Search results for: cross-sectoral collaboration in health care

Authors: Hind Mohammed A. Asiri, Asia Mohammed Asiri, Hana Falah Alruwaili, Joseph Almazan

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With the rapid growth of the older adult population, an underlying growth of public health concern is also seen. Various technologies were developed to help mitigate the arising problems of older adults with cognitive impairment and the improvement of their cognitive functions. This scooping review used the Joanna Briggs Institute (JBI) and the PRISMA extension for scoping reviews. The eligibility criteria were defined using the Population, Concept, Context (PCC) framework, as described in the JBI’s Reviewers Manual (Peters et al.,2020). The population of interest for this review is older adults 65 years old or older. Studies involving monitoring technology devices utilized in caring with older adult with cognitive impairment. This scoping review has shown information that researchers are more focused on creating alternative and novel methods or technological devices and use these as a tool for designing interventions depending on the data of the patient. This study has shown the type of technologies that have been explored in terms of assessing, detecting, monitoring, and interventions for cognitive impairment. Thus, there is a need for this technology to be applied in the practical field to further strengthen the evidence that it could enhance the lives of older adults.

Keywords: technology devices, cognitive impairment, older adult, nursing care, caring

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Authors: Christian Louis Kühner, Florian Pfeffel, Valentin Nickolai

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Taking care of children, dependents, or pets can be a difficult and time-consuming task. Especially for part- and full-time employees, it can feel exhausting and overwhelming to meet these obligations besides working a job. Thus, working mostly at home and not having to drive to the company can save valuable time and stress. This study aims to show the influence that the working model has on the job satisfaction of employees with care responsibilities in comparison to employees who do not have such obligations. Using structural equation modeling (SEM), the three work models, “work from home”, “working remotely”, and a hybrid model, have been analyzed based on 13 influencing constructs on job satisfaction. These 13 factors have been further summarized into three groups “classic influencing factors”, “influencing factors changed by remote working”, and “new remote working influencing factors”. Based on the influencing factors on job satisfaction, an online survey was conducted with n = 684 employees from the service sector. Here, Cronbach’s alpha of the individual constructs was shown to be suitable. Furthermore, the construct validity of the constructs was confirmed by face validity, content validity, convergent validity (AVE > 0.5: CR > 0.7), and discriminant validity. In addition, confirmatory factor analysis (CFA) confirmed the model fit for the investigated sample (CMIN/DF: 2.567; CFI: 0.927; RMSEA: 0.048). The SEM-analysis has shown that the most significant influencing factor on job satisfaction is “identification with the work” with β = 0.540, followed by “Appreciation” (β = 0.151), “Compensation” (β = 0.124), “Work-Life-Balance” (β = 0.116), and “Communication and Exchange of Information” (β = 0.105). While the significance of each factor can vary depending on the work model, the SEM-analysis shows that the identification with the work is the most significant factor in all three work models and, in the case of the traditional office work model, it is the only significant influencing factor. The study shows that among the employees with care responsibilities, the higher the proportion of working from home in comparison to working from the office, the more satisfied the employees are with their job. Since the work models that meet the requirements of comprehensive care led to higher job satisfaction amongst employees with such obligations, adapting as a company to such private obligations by employees can be crucial to sustained success. Conversely, the satisfaction level of the working model where employees work at the office is higher for workers without caregiving responsibilities.

Keywords: care responsibilities, home office, job satisfaction, structural equation modeling

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: A. F. G. Van Woezik, L. M. A. Braakman-Jansen, O. A. Kulyk, J. E. W. C. Van Gemert-Pijnen

