Search results for: healthcare regulations

Authors: Anasuya Ghosh, Subhramoy Chaudhury

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

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

Procedia PDF Downloads 325

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

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

Keywords: diabetes, fall, elderly, risk factors

Procedia PDF Downloads 105

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

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

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

Procedia PDF Downloads 142

Authors: Shinoy Vengaramkode Bhaskaran, Kaushik Sathupadi, Sandesh Achar

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Human locomotion recognition is important in a variety of sectors, such as robotics, security, healthcare, fitness tracking and cloud computing. With the increasing pervasiveness of peripheral devices, particularly Inertial Measurement Units (IMUs) sensors, researchers have attempted to exploit these advancements in order to precisely and efficiently identify and categorize human activities. This research paper introduces a state-of-the-art methodology for the recognition of human locomotion patterns in a cloud environment. The methodology is based on a publicly available benchmark dataset. The investigation implements a denoising and windowing strategy to deal with the unprocessed data. Next, feature extraction is adopted to abstract the main cues from the data. The SelectKBest strategy is used to abstract optimal features from the data. Furthermore, state-of-the-art ML classifiers are used to evaluate the performance of the system, including logistic regression, random forest, gradient boosting and SVM have been investigated to accomplish precise locomotion classification. Finally, a detailed comparative analysis of results is presented to reveal the performance of recognition models.

Keywords: artificial intelligence, cloud computing, IoT, human locomotion, gradient boosting, random forest, neural networks, body-worn sensors

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Authors: Anastasios Manos, Despina Elisabeth Filippidou

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Introduction: Historical buildings are an inte-gral part of the cultural heritage of every place, and beyond the obvious need for protection against risks, they have specific requirements regarding the handling of hazards and disasters such as fire, floods, earthquakes, etc. Ensuring high levels of protection and safety for these buildings is impera-tive for two distinct but interconnected reasons: a) they themselves constitute cultural heritage, and b) they are often used as museums/cultural spaces, necessitating the protection of both human life (vis-itors and workers) and the cultural treasures they house. However, these buildings present serious constraints in implementing the necessary measures to protect them from destruction due to their unique architecture, construction methods, and/or the structural materials used in the past, which have created an existing condition that is sometimes challenging to reshape and operate within the framework of modern regulations and protection measures. One of the most devastating risks that threaten historical buildings is fire. Catastrophic fires demonstrate the need for timely evaluation of fire safety measures in historical buildings. Recog-nizing the criticality of protecting historical build-ings from the risk of fire, the Confederation of Fire Protection Associations in Europe (CFPA E) issued specific guidelines in 2013 (CFPA-E Guideline No 30:2013 F) for the fire protection of historical buildings at the European level. However, until now, few actions have been implemented towards leveraging modern technologies in the field of con-struction and maintenance of buildings, such as Building Information Modeling (BIM) and the Inter-net of Things (IoT), for the protection of historical buildings from risks like fires, floods, etc. The pro-ject BIM4Cult has bee developed in order to fill this gap. It is a tool for timely assessing and monitoring of the fire safety level of historical buildings using BIM and IoT technologies in an integrated manner. The tool serves as a decision support expert system for improving the fire safety of historical buildings by continuously monitoring, controlling and as-sessing critical risk factors for fire.

Keywords: Iot, fire, BIM, expert system

Procedia PDF Downloads 71

Authors: Tomasz Kosicki

Abstract:

