Search results for: digital healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4272

Search results for: digital healthcare

2982 Using the Clinical Decision Support Platform, Dem DX, to Assess the ‘Urgent Community Care Team’s Notes Regarding Clinical Assessment, Management, and Healthcare Outcomes

Authors: R. Tariq, R. Lee

Abstract:

Background: Heywood, Middleton & Rochdale Urgent Community Care Team (UCCT)1 is a great example of using a multidisciplinary team to cope with demand. The service reduces unnecessary admissions to hospitals and ensures that patients can leave the hospital quicker by making care more readily available within the community and patient’s homes. The team comprises nurses, community practitioners, and allied health professions, including physiotherapy, occupational therapy, pharmacy, and GPs. The main challenge for a team with a range of experiences and skill sets is to maintain consistency of care, which technology can help address. Allied healthcare professionals (HCPs) are often used in expanded roles with duties mainly involving patient consultations and decision making to ease pressure on doctors. The Clinical Reasoning Platform (CRP) Dem Dx is used to support new as well as experienced professionals in the decision making process. By guiding HCPs through diagnosing patients from an expansive directory of differential diagnoses, patients can receive quality care in the community. Actions on the platform are determined using NICE guidelines along with local guidance influencing the assessment and management of a patient. Objective: To compare the clinical assessment, decisions, and actions taken by the UCCT multidisciplinary team in the community and Dem Dx, using retrospective clinical cases. Methodology: Dem Dx was used to analyse 192 anonymised cases provided by the HMR UCCT. The team’s performance was compared with Dem Dx regarding the quality of the documentation of the clinical assessment and the next steps on the patient’s journey, including the initial management, actions, and any onward referrals made. The cases were audited by two medical doctors. Results: The study found that the actions outlined by the Dem Dx platform were appropriate in almost 87% of cases. When in a direct comparison between DemDX and the actions taken by the clinical team, it was found that the platform was suitable 83% (p<0.001) of the time and could lead to a potential improvement of 66% in the assessment and management of cases. Dem Dx also served to highlight the importance of comprehensive and high quality clinical documentation. The quality of documentation of cases by UCCT can be improved to provide a detailed account of the assessment and management process. By providing step-by-step guidance and documentation at every stage, Dem Dx may ensure that legal accountability has been fulfilled. Conclusion: With the ever expanding workforce in the NHS, technology has become a key component in driving healthcare outcomes. To improve healthcare provision and clinical reasoning, a decision support platform can be integrated into HCPs’ clinical practice. Potential assistance with clinical assessments, the most appropriate next step and actions in a patient’s care, and improvements in the documentation was highlighted by this retrospective study. A further study has been planned to ascertain the effectiveness of improving outcomes using the clinical reasoning platform within the clinical setting by clinicians.

Keywords: allied health professional, assessment, clinical reasoning, clinical records, clinical decision-making, ocumentation

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2981 Micro-Scale Digital Image Correlation-Driven Finite Element Simulations of Deformation and Damage Initiation in Advanced High Strength Steels

Authors: Asim Alsharif, Christophe Pinna, Hassan Ghadbeigi

Abstract:

The development of next-generation advanced high strength steels (AHSS) used in the automotive industry requires a better understanding of local deformation and damage development at the scale of their microstructures. This work is focused on dual-phase DP1000 steels and involves micro-mechanical tensile testing inside a scanning electron microscope (SEM) combined with digital image correlation (DIC) to quantify the heterogeneity of deformation in both ferrite and martensite and its evolution up to fracture. Natural features of the microstructure are used for the correlation carried out using Davis LaVision software. Strain localization is observed in both phases with tensile strain values up to 130% and 110% recorded in ferrite and martensite respectively just before final fracture. Damage initiation sites have been observed during deformation in martensite but could not be correlated to local strain values. A finite element (FE) model of the microstructure has then been developed using Abaqus to map stress distributions over representative areas of the microstructure by forcing the model to deform as in the experiment using DIC-measured displacement maps as boundary conditions. A MATLAB code has been developed to automatically mesh the microstructure from SEM images and to map displacement vectors from DIC onto the FE mesh. Results show a correlation of damage initiation at the interface between ferrite and martensite with local principal stress values of about 1700MPa in the martensite phase. Damage in ferrite is now being investigated, and results are expected to bring new insight into damage development in DP steels.