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Background: Zoonoses pose a serious threat to public health and economies worldwide, especially as antimicrobial resistance grows and newly emerging zoonoses can cause unpredictable outbreaks. In order to prevent and control emerging and re-emerging zoonoses, collaboration between veterinary, human health and public health domains is essential. In reality however, there is a lack of cooperation between these three disciplines and uncertainties exist about their tasks and responsibilities. The objective of this ongoing research project (ZonMw funded, 2014-2018) is to develop an online education and communication One Health platform, “eZoon”, for the general public and professionals working in veterinary, human health and public health domains to support the risk communication of non-alimentary zoonoses in the Netherlands. The main focus is on education and communication in times of outbreak as well as in daily non-outbreak situations. Methods: A participatory development approach was used in which stakeholders from veterinary, human health and public health domains participated. Key stakeholders were identified using business modeling techniques previously used for the design and implementation of antibiotic stewardship interventions and consisted of a literature scan, expert recommendations, and snowball sampling. We used a stakeholder salience approach to rank stakeholders according to their power, legitimacy, and urgency. Semi-structured interviews were conducted with stakeholders (N=20) from all three disciplines to identify current problems in risk communication and stakeholder values for the One Health platform. Interviews were transcribed verbatim and coded inductively by two researchers. Results: The following key values were identified (but were not limited to): (a) need for improved awareness of veterinary and human health of each other’s fields, (b) information exchange between veterinary and human health, in particularly at a regional level; (c) legal regulations need to match with daily practice; (d) professionals and general public need to be addressed separately using tailored language and information; (e) information needs to be of value to professionals (relevant, important, accurate, and have financial or other important consequences if ignored) in order to be picked up; and (f) need for accurate information from trustworthy, centrally organised sources to inform the general public. Conclusion: By applying a participatory development approach, we gained insights from multiple perspectives into the main problems of current risk communication strategies in the Netherlands and stakeholder values. Next, we will continue the iterative development of the One Health platform by presenting key values to stakeholders for validation and ranking, which will guide further development. We will develop a communication platform with a serious game in which professionals at the regional level will be trained in shared decision making in time-critical outbreak situations, a smart Question & Answer (Q&A) system for the general public tailored towards different user profiles, and social media to inform the general public adequately during outbreaks.

Keywords: ehealth, one health, risk communication, stakeholder, zoonosis

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Authors: Shawna Staud, Mary Kaye Scaramucci

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Objective: Rubber cup polishing has been a traditional method of preventative therapy in dental hygiene treatment. Newer methods such as air polishing have changed the way dental hygiene care is provided, yet this technique has not been embraced by students in the program nor by practitioners in the workforce. Students entering the workforce tend to follow office protocol and are limited in confidence to introduce technologies learned in the curriculum. This project was designed to help students gain confidence in newer skills and encourage private practice settings to adopt newer technologies for patient care. Our program recently introduced air polishing earlier in the program before the rubber cup technique to determine if students would embrace the technology to become leading-edge professionals when they enter the marketplace. Methods: The class of 2022 was taught the traditional method of polishing in the first-year curriculum and air polishing in the second-year curriculum. The class of 2023 will be taught the air polishing method in the first-year curriculum and the traditional method of polishing in the second-year curriculum. Pre- and post-graduation survey data will be collected from both cohorts. Descriptive statistics and pre and post-paired t-tests with alpha set at .05 to compare pre and post-survey results will be used to assess data. Results: This study is currently in progress, with a completion date of October 2023. The class of 2022 completed the pre-graduation survey in the spring of 2022. The post-gradation survey will be sent out in October 2022. The class of 2023 cohort will be surveyed in the spring of 2023 and October 2023. Conclusion: Our hypothesis is students who are taught air polishing first will be more inclined to adopt that skill in private practice, thereby embracing newer technology and improving oral health care.

Keywords: luggage handling system at world’s largest pilgrimage center

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Authors: Muhammad Anwar

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The prime objective of the study is to investigate the research productivity of the PAKISTAN STUDIES Bilingual / Bi-annual Pakistan Studies, English / Urdu Research Journal from 2015 to 2020. The present study also finds the frequency of publications, author contributions; paper length, references and most productive authors and degree of collaboration also have been checked. The current study finds 271 research articles have been contributed by faculty members of university of Balochistan, Quetta. The highest number of papers has been published 75(27.67%) in 2020 and 59(21.77%) papers were published in 2019. The current study finds the vol.10 and vol.11 were Contributed 36(13.28%) and 45(16.00%) research articles respectively. This present study recognizes those 179(66.05%) two authors and 62(22.87%) authors were counted in three. The results revealed the degree of collaboration was 0.97. The study further discloses the length of the paper where the majority of the 122(45.07%) papers were range of 11-15 and 73(26.93%) articles were range of 6-10. The utmost prolfic author was Dr.Noor Ahmed from the Pakistan study center with 15 papers ranked 1st and Dr.Kaleem Bareach contributed 14 articles ranked 2nd.