The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

Procedia PDF Downloads 86

Authors: Natsuda Rattamanee

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Like other countries, Thailand continually experiences strong protests against dam and reservoir proposals, especially large-scale projects. The protestors are constantly worried about the potential significant adverse impacts of the projects on the environment and society. Although project proponents are required by laws to assess the environmental and social impacts of the dam proposals by making environmental impact assessment (EIA) reports and finding mitigation measures before implementing the plans, the outcomes of the assessments often do not lessen the affected people and public’s concerns about the potential negative effects of the projects. One of the main reasons is that Thailand does not have a proper and efficient law to regulate project proponents when determining the scope of environmental impact assessments. Scoping is the crucial second stage of the preparation of an EIA report. The appropriate scope of assessments will allow EIA studies to focus only on the significant effects of the proposed project on particular resources, areas, and communities. It will offer crucial and sufficient information to the decision-makers and the public. The decision to implement the dam and reservoir projects considered based on the assessments with a proper scoping will eventually be more widely accepted by the public and reduce community opposition. The research work seeks to identify flaws in the current requirements of scoping steps under Thai laws and regulations and proposes recommendations to improve the legal scheme. The paper explores the well-established United States laws and relevant rules regulating how lead agencies determine the scope of their environmental impact assessments and some guidelines concerning scoping published by dominant institutions. Policymakers and legislature will find the results of studies helpful in improving the scoping-step requirements of EIA for dam and reservoir projects and reducing the level of anti-dam protests in Thailand.

Keywords: dam and reservoir, EIA, environmental impact assessment, law, scoping, Thailand

Procedia PDF Downloads 88

Authors: Mirza Mujtaba Baig

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

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

Procedia PDF Downloads 119

Authors: Ziwei Guo, Liangping Hong, Zhiguo Ye

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The exogenous modernization process in China and other late-coming countries, is not resulted from a gradual growth of their own modernity features, but a conscious response to external challenges. Under this context, it had been equally important for Chinese cities to make themselves ‘Chinese’ as well as ‘modern’. Wuhan was the first opened inland treaty port in late Qing Dynasty. In the following one hundred years, Wuhan transferred from a feudal town to a modern industrial city. It is a good example to illustrate the urban construction and cultural heritage through the process and impact of social transformation. An overall perspective on transformation will contribute to develop the city`s uniqueness and enhance its inclusive development. The study chooses the history of Wuhan from 1861 to 1957 as the study period. The whole transformation process will be divided into four typical periods based on key historical events, and the paper analyzes the changes on urban structure and constructions activities in each period. Then, a lot of examples are used to compare the features of Wuhan modern city heritage in the four periods. In this way, three characteristics of Wuhan modern city heritage are summarized. The paper finds that globalization and localization worked together to shape the urban physical space environment. For Wuhan, social transformation has a profound and comprehensive impact on urban construction, which can be analyzed in the aspects of main construction, architecture style, location and actors. Moreover, the three towns of Wuhan have a disparate cityscape that is reflected by the varied heritages and architecture features over different transformation periods. Lastly, the protection regulations and conservation planning of heritage in Wuhan are discussed, and suggestions about the conservation of Wuhan modern heritage are tried to be drawn. The implications of the study are providing a new perspective on modern city heritage for cities like Wuhan, and the future local planning system and heritage conservation policies can take into consideration the ‘Modern Cultural Transformation Route’ in this paper.

Keywords: modern city heritage, transformation, identity, Wuhan

Procedia PDF Downloads 131

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

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

Keywords: deep learning, delirium, healthcare, pervasive sensing

Procedia PDF Downloads 93

Authors: Tomasz Kosicki

Abstract:

The subject of the presentation will be the administrative and legal instruments of disciplining maintenance debtors adopted by the Polish legislator, the substantive legal bases of which were adopted in the Act of 7 September 2007 on assistance to persons entitled to maintenance (Journal of Laws of 2022, item 1205). These provisions are complemented by procedural regulations resulting from the Act of 14 June 1960 - Code of Administrative Procedure (Journal of Laws of 2021, item 735, as amended). The first part of the paper will focus on the administrative proceedings regarding the recognition of the debtor as evading maintenance obligations. The initiation of this procedure ex officio is preceded by a number of actions by public administration bodies, including Conducting a maintenance interview with the debtor, during which his health and professional situation and the reasons for non-payment of maintenance are determined, Professional activation in a situation where the lack of payment of maintenance results from the lack of employment. The reasons for initiating the above-mentioned administrative proceedings ex officio will be indicated, taking into account the current views of the judicial decisions. The second part of the paper will focus on the instrument of retaining the driving license of the debtor, who was previously found to be evading maintenance. The author points out that the detention of the driving license is one of the types of administrative sanctions of a very severe nature. Doubts of a constitutional nature will also be highlighted, as well as those concerning the effectiveness of this legal instrument and the protection of the debtor's rights. The thesis will be presented that the administrative procedure for the retention of a driving license does not fulfill its role and especially does not affect the collection of maintenance obligations from debtors. All the considerations will be based on the current and most representative views of the literature on the subject and the jurisprudence of Polish administrative courts.