Keywords: advanced high strength steels, digital image correlation, finite element modelling, micro-mechanical testing

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2980 Factors Influencing Telehealth Services for Diabetes Care in Nepal: A Mixed Method Study

Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

Abstract:

Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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2979 From Design, Experience and Play Framework to Common Design Thinking Tools: Using Serious Modern Board Games

Authors: Micael Sousa

Abstract:

Board games (BGs) are thriving as new designs emerge from the hobby community to greater audiences all around the world. Although digital games are gathering most of the attention in game studies and serious games research fields, the post-digital movement helps to explain why in the world dominated by digital technologies, the analog experiences are still unique and irreplaceable to users, allowing innovation in new hybrid environments. The BG’s new designs are part of these post-digital and hybrid movements because they result from the use of powerful digital tools that enable the production and knowledge sharing about the BGs and their face-to-face unique social experiences. These new BGs, defined as modern by many authors, are providing innovative designs and unique game mechanics that are still not yet fully explored by the main serious games (SG) approaches. Even the most established frameworks settled to address SG, as fun games implemented to achieve predefined goals need more development, especially when considering modern BGs. Despite the many anecdotic perceptions, researchers are only now starting to rediscover BGs and demonstrating their potentials. They are proving that BGs are easy to adapt and to grasp by non-expert players in experimental approaches, with the possibility of easy-going adaptation to players’ profiles and serious objectives even during gameplay. Although there are many design thinking (DT) models and practices, their relations with SG frameworks are also underdeveloped, mostly because this is a new research field, lacking theoretical development and the systematization of the experimental practices. Using BG as case studies promise to help develop these frameworks. Departing from the Design, Experience, and Play (DPE) framework and considering the Common Design Think Tools (CDST), this paper proposes a new experimental framework for the adaptation and development of modern BG design for DT: the Design, Experience, and Play for Think (DPET) experimental framework. This is done through the systematization of the DPE and CDST approaches applied in two case studies, where two different sequences of adapted BG were employed to establish a DT collaborative process. These two sessions occurred with different participants and in different contexts, also using different sequences of games for the same DT approach. The first session took place at the Faculty of Economics at the University of Coimbra in a training session of serious games for project development. The second session took place in the Casa do Impacto through The Great Village Design Jam light. Both sessions had the same duration and were designed to progressively achieve DT goals, using BGs as SGs in a collaborative process. The results from the sessions show that a sequence of BGs, when properly adapted to address the DPET framework, can generate a viable and innovative process of collaborative DT that is productive, fun, and engaging. The DPET proposed framework intents to help establish how new SG solutions could be defined for new goals through flexible DT. Applications in other areas of research and development can also benefit from these findings.

Keywords: board games, design thinking, methodology, serious games

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2978 Tree Dress and the Internet of Living Things

Authors: Vibeke Sorensen, Nagaraju Thummanapalli, J. Stephen Lansing

Abstract:

Inspired by the indigenous people of Borneo, Indonesia and their traditional bark cloth, artist and professor Vibeke Sorensen executed a “digital unwrapping” of several trees in Southeast Asia using a digital panorama camera and digitally “stitched” them together for printing onto sustainable silk and fashioning into the “Tree Dress”. This dress is a symbolic “un-wrapping” and “re-wrapping” of the tree’s bark onto a person as a second skin. The “digital bark” is directly responsive to the real tree through embedded and networked electronics that connect in real-time to sensors at the physical site of the living tree. LEDs and circuits inserted into the dress display the continuous measurement of the O2 / CO2, temperature, humidity, and light conditions at the tree. It is an “Internet of Living Things” (IOLT) textile that can be worn to track and interact with it. The computer system connecting the dress and the tree converts the gas emission data at the site of the real tree into sound and music as sonification. This communicates not only the scientific data but also translates it into a poetic representation. The wearer of the garment can symbolically identify with the tree, or “become one” with it by adorning its “skin.” In this way, the wearer also becomes a human agent for the tree, bringing its actual condition to direct perception of the wearer and others who may engage it. This project is an attempt to bring greater awareness to issues of deforestation by providing a direct access to living things separated by physical distance, and hopefully, to increase empathy for them by providing a way to sense individual trees and their daily existential condition through remote monitoring of data. Further extensions to this project and related issues of sustainability include the use of recycled and alternative plant materials such as bamboo and air plants, among others.

Keywords: IOLT, sonification, sustainability, tree, wearable technology

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2977 Hospital Workers’ Psychological Resilience after 2015 Middle East Respiratory Syndrome Outbreak

Authors: Myoungsoon You, Heejung Son

Abstract:

During a pandemic, hospital workers should protect not only their vulnerable patients but also themselves from the consequences of rapidly spreading infection. However, the evidence on the psychological impact of an outbreak on hospital workers is limited. In this study, we aim to assess hospital workers’ psychological well-being and function at the workplace after an outbreak, by focusing on ‘psychological resilience’. Specifically, the effects of risk appraisal, emotional experience, and coping ability on resilience indicated by the likelihood of post-traumatic syndrome disorder and willingness to work were investigated. Such role and position of each factor were analyzed using a path model, and the result was compared between the healthcare worker and non-healthcare worker groups. In the investigation, 280 hospital workers who experienced the 2015 Middle East Respiratory Syndrome outbreak in South Korea have participated. The result presented, in both groups, the role of the appraisal of risk and coping ability appeared consistent with a previous research, that was, the former interrupted resilience while the latter facilitated it. In addition, the role of emotional experience was highlighted as, in both groups, emotional disruption not only directly associated with low resilience but mediated the effect of perceived risk on resilience. The differences between the groups were also identified, which were, the role of emotional experience and coping ability was more prominent in the non-HCW group in explaining resilience. From the results, implications on how to support hospital personnel during an outbreak in a way to facilitate their resilience after the outbreak were drawn.