Keywords: research, bibliometric, bilingual, bi-annual, Pakistan, university, Balochistan

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Authors: Sharlene Fernandes

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Literature has shed light on the challenges of mothers of children with ASD, one of which involves sacrificing their professional jobs to fulfill the demands of their caregiving roles. However, the voices of the mothers who pursue employment along with caregiving roles have been overlooked. This study aimed to address this issue by exploring the narratives of Employed Mothers of Children with Autism Spectrum Disorder using the Narrative approach to inquiry. Through the view of Feminist Standpoint Theory, this study attempted to understand the role of sociocultural and systemic factors in shaping the lives of mothers. By employing the theoretical lens of Ethics of Care, this study explored how mothers balance care with their employment responsibilities, which are expected to be balanced seamlessly. Through narrative interviews, the study addressed the mothers' narratives on navigating work and caregiving, delving into their interpretations regarding expectations of care. The study gained valuable insights into the nuanced dynamics of employment, caregiving, and gender roles among mothers of children with Autism in the Indian context, implicating the urgent need for organizational policies, enhanced support systems, better quality therapeutic services, and inclusive school developments.

Keywords: Autism Spectrum Disorder, Caregivers, Employed Mothers, India, Narratives

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Authors: Alexander Street, Nina Wollersberger, Paul Fernie, Leonardo Muller, Ming Hung HSU, Helen Odell-Miller, Jorg Fachner, Patrizia Di Campli San Vito, Stephen Brewster, Hari Shaji, Satvik Venkatesh, Paolo Itaborai, Nicolas Farina, Alexis Kirke, Sube Banerjee, Eduardo Reck Miranda

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Escalating neuropsychiatric symptoms (NPS) in people with dementia may lead to earlier care home admission. Music listening has been reported to stimulate cognitive function, potentially reducing agitation in this population. We present a scoping review, reporting on current developments and discussing the potential for music listening with related technology in managing agitation in dementia care. Of two searches for music listening studies, one focused on older people or people living with dementia where music listening interventions, including technology, were delivered in participants’ homes or in institutions to address neuropsychiatric symptoms, quality of life and independence. The second included any population focusing on the use of music technology for health and wellbeing. In search one 70/251 full texts were included. The majority reported either statistical significance (6, 8.5%), significance (17, 24.2%) or improvements (26, 37.1%). Agitation was specifically reported in 36 (51.4%). The second search included 51/99 full texts, reporting improvement (28, 54.9%), significance (11, 21.5%), statistical significance (1, 1.9%) and no difference compared to the control (6, 11.7%). The majority in the first focused on mood and agitation, and the second on mood and psychophysiological responses. Five studies used AI or machine learning systems to select music, all involving healthy controls and reporting benefits. Most studies in both reviews were not conducted in a home environment (review 1 = 12; 17.1%; review 2 = 11; 21.5%). Preferred music listening may help manage NPS in the care home settings. Based on these and other data extracted in the review, a reasonable progression would be to co-design and test music listening systems and protocols for NPS in all settings, including people’s homes. Machine learning and automated technology for music selection and arousal adjustment, driven by live biodata, have not been explored in dementia care. Such approaches may help deliver the right music at the appropriate time in the required dosage, reducing the use of medication and improving quality of life.

Keywords: music listening, dementia, agitation, scoping review, technology

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: M. R. Akshaya, Veena Rao

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Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: behavioral response, design parameters, dog boarding centers, interior environment

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Authors: Austin Oduor Otieno

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There is an ingrained belief that the use of performance-enhancing drugs by athletes enable them to perform better. While this has been found to be truth, it also raises ethical and health issues. This paper analyzes the health hazards associated with performance enhancing drugs. It seeks to achieve this through the analysis of different academic journals as well as publications on the relationship between doping in sports and health. It concludes that there are inherent health hazards associated with the use of performance-enhancing drugs as they affect the physical and psychological health and wellbeing of a user (athlete).

Keywords: doping, health hazards, athletes, drugs

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Authors: Ghadeer Mohammad Said El-Sheikh, Samer Mohamad Shalhoob

