Search results for: healthcare regulations
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2425

Search results for: healthcare regulations

1105 CO2 Emission and Cost Optimization of Reinforced Concrete Frame Designed by Performance Based Design Approach

Authors: Jin Woo Hwang, Byung Kwan Oh, Yousok Kim, Hyo Seon Park

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As greenhouse effect has been recognized as serious environmental problem of the world, interests in carbon dioxide (CO2) emission which comprises major part of greenhouse gas (GHG) emissions have been increased recently. Since construction industry takes a relatively large portion of total CO2 emissions of the world, extensive studies about reducing CO2 emissions in construction and operation of building have been carried out after the 2000s. Also, performance based design (PBD) methodology based on nonlinear analysis has been robustly developed after Northridge Earthquake in 1994 to assure and assess seismic performance of building more exactly because structural engineers recognized that prescriptive code based design approach cannot address inelastic earthquake responses directly and assure performance of building exactly. Although CO2 emissions and PBD approach are recent rising issues on construction industry and structural engineering, there were few or no researches considering these two issues simultaneously. Thus, the objective of this study is to minimize the CO2 emissions and cost of building designed by PBD approach in structural design stage considering structural materials. 4 story and 4 span reinforced concrete building optimally designed to minimize CO2 emissions and cost of building and to satisfy specific seismic performance (collapse prevention in maximum considered earthquake) of building satisfying prescriptive code regulations using non-dominated sorting genetic algorithm-II (NSGA-II). Optimized design result showed that minimized CO2 emissions and cost of building were acquired satisfying specific seismic performance. Therefore, the methodology proposed in this paper can be used to reduce both CO2 emissions and cost of building designed by PBD approach.

Keywords: CO2 emissions, performance based design, optimization, sustainable design

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1104 Social Assistive Robots, Reframing the Human Robotics Interaction Benchmark of Social Success

Authors: Antonio Espingardeiro

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It is likely that robots will cross the boundaries of industry into households over the next decades. With demographic challenges worldwide, the future ageing populations will require the introduction of assistive technologies capable of providing, care, human dignity and quality of life through the aging process. Robotics technology has a high potential for being used in the areas of social and healthcare by promoting a wide range of activities such as entertainment, companionship, supervision or cognitive and physical assistance. However, such close Human Robotics Interactions (HRIs) encompass a rich set of ethical scenarios that need to be addressed before Socially Assistive Robots (SARs) reach the global markets. Such interactions with robots may seem a worthy goal for many technical/financial reasons but inevitably require close attention to the ethical dimensions of such interactions. This article investigates the current HRI benchmark of social success. It revises it according to the ethical principles of beneficence, non-maleficence and justice aligned with social care ethos. An extension of such benchmark is proposed based on an empirical study of HRIs with elderly groups.

Keywords: HRI, SARs, social success, benchmark, elderly care

Procedia PDF Downloads 495
1103 PitMod: The Lorax Pit Lake Hydrodynamic and Water Quality Model

Authors: Silvano Salvador, Maryam Zarrinderakht, Alan Martin

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Open pits, which are the result of mining, are filled by water over time until the water reaches the elevation of the local water table and generates mine pit lakes. There are several specific regulations about the water quality of pit lakes, and mining operations should keep the quality of groundwater above pre-defined standards. Therefore, an accurate, acceptable numerical model predicting pit lakes’ water balance and water quality is needed in advance of mine excavation. We carry on analyzing and developing the model introduced by Crusius, Dunbar, et al. (2002) for pit lakes. This model, called “PitMod”, simulates the physical and geochemical evolution of pit lakes over time scales ranging from a few months up to a century or more. Here, a lake is approximated as one-dimensional, horizontally averaged vertical layers. PitMod calculates the time-dependent vertical distribution of physical and geochemical pit lake properties, like temperature, salinity, conductivity, pH, trace metals, and dissolved oxygen, within each model layer. This model considers the effect of pit morphology, climate data, multiple surface and subsurface (groundwater) inflows/outflows, precipitation/evaporation, surface ice formation/melting, vertical mixing due to surface wind stress, convection, background turbulence and equilibrium geochemistry using PHREEQC and linking that to the geochemical reactions. PitMod, which is used and validated in over 50 mines projects since 2002, incorporates physical processes like those found in other lake models such as DYRESM (Imerito 2007). However, unlike DYRESM PitMod also includes geochemical processes, pit wall runoff, and other effects. In addition, PitMod is actively under development and can be customized as required for a particular site.

Keywords: pit lakes, mining, modeling, hydrology

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1102 Ultrasonic Treatment of Baker’s Yeast Effluent

Authors: Emine Yılmaz, Serap Fındık

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Baker’s yeast industry uses molasses as a raw material. Molasses is end product of sugar industry. Wastewater from molasses processing presents large amount of coloured substances that give dark brown color and high organic load to the effluents. The main coloured compounds are known as melanoidins. Melanoidins are product of Maillard reaction between amino acid and carbonyl groups in molasses. Dark colour prevents sunlight penetration and reduces photosynthetic activity and dissolved oxygen level of surface waters. Various methods like biological processes (aerobic and anaerobic), ozonation, wet air oxidation, coagulation/flocculation are used to treatment of baker’s yeast effluent. Before effluent is discharged adequate treatment is imperative. In addition to this, increasingly stringent environmental regulations are forcing distilleries to improve existing treatment and also to find alternative methods of effluent management or combination of treatment methods. Sonochemical oxidation is one of the alternative methods. Sonochemical oxidation employs ultrasound resulting in cavitation phenomena. In this study, decolorization of baker’s yeast effluent was investigated by using ultrasound. Baker’s yeast effluent was supplied from a factory which is located in the north of Turkey. An ultrasonic homogenizator used for this study. Its operating frequency is 20 kHz. TiO2-ZnO catalyst has been used as sonocatalyst. The effects of molar proportion of TiO2-ZnO, calcination temperature and time, catalyst amount were investigated on the decolorization of baker’s yeast effluent. The results showed that prepared composite TiO2-ZnO with 4:1 molar proportion treated at 700°C for 90 min provides better result. Initial decolorization rate at 15 min is 3% without catalyst, 14,5% with catalyst treated at 700°C for 90 min respectively.

