino older adults have a low level of sexuality expressed by the participants’ sexual desire, behavior, and intimacy. Males have significantly higher level of sexual desire, behavior, and intimacy. Living arrangement does not seem to influence the level of sexuality in all its 3 facets. Sexual desire was significantly higher among those with tertiary education and without chronic illness. Recommendation: It is recommended that nurses carry out their assessment of clients to include the exploration of their sexuality especially the older adults. A similar study may be done to explore other variables like demographic location, i.e., rural or urban setting; socio-cultural factors; and functional performance status. It is also recommended that a similar study may be done exploring the different facets of sexuality among homosexual older persons.

Keywords: geriatrics, older adults, Philippines, sexuality

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Authors: Muhammad Khaleequzzaman, Muhammad Mansoori, Abdul Rashid

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The legitimacy of Islamic banking refers to the compliance with the precepts of Shariah (Islamic law) of the pronouncements and their implementation, requisites of various contracts, as well as, observance of the welfare objectives. Therefore, the Islamic banks are supposed to follow the Islamic values focused to bring benefit to the society alongside the commercial motive. These distinguishing features establish identity of the Islamic banks separate from their conventional counterparts and require pursuing normative values of Islamic injunctions instead of profit maximization merely through commercial motive. Given this, the efficiency of the Islamic banks should be evaluated against the value judgements prescribed by the Islamic economic philosophy and their role in establishing the just economy. Nevertheless, the empirical evidence on such value-oriented role of Islamic banking is limited that is filled by this research. The primary focus of the research is two folds; developing a theoretical framework that affords a holistic approach of Shariah legitimacy of Islamic banking practices, including welfare pursuits in addition to the usual compliance mechanism, to help evaluating legitimacy of Islamic banking practices in Pakistan. Therefore, the research has been commissioned by developing the constructs of Shariah legitimacy through extensive review of the relevant literature. At the same time, the empirical analysis based on the opinion of 836 customers of Islamic and conventional banks in all the four provinces and the capital city of Pakistan has produced important conclusions regarding their perception about legitimacy of the Islamic banking practices. The results have helped to know as to how the legitimacy through Shariah perspective is viewed by them. The data analysis using various statistical techniques has yielded results consistent with the objectives of the study. The key findings of the theoretical framework conclude that the value judgements have been grossly ignored by the Islamic banks. The empirical research achieves that about half of the customers perceived Islamic banking as Shariah legitimate. On overall basis, the other half viewed contrary to this or preferred to remain indifferent. There is a need that Islamic banks should look into the desired goals of Shariah legitimacy in both contexts; the value judgement and the perception of the customers.

Keywords: Islamic banking, Shariah legitimacy, Maqasid al Shariah (higher purposes of the lawgiver), value judgment, distributive justice

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: data integrity, data integrity challenges, hospital information systems, South Africa

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Authors: Parvin Abedi, Poorandokht Afshari

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Introduction: In 2022, the Youth Law of the Population was notified to all organizations, including the Iranian Ministry of Health. Some of the articles of this law are about the role of midwives in health and treatment to promote childbearing. In this regard, articles number 45, 48, 49, and 50 are related to midwifery work that will be reviewed in this article. Methods: In this review, the law of population youth was reviewed. In this regard, the statistics of midwives working in the treatment and health sector were collected and analyzed according to the population youth law. Results: Nearly 47 000 midwives are working in the public and private sectors of the country and in the healthcare sector; according to Article 49, which states that there should be one midwife for every two parturient women, about 12,000 midwives are needed in the treatment department and about 8,000 midwives are needed in the health department. In Article 50 it is mentioned to modify tariffs and efficiency in order to increase natural childbirth, and in this field, insurance organizations should have sufficient cooperation with payments. The tariff for midwifery services has been increased, but it is not enough for the stressful job of midwifery. The labor incentive for delivery by midwives is also low. Conclusion: Midwives are one of the fundamental pillars of the law of the population, and without increasing the motivation of midwives, it is not possible to increase the rate of natural childbirth and make childbirth pleasant.