Keywords: hospital workers, emotions, infectious disease outbreak, psychological resilience

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2976 Community Strengths and Indigenous Resilience as Drivers for Health Reform Change

Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

Abstract:

Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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2975 Students’ Perceptions of Communication Design in Media: Case Study of Portuguese and Spanish Communication Students

Authors: Fátima Gonçalves, Joaquim Brigas, Jorge Gonçalves

Abstract:

The proliferation of mobile devices in society enables the media to disseminate information and knowledge more rapidly. Higher education students access these contents and share them with each other, in the most diverse platforms, allowing the ubiquity in access to information. This article presents the results and respective quantitative analysis of a survey applied to communication students of two higher education institutions: one in Portugal and another in Spain. The results show that, in this sample, higher education students regularly access news content believing traditional news sources to be more credible. Regarding online sources, it was verified that the access was mostly to free news contents. This study intends to promote the knowledge about the changes that occur in the relationship of higher education students with the media, characterizing how news consumption is processed by these students, considering the resulting effects of the digital media evolution. It is intended to present not only the news sources they use, but also to know some of their habits and relationship with the news media.

Keywords: students' perceptions, communication design, mass media, higher education, digital media

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2974 Assessing Distance Education Practices: Teachers Experience and Perceptions

Authors: Mohammed Amraouy, Mostafa Bellafkih, Abdellah Bennane, Aziza Benomar

Abstract:

Distance education has become popular due to their ability to provide learning from almost anywhere and anytime. COVID-19 forced educational institutions to urgently introduce distance education to ensure pedagogical continuity, so all stakeholders were invited to adapt to this new paradigm. In order to identify strengths and weaknesses, the research focuses on the need to create an effective mechanism for evaluating distance education. The aims of this research were to explore and evaluate the use of digital media in general and official platforms in particular in distance education practices. To this end, we have developed and validated a questionnaire before administering it to a sample of 431 teachers in Morocco. Teachers reported lower knowledge and skills in the didactic use of ICT in the distance education process. In addition, although age and educative experience of the teachers continue to modulate the level of instrumental skills. Therefore, resources (digital resources and infrastructure) and the teachers’ ICT training present serious limitations, which require a training more focused on the distance educational paradigm and educational environments that allow teachers to create educational activities able to promote and facilitate the distance learning process.

Keywords: distance education, e-learning, teachers’ perceptions, assessment

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2973 The Developing of Knowledge-Based System for the Medical Treatment with Herbs

Authors: Rujijan Vichivanives

Abstract:

This research aims to create a knowledge-based system as a database for self-healthcare analysis, diagnosis of simple illnesses, and the use of Thai herbs instead of modern medicine by using principles of Thai traditional medication theory. These were disseminated by website network programs within Suan Sunandha Rajabhat University. The population used in this study was divided into two groups: the first group consisted of four experts of Thai traditional medication and the second group was 300 website users. The methods used for collecting data were paper questionnaires and poll questionnaires on the website. The statistics used for analyzing data was at an average level. The results were divided into three parts: the first part was the development of a knowledge-based system and the second part was applied programs on website. Both parts could be fulfilled and achieved according to the set goal. The third part was the evaluation of the study: The evaluation of the viewpoints of the experts towards website designs were evaluated at a good level of 4.20. The satisfaction evaluation of the users was found at a good level of average satisfactory level at 4.24. It was found that the young population of those under the age of 16 had less cares about their health than the population of other teenagers, working age adults and those of older age. The research findings should be extended in order to encourage the lifestyle modifications to people of all ages by using the self-healthcare principles.

Keywords: developing, herbs, knowledge-based system, medical treatment

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2972 Modern Construction Methods and Technologies and Their Impacts on Construction Projects

Authors: Michael Anthony Doherty

Abstract:

Modern Methods of Construction (MMC) is a significant topic in the construction industry; while reviewing (MMC) over different fields that are significant in the modern construction world, the following areas were assessed where (MMC) is developing, supply chain management, automation, digital technology, and new construction technologies. Different methods were considered as an approach to research and exploring areas highlighted within the construction industry that are making advancements using Modern Methods of Construction Methods and Technologies (MCMTs). The research was conducted using the following methodologies, literature review of academic sources, primary and secondary data sources, questionaries, and interviews. The paper is composed of two parts, firstly a literature review and secondly a questionnaire used as the basis for interviews were utilised to achieve the following key objectives: to identify (MCMTs) being implemented in the construction industry, research and compile information with regards to these methods, determine their purpose and their application in the industry, establishing what (MCMTs) are being used in the industry while also determining the success of the methods. The research considers the evolution and development of these methods in projects and within the industry itself. Major findings were as follows; automation technologies such as robotics, offsite fabrication utilising automated production lines are increasingly part of project execution, digital technologies such as AR and VR are increasingly utilised in project co-ordination, (MMCTs) are proving to be a solution to the construction industry problems such as a lack of skilled workforce, hazardous work tasks, and situations, new construction technologies are available and finding their place in mainstream construction, (SCM) and (GSCM) are evolving to new levels using new systems and technologies such as block chain technology as well as Company Size and Project size influence the use of (MMCTs) and the adoption of (MMCTS). In summary the paper endeavours to identify and detail how areas of (MMCTs) are developing and are gaining traction within mainstream construction.

Keywords: automation, digital technology, new construction technologies, supply chain management

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2971 In vivo Mechanical Characterization of Facial Skin Combining Digital Image Correlation and Finite Element

Authors: Huixin Wei, Shibin Wang, Linan Li, Lei Zhou, Xinhao Tu

Abstract:

Facial skin is a biomedical material with complex mechanical properties of anisotropy, viscoelasticity, and hyperelasticity. The mechanical properties of facial skin are crucial for a number of applications including facial plastic surgery, animation, dermatology, cosmetic industry, and impact biomechanics. Skin is a complex multi-layered material which can be broadly divided into three main layers, the epidermis, the dermis, and the hypodermis. Collagen fibers account for 75% of the dry weight of dermal tissue, and it is these fibers which are responsible for the mechanical properties of skin. Many research on the anisotropic mechanical properties are mainly concentrated on in vitro, but there is a great difference between in vivo and in vitro for mechanical properties of the skin. In this study, we presented a method to measure the mechanical properties of facial skin in vivo. Digital image correlation (DIC) and indentation tests were used to obtain the experiment data, including the deformation of facial surface and indentation force-displacement curve. Then, the experiment was simulated using a finite element (FE) model. Application of Computed Tomography (CT) and reconstruction techniques obtained the real tissue geometry. A three-dimensional FE model of facial skin, including a bi-layer system, was obtained. As the epidermis is relatively thin, the epidermis and dermis were regarded as one layer and below it was hypodermis in this study. The upper layer was modeled as a Gasser-Ogden-Holzapfel (GOH) model to describe hyperelastic and anisotropic behaviors of the dermis. The under layer was modeled as a linear elastic model. In conclusion, the material properties of two-layer were determined by minimizing the error between the FE data and experimental data.

Keywords: facial skin, indentation test, finite element, digital image correlation, computed tomography

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2970 talk2all: A Revolutionary Tool for International Medical Tourism

Authors: Madhukar Kasarla, Sumit Fogla, Kiran Panuganti, Gaurav Jain, Abhijit Ramanujam, Astha Jain, Shashank Kraleti, Sharat Musham, Arun Chaudhury

Abstract:

Patients have often chosen to travel for care — making pilgrimages to academic meccas and state-of-the-art hospitals for sophisticated surgery. This culture is still persistent in the landscape of US healthcare, with hundred thousand of visitors coming to the shores of United States to seek the high quality of medical care. One of the major challenges in this form of medical tourism has been the language barrier. Thus, an Iraqi patient, with immediate needs of communicating the healthcare needs to the treating team in the hospital, may face huge barrier in effective patient-doctor communication, delaying care and even at times reducing the quality. To circumvent these challenges, we are proposing the use of a state-of-the-art tool, Talk2All, which can translate nearly one hundred international languages (and even sign language) in real time. The tool is an easy to download app and highly user friendly. It builds on machine learning principles to decode different languages in real time. We suggest that the use of Talk2All will tremendously enhance communication in the hospital setting, effectively breaking the language barrier. We propose that vigorous incorporation of Talk2All shall overcome practical challenges in international medical and surgical tourism.

Keywords: language translation, communication, machine learning, medical tourism

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2969 Sentiment Mapping through Social Media and Its Implications

Authors: G. C. Joshi, M. Paul, B. K. Kalita, V. Ranga, J. S. Rawat, P. S. Rawat

Abstract:

Being a habitat of the global village, every place has established connection through the strength and power of social media piercing through the political boundaries. Social media is a digital platform, where people across the world can interact as it has advantages of being universal, anonymous, easily accessible, indirect interaction, gathering and sharing information. The power of social media lies in the intensity of sharing extreme opinions or feelings, in contrast to the personal interactions which can be easily mapped in the form of Sentiment Mapping. The easy access to social networking sites such as Facebook, Twitter and blogs made unprecedented opportunities for citizens to voice their opinions loaded with dynamics of emotions. These further influence human thoughts where social media plays a very active role. A recent incident of public importance was selected as a case study to map the sentiments of people through Twitter. Understanding those dynamics through the eye of an ordinary people can be challenging. With the help of R-programming language and by the aid of GIS techniques sentiment maps has been produced. The emotions flowing worldwide in the form of tweets were extracted and analyzed. The number of tweets had diminished by 91 % from 25/08/2017 to 31/08/2017. A boom of sentiments emerged near the origin of the case, i.e., Delhi, Haryana and Punjab and the capital showed maximum influence resulting in spillover effect near Delhi. The trend of sentiments was prevailing more as neutral (45.37%), negative (28.6%) and positive (21.6%) after calculating the sentiment scores of the tweets. The result can be used to know the spatial distribution of digital penetration in India, where highest concentration lies in Mumbai and lowest in North East India and Jammu and Kashmir.

Keywords: sentiment mapping, digital literacy, GIS, R statistical language, spatio-temporal

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2968 Changing Behaviour in the Digital Era: A Concrete Use Case from the Domain of Health

Authors: Francesca Spagnoli, Shenja van der Graaf, Pieter Ballon

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Humans do not behave rationally. We are emotional, easily influenced by others, as well as by our context. The study of human behaviour became a supreme endeavour within many academic disciplines, including economics, sociology, and clinical and social psychology. Understanding what motivates humans and triggers them to perform certain activities, and what it takes to change their behaviour, is central both for researchers and companies, as well as policy makers to implement efficient public policies. While numerous theoretical approaches for diverse domains such as health, retail, environment have been developed, the methodological models guiding the evaluation of such research have reached for a long time their limits. Within this context, digitisation, the Information and communication technologies (ICT) and wearable, the Internet of Things (IoT) connecting networks of devices, and new possibilities to collect and analyse massive amounts of data made it possible to study behaviour from a realistic perspective, as never before. Digital technologies make it possible to (1) capture data in real-life settings, (2) regain control over data by capturing the context of behaviour, and (3) analyse huge set of information through continuous measurement. Within this complex context, this paper describes a new framework for initiating behavioural change, capitalising on the digital developments in applied research projects and applicable both to academia, enterprises and policy makers. By applying this model, behavioural research can be conducted to address the issues of different domains, such as mobility, environment, health or media. The Modular Behavioural Analysis Approach (MBAA) is here described and firstly validated through a concrete use case within the domain of health. The results gathered have proven that disclosing information about health in connection with the use of digital apps for health, can be a leverage for changing behaviour, but it is only a first component requiring further follow-up actions. To this end, a clear definition of different 'behavioural profiles', towards which addressing several typologies of interventions, it is essential to effectively enable behavioural change. In the refined version of the MBAA a strong focus will rely on defining a methodology for shaping 'behavioural profiles' and related interventions, as well as the evaluation of side-effects on the creation of new business models and sustainability plans.

Keywords: behavioural change, framework, health, nudging, sustainability

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2967 Analysis of Influence of Intrinsic Motivation on Employee Affective Commitment

Authors: Yashar Ibragimov, Nino Berishvili

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Technological, economic and other innovation-related advances of the 21st century have influenced the old, traditional business models. Presently, organizational change has become an integral part of corporate strategy for the majority of businesses. Such shifts have resulted in both new challenges and opportunities. The expansion of the use of information and communication technologies has driven fundamental shifts towards digital change. Organizations are being forced to revise processes, goals and overall mission in order to stay competitive in the marketplace. However, the implementation of digital transformation brings uncertainty, causes stress and raises concerns about future jobs. The study employs systematic literature review to fill the gap in understanding relationship between employee motivation and commitment during the transformation. A conceptual model proposes the antecedents (OCB and Leader Member Exchange) of employee motivation and investigates its impact on employee commitment to change. The utilized model elucidates how to maintain employee motivation and commitment in the context of organizational transformation and sets the ground for future research.

Keywords: employee motivation, change commitment, change management, leader member exchange, organizational citizenship behavior

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2966 Assessing the Competence of Junior Pediatric Doctors in Managing Pediatric Diabetic Ketoacidosis: An Exploration Across Pediatric Care Units

Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they'll encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in pediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing diabetic ketoacidosis (DKA) emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: junior pediatrician, DKA, standardized protocols, level of competence

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2965 Prospects for Sustainable Chemistry in South Africa: A Plural Healthcare System

Authors: Ntokozo C. Mthembu

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The notion of sustainable chemistry has become significant in the discourse for a global post-colonial era, including South Africa, especially when it comes to access to the general health system and related policies in relation to disease or ease of human life. In view of the stubborn vestiges of coloniality in the daily lives of indigenous African people in general, the fundamentals of present Western medical and traditional medicine systems and related policies in the democratic era were examined in this study. The situation of traditional healers in relation to current policy was also reviewed. The advent of democracy in South Africa brought about a variety of development opportunities and limitations, particularly with respect to indigenous African knowledge systems such as traditional medicine. There were high hopes that the limitations of previous narrow cultural perspectives would be rectified in the democratic era through development interventions, but some sections of society, such as traditional healers, remain marginalised. The Afrocentric perspective was explored in dissecting government interventions related to traditional medicine. This article highlights that multiple medical systems should be adopted and that health policies should be aligned in order to guarantee mutual respect and to address the remnants of colonialism in South Africa, Africa and the broader global community.