Keywords: maintenance debtor, administrative proceedings, detention of driving license, administrative sanction, polish administrative law, public administration

Procedia PDF Downloads 84

Authors: Babak Nemat

Abstract:

Background: Exercise behavior (EB) has a significant impact on infertility, but the magnitude of the effect is not easily determined. The aim of the present study was to assess the effect of social support and self-regulation, as external and internal factors, on changes in exercise behavior among infertile women. Methods: For a cross-sectional study conducted in Sanandaj (Iran) in 2023, we recruited infertile women (n=483) from 35 comprehensive healthcare centers by means of convenience sampling. Standardized face-to-face interviews were conducted using established and reliable instruments for the assessment of EB, social support, and self-regulation. Logistic regression models were applied to assess the association between EB, social support and self-regulation. Results: The majority of the participants (56.7%) had secondary infertility, while 70.8% of them did not perform any exercise. Self-regulation and social support were significantly higher in women with secondary infertility than in those with primary infertility (p < 0.01). Self-regulation was significantly lower in women whose height was below 160 centimeters (cm) (p<0.05). Social support was significantly higher among participants aged ≥ 35 years and weighing ≥ 60 kilograms (kg) (p < 0.01). The odds of EB adoption increased with self-regulation and social support (OR=1.05, 95% CI=1.02-1.09, p <0.01), (OR=1.06, 95% CI=1.02-1.11, p <0.01). Conclusion: Social support and self-regulation almost equally influenced EB in infertile women. Designing support and consultation programs can be considered in encouraging infertile women to exercise in future research.

Keywords: social support, regulation, infertility, women

Procedia PDF Downloads 63

Authors: Taoues Hadour

Abstract:

Twitter has become a popular means of communication used in a variety of fields, such as politics, journalism, and academia. This widely used online platform has an impact on the way people express themselves and is changing language usage worldwide at an unprecedented pace. The language used online reflects the linguistic battle that has been going on for several decades in French society. This study enables a deeper understanding of users' linguistic behavior online. The implications are important and allow for a rise in awareness of intercultural and cross-language exchanges. This project investigates the mixing of French-English language usage among French users of Twitter using a topic analysis approach. This analysis draws on Gumperz's theory of conversational switching. In order to collect tweets at a large scale, the data was collected in R using the rtweet package to access and retrieve French tweets data through Twitter’s REST and stream APIs (Application Program Interface) using the software RStudio, the integrated development environment for R. The dataset was filtered manually and certain repetitions of themes were observed. A total of nine topic categories were identified and analyzed in this study: entertainment, internet/social media, events/community, politics/news, sports, sex/pornography, innovation/technology, fashion/make up, and business. The study reveals that entertainment is the most frequent topic discussed on Twitter. Entertainment includes movies, music, games, and books. Anglicisms such as trailer, spoil, and live are identified in the data. Change in language usage is inevitable and is a natural result of linguistic interactions. The use of different languages online is just an example of what the real world would look like without linguistic regulations. Social media reveals a multicultural and multilinguistic richness which can deepen and expand our understanding of contemporary human attitudes.