Keywords: law of the population, midwife, motivation, childbearing

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Authors: Sejuti Malakar

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Textile sensors have gained a lot of interest in recent years as it is instrumental in monitoring physiological and environmental changes, for a better diagnosis that can be useful in various fields like medical textiles, sports textiles, protective textiles, agro textiles, and geo-textiles. Moreover, with the development of flexible textile-based wearable sensors, the functionality of smart clothing is augmented for a more improved user experience when it comes to technical textiles. In this context, conductive textiles using new composites and nanomaterials are being developed while considering its compatibility with the textile manufacturing processes. This review aims to provide a comprehensive and detailed overview of the contemporary advancements in textile-based wearable physical sensors, used in the field of medical, security, surveillance, and protection, from a global perspective. The methodology used is through analysing various examples of integration of wearable textile-based sensors with clothing for daily use, keeping in mind the technological advances in the same. By comparing various case studies, we come across various challenges textile sensors, in terms of stability, the comfort of movement, and reliable sensing components to enable accurate measurements, in spite of progress in the engineering of the wearable. Addressing such concerns is critical for the future success of wearable sensors.

Keywords: flexible textile-based wearable sensors, contemporary advancements, conductive textiles, body conformal design

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Authors: Kulsoom S. Bughio, Naeem K. Janjua, Gordana Dermody, Leslie F. Sikos, Shamsul Islam

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The advancement in information and communication technologies (ICT) and wireless sensor networks have played a pivotal role in the design and development of real-time healthcare solutions, mainly targeting the elderly living in health-assistive smart homes. Such smart homes are equipped with sensor technologies to detect and record activities of daily living (ADL). This survey reviews and evaluates existing approaches and techniques based on real-time sensor-based modeling and reasoning in single-user and multi-user environments. It classifies the approaches into three main categories: learning-based, knowledge-based, and hybrid, and evaluates how they handle temporal relations, granularity, and uncertainty. The survey also highlights open challenges across various disciplines (including computer and information sciences and health sciences) to encourage interdisciplinary research for the detection and recognition of ADLs and discusses future directions.

Keywords: daily living activities, smart homes, single-user environment, multi-user environment

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Authors: Genevieve Zingg

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Since the onset of the 2015 ‘refugee crisis’ in the European Union (EU), migrant deaths have overwhelmingly occurred in the Mediterranean Sea. However, far less attention has been paid to the startling number of injuries, deaths, and allegations of systematic human rights violations occurring within European refugee camps. Most troubling is the assertion that injuries and deaths in EU refugee camps have occurred as a result of negligent management and poor access to healthcare, food, water and sanitation, and other elements that comprise an adequate standard of living under international human rights law. Using available evidence and documentation, this paper will conduct a thorough examination of the causes of death and injury in EU refugee camps, with a specific focus on Greece, in order to identify instances of negligence or conditions that amount to potential breaches of human rights law. Based on its analysis, this paper will subsequently explore potential legal avenues to achieving justice and accountability under international human rights law in order to effectively address and remedy inadequate standards of living causing wrongful death or injury in European refugee camps.

Keywords: European Union, Greece, human rights, international human rights law, migration, refugees

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: K. M. Saif Ur Rahman, Razib Mamun, Himica Arjuman, Fida Al Shams

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Introduction: Autism spectrum disorder (ASD) has become an emerging neurodevelopmental disorder with increasing prevalence. It has become an important public health issue globally. Many approaches including speech and language therapy (SLT), occupational therapy, behavioral therapy etc. are being applied for the betterment of the ASD patients. This study aims to describe the characteristics of ASD patients and perception of caregiver regarding SLT in Bangladesh. Methods: This cross-sectional study was conducted in a therapy and rehabilitation center at Dhaka city. Caregivers of 48 ASD patients responded regarding their perception of SLT and characteristics of patients. Results: Among 48 ASD patients, 56.3% were between 3 to 5 years age group with a male predominance (87.5%). More than half of the participants (56.3%) initiated SLT at the age of 1-3 years and the majority (43.8%) were taking SLT for less than 1 year. Majority of the patients (64.6%) were taken to a physician for healthcare as a first contact of which 29.2% were referred to SLT by physicians. More than half (56.3%) of the caregivers were moderately satisfied with SLT and most of them (62.5%) mentioned moderate improvement through SLT. Improvement rate was 10-15% in specific symptoms such as eye contact, complex mannerism, pointing, imitation etc. Conclusion: This study reveals the self-reported perception of caregivers on SLT. Despite reported improvements, more exploration of different approaches and intervention for management of ASD is recommended.