Keywords: traditional healing system, healers, pluralist healthcare system, post-colonial era

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2964 Use of McCloskey/Mueller Satisfaction Scale in Evaluating Satisfaction with Working Conditions of Nurses in Slovakia

Authors: Vladimir Siska, Lukas Kober

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Introduction: The research deals with the work satisfaction of nurses working in healthcare institutions in the Slovak Republic, and factors influencing it. Employers should create working conditions that are consonant with the requirements of their employees and make the most of motivation strategies to help them answer to the employess' needs in concordance with various needs and motivation process theories. Methodology: In our research, we aimed to investigate the level of work satisfaction in nurses by carrying out a quantitative analysis using the standardized McCloskey/Mueller Satisfaction scale questionnaire. We used the descriptive positioning characteristics (average, median and variability, standard deviation, minimum and maximum) to process the collected data and, to verify our hypotheses; we employed the double-selection Student T-test, Mann-Whitney U test, and a one-way analysis of variance (One-way ANOVA). Results: Nurses´satisfaction with external rewards is influenced by their age, years of experience, and level of completed education, with all of the abovementioned factors also impacting on the nurses' satisfaction with their work schedule. The type of founding authority of the healthcare institution also constitutes an influence on the nurses' satisfaction concerning relationships in the workplace. Conclusion: The feelling of work dissatisfaction can influence employees in many ways, e.g., it can take the form of burn-out syndrome, absenteeism, or increased fluctuation. Therefore, it is important to pay increased attention to all employees of an organisation, regardless of their position.

Keywords: motivation, nurse, work satisfaction, McCloskey/Mueller satisfaction scale

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2963 Contrast Enhancement in Digital Images Using an Adaptive Unsharp Masking Method

Authors: Z. Mortezaie, H. Hassanpour, S. Asadi Amiri

Abstract:

Captured images may suffer from Gaussian blur due to poor lens focus or camera motion. Unsharp masking is a simple and effective technique to boost the image contrast and to improve digital images suffering from Gaussian blur. The technique is based on sharpening object edges by appending the scaled high-frequency components of the image to the original. The quality of the enhanced image is highly dependent on the characteristics of both the high-frequency components and the scaling/gain factor. Since the quality of an image may not be the same throughout, we propose an adaptive unsharp masking method in this paper. In this method, the gain factor is computed, considering the gradient variations, for individual pixels of the image. Subjective and objective image quality assessments are used to compare the performance of the proposed method both with the classic and the recently developed unsharp masking methods. The experimental results show that the proposed method has a better performance in comparison to the other existing methods.

Keywords: unsharp masking, blur image, sub-region gradient, image enhancement

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2962 Evaluation of Medication Errors in Outpatient Pharmacies: Electronic Prescription System vs. Paper System

Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h

Abstract:

Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.

Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription

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2961 Patient Progression at Discharge: A Communication, Coordination, and Accountability Gap among Hospital Teams

Authors: Nana Benma Osei

Abstract:

Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

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2960 Effect of Institution Volume on Mortality and Outcomes in Osteoporotic Hip Fracture Care

Authors: J. Milton, C. Uzoigwe, O. Ayeko, B. Offorha, K. Anderson, R. G. Middleton

Abstract:

Background: We used the UK National Hip Fracture database to determine the effect of institution hip fracture case volume on hip fracture healthcare outcomes in 2019. Using logistic regression for each healthcare outcome, we compared the best performing 50 units with the poorest performing 50 units in order to determine if the unit volume was associated with performance for each particular outcome. Method: We analysed 175 institutions treating a total of 67,673 patients over the course of a year. Results: The number of hip fractures seen per unit ranged between 86 and 952. Larger units tendered to perform health assessments more consistently and mobilise patients more expeditiously post-operatively. Patients treated at large institutions had shorter lengths of stay. With regard to most other outcomes, there was no association between unit case volume and performance, notably compliance with the Best Practice Tariff, time to surgery, proportion of eligible patients undergoing total hip arthroplasty, length of stay, delirium risk, and pressure sore risk assessments. Conclusion: There is no relationship between unit volume and the majority of health care outcomes. It would seem that larger institutions tend to perform better at parameters that are dependent upon personnel numbers. However, where the outcome is contingent, even partially, on physical infrastructure capacity, there was no difference between larger and smaller units.