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Medical equipment operation state is a valid reflection of health care organizations' performance, where such equipment highly contributes to the quality of healthcare services on several levels in which quality improvement has become an intrinsic part of the discourse and activities of health care services. In healthcare organizations, clinical and biomedical engineering departments play an essential role in maintaining the safety and efficiency of such equipment. One of the most challenging topics when it comes to such sophisticated equipment is the lifespan of medical equipment, where many factors will impact such characteristics of medical equipment through its life cycle. So far, many attempts have been made in order to address this issue where most of the approaches are kind of arbitrary approaches and one of the criticisms of existing approaches trying to estimate and understand the lifetime of a medical equipment lies under the inquiry of what are the environmental factors that can play into such a critical characteristic of a medical equipment. In an attempt to address this shortcoming, the purpose of our study rises where in addition to the standard technical factors taken into consideration through the decision-making process by a clinical engineer in case of medical equipment failure, the dimension of environmental factors shall be added. The investigations, researches and studies applied for the purpose of supporting the decision making process by a clinical engineers and assessing the lifespan of healthcare equipment’s in the Lebanese society was highly dependent on the identification of technical criteria’s that impacts the lifespan of a medical equipment where the affecting environmental factors didn’t receive the proper attention. The objective of our study is based on the need for introducing a new well-designed plan for evaluating medical equipment depending on two dimensions. According to this approach, the equipment that should be replaced or repaired will be classified based on a systematic method taking into account two essential criteria; the standard identified technical criteria and the added environmental criteria.

Keywords: technical, environmental, healthcare, characteristic of medical equipment

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Authors: Utsamani Cintyamena, Sandra Frans Olivia, Shita Lisyadewi, Ariane Utomo

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Family planning is one of fundamental aspects in preventing maternal morbidity and mortality. However, the prevalence rate of Indonesia’s married women in choosing contraception is low. This study purpose to assess opportunities and challenges in family planning. Methodology: We conducted a qualitative study in Banyumas District which has huge reduction of maternal mortality rate from 2013 to 2015. Four focus group discussions and four small group discussions were conducted to assess knowledge and attitude of women in using contraceptive and their method of choice, as well as in-depth interview to four health workers and two family planning field officers as triangulation. Thematic content analysis was done manually. Results: Key themes emerge across interviews including (1) first choice of contraception is the one that they previously had, provided that they did not encountered problems with it, (2) rumor and fear of side effect affected their method of choice, (3) selection of contraceptive method was influenced by approval of husband, believes, and role model in community. Conclusion: Collaboration of health worker, family planning field officers, community, as well as support from stakeholder, must be increased to socializing family planning.

Keywords: attitude, challenge, chance, family planning, knowledge

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Authors: Eduardo Costa

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Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent, raising concerns in what respects patient safety. In fact, data shows that mortality rates for patients admitted during strikes are up to 30% higher than for patients admitted in other days. This paper analyses the effects of hospital strikes on patients’ outcomes. Specifically, it analyzes the impact of different strikes (physicians, nurses and other health professionals), on in-hospital mortality rates, readmission rates and length of stay. The paper uses patient-level data containing all NHS hospital admissions in mainland Portugal from 2012 to 2017, together with a comprehensive strike dataset comprising over 250 strike days (19 physicians-strike days, 150 nurses-strike days and 50 other health professionals-strike days) from 135 different strikes. The paper uses a linear probability model and controls for hospital and regional characteristics, time trends, and changes in patients’ composition and diagnoses. Preliminary results suggest a 6-7% increase in in-hospital mortality rates for patients exposed to physicians’ strikes. The effect is smaller for patients exposed to nurses’ strikes (2-5%). Patients exposed to nurses strikes during their stay have, on average, higher 30-days urgent readmission rates (4%). Length of stay also seems to increase for patients exposed to any strike. Results – conditional on further testing, namely on non-linear models - suggest that hospital operations and service levels are partially disrupted during strikes.

Keywords: health sector strikes, in-hospital mortality rate, length of stay, readmission rate

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Authors: Caterina Grandi, Lukas Lochner, Marco Padovan, Mirco Rizzi, Paola Sperinde, Fabio Vittadello, Luisa Cavada