Keywords: ASD, characteristics, SLT, Bangladesh

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Authors: Patrik Johansson, Selina Mardh

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The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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Authors: Azizah Nurdin, Trika Irianta, Mardiah Tahir, Maisuri T. Chalid

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Background: Studies of anal incontinence in the general population are rare however its financial healthcare cost is significant. Women attended Hasanuddin University Teaching Hospital and its networking in Makassar, Indonesia was surveyed between February to April 2015 about their obstetrical and gynecological history. Aims: To establish obstetrical risk factor of anal incontinence among women in Makassar. Methods: In a cross sectional face to face interview study, 135 women aged 30 years or more were selected randomly. Participants were asked to complete an anal incontinence questionnaire. Results: From a total sample of 135 respondents, 42,2 % reported has flatulence incontinence. Parity, history of anal sphincter laceration, history of having large baby, history of assisted vaginal delivery were shown have no significant association with anal incontinence, while history of episiotomy was shown have a significant association with anal incontinence (p value < 0.05). The risk of flatulence incontinence was higher among women with history of episiotomy (OR : 2,85, 95 % CI = 1,58- 5,13) Conclusions: This study has confirmed that fecal incontinence is a fairly common symptom. Flatulence incontinence is the most frequent even. An obstetrical factor like episiotomy is one of risk factor that could be avoided in order to prevent anal incontinence.

Keywords: anal incontinence, flatulence incontinence, obstetrical risk factor, women

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Authors: Fanny Guay

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Building resilience, sustainable buildings, urbanization, climate change, resilient cities, are just a few examples of where the focus of research has been in the last few years. It is obvious that there is a need to rethink how we are building our cities and how we are renovating our existing buildings. However, the question remaining is how can we assure that we are building sustainable yet resilient cities? There are many aspects one can touch upon when discussing resilience in cities, but after the event of Grenfell in June 2017, it has become clear that fire resilience must be a priority. We define resilience as a holistic approach including communities, society and systems, focusing not only on resisting the effects of a disaster, but also how it will cope and recover from it. Cities are an example of such a system, where components such as buildings have an important role to play. A building on fire will have an impact on the community, the economy, the environment, and so the entire system. Therefore, we believe that fire and resilience go hand in hand when we discuss building resilient cities. This article aims at discussing the current state of the concept of fire resilience and suggests actions to support the built of more fire resilient buildings. Using the case of Grenfell and the fire safety regulations in the UK, we will briefly compare the fire regulations in other European countries, more precisely France, Germany and Denmark, to underline the difference and make some suggestions to increase fire resilience via regulation. For this research, we will also include other types of resilience such as technological resilience, discussing the structure of buildings itself, as well as community resilience, considering the role of communities in building resilience. Our findings demonstrate that to increase fire resilience, amending existing regulations might be necessary, for example, how we performed reaction to fire tests and how we classify building products. However, as we are looking at national regulations, we are only able to make general suggestions for improvement. Another finding of this research is that the capacity of the community to recover and adapt after a fire is also an essential factor. Fundamentally, fire resilience, technological resilience and community resilience are closely connected. Building resilient cities is not only about sustainable buildings or energy efficiency; it is about assuring that all the aspects of resilience are included when building or renovating buildings. We must ask ourselves questions as: Who are the users of this building? Where is the building located? What are the components of the building, how was it designed and which construction products have been used? If we want to have resilient cities, we must answer these basic questions and assure that basic factors such as fire resilience are included in our assessment.

Keywords: buildings, cities, fire, resilience

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Authors: Daniel D'Souza, Ping Zou

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The period before, during, and after menopause is a sensitive time for women as they experience intense physical and psychological health changes and symptoms. These changes accompany the hormonal changes that mark the end of a woman’s reproductive age. To help mitigate and cope with these changes, prompt and correct treatment is needed. eHealth has emerged as a branch of telemedicine in the past few decades as an alternate avenue for patients to receive care quickly and conveniently, as it relies on the Internet and computers. Within the past few years, eHealth has also given rise to mHealth, which is the use of personal mobile devices to receive treatment and care. However, there is a lack of study on their use for menopause. This review aimed to review and summarize the literature for eHealth or mHealth and menopause. Several databases related to women’s health and digital health were searched for original studies about eHealth or mHealth and menopause. The search yielded 25 results. The results were generally positive, with these interventions being feasible and having positive effects on physical and psychosocial outcomes. However, several issues were raised regarding their design process that may inadvertently prevent these interventions from addressing the needs of all potential users. Therefore, while eHealth and mHealth certainly represent a future model of healthcare delivery for menopausal women, further research and design modifications are needed before this can happen.