Keywords: institution volume, mortality, neck of femur fractures, osteoporosis

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2959 Microstrip Bandpass Filter with Wide Stopband and High Out-of-Band Rejection Based on Inter-Digital Capacitor

Authors: Mohamad Farhat, Bal Virdee

Abstract:

This paper present a compact Microstrip Bandpass filter exhibiting a very wide stop band and high selectivity. The filter comprises of asymmetric resonator structures, which are interconnected by an inter-digital capacitor to enable the realization of a wide bandwidth with high rejection level. High selectivity is obtained by optimizing the parameters of the interdigital capacitor. The filter has high out-of-band rejection (> 30 dB), less than 0.6 dB of insertion-loss, up to 5.5 GHz spurii free, and about 18 dB of return-loss. Full-wave electromagnetic simulator ADSTM (Mom) is used to analyze and optimize the prototype bandpass filter. The proposed technique was verified practically to validate the design methodology. The experimental results of the prototype circuit are presented and a good agreement was obtained comparing with the simulation results. The dimensions of the proposed filter are 32 x 24 mm2.The filter’s characteristics and compact size make it suitable for wireless communication systems.

Keywords: asymmetric resonator, bandpass filter, microstrip, spurious suppression, ultra-wide stop band

Procedia PDF Downloads 189
2958 Impact of U.S. Insurance Reimbursement Policy on Healthcare Business and Entrepreneurship

Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

Abstract:

This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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2957 The Digital Video and Online Media Development for Integrated Marketing Communication and Tourism Promote in Taling Chan District, Bangkok

Authors: Somsak Klaysung

Abstract:

This study purpose to develop video to promote cultural tourism in Taling Chan District. For qualitative research, the sample size was 40 people from 5 group of the tourism entrepreneur in Taling Chan district, conducted the key informants’ content analysis by using focus group and structures in-depth interview from all stakeholders. Quota sampling was used for this kind of research. The findings indicated that get media video marketing and tourism contribute a set length 11.35 9 minutes there is plenty of social capital in Taling Chan District including detail like local wisdom, knowledge, and way of thinking related to nature, history, historic document, occupation, administration and attribute of local people. Additional research found the new path of travel through the water route according to Khlong Bang Ramat called Route 9 temples that travelers can travel by boat are available in the market in four areas Taling Chan also as well.

Keywords: digital video, integrated marketing communication, online media development, Taling Chan district

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2956 Health Care Teams during COVID-19: Roles, Challenges, Emotional State and Perceived Preparedness to the Next Pandemic

Authors: Miriam Schiff, Hadas Rosenne, Ran Nir-Paz, Shiri Shinan Altman

Abstract:

To examine (1) the level, predictors, and subjective perception of professional quality of life (PRoQL), posttraumatic growth, roles, task changes during the pandemic, and perceived preparedness for the next pandemic. These variables were added as part of an international study on social workers in healthcare stress, resilience, and perceived preparedness we took part in, along with Australia, Canada, China, Hong Kong, Singapore, and Taiwan. (2) The extent to which background variables, rate of exposure to the virus, working in COVID wards, profession, personal resilience, and resistance to organizational change predict posttraumatic growth, perceived preparedness, and PRoQL (the latter was examined among social workers only). (3) The teams' perceptions of how the pandemic impacted them at the personal, professional, and organizational levels and what assisted them. Methodologies: Mixed quantitative and qualitative methods were used. 1039 hospital healthcare workers from various professions participated in the quantitative study while 32 participated in in-depth interviews. The same methods were used in six other countries. Findings: The level of PRoQL was moderate, with higher burnout and secondary traumatization level than during routine times. Differences between countries in the level of PRoQL were found as well. Perceived preparedness for the next pandemic at the personal level was moderate and similar among the different health professions. Higher exposure to the virus was associated with lower perceived preparedness of the hospitals. Compared to other professions, doctors and nurses perceived hospitals as significantly less prepared for the next pandemic. The preparedness of the State of Israel for the next pandemic is perceived as low by all healthcare professionals. A moderate level of posttraumatic growth was found. Staff who worked at the COVID ward reported a greater level of growth. Doctors reported the lowest level of growth. The staff's resilience was high, with no differences among professions or levels of exposure. Working in the COVID ward and resilience predicted better preparedness, while resistance to organizational change predicted worse preparedness. Findings from the qualitative part of the study revealed that healthcare workers reported challenges at the personal, professional and organizational level during the different waves of the pandemic. They also report on internal and external resources they either owned or obtained during that period. Conclusion: Exposure to the COVID-19 virus is associated with secondary traumatization on one hand and personal posttraumatic growth on the other hand. Personal and professional discoveries and a sense of mission helped cope with the pandemic that was perceived as a historical event, war, or mass casualty event. Personal resilience, along with the support of colleagues, family, and direct management, were seen as significant components of coping. Hospitals should plan ahead and improve their preparedness to the next pandemic.