Keywords: baker’s yeast effluent, decolorization, sonocatalyst, ultrasound

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1101 Elderly Home Care the Need of an Hour In India

Authors: Varsha Reddy Jayar

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Background: Our elderly family members deserve our best care. It's our responsibility to ensure they're healthy and safe. The population of India is increasing rapidly. People are literally being born in the streets, and there is a high growth on taxes and healthcare costs. Indian families are challenged with taking care of everyone. When you have elderly parents and a demanding job, it can be difficult to take care of them. You might not have enough time to care for them when you're already working or dealing with emotional difficulties. Living alone in old age can cause older individuals to face many health risks. Many seniors find living and caring for themselves challenging when they live by themselves. This study explored the factors that affect whether or not elderly people choose to live in old age homes. Methods: This study was carried out on 123 elderly people living in different old age homes in Karnataka, India. The reason for their residence at the home was explored using an interview. Results: It was found that the most common reason for living in an old age home is due to abuse from children and grandchildren; the majority reported were Daughter in law issues in the family specific to the adjustment and understanding amongst them. Conclusion: More and more elderly people in India are choosing to stay in old age homes as they get older. The government and voluntary agencies must have some sort of arrangements for institutional support.

Keywords: old age home, elderly, Aging, challenges of aging

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1100 Knowledge Management (KM) Practices: A Study of KM Adoption among Doctors in Kuwait

Authors: B. Alajmi, L. Marouf, A. S. Chaudhry

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In recent years, increasing emphasis has been placed upon issues concerning the evaluation of health care. In this regard, knowledge management has also been considered an important component of the evaluation process. KM facilitates the transfer of existing knowledge or the development of new knowledge among healthcare staff and patients. This research aimed to examine how hospitals in Kuwait employ knowledge management practices, including capturing, sharing, and generating, and the perceived impact of KM practices on performance of hospitals in Kuwait. Through adopting a quantitative survey method with 277 sample of doctors, the study found that in terms of the three major knowledge management practices – knowledge capturing, sharing, and generating – the adoption of KM practices were rated very low in the sampled hospitals in Kuwait. Hospitals paid little attention to the main activities that support the transfer of expertise among doctors in hospitals. However, as predicted by previous studies, knowledge management practices were perceived to have an impact on hospitals’ performance. Through knowledge capturing, sharing, and generating, hospitals could improve the services they provide through documenting best practices, transforming their hospitals into learning organizations in which lessons learned are captured, stored, and made available for others to learn from.

Keywords: knowledge management, hospitals, knowledge management practices, knowledge management tools, performance

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1099 Empowering the Sustainability of Community Health: An Application of the Theory of Maqasid Al-Shariah

Authors: Ahasanul Haque, Noor Hazilah Abd Manaf, Zohurul Anis, Tarekol Islam

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Sustainable community health (SCH) is an example of a new healthcare concept formed from applying the Maqasid al-Shariah principle to hospital management and delivery services. Because the idea is novel, it needs comprehensive and ongoing investigation to be improved. However, there is a lack of research on the necessity of developing sustainable community health (SCH), particularly its organizational structure. Furthermore, there is a misconception about the order of components in Maqasid al-Shariah, particularly in a hospital setting. Furthermore, the use of medicines and treatment by conventional recommendations to carry out the treatment by the Maqasid al Shariah. As such, this study focuses on the essential prerequisite for establishing a sustainable community health system based on Maqasid al-Shariah. This study discusses the use of Maqasid al-Shariah in administration and treatment. In this qualitative research approach, a literature search and interviews with specialists are conducted. The gathered data is examined using content analysis, emphasizing inductive and deductive reasoning. The research reveals that the Shariah Advisory Council and Shariah Critical Point are necessary for sustainable community health. In conclusion, by discussing the causes for each instance, this research adds to the creation of methods for determining the level of Maasid al-Shariah in-hospital care.

Keywords: empowering, sustainability, community health, maqasid al shariah, hospital and malaysia

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1098 The Consumption of Sodium and Fat from Processed Foods

Authors: Pil Kyoo Jo, Jee Young Kim, Yu Jin Oh, Sohyun Park, Young Ha Joo, Hye Suk Kim, Semi Kang

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When convenience drives daily food choices, the increased consumption of processed foods may be associated with the increased intakes of sodium and fat and further with the onset of chronic diseases. The purpose of this study was to investigate the levels of sodium, saturated fat, and calories intakes through processed foods and the dietary patterns among adult populations in South Korea. We used the nationally representative data from the 5th Korea National Health and Nutrition Examination Survey (KNHANES, 2010-2012) and a cross-sectional survey on the eating behaviors among university students(N=893, 380 men, 513 women) aged from 20 to 24 years. Results showed that South Koreans consumed 43.5% of their total food consumption from processed foods. The 24-hour recalls data showed that 77% of sodium, 60% of fats, 59% of saturated fat, and 44% of calories were consumed from processed food. The intake of processed foods increased by 1.7% in average since 2008 annually. Only 33% of processed food that respondents consumed had nutrition labeling. The data from university students showed that students selected processed foods in convenience store when eating alone compared to eating with someone else. Given the convenience and lack of time, more people will consume processed foods and it may impact their overall dietary intake and further their health. In order to help people to make healthier food choices, regulations and policies to reduce the potentially unhealthy nutrients of processed foods should be strengthened. This research was supported by the National Research Foundation of Korea for 2011 Korea-Japan Basic Scientific Cooperation Program. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2015S1A5B6037369).