Keywords: eHealth, menopause, mHealth, midlife women

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Authors: Natalie Rosales

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Based on an ethical vision which recognizes the vital role of human rights, shared values, social responsibility and justice, and environmental ethics, planning may be interpreted as a process aimed at reducing inequalities and overcoming marginality. Seen from this sustainability perspective, planning evaluation must utilize critical-evaluative and narrative receptive models which assist different stakeholders in their understanding of urban fabric while trigger reflexive processes that catalyze wider transformations. In this paper, this approach servers as a guide for the evaluation of Mexico´s urban planning systems, and postulates a framework to better integrate sustainability notions into planning evaluation. The paper is introduced by an overview of the current debate on evaluation in urban planning. The state of art presented includes: the different perspectives and paradigms of planning evaluation and their fundamentals and scope, which have focused on three main aspects; goal attainment (did planning instruments do what they were supposed to?); performance and effectiveness of planning (retrospective analysis of planning process and policy analysis assessment); and the effects of process-considering decision problems and contexts rather than the techniques and methods. As well as, methodological innovations and improvements in planning evaluation. This comprehensive literature review provides the background to support the authors’ proposal for a set of general principles to evaluate urban planning, grounded on a sustainability perspective. In the second part the description of the shortcomings of the approaches to evaluate urban planning in Mexico set the basis for highlighting the need of regulatory and instrumental– but also explorative- and collaborative approaches. As a response to the inability of these isolated methods to capture planning complexity and strengthen the usefulness of evaluation process to improve the coherence and internal consistency of the planning practice itself. In the third section the general proposal to evaluate planning is described in its main aspects. It presents an innovative methodology for establishing a more holistic and integrated assessment which considers the interdependence between values, levels, roles and methods, and incorporates different stakeholders in the evaluation process. By doing so, this piece of work sheds light on how to advance urban sustainability through the integration of evaluation methodologies into planning.

Keywords: urban planning, evaluation methodologies, urban sustainability, innovative approaches

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Authors: Les Paul Valdez, Rowena Manzarate, Joseph Carl Lunizo, Mary Thereze Mabaquiao, Mary Deo Luigi Mabunay

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Background: Across the literature, varying definitions of successful aging can be found. As a result, several determinants have been associated with successful aging. However, there is a paucity of literature exploring the relationship between successful aging and factors such as spiritual experience, gerotranscendence, and social engagement. Objective: Thus, this study purports to ascertain the relationship between and among spiritual experience, gerotranscendence, social engagement and successful aging. Methods: The Daily Spiritual Experience Scale (DSES), Social Engagement Scale (SES), Gerotranscendence Scale Revised (GS-R) and Expectations Regarding Aging (ERA) were fielded to 349 incarcerated elderly to measure spiritual experience, social engagement, gerotranscendence and successful aging respectively. Data was analyzed using Structural Equation Modelling through AMOS 21. The hypothesized model was evaluated using the goodness of fit and parsimony indices. Results: Social engagement (β= .179, p=.128) and spiritual experience (β= .375, p=.262) contribute to successful aging through the mediating effect of gerotranscendence (β= .973, p=.718). Conclusion: Today more than ever, healthcare providers in penal institutions are challenged to ensure that incarcerated elderly are socially and spiritually engaged; and have high levels of gerotranscendence.

Keywords: elderly, Filipino, gerotranscendence, social engagement, spiritual experience, successful aging

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Authors: Saurav Dhawan, Sanchit Bansal

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Background T-MACS is a computer-based decision aid that ‘rules in’ and ‘rules out’ ACS using a combination of the presence or absence of six clinical features with only one biomarker measured on arrival: hs-cTnT. T-MACS had 99.3% negative predictive value and 98.7% sensitivity for ACS, ‘ruling out’ ACS in 40% of patients while ‘ruling in’ 5% at the highest risk. We aim at benchmarking the use of T-MACS which could help to conserve healthcare resources, facilitate early discharges, and ensure safe practice. Methodology Randomized retrospective data collection (n=300) was done from ED electronic records across 3 hospital sites within MFT over a period of 2 months. Data was analysed and compared by percentage for the usage of T-MACS, number of admissions/discharges, and in days for length of stay in hospital. Results MRI A&E had the maximum compliance with the use of T-MACS in the trust at 66%, with minimum admissions (44%) and an average length of stay of 1.825 days. NMG A&E had an extremely low compliance rate (8 %), with 75% admission and 3.387 days as the average length of stay. WYT A&E had no TMACS recorded, with a maximum of 79% admissions and the longest average length of stay at 5.07 days. Conclusion All three hospital sites had a RAG rating of ‘RED’ as per the compliance levels. The assurance level was calculated as ‘Very Limited’ across all sites. There was a positive correlation observed between compliance with TMACS and direct discharges from ED, thereby reducing the average length of stay for patients in the hospital.