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Background: In recent years, the use of Complementary Alternative Medicine (CAM) has achieved worldwide popularity. With the increased public interest in CAMs, attention to it within Health Care Schools and Colleges has also improved. Studies generally assess the knowledge and attitudes regarding CAMs in medical and nursing students. The current study focused on the knowledge, attitudes and practice of CAM in healthcare students. Aim: To assess the knowledge and attitudes regarding complementary and alternative medicine (CAM) in healthcare students in South Tyrol, a region in Northern Italy. Methodology: This cross-sectional study was carried out among 361 students. Self-administered questionnaire was adapted and modified by the researchers from several questionnaires. The instrument consisted of three sections: 1) demographical characteristics (gender, place of residence and year of study); 2) general attitudes towards CAM, evaluated through 11 items using a Likert scale (agree, partly agree, partly disagree, disagree); 3) knowledge and use about any particular CAM practices (acupuncture, aromatherapy, creative therapies, diet/nutritional therapies, phytotherapy/herbal therapies, compresses, massage therapy, Ayurvedic therapy, Tibetan medicine, naturopathy, homeopathy, pet therapy, reflexology, therapeutic touch, chiropractic/osteopathy). Results: The sample consisted of 63 males and 297 females, 58% living in villages. 151 students (42%) were in the first year, 99 (27%) in the second and 106 (30%) in the third. Both men and women agreed with statements about the utility and benefits of CAMs. Women were significantly more likely than men to agree that the CAM practices should be included in the curriculum (p < 0.004), that the health professionals should be able to advice their patients about commonly used CAM methods (p < 0.002) and that the clinical care should integrate CAM practices (p < 0.04). Students in the second year showed the highest mean score for the statement 'CAM includes ideas and methods from which conventional medicine could benefit' (p = 0.049), highlighting a positive attitude, while students in the third year achieved the lowest mean score for the negative statement 'The results of CAM are in most cases due to a placebo effect'. Regarding this statement, participants living in villages disagreed significantly than students living in the city (p < 0.001). Females appeared to be significantly more familiar with homeopathy (p < 0.002), aromatherapy (p < 0.033), creative therapies (p < 0.001) and herbal therapies (p<0.002) than males. Moreover, women were likely to use CAM more frequently than men, particularly to solve psychological problems (p < 0.004). In addition, women perceived the benefit significantly more positive than men (p < 0.001). Students in the second year revealed to use the CAM mostly to improve the quality of life (p < 0.023), while students in the third year used CAMs particularly for chronic diseases (p < 0.001). Conclusions: Results from this study suggested that female students show more positive attitudes on CAM than male students. Moreover, the prevalence of CAM use and its perceived benefits differ between males and females, so that women are more willing to use CAM practices.

Keywords: attitude, CAM, complementary and alternative medicine, healthcare students, knowledge

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Authors: Mohammad Ranjbar, Mohammad Bazyar, Blake Angell, Thomas Lung, Yibeltal Assefa

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Background: Current health insurance programs in Iran suffer from low enrolment and are not sufficient to attain the country to universal health coverage (UHC). We hypothesize that improving the enrollment rate and moving towards a more sustainable UHC can be achieved by improving the benefits package and providing new incentives. The objective of this study is to assess public preferences and willingness to pay (WTP) for social health insurance (SHI) in Iran. Methods: A discrete choice experiment (DCE) was conducted in 2021, using a self-administered questionnaire on 500 participants to estimate WTP and determine individual preferences for the SHI in Yazd, Iran. Respondents were presented with an eight-choice set and asked to select their preferred one. In each choice set, scenarios were described by eight attributes with varying levels. The conditional logit regression model was used to analyze the participants' preferences. Willingness to pay for each attribute was also calculated. Results: Most included attributes were significant predictors of the choice of a health insurance package. The maximum coverage of hospitalization costs in the private sector, ancillary services such as glasses, canes, etc., as well as coverage for hospitalization costs in the public sector and drug costs, were the most important determining factors for this choice. Coverage of preventive dental care did not significantly influence respondent choices. Estimating WTP showed that individuals are willing to pay more for higher financial protection, particularly against private sector costs; the WTP to increase the coverage of hospitalization costs in the private sector from 50% to 90% is estimated at 362,068 IR, Rials per month. Conclusion: This study identifies the key factors that the population value with regard to health insurance and the tradeoffs they are willing to make between them. Hospitalization, drugs, and ancillary services were the most important determining factors for their choice. The data suggest that additional resources coming into the Iranian health system might best be prioritized to cover hospitalization and drug costs and those associated with ancillary services.

Keywords: social health insurance, preferences, discrete choice experiment, willingness to pay

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Authors: Makkia Ahmad Ali Al-Falahi, Abdullah Abdelaziz Muharram