Keywords: sodium, fat, processed foods, diet trends

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1097 Embodied Empowerment: A Design Framework for Augmenting Human Agency in Assistive Technologies

Authors: Melina Kopke, Jelle Van Dijk

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Persons with cognitive disabilities, such as Autism Spectrum Disorder (ASD) are often dependent on some form of professional support. Recent transformations in Dutch healthcare have spurred institutions to apply new, empowering methods and tools to enable their clients to cope (more) independently in daily life. Assistive Technologies (ATs) seem promising as empowering tools. While ATs can, functionally speaking, help people to perform certain activities without human assistance, we hold that, from a design-theoretical perspective, such technologies often fail to empower in a deeper sense. Most technologies serve either to prescribe or to monitor users’ actions, which in some sense objectifies them, rather than strengthening their agency. This paper proposes that theories of embodied interaction could help formulating a design vision in which interactive assistive devices augment, rather than replace, human agency and thereby add to a persons’ empowerment in daily life settings. It aims to close the gap between empowerment theory and the opportunities provided by assistive technologies, by showing how embodiment and empowerment theory can be applied in practice in the design of new, interactive assistive devices. Taking a Research-through-Design approach, we conducted a case study of designing to support independently living people with ASD with structuring daily activities. In three iterations we interlaced design action, active involvement and prototype evaluations with future end-users and healthcare professionals, and theoretical reflection. Our co-design sessions revealed the issue of handling daily activities being multidimensional. Not having the ability to self-manage one’s daily life has immense consequences on one’s self-image, and also has major effects on the relationship with professional caregivers. Over the course of the project relevant theoretical principles of both embodiment and empowerment theory together with user-insights, informed our design decisions. This resulted in a system of wireless light units that users can program as a reminder for tasks, but also to record and reflect on their actions. The iterative process helped to gradually refine and reframe our growing understanding of what it concretely means for a technology to empower a person in daily life. Drawing on the case study insights we propose a set of concrete design principles that together form what we call the embodied empowerment design framework. The framework includes four main principles: Enabling ‘reflection-in-action’; making information ‘publicly available’ in order to enable co-reflection and social coupling; enabling the implementation of shared reflections into an ‘endurable-external feedback loop’ embedded in the persons familiar ’lifeworld’; and nudging situated actions with self-created action-affordances. In essence, the framework aims for the self-development of a suitable routine, or ‘situated practice’, by building on a growing shared insight of what works for the person. The framework, we propose, may serve as a starting point for AT designers to create truly empowering interactive products. In a set of follow-up projects involving the participation of persons with ASD, Intellectual Disabilities, Dementia and Acquired Brain Injury, the framework will be applied, evaluated and further refined.

Keywords: assistive technology, design, embodiment, empowerment

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1096 Object Detection Based on Plane Segmentation and Features Matching for a Service Robot

Authors: António J. R. Neves, Rui Garcia, Paulo Dias, Alina Trifan

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With the aging of the world population and the continuous growth in technology, service robots are more and more explored nowadays as alternatives to healthcare givers or personal assistants for the elderly or disabled people. Any service robot should be capable of interacting with the human companion, receive commands, navigate through the environment, either known or unknown, and recognize objects. This paper proposes an approach for object recognition based on the use of depth information and color images for a service robot. We present a study on two of the most used methods for object detection, where 3D data is used to detect the position of objects to classify that are found on horizontal surfaces. Since most of the objects of interest accessible for service robots are on these surfaces, the proposed 3D segmentation reduces the processing time and simplifies the scene for object recognition. The first approach for object recognition is based on color histograms, while the second is based on the use of the SIFT and SURF feature descriptors. We present comparative experimental results obtained with a real service robot.

Keywords: object detection, feature, descriptors, SIFT, SURF, depth images, service robots

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1095 The History of Chartered Certified Accountants: The Case of Tunisia

Authors: Mariam Dammak, Yosra Makni Fourati, Rania Mnejja

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This paper aims to highlight the conditions and the context of the birth and the implementation of the Chartered Certified Accountants in Tunisian universities. For this purpose, we present an historical overview of the establishment of institutions that started the courses of Chartered accounting, including the Institute of Higher Commercial Studies (IHEC) of Carthage, the Higher Institute of Management (ISG) of Tunis, the Faculty of Economics and Management (FSEG) of Sfax and later the Higher Institute of Accounting and Administration of Enterprises (ISCAE) of Tunis. Then, it would be relevant to examine the changes, carried out by the Tunisian government, of the regulations in force relating to this academic path, from its birth during the 1970s until nowadays. We conducted a documentary study (archival documents, official documents, etc.) accompanied by semi-structured interviews with key actors (accountants, academics, officials of the Ministry of Higher Education) who marked the history of the studies of Tunisian charted accounting. Addressing this research question in Tunisia may contribute to the literature in three ways. First, previous researches dealing with the history of charted accounting-education are scared. Second, this paper allows us to understand the circumstances and context of the birth and teaching of accounting in Tunisia. Eventually, it helps to position the accounting curriculum in relation to international requirements. In fact, the training of accountants is closely related to the practice of the profession, regulated by the Order of Chartered Accountants in Tunisia (OECT). This Order is a member of the International Federation of Accountants (IFAC), since its creation in the 80s, has obligations to align with international requirements, particularly those relating to higher education, set up in 2005 and updated in 2015 (International Standard Education: IES).