Keywords: ACS, discharges, ED, T-MACS

Procedia PDF Downloads 46

Authors: Julian Donovan, Jessica Brealey, Matthew Bowker, Marianne Feghali, Gregory Smith, Lee Thompson, Deborah Henderson

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This article details the development of the X-ray response team (XRT), a service that utilises innovative technology to safely deliver acute and elective imaging and medical assessment service in the pre-hospital and community setting. This involves a partnership between Northumbria Healthcare NHS Foundation Trust’s Radiology and Emergency Medicine departments and the North East Ambulance Service to create a multidisciplinary prehospital team. The team committed to the delivery of a two-day acute service every week, alongside elective referrals, starting in November 2020. The service was originally made available to a 15-mile radius surrounding the Northumbria Hospital. Due to demand, this was expanded to include the North Tyneside and Northumberland regions. The target population was specified as frail and vulnerable patients, as well as those deemed to benefit from staying in their own environment. Within the first two months, thirty-six percent of patients assessed were able to stay at home due to the provision of off-site imaging. In the future, this service aims to allow patient transfer directly to an appropriate ward or clinic, bypassing the emergency department to improve the patient journey and reduce emergency care pressures.

Keywords: frailty, imaging, pre-hospital, X-ray

Procedia PDF Downloads 187

Authors: Natalie Frandsen

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Pursuing post-secondary education is a milestone for many Canadian youths. This transition involves many changes and opportunities for growth. However, this may also be a period where challenges arise. Perhaps not surprisingly, mental health challenges for post-secondary students are common. This poses difficulties for students and instructors. Common mental-health-related symptoms (e.g., low motivation, fatigue, inability to concentrate) can affect academic performance, and instructors may need to provide accommodations for these students without the necessary expertise. ‘Distance education’ has been growing and gaining momentum in Canada for three decades. As a consequence of the COVID-19 pandemic, post-secondary institutions have been required to deliver courses using ‘remote’ methods (i.e., various online delivery modalities). The learning challenges and subsequent academic performance issues experienced by students with mental-health-related disabilities studying online are not well understood. However, we can postulate potential factors drawing from learning theories, the relationship between mental-health-related symptoms and academic performance, and learning design. Identifying barriers and opportunities to academic performance is an essential step in ensuring that students with mental-health-related disabilities are able to achieve their academic goals. Completing post-secondary education provides graduates with more employment opportunities. It is imperative that our post-secondary institutions take a holistic view of learning by providing learning and mental health support while reducing structural barriers. Health-promoting universities and colleges infuse health into their daily operations and academic mandates. Acknowledged in this Charter is the notion that all sectors must take an active role in favour of health, social justice, and equity for all. Drawing from mental health promotion and Universal Design for Learning (UDL) frameworks, relevant adult learning concepts, and critical digital pedagogy, considerations for mental-health-promoting, online learning community development will be summarized. The education sector has the opportunity to create and foster equitable and mental health-promoting learning environments. This is of particular importance during a global pandemic when the mental health of students is being disproportionately impacted.

Keywords: academic performance, community, mental health promotion, online learning

Procedia PDF Downloads 122

Authors: Layla Mujahed

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COVID-19 is an exam for all the city’s systems. It shows many gaps in the systems such as healthcare, economic, social, and environment. This pandemic is paving for a new era, an era of technology and it has changed people’s lives, such as physical, and emotional changes, and converting communication into digitalized. The effect of COVID-19 has covered all urban city parts. COVID-19 will not be the last pandemic our cities will face. For that, more researches focus on enhancing the quality of the urban environment. This pandemic encourages a rethinking of the environment’s role, especially in cities. Cities are trying to provide the best suitable strategies and regulations to prevent the spread of COVID-19, and an example of that is Amman city. Amman has a high increment in the number of COVID-19 infected people, while it has controlled the situation for months. For that, this paper studies the relation between COVID-19 and urban environmental studies cases about cities around the world, and learns from their models to face COVID-19. In Amman, people’s behavior has changed towards public transportation and public green spaces. N­ew governmental regulations focus on increasing people’s mental awareness, supporting local businesses, and enhancing neighborhood planning that can help Amman to face any future pandemics.