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Background: Healthcare workers (HCWs) in Yemen are exposed to a myriad of occupational health hazards, including biological, physical, ergonomic, chemical and psychosocial hazards. HCWs operate in an environment that is considered to be one of the most hazardous occupational settings. Objective: To assess the prevalence of occupational health hazards among healthcare workers and associated risk factors in public hospitals in Sana'a City, Yemen. Method: Descriptive cross-sectional design was utilized; out of 5443 totals of HCWs 396 were selected by multistage sampling technique was carried out in the public hospitals in Sana'a city, Yemen. Results: More the half (60.6%) of HCWs aged between 20-30 years, (50.8%) were males, (56.3%) were married, and (45.5%) had a diploma qualification, while (65.2%) of HCWs had less than 6 years of experience. The result showed that the highest prevalence of occupational hazards was (99%), (ergonomic hazards (93.4%), biological hazards (87.6%), psychosocial (86.65%), physical hazards (83.3%), and chemical hazards (73.5%). There were no statistically significant differences between demographic characteristics and the prevalence of occupational hazards (p >0.05). Conclusion and recommendations: The study showed the highest prevalence of occupational hazards; regarding the prevalence of biological hazards exposure to sharp-related injury, the most prevalent physical hazards were slip/trip/and fall. Ergonomic hazards had back or neck pain during work. Chemical hazards were allergic to medical gloves powder. On psychosocial hazards was suffered from verbal and physical harassment. The study concluded by raising awareness among HCWs by conducting training courses to prevent occupational hazards.

Keywords: health workers, occupational hazards, risk factors, the prevalence

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Authors: Erin C. Rodenburg, Jennifer McWhirter, Andrew Papadopoulos

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Support workers for adults with developmental disabilities promote the care and wellbeing of a historically underserved population. Poor employment training and low work satisfaction for these disability support workers are linked to low productivity, poor quality of care, turnover, and intention to leave employment. Therefore, to improve the lives of those within disability support homes, both client and caregiver, it is vital to determine where improvements to training and support for those providing direct care can be made. The current study aims to explore disability support worker’s perceptions of the training received in their employment at the residential homes, how it prepared them for their role, and where there is room for improvement with the aim of developing recommendations for an improved training experience. Responses were collected from 85 disability support workers across 40 Ontario group homes. Findings suggest most disability support workers within the 40 support homes feel adequately trained in their responsibilities of employment. For those who did not feel adequately trained, the main issues expressed were a lack of standardization in training, a need for more continuous training, and a move away from trial and error in performing tasks to support clients with developmental disabilities.

Keywords: developmental disabilities, disability workers, support homes, training

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Authors: Priya Nambisan, Lien B. Nguyen

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Women participate extensively in the healthcare field, professionally (as physicians, nurses, dietitians, etc.) as well as informally (as caregivers at home). This provides them with a better understanding of the health needs of people. Women are also in the forefront of using social media and other mobile health related apps. Further, many health mobile apps are specifically designed for women users. All of these indicate the potential for women to be successful entrepreneurs in healthcare, especially, in the area of mobile health app development. However, extant research in entrepreneurship has paid limited attention to women entrepreneurship in healthcare. The objective of this study is to determine the key factors that shape the intentions and actions of women entrepreneurs with regard to their entrepreneurial pursuits in the healthcare field. Specifically, the study advances several hypotheses that relate key variables such as personal skills and capabilities, experience, support from institutions and family, and perceptions regarding entrepreneurship to individual intentions and actions regarding entrepreneurship (specifically, in the area of mobile apps). The study research model will be validated using survey data collected from potential women entrepreneurs in the healthcare field – students in the area of health informatics and engineering. The questionnaire-based survey relates to woman respondents’ intention to become entrepreneurs in healthcare and the key factors (independent variables) that may facilitate or inhibit their entrepreneurial intentions and pursuits. The survey data collection is currently ongoing. We also plan to conduct semi-structured interviews with around 10-15 women entrepreneurs who are currently developing mobile apps to understand the key issues and challenges that they face in this area. This is an exploratory study and as such our goal is to combine the findings from the regression analysis of the survey data and that from the content analysis of the interview data to inform on future research on women entrepreneurship in healthcare. The study findings will hold important policy implications, specifically for the development of new programs and initiatives to promote women entrepreneurship, particularly in healthcare and technology areas.

Keywords: women entrepreneurship, healthcare, mobile apps, health apps

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Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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Authors: Metrek Almetrek, Naser Alqahtani, Eisa Ghazwani, Mona Asiri, Mohammed Alqahtani, Magboolah Balobaid