Keywords: accounting history, chartered certified accountants, higher accounting education, Tunisian context

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1094 A Tomb Structure in Pursuit of Tradition in 2oth Century Turkey and Its Story; the Tomb of Haci Hâkim Kemal Onsun and His Wife

Authors: Yavuz Arat, Ugur Tuztasi, Mehmet Uysal

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Anatolia has been the host of many civilizations and a site where architectural structures of many cultural layers were interpreted. Most significantly the Turks who settled in Central Asia brought their architectural dynamics and cultural accumulation to Anatolia after the 12th century. The tomb structures first observed in Central Asia under the influence of Islamic faith and Turkish cultural heritage has blossomed under Great Seljuk Empire and with the Anatolian Seljuk Empire these tombs changed both in size and form with rich and beautiful samples from Ahlat to Sivas to Kayseri and Konya. This tomb tradition which started during 13th century has continued during the Ottoman Empire period with some alterations of form and evolved into the rarely observed mausoleum type tombs. The Ottoman tradition of building tombs inside mosque gardens and their forms present the clues of an important burial tradition. However this understanding was abandoned in 20th century Turkey. This tradition was abandoned with regard to legal regulations and health conditions. This study investigates the vestiges of this tradition and its spatial reflections over a sample. The present sample is representative of a tradition that started in 1970s and the case of building tombs inside mosque gardens will be illustrated over the tomb of Hacı Kemal Onsun and his wife which is located in Konya, the capital of the Anatolian Seljuks. The building process of this tomb will be evaluated with regard to burial traditions and architectural stylization.

Keywords: tomb, language of architectural form, Anatolian Seljuk tombs, Ottoman tombs

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1093 Energy Performance Gaps in Residences: An Analysis of the Variables That Cause Energy Gaps and Their Impact

Authors: Amrutha Kishor

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Today, with the rising global warming and depletion of resources every industry is moving toward sustainability and energy efficiency. As part of this movement, it is nowadays obligatory for architects to play their part by creating energy predictions for their designs. But in a lot of cases, these predictions do not reflect the real quantities of energy in newly built buildings when operating. These can be described as ‘Energy Performance Gaps’. This study aims to determine the underlying reasons for these gaps. Seven houses designed by Allan Joyce Architects, UK from 1998 until 2019 were considered for this study. The data from the residents’ energy bills were cross-referenced with the predictions made with the software SefairaPro and from energy reports. Results indicated that the predictions did not match the actual energy usage. An account of how energy was used in these seven houses was made by means of personal interviews. The main factors considered in the study were occupancy patterns, heating systems and usage, lighting profile and usage, and appliances’ profile and usage. The study found that the main reasons for the creation of energy gaps were the discrepancies in occupant usage and patterns of energy consumption that are predicted as opposed to the actual ones. This study is particularly useful for energy-conscious architectural firms to fine-tune the approach to designing houses and analysing their energy performance. As the findings reveal that energy usage in homes varies based on the way residents use the space, it helps deduce the most efficient technological combinations. This information can be used to set guidelines for future policies and regulations related to energy consumption in homes. This study can also be used by the developers of simulation software to understand how architects use their product and drive improvements in its future versions.

Keywords: architectural simulation, energy efficient design, energy performance gaps, environmental design

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1092 Lung Disease Detection from the Chest X Ray Images Using Various Transfer Learning

Authors: Aicha Akrout, Amira Echtioui, Mohamed Ghorbel

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Pneumonia remains a significant global health concern, posing a substantial threat to human lives due to its contagious nature and potentially fatal respiratory complications caused by bacteria, fungi, or viruses. The reliance on chest X-rays for diagnosis, although common, often necessitates expert interpretation, leading to delays and potential inaccuracies in treatment. This study addresses these challenges by employing transfer learning techniques to automate the detection of lung diseases, with a focus on pneumonia. Leveraging three pre-trained models, VGG-16, ResNet50V2, and MobileNetV2, we conducted comprehensive experiments to evaluate their performance. Our findings reveal that the proposed model based on VGG-16 demonstrates superior accuracy, precision, recall, and F1 score, achieving impressive results with an accuracy of 93.75%, precision of 94.50%, recall of 94.00%, and an F1 score of 93.50%. This research underscores the potential of transfer learning in enhancing pneumonia diagnosis and treatment outcomes, offering a promising avenue for improving healthcare delivery and reducing mortality rates associated with this debilitating respiratory condition.