Keywords: COVID-19, urban environment, urban planning, urban resilience

Procedia PDF Downloads 111

Authors: Nicky Wilson, Graeme Ralph

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Legacy aerostructure assembly is defined by large components, low build rates, and manual assembly methods. With an increasing demand for commercial aircraft and emerging markets such as the eVTOL (electric vertical take-off and landing) market, current methods of manufacturing are not capable of efficiently hitting these higher-rate demands. This project will look at how legacy manufacturing processes can be rate enabled by taking a holistic view of data usage, focusing on how data can be collected to enable fully integrated digital factories and supply chains. The study will focus on how data is flowed both up and down the supply chain to create a digital thread specific to each part and assembly while enabling machine learning through real-time, closed-loop feedback systems. The study will also develop a bespoke architecture to enable connectivity both within the factory and the wider PLM (product lifecycle management) system, moving away from traditional point-to-point systems used to connect IO devices to a hub and spoke architecture that will exploit report-by-exception principles. This paper outlines the key issues facing legacy aircraft manufacturers, focusing on what future manufacturing will look like from adopting Industry 4 principles. The research also defines the data architecture of a PLM system to enable the transfer and control of a digital thread within the supply chain and proposes a standardised communications protocol to enable a scalable solution to connect IO devices within a production environment. This research comes at a critical time for aerospace manufacturers, who are seeing a shift towards the integration of digital technologies within legacy production environments, while also seeing build rates continue to grow. It is vital that manufacturing processes become more efficient in order to meet these demands while also securing future work for many manufacturers.

Keywords: Industry 4, digital transformation, IoT, PLM, automated assembly, connected factories

Procedia PDF Downloads 65

Authors: Ankan Saha, Sourav Majumder, Md. Motaleb Hossen Manik, M. M. A. Hashem

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Hyperledger Fabric (HF), one of the private blockchain architectures, has gained popularity for enterprise use cases, namely supply chain management, finance, healthcare, etc., while focusing on the demand of users and functionalities like privacy, scalability, throughput, and modular architecture. However, enhancing performance is a crucial focus in the everchanging field of blockchain technology, particularly for private blockchains like HF. This paper focuses on the inherent difficulties related to scalability, throughput, and efficiency in handling large transactions. Our framework establishes a solid network architecture with two organizations, each having two types of peers (i.e., endorsing and anchor peers) and three raft orderers. It brings innovation to the chaincode, addresses functionalities like registration and transaction management via CouchDB, and integrates transaction management and block retrieval. Additionally, it includes a distributed consensus mechanism to gain maximum performance in a large architecture. Eventually, the findings assert an apparent enhancement in scalability, transaction speed, and system responsiveness, highlighting the effectiveness of our framework in optimizing the HF architecture.

Keywords: hyperledger fabric, private blockchain, scalability, transaction throughput, latency, consensus mechanism

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Authors: Harper Staples

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A necessary outcome of today’s contemporary globalised reality, current views of multilingualism hold that it no longer represents the exception, but rather the rule. As such, the simultaneous acquisition of multiple languages represents a common experience for many of today's students and therefore represents a key area of inquiry in the domain of foreign language learner identity. Second and multilingual language acquisition processes parallel each other in many ways; however, there are differences to be found in the ways in which a student may learn a third language. A multilingual repertoire will have to negotiate complex change as language competencies dynamically evolve; moreover, this process will vary according to the contextual factors attributed to a unique learner. A developing multilingual identity must, therefore, contend with an array of potential challenges specific to the individual in question. Despite an overarching recognition in the literature that pluri-language acquisition represents a unique field of inquiry within applied linguistic research, there is a paucity of empirical work which examines the ways in which individuals construct a sense of their own identity as multilingual speakers in such contexts of learning. This study explores this phenomenon via a mixed-methods, comparative case study approach at four school sites based in Finland, France, Wales, and England. It takes a strongly individual-in-context view, conceptualising each adolescent participant in dynamic terms in order to undertake a holistic exploration of the myriad factors that might impact upon, and indeed be impacted by, a learner's developing multilingual identity. Emerging themes of note thus far suggest that, beyond the expected divergences in the experience of multilinguality at the individual level, there are contradictions in the way in which adolescent students in each site 'claim' their plurilingualism. This can be argued to be linked to both meso and macro-level factors, including the foreign language curriculum and, more broadly, societal attitudes towards multilingualism. These diverse emergent identifications have implications not only for attainment in the foreign language but also for student well-being more generally.

Keywords: foreign language learning, student identity, multilingualism, educational psychology

Procedia PDF Downloads 164