Keywords: covid-19, health-care, social workers, burnout, preparedness, international perspective

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2955 Medicompills Architecture: A Mathematical Precise Tool to Reduce the Risk of Diagnosis Errors on Precise Medicine

Authors: Adriana Haulica

Abstract:

Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.

Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics

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2954 The Impact of Land Cover Change on Stream Discharges and Water Resources in Luvuvhu River Catchment, Vhembe District, Limpopo Province, South Africa

Authors: P. M. Kundu, L. R. Singo, J. O. Odiyo

Abstract:

Luvuvhu River catchment in South Africa experiences floods resulting from heavy rainfall of intensities exceeding 15 mm per hour associated with the Inter-tropical Convergence Zone (ITCZ). The generation of runoff is triggered by the rainfall intensity and soil moisture status. In this study, remote sensing and GIS techniques were used to analyze the hydrologic response to land cover changes. Runoff was calculated as a product of the net precipitation and a curve number coefficient. It was then routed using the Muskingum-Cunge method using a diffusive wave transfer model that enabled the calculation of response functions between start and end point. Flood frequency analysis was determined using theoretical probability distributions. Spatial data on land cover was obtained from multi-temporal Landsat images while data on rainfall, soil type, runoff and stream discharges was obtained by direct measurements in the field and from the Department of Water. A digital elevation model was generated from contour maps available at http://www.ngi.gov.za. The results showed that land cover changes had impacted negatively to the hydrology of the catchment. Peak discharges in the whole catchment were noted to have increased by at least 17% over the period while flood volumes were noted to have increased by at least 11% over the same period. The flood time to peak indicated a decreasing trend, in the range of 0.5 to 1 hour within the years. The synergism between remotely sensed digital data and GIS for land surface analysis and modeling was realized, and it was therefore concluded that hydrologic modeling has potential for determining the influence of changes in land cover on the hydrologic response of the catchment.

Keywords: catchment, digital elevation model, hydrological model, routing, runoff

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2953 Developing a Framework for Designing Digital Assessments for Middle-school Aged Deaf or Hard of Hearing Students in the United States

Authors: Alexis Polanco Jr, Tsai Lu Liu

Abstract:

Research on digital assessment for deaf and hard of hearing (DHH) students is negligible. Part of this stems from the DHH assessment design existing at the intersection of the emergent disciplines of usability, accessibility, and child-computer interaction (CCI). While these disciplines have some prevailing guidelines —e.g. in user experience design (UXD), there is Jacob Nielsen’s 10 Usability Heuristics (Nielsen-10); for accessibility, there are the Web Content Accessibility Guidelines (WCAG) & the Principles of Universal Design (PUD)— this research was unable to uncover a unified set of guidelines. Given that digital assessments have lasting implications for the funding and shaping of U.S. school districts, it is vital that cross-disciplinary guidelines emerge. As a result, this research seeks to provide a framework by which these disciplines can share knowledge. The framework entails a process of asking subject-matter experts (SMEs) and design & development professionals to self-describe their fields of expertise, how their work might serve DHH students, and to expose any incongruence between their ideal process and what is permissible at their workplace. This research used two rounds of mixed methods. The first round consisted of structured interviews with SMEs in usability, accessibility, CCI, and DHH education. These practitioners were not designers by trade but were revealed to use designerly work processes. In addition to asking these SMEs about their field of expertise, work process, etc., these SMEs were asked to comment about whether they believed Nielsen-10 and/or PUD were sufficient for designing products for middle-school DHH students. This first round of interviews revealed that Nielsen-10 and PUD were, at best, a starting point for creating middle-school DHH design guidelines or, at worst insufficient. The second round of interviews followed a semi-structured interview methodology. The SMEs who were interviewed in the first round were asked open-ended follow-up questions about their semantic understanding of guidelines— going from the most general sense down to the level of design guidelines for DHH middle school students. Designers and developers who were never interviewed previously were asked the same questions that the SMEs had been asked across both rounds of interviews. In terms of the research goals: it was confirmed that the design of digital assessments for DHH students is inherently cross-disciplinary. Unexpectedly, 1) guidelines did not emerge from the interviews conducted in this study, and 2) the principles of Nielsen-10 and PUD were deemed to be less relevant than expected. Given the prevalence of Nielsen-10 in UXD curricula across academia and certificate programs, this poses a risk to the efficacy of DHH assessments designed by UX designers. Furthermore, the following findings emerged: A) deep collaboration between the disciplines of usability, accessibility, and CCI is low to non-existent; B) there are no universally agreed-upon guidelines for designing digital assessments for DHH middle school students; C) these disciplines are structured academically and professionally in such a way that practitioners may not know to reach out to other disciplines. For example, accessibility teams at large organizations do not have designers and accessibility specialists on the same team.

Keywords: deaf, hard of hearing, design, guidelines, education, assessment

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