Keywords: chest x-ray, lung diseases, transfer learning, pneumonia detection

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1091 Psychotraumatology: The Relationship Between Posttraumatic Stress Disorder and Criminal Justice Involvement in Vietnam War Veterans

Authors: Danielle Page

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Foregoing studies, statistics, and medical evaluations have established a relationship between Posttraumatic stress disorder (PTSD) and criminal justice involvement in Vietnam veterans. War is highly trauma inducing and can leave combat veterans with mental disorders ranging from psychopathic thoughts to suicidal ideation. The majority of those suffering are unaware that they have PTSD, and as a coping mechanism, they often turn to self isolation. Beyond isolation, many veterans with symptomatic PTSD turn to aggression and substance abuse to cope with their internal agony. The most common crimes committed by veterans with PTSD fall into the assault and drug/alcohol abuse categories. Thus, a relationship is established between veteran populations and the criminal justice system. This dissertation aims to define the relationship between PTSD and criminal justice involvement in veterans, explore the mediating factors in this relationship, and analyze numerous court cases in this subject area. Further, it will examine the ways in which crime rates can be reduced for veterans with symptoms of PTSD. This ranges from the improvement of healthcare systems to the implementation of special courts to handle veteran cases.

Keywords: psychotraumatology, forensic psychology, PTSD, vietnam veterans

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1090 Conducting Quality Planning, Assurance and Control According to GMP (Good Manufacturing Practices) Standards and Benchmarking Data for Kuwait Food Industries

Authors: Alaa Alateeqi, Sara Aldhulaiee, Sara Alibraheem, Noura Alsaleh

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For the past few decades or so, Kuwait's local food industry has grown remarkably due to increase in demand for processed or semi processed food products in the market. It is important that the ever increasing food manufacturing/processing units maintain the required quality standards as per regional and to some extent international quality requirements. It has been realized that all Kuwait food manufacturing units should understand and follow the international standard practices, and moreover a set of guidelines must be set for quality assurance such that any new business in this area is aware of the minimum requirements. The current study has been undertaken to identify the gaps in Kuwait food industries in following the Good Manufacturing Practices (GMP) in terms of quality planning, control and quality assurance. GMP refers to Good Manufacturing Practices, which are a set of rules, laws or regulations that certify producing products within quality standards and ensuring that it is safe, pure and effective. The present study therefore reports about a ‘case study’ in a reputed food manufacturing unit in Kuwait; starting from assessment of the current practices followed by diagnosis, report of the diagnosis and road map and corrective measures for GMP implementation in the unit. The case study has also been able to identify the best practices and establish a benchmarking data for other companies to follow, through measuring the selected company's quality, policies, products and strategies and compare it with the established benchmarking data. A set of questionnaires and assessment mechanism has been established for companies to identify their ‘benchmarking score’ in relation to the number of non-conformities and conformities with the GMP standard requirements.

Keywords: good manufacturing practices, GMP, benchmarking, Kuwait Food Industries, food quality

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1089 Client Importance and Audit Quality under Civil Law versus Common Law Societies

Authors: Kelly Grani Yuen

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Accounting scandals and auditing frauds are perceived to be driven by aggressive companies and misrepresentation of audit reports. However, local legal systems and law enforcements may affect the services auditors provide to their ‘important’ clients. Under the civil law and common law jurisdictions, the standard setters, the government, and the regulatory bodies treat cases differently. As such, whether or not different forms of legal systems and extent of law enforcement plays an important role in auditor’s Audit Quality is a question this paper attempts to explore. The paper focuses on the investigation in Asia, where Hong Kong represents the common-law jurisdiction, while Taiwan and China represent the civil law jurisdiction. Only the ten reputable accounting firms are used in this study due to the differences in rankings and establishments of some of the small local audit firms. This will also contribute to the data collected between the years 2007-2013. By focusing on the use of multiple regression based on the dependent (Audit Quality) and independent variables (Client Importance, Law Enforcement, and Press Freedom), six different models are established. Results demonstrate that since different jurisdictions have different legal systems and market regulations, auditor’s treatment on ‘important’ clients will vary. However, with the moderators in place (law enforcement and press freedom), the relationship between client importance and audit quality may be smoothed out. With that in mind, this study contributes to local governments and standard setters’ consideration on legal reform and proper law enforcement in the market. Perhaps, with such modifications on the economic systems, collusion between companies and auditors can finally be put to a halt.

Keywords: audit quality, client importance, jurisdiction, modified audit opinions

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1088 Heroin Withdrawal, Prison and Multiple Temporalities

Authors: Ian Walmsley

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The aim of this paper is to explore the influence of time and temporality on the experience of coming off heroin in prison. The presentation draws on qualitative data collected during a small-scale pilot study of the role of self-care in the process of coming off drugs in prison. Time and temporality emerged as a key theme in the interview transcripts. Drug dependent prisoners experience of time in prison has not been recognized in the research literature. Instead, the literature on prison time typically views prisoners as a homogenous group or tends to focus on the influence of aging and gender on prison time. Furthermore, there is a tendency in the literature on prison drug treatment and recovery to conceptualize drug dependent prisoners as passive recipients of prison healthcare, rather than active agents. In building on these gaps, this paper argues that drug dependent prisoners experience multiple temporalities which involve an interaction between the body-times of the drug dependent prisoner and the economy of time in prison. One consequence of this interaction is the feeling that they are doing, at this point in their prison sentence, double prison time. The second part of the argument is that time and temporality were a means through which they governed their withdrawing bodies. In addition, this paper will comment on the challenges of prison research in England.