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Background: Advocacy of potential for community coalitions to positively address social determinants of health and quality of life, little is known about the views of stakeholders involved in such efforts. This study sought to assess the provinces leaders’ perspectives about social determinants related to the Health Neighborhood Initiative (HNI), a new county effort to support community coalitions. Method and Subjects: We used a descriptive, qualitative study using personal interviews in 2022. We conducted it in the community coalition's “main cities committees” set across service planning areas that serve vulnerable groups located in the seven registered healthy cities to WHO (Abha, Tareeb, Muhayel, Balqarn, Alharajah, Alamwah, and Bisha). We conducted key informant interviews with 76 governmental, profit, non-profit, and community leaders to understand their perspectives about the HNI. As part of a larger project, this study focused on leaders’ views about social determinants of health related to the HNI. All interviews were audio-recorded and transcribed. An inductive approach to coding was used, with text segments grouped by social determinant categories. Results: Provinces leaders described multiple social determinants of health and quality of life that were relevant to the HNI community coalitions: housing and safety, community violence, economic stability, city services coordination and employment and education. Leaders discussed how social determinants were interconnected with each other and the need for efforts to address multiple social determinants simultaneously to effectively improve health and quality of life. Conclusions: Community coalitions have an opportunity to address multiple social determinants of health and quality of life to meet the social needs of vulnerable groups. Future research should examine how community coalitions, like those in the HNI, can actively engage with community members to identify needs and then deliver evidence-based care.

Keywords: social determinants, health and quality of life, vulnerable groups, qualitative research

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Authors: Tris Kee

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As the urban design discipline develops renewed interests in participatory design and collaborative place-making, it becomes critical to review the potential and limitations in current processes to ensure a sustainable method for future development.This paper explores how collaborative design can be a key to future sustainable urban development through two case studies from Asia.The process involves a multi-disciplinary collaboration and an innovative learning process by sharing ideas as well as careful consideration on social, economic and political circumstances among government and district stakeholders.This intrinsic proposition of innovative participatory planning implies interdisciplinary collaboration between professionals and local residents to integrate knowledge into new urban place-making thinking.Design innovation in contemporary society can manifest itself in the discourse sustainable urban development by bottom-up planning and community driven design. This paper examines the emerging design pedagogy which promotes interdisciplinary coalition of professionals and local stakeholders in community development as an innovative design rubric to create a sustainable urban approach.Through two case studies in Hong Kong, this paper reviews and critically evaluates the process of how the notion of sustainable development in contemporary urban planning theory is underpinned by the collaborative design practice.

Keywords: collaborative design, design innovation, sustainable development, urban development

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Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

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Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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Authors: Zahid Ullah, Atlas Khan

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The rapid growth of data in diverse domains has created an urgent need for effective utilization of mathematical and statistical sciences in data analytics. This abstract explores the journey from theory to practice, emphasizing the importance of harnessing mathematical and statistical innovations to unlock the full potential of data analytics. Drawing on a comprehensive review of existing literature and research, this study investigates the fundamental theories and principles underpinning mathematical and statistical sciences in the context of data analytics. It delves into key mathematical concepts such as optimization, probability theory, statistical modeling, and machine learning algorithms, highlighting their significance in analyzing and extracting insights from complex datasets. Moreover, this abstract sheds light on the practical applications of mathematical and statistical sciences in real-world data analytics scenarios. Through case studies and examples, it showcases how mathematical and statistical innovations are being applied to tackle challenges in various fields such as finance, healthcare, marketing, and social sciences. These applications demonstrate the transformative power of mathematical and statistical sciences in data-driven decision-making. The abstract also emphasizes the importance of interdisciplinary collaboration, as it recognizes the synergy between mathematical and statistical sciences and other domains such as computer science, information technology, and domain-specific knowledge. Collaborative efforts enable the development of innovative methodologies and tools that bridge the gap between theory and practice, ultimately enhancing the effectiveness of data analytics. Furthermore, ethical considerations surrounding data analytics, including privacy, bias, and fairness, are addressed within the abstract. It underscores the need for responsible and transparent practices in data analytics, and highlights the role of mathematical and statistical sciences in ensuring ethical data handling and analysis. In conclusion, this abstract highlights the journey from theory to practice in harnessing mathematical and statistical sciences in data analytics. It showcases the practical applications of these sciences, the importance of interdisciplinary collaboration, and the need for ethical considerations. By bridging the gap between theory and practice, mathematical and statistical sciences contribute to unlocking the full potential of data analytics, empowering organizations and decision-makers with valuable insights for informed decision-making.