Keywords: heroin withdrawal, time and temporality, prison, body

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1087 Nonlinear Multivariable Analysis of CO2 Emissions in China

Authors: Hsiao-Tien Pao, Yi-Ying Li, Hsin-Chia Fu

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This paper addressed the impacts of energy consumption, economic growth, financial development, and population size on environmental degradation using grey relational analysis (GRA) for China, where foreign direct investment (FDI) inflows is the proxy variable for financial development. The more recent historical data during the period 2004–2011 are used, because the use of very old data for data analysis may not be suitable for rapidly developing countries. The results of the GRA indicate that the linkage effects of energy consumption–emissions and GDP–emissions are ranked first and second, respectively. These reveal that energy consumption and economic growth are strongly correlated with emissions. Higher economic growth requires more energy consumption and increasing environmental pollution. Likewise, more efficient energy use needs a higher level of economic development. Therefore, policies to improve energy efficiency and create a low-carbon economy can reduce emissions without hurting economic growth. The finding of FDI–emissions linkage is ranked third. This indicates that China do not apply weak environmental regulations to attract inward FDI. Furthermore, China’s government in attracting inward FDI should strengthen environmental policy. The finding of population–emissions linkage effect is ranked fourth, implying that population size does not directly affect CO2 emissions, even though China has the world’s largest population, and Chinese people are very economical use of energy-related products. Overall, the energy conservation, improving efficiency, managing demand, and financial development, which aim at curtailing waste of energy, reducing both energy consumption and emissions, and without loss of the country’s competitiveness, can be adopted for developing economies. The GRA is one of the best way to use a lower data to build a dynamic analysis model.

Keywords: China, CO₂ emissions, foreign direct investment, grey relational analysis

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1086 Exploring Elder Care in Different Settings in West Bengal: A Psycho-Social Study of Private Homes, Hospitals and Long-Term Care Facilities

Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: elder care settings, family caregiver, home care, geriatric hospital care, long term care facility

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1085 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

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Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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1084 The Role of NAD+ and Nicotinamide (Vitamin B3) in Glaucoma: A Literature Review

Authors: James Pietris

Abstract:

Glaucoma is a collection of irreversible optic neuropathies which, if left untreated, lead to severe visual field loss. These diseases are a leading cause of blindness across the globe and are estimated to affect approximately 80 million people, particularly women and people of Asian descent.1This represents a major burden on healthcare systems worldwide. Recently, there has been increasing interest in the potential of nicotinamide (vitamin B3) as a novel option in the management of glaucoma. This review aims to analyse the currently available literature to determine whether there is evidence of an association between nicotinamide adenine dinucleotide (NAD+) and glaucomatous optic neuropathy and whether nicotinamide has the potential to prevent or reverse these effects. The literature showed a strong connection between reduced NAD+ levels and retinal ganglion cell dysfunction through multiple different studies. There is also evidence of the positive effect of nicotinamide supplementation on retinal ganglion cell function in models of mouse glaucoma and in a study involving humans. Based on the literature findings, a recommendation has been made that more research into the efficacy, appropriate dosing, and potential side effects of nicotinamide supplementation is needed before it can be definitively determined whether it is appropriate for widespread prophylactic and therapeutic use against glaucoma in humans.

Keywords: glaucoma, nicotinamide, vitamin B3, optic neuropathy

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1083 Pros and Cons of Nanoparticles on Health

Authors: Amber Shahi, Ayesha Tazeen, Abdus Samad, Shama Parveen

Abstract:

Nanoparticles (NPs) are tiny particles. According to the International Organization for Standardization, the size range of NPs is in the nanometer range (1-100 nm). They show distinct properties that are not shown by larger particles of the same material. NPs are currently being used in different fields due to their unique physicochemical nature. NPs are a boon for medical sciences, environmental sciences, electronics, and textile industries. However, there is growing concern about their potential adverse effects on human health. This poster presents a comprehensive review of the current literature on the pros and cons of NPs on human health. The poster will discuss the various types of interactions of NPs with biological systems. There are a number of beneficial uses of NPs in the field of health and environmental welfare. NPs are very useful in disease diagnosis, antimicrobial action, and the treatment of diseases like Alzheimer’s. They can also cross the blood-brain barrier, making them capable of treating brain diseases. Additionally, NPs can target specific tumors and be used for cancer treatment. To treat environmental health, NPs also act as catalytic converters to reduce pollution from the environment. On the other hand, NPs also have some negative impacts on the human body, such as being cytotoxic and genotoxic. They can also affect the reproductive system, such as the testis and ovary, and sexual behavior. The poster will further discuss the routes of exposure of NPs. The poster will conclude with a discussion of the current regulations and guidelines on the use of NPs in various applications. It will highlight the need for further research and the development of standardized toxicity testing methods to ensure the safe use of NPs in various applications. When using NPs in diagnosis and treatment, we should also take into consideration their safe concentration in the body. Overall, this poster aims to provide a comprehensive overview of the pros and cons of NPs on human health and to promote awareness and understanding of the potential risks and benefits associated with their use.

Keywords: disease diagnosis, human health, nanoparticles, toxicity testing

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1082 Medical Decision-Making in Advanced Dementia from the Family Caregiver Perspective: A Qualitative Study

Authors: Elzbieta Sikorska-Simmons

Abstract:

Advanced dementia is a progressive terminal brain disease that is accompanied by a syndrome of difficult to manage symptoms and complications that eventually lead to death. The management of advanced dementia poses major challenges to family caregivers who act as patient health care proxies in making medical treatment decisions. Little is known, however, about how they manage advanced dementia and how their treatment choices influence the quality of patient life. This prospective qualitative study examines the key medical treatment decisions that family caregivers make while managing advanced dementia. The term ‘family caregiver’ refers to a relative or a friend who is primarily responsible for managing patient’s medical care needs and legally authorized to give informed consent for medical treatments. Medical decision-making implies a process of choosing between treatment options in response to patient’s medical care needs (e.g., worsening comorbid conditions, pain, infections, acute medical events). Family caregivers engage in this process when they actively seek treatments or follow recommendations by healthcare professionals. Better understanding of medical decision-making from the family caregiver perspective is needed to design interventions that maximize the quality of patient life and limit inappropriate treatments. Data were collected in three waves of semi-structured interviews with 20 family caregivers for patients with advanced dementia. A purposive sample of 20 family caregivers was recruited from a senior care center in Central Florida. The qualitative personal interviews were conducted by the author in 4-5 months intervals. The ethical approval for the study was obtained prior to the data collection. Advanced dementia was operationalized as stage five or higher on the Global Deterioration Scale (GDS) (i.e., starting with the GDS score of five, patients are no longer able survive without assistance due to major cognitive and functional impairments). Information about patients’ GDS scores was obtained from the Center’s Medical Director, who had an in-depth knowledge of each patient’s health and medical treatment history. All interviews were audiotaped and transcribed verbatim. The qualitative data analysis was conducted to answer the following research questions: 1) what treatment decisions do family caregivers make while managing the symptoms of advanced dementia and 2) how do these treatment decisions influence the quality of patient life? To validate the results, the author asked each participating family caregiver if the summarized findings accurately captured his/her experiences. The identified medical decisions ranged from seeking specialist medical care to end-of-life care. The most common decisions were related to arranging medical appointments, medication management, seeking treatments for pain and other symptoms, nursing home placement, and accessing community-based healthcare services. The most challenging and consequential decisions were related to the management of acute complications, hospitalizations, and discontinuation of treatments. Decisions that had the greatest impact on the quality of patient life and survival were triggered by traumatic falls, worsening psychiatric symptoms, and aspiration pneumonia. The study findings have important implications for geriatric nurses in the context of patient/caregiver-centered dementia care. Innovative nursing approaches are needed to support family caregivers to effectively manage medical care needs of patients with advanced dementia.

Keywords: advanced dementia, family caregiver, medical decision-making, symptom management

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1081 “Human Trafficking In Your Backyard: Know The Signs And How To Help”

Authors: Jessie Fazel, Kristen Smith

Abstract:

Human trafficking is a multi-billion-dollar criminal industry that affects 24.9 million people around the world. There are several different types of trafficking, the most common being sex trafficking, labor trafficking, and domestic servitude. Survival sex is common in the pediatric population, as they engage in sex for food, a place to sleep, or other basic needs. Statistics show that health care workers are at a unique advantage to help identify victims and get them the help they need, as 88% of trafficked victims encounter a health care worker while being trafficked. Unfortunately, victims don’t usually self-identify that they are being trafficked and the situations they face can vary dramatically. It is imperative to remember that traditional red flags are not always present in the pediatric population. Risk factors and red flags with their history and physical exam are one of the best indicators that health care providers need to be vigilant in looking at. There are numerous barriers for disclosure in the healthcare setting. Periods of time before and after disclosure are often emotionally difficult and could be dangerous for the victim. It is extremely important to have a plan in place for intervention if the victim does disclose trafficking. A trauma informed approach to medical and mental health interventions, that focus on safety, are vital in this population. This is happening where you live and you can make a difference in their lives.

Keywords: human trafficking, public health, emergency medicine, sexual health

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1080 Integrating AI into Breast Cancer Diagnosis: Aligning Perspectives for Effective Clinical Practice

Authors: Mehrnaz Mostafavi, Mahtab Shabani, Alireza Azani, Fatemeh Ghafari

Abstract:

Artificial intelligence (AI) can transform breast cancer diagnosis and therapy by providing sophisticated solutions for screening, imaging interpretation, histopathological analysis, and treatment planning. This literature review digs into the many uses of AI in breast cancer treatment, highlighting the need for collaboration between AI scientists and healthcare practitioners. It emphasizes advances in AI-driven breast imaging interpretation, such as computer-aided detection and diagnosis (CADe/CADx) systems and deep learning algorithms. These have shown significant potential for improving diagnostic accuracy and lowering radiologists' workloads. Furthermore, AI approaches such as deep learning have been used in histopathological research to accurately predict hormone receptor status and categorize tumor-associated stroma from regular H&E stains. These AI-powered approaches simplify diagnostic procedures while providing insights into tumor biology and prognosis. As AI becomes more embedded in breast cancer care, it is crucial to ensure its ethical, efficient, and patient-focused implementation to improve outcomes for breast cancer patients ultimately.

Keywords: breast cancer, artificial intelligence, cancer diagnosis, clinical practice

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1079 Global Indicators of Successful Remote Monitoring Adoption Applying Diffusion of Innovation Theory

Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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1078 Facilitating Primary Care Practitioners to Improve Outcomes for People With Oropharyngeal Dysphagia Living in the Community: An Ongoing Realist Review

Authors: Caroline Smith, Professor Debi Bhattacharya, Sion Scott

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Introduction: Oropharyngeal Dysphagia (OD) effects around 15% of older people, however it is often unrecognised and under diagnosed until they are hospitalised. There is a need for primary care healthcare practitioners (HCPs) to assume a proactive role in identifying and managing OD to prevent adverse outcomes such as aspiration pneumonia. Understanding the determinants of primary care HCPs undertaking this new behaviour provides the intervention targets for addressing. This realist review, underpinned by the Theoretical Domains Framework (TDF), aims to synthesise relevant literature and develop programme theories to understand what interventions work, how they work and under what circumstances to facilitate HCPs to prevent harm from OD. Combining realist methodology with behavioural science will permit conceptualisation of intervention components as theoretical behavioural constructs, thus informing the design of a future behaviour change intervention. Furthermore, through the TDF’s linkage to a taxonomy of behaviour change techniques, we will identify corresponding behaviour change techniques to include in this intervention. Methods & analysis: We are following the five steps for undertaking a realist review: 1) clarify the scope 2) Literature search 3) appraise and extract data 4) evidence synthesis 5) evaluation. We have searched Medline, Google scholar, PubMed, EMBASE, CINAHL, AMED, Scopus and PsycINFO databases. We are obtaining additional evidence through grey literature, snowball sampling, lateral searching and consulting the stakeholder group. Literature is being screened, evaluated and synthesised in Excel and Nvivo. We will appraise evidence in relation to its relevance and rigour. Data will be extracted and synthesised according to its relation to Initial programme theories (IPTs). IPTs were constructed after the preliminary literature search, informed by the TDF and with input from a stakeholder group of patient and public involvement advisors, general practitioners, speech and language therapists, geriatricians and pharmacists. We will follow the Realist and Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) quality and publication standards to report study results. Results: In this ongoing review our search has identified 1417 manuscripts with approximately 20% progressing to full text screening. We inductively generated 10 IPTs that hypothesise practitioners require: the knowledge to spot the signs and symptoms of OD; the skills to provide initial advice and support; and access to resources in their working environment to support them conducting these new behaviours. We mapped the 10 IPTs to 8 TDF domains and then generated a further 12 IPTs deductively using domain definitions to fulfil the remaining 6 TDF domains. Deductively generated IPTs broadened our thinking to consider domains such as ‘Emotion,’ ‘Optimism’ and ‘Social Influence’, e.g. If practitioners perceive that patients, carers and relatives expect initial advice and support, then they will be more likely to provide this, because they will feel obligated to do so. After prioritisation with stakeholders using a modified nominal group technique approach, a maximum of 10 IPTs will progress to test against the literature.

Keywords: behaviour change, deglutition disorders, primary healthcare, realist review

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1077 Need for Privacy in the Technological Era: An Analysis in the Indian Perspective

Authors: Amrashaa Singh

Abstract:

In the digital age and the large cyberspace, Data Protection and Privacy have become major issues in this technological era. There was a time when social media and online shopping websites were treated as a blessing for the people. But now the tables have turned, and the people have started to look at them with suspicion. They are getting aware of the privacy implications, and they do not feel as safe as they used to initially. When Edward Snowden informed the world about the snooping United States Security Agencies had been doing, that is when the picture became clear for the people. After the Cambridge Analytica case where the data of Facebook users were stored without their consent, the doubts arose in the minds of people about how safe they actually are. In India, the case of spyware Pegasus also raised a lot of concerns. It was used to snoop on a lot of human right activists and lawyers and the company which invented the spyware claims that it only sells it to the government. The paper will be dealing with the privacy concerns in the Indian perspective with an analytical methodology. The Supreme Court here had recently declared a right to privacy a Fundamental Right under Article 21 of the Constitution of India. Further, the Government is also working on the Data Protection Bill. The point to note is that India is still a developing country, and with the bill, the government aims at data localization. But there are doubts in the minds of many people that the Government would actually be snooping on the data of the individuals. It looks more like an attempt to curb dissenters ‘lawfully’. The focus of the paper would be on these issues in India in light of the European Union (EU) General Data Protection Regulation (GDPR). The Indian Data Protection Bill is also said to be loosely based on EU GDPR. But how helpful would these laws actually be is another concern since the economic and social conditions in both countries are very different? The paper aims at discussing these concerns, how good or bad is the intention of the government behind the bill, and how the nations can act together and draft common regulations so that there is some uniformity in the laws and their application.

Keywords: Article 21, data protection, dissent, fundamental right, India, privacy

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1076 Storm-water Management for Greenfield Area Using Low Impact Development Concept for Town Planning Scheme Mechanism

Authors: Sahil Patel

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Increasing urbanization leads to a concrete forest. The effects of new development practices occur in the natural hydrologic cycle. Here the concerns have been raised about the groundwater recharge in sufficient quantity. With further development, porous surfaces reduce rapidly. A city like Ahmedabad, with a non-perennial river, is 100% dependent on groundwater. The Ahmedabad city receives its domestic use water from the Narmada river, located about 200 km away. The expenses to bring water is much higher. Ahmedabad city receives annually 800 mm rainfall, and mostly this water increases the local level waterlogging problems; after that, water goes to the Sabarmati river and merges into the sea. The existing developed area of Ahmedabad city is very dense, and does not offer many chances to change the built form and increase porous surfaces to absorb storm-water. Therefore, there is a need to plan upcoming areas with more effective solutions to manage storm-water. This paper is focusing on the management of stormwater for new development by retaining natural hydrology. The Low Impact Development (LID) concept is used to manage storm-water efficiently. Ahmedabad city has a tool called the “Town Planning Scheme,” which helps the local body drive new development by land pooling mechanism. This paper gives a detailed analysis of the selected area (proposed Town Planning Scheme area by the local authority) in Ahmedabad. Here the development control regulations for individual developers and some physical elements for public places are presented to manage storm-water. There is a different solution for the Town Planning scheme than that of the conventional way. A local authority can use it for any area, but it can be site-specific. In the end, there are benefits to locals with some financial analysis and comparisons.

Keywords: water management, green field development, low impact development, town planning scheme

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