Keywords: data analytics, mathematical sciences, optimization, machine learning, interdisciplinary collaboration, practical applications

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Authors: Felipa De Mello-Sampayo

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Background: The aim of this study is to undertake, from a patient perspective, an economic analysis of presurgical teledermatology, comparing it with a conventional referral system. Store-and-forward teledermatology allows surgical planning, saving both time and number of visits involving travel, thereby reducing patients’ out-of-pocket expenses, i.e., costs that patients incur when traveling to and from health providers for treatment, visits’ fees, and the opportunity cost of time spent in visits. Method: Patients’ out-of-pocket expenses-effectiveness of presurgical teledermatology were analyzed in the setting of a public hospital during two years. The mean delay in surgery was used to measure effectiveness. The teledermatology network covering the area served by the Hospital Garcia da Horta (HGO), Portugal, linked the primary care centers of 24 health districts with the hospital’s dermatology department. The patients’ opportunity cost of visits, travel costs, and visits’ fee of each presurgical modality (teledermatology and conventional referral), the cost ratio between the most and least expensive alternative, and the incremental cost-effectiveness ratio were calculated from initial primary care visit until surgical intervention. Two groups of patients: those with squamous cell carcinoma and those with basal cell carcinoma were distinguished in order to compare the effectiveness according to the dermatoses. Results: From a patient perspective, the conventional system was 2.15 times more expensive than presurgical teledermatology. Teledermatology had an incremental out-of-pocket expenses-effectiveness ratio of €1.22 per patient and per day of delay avoided. This saving was greater in patients with squamous cell carcinoma than in patients with basal cell carcinoma. Conclusion: From a patient economic perspective, teledermatology used for presurgical planning and preparation is the dominant strategy in terms of out-of-pocket expenses-effectiveness than the conventional referral system, especially for patients with severe dermatoses.

Keywords: economic analysis, out-of-pocket expenses, opportunity cost, teledermatology, waiting time

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Authors: Pornwipa Daoduong, Jairak Loysongkroa, Napaphan Viriyautsahakul, Wachira Pengjuntr

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Obesity is on of serious health problem in many countries including Thailand where the prevalence of childhood obesity has increased from 8.8 % in 2014 to 9.5 % in 2015 and 12.9 % in 2016. The Ministry of Public Health’s objective is to reduce prevalence of childhood Obesity to 10% or lower in 2017, by implementing the measure in relation to nutrition, physical activity (PA) and environment in 6,405 targeted school with proportion of school children with obesity is higher than 10 %. Smart Kids Coacher (SKC)” is a new innovative intervention created by Department of Health and consists of 252 regional and provincial officers. The SKC aims to train the super trainers about food and nutrition.PA and emotional control through implementing three learning activities including 1) Food for Fun is about Nutrition flag, Nutrition label, food portion and Nutrition surveillance; 2) Fun for Fit includes intermediated- and advanced level workouts within 60 minutes such as kangaroo dance, Chair stretching; and 3) Control emotional is about to prevent probability of access to unhealthy food, to ensure for having meal in appropriate time, and to recruit peers and family member to increase awareness among target groups. Apart from providing SKC lesson for 3,828 officers at district level, a number of students (2,176) as role model are selected through implementing “Smart Kids Leader: (SKL)”.Consequently. The SKC lowers proportion of childhood obesity from 17% in 2012 to 12.9% in 2016. Further, the SKC coverage should be expanded to other setting. Policy maker should be aware of the important of reduction of the prevalence of childhood obesity, and it’s related risk. Network and Collaboration between stakeholders are essential as well as an improvement of holistic intervention and knowledge “NuPETHS” for kids in the future.

Keywords: childhood obesity, model, obesity, smart kids coacher

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Authors: Agbor Ekama Prisca Anne

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Current data on the prevalence and psychosocial correlates of sexual violence in the Cameroon is lacking, with the most recent sexual abuse and violence survey dating back to 2001. The current study sought to identify what proportion of University students have experienced sexual violence, if there are sex differences in exposure to different forms of sexual violence, and to what extent different forms of sexual violence are associated with adverse psychosocial outcomes. A nationally representative sample of University students (N = 1,020) completed self-report measures of history of sexual violence and mental health. Approximately one-in-three (34.4%) students experienced some form of sexual violence, including 14.8% who were sexually assaulted (raped) and 31.1% who were sexually harassed. Female students were significantly more likely than men to have experienced all forms of sexual violence (ps < .001), with the exception of sexual assault by teachers or guardian. All forms of sexual violence were associated with an increased likelihood of serious mental health problems, with sexual assault by a teacher associated with several other psychosocial outcomes in life, including education achievement, and behavior disorder. Sexual violence is a common experience in the general population and female students are disproportionately affected (1-in-2 girls versus 1-in-5 boys). Additional resources to increase mental health care among survivors of sexual violence is urgently needed.

Keywords: psychosocial, effects sexual, violence, females, students

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain

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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.

Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement

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