Keywords: code-switching, French, sociolinguistics, Twitter

Procedia PDF Downloads 137

Authors: Martin Georgiev, Milena Nanova, Damyan Damov

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Architects, engineers, and developers need to analyse and implement a wide spectrum of data in different formats, if they want to produce viable residential developments. Usually, this data comes from a number of different sources and is not well structured. The main objective of this research project is to provide parametric tools working with real geodesic data that can generate residential solutions. Various codes, regulations and design constraints are described by variables and prioritized. In this way, we establish a common workflow for architects, geodesists, and other professionals involved in the building and investment process. This collaborative medium ensures that the generated design variants conform to various requirements, contributing to a more streamlined and informed decision-making process. The quantification of distinctive characteristics inherent to typical residential structures allows a systematic evaluation of the generated variants, focusing on factors crucial to designers, such as daylight simulation, circulation analysis, space utilization, view orientation, etc. Integrating real geodesic data offers a holistic view of the built environment, enhancing the accuracy and relevance of the design solutions. The use of generative algorithms and parametric models offers high productivity and flexibility of the design variants. It can be implemented in more conventional CAD and BIM workflow. Experts from different specialties can join their efforts, sharing a common digital workspace. In conclusion, our research demonstrates that a generative parametric approach based on real geodesic data and collaborative decision-making could be introduced in the early phases of the design process. This gives the designers powerful tools to explore diverse design possibilities, significantly improving the qualities of the building investment during its entire lifecycle.

Keywords: architectural design, residential buildings, urban development, geodesic data, generative design, parametric models, workflow optimization

Procedia PDF Downloads 52

Authors: Maulita Sari Hani, Abraham B. Sianipar, Abdi Hasan, Erfa Canistya, Ismail Alaydrus, Asril Djunaidi

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Whale shark tourism offer potential benefits to support economic alternative livelihood. Since 2017, Conservation International Indonesia worked in Sumbawa to monitor whale shark distribution and identified species aggregation in Teluk Saleh. We conducted a survey on May 23th-27th, 2018 and involved 86 local community from five hamlets in Labuan Jambu village. Furthermore, forum group discussion (FGD) held with 20 village representative on July 30th, 2018. The result of frequency distribution demonstrated 95% of respondents show positive perceptions towards sustainable development of whale shark tourism with 40% willing to participate in boat rental services. The community also proposes to participate in providing other tourism services including the local guide (12%), food and beverage or F&B (8%), local transport (8%), and homestay (6%). 34% of respondents agreed to establish a new institution (under village officials) to coordinate tourism services provided by the local community. We also conducted participatory mapping with 15 key informants where the result confirmed 13 areas of whale shark aggregation with all-year-round sightings. The FGD results in 20 participants ready to start the pilot project of community-based whale shark tourism in August 2018, including 4 boat rental (3 speedboats and 1 floating cage boat), 6 homestays, 4 car rentals, 1 F&B, 1 gear rental, 2 guides, and 2 local products. In addition, we facilitate village official in establishing policy and regulations for whale shark conservation and sustainable community-based tourism through village regulation, code of conduct, best practices, and capacity building program.

Keywords: marine wildlife tourism, elasmobranch, conservation, sustainable tourism, co-management

Procedia PDF Downloads 164

Authors: Komal Fizza

Abstract:

All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

Procedia PDF Downloads 490

Authors: Simrin Kafle, Ulrika Enemark

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Catastrophic health expenditure (CHE) is a critical issue in low- and middle-income countries like Nepal, exacerbating financial hardship among vulnerable households. This study assesses the effectiveness of Nepal’s National Health Insurance Program (NHIP), launched in 2015, to reduce out-of-pocket (OOP) healthcare costs and mitigate CHE. Conducted in Pokhara Metropolitan City, the study used an analytical cross-sectional design, sampling 1276 households through a two-stage random sampling method. Data was collected via face-to-face interviews between May and October 2023. The analysis was conducted using SPSS version 29, incorporating propensity score matching to minimize biases and create comparable groups of enrolled and non-enrolled households in the NHIP. PSM helped reduce confounding effects by matching households with similar baseline characteristics. Additionally, a doubly robust methodology was employed, combining propensity score adjustment with regression modeling to enhance the reliability of the results. This comprehensive approach ensured a more accurate estimation of the impact of NHIP enrollment on CHE. Among the 1276 samples, 534 households (41.8%) were enrolled in NHIP. Of them, 84.3% of households renewed their insurance card, though some cited long waiting times, lack of medications, and complex procedures as barriers to renewal. Approximately 57.3% of households reported known diseases before enrollment, with 49.8% attending routine health check-ups in the past year. The primary motivation for enrollment was encouragement from insurance employees (50.2%). The data indicates that 12.5% of enrolled households experienced CHE versus 7.5% among non-enrolled. Enrollment into NHIP does not contribute to lower CHE (AOR: 1.98, 95% CI: 1.21-3.24). Key factors associated with increased CHE risk were presence of non-communicable diseases (NCDs) (AOR: 3.94, 95% CI: 2.10-7.39), acute illnesses/injuries (AOR: 6.70, 95% CI: 3.97-11.30), larger household size (AOR: 3.09, 95% CI: 1.81-5.28), and households below the poverty line (AOR: 5.82, 95% CI: 3.05-11.09). Other factors such as gender, education level, caste/ethnicity, presence of elderly members, and under-five children also showed varying associations with CHE, though not all were statistically significant. The study concludes that enrollment in the NHIP does not significantly reduce the risk of CHE. The reason for this could be inadequate coverage, where high-cost medicines, treatments, and transportation costs are not fully included in the insurance package, leading to significant out-of-pocket expenses. We also considered the long waiting time, lack of medicines, and complex procedures for the utilization of NHIP benefits, which might result in the underuse of covered services. Finally, gaps in enrollment and retention might leave certain households vulnerable to CHE despite the existence of NHIP. Key factors contributing to increased CHE include NCDs, acute illnesses, larger household sizes, and poverty. To improve the program’s effectiveness, it is recommended that NHIP benefits and coverage be expanded to better protect against high healthcare costs. Additionally, simplifying the renewal process, addressing long waiting times, and enhancing the availability of services could improve member satisfaction and retention. Targeted financial protection measures should be implemented for high-risk groups, and efforts should be made to increase awareness and encourage routine health check-ups to prevent severe health issues that contribute to CHE.

Keywords: catastrophic health expenditure, effectiveness, national health insurance program, Nepal

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Authors: Sara Piccirillo

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The integrated urban regeneration represents a great opportunity to deliver correct management of the territory if implemented through the reuse, enhancement, and transformation of abandoned industrial areas, according to sustainability strategies. In environmental terms, recycling abandoned sites by demolishing buildings and regenerating the urban areas means promoting adaptation to climate change and a new sensitivity towards city living. The strategic vision of 'metabolism' can be implemented through diverse actions made on urban settlements, and planning certainly plays a primary role. Planning an urban transformation in a sustainable way is more than auspicable. It is necessary to introduce innovative urban soil management actions to mitigate the environmental costs associated with current land use and to promote projects for the recovery/renaturalization of urban or non-agricultural soils. However, by freeing up these through systematic demolition of the disused heritage, new questions open up in terms of environmental costs deriving from the inevitable impacts caused by the disposal of waste. The mitigation of these impacts involves serious reflection on the recycling supply chains aimed at the production and reuse of secondary raw materials in the construction industry. The recent developments in R&D of recycling materials are gradually becoming more and more pivotal in consideration of environmental issues such as increasing difficulties in exploiting natural quarries or strict regulations for the management and disposal of waste sites. Therefore, this contribution, set as a critical essay, presents the reconstruction outputs of the regulatory background on the material recycling chain up to the 'end of waste' stage, both at a national and regional scale. This extended approach to this urban design practice goes beyond the cultural dimension that has relegated urban regeneration to pure design only. It redefines its processes through an interdisciplinary system that affects human, environmental and financial resources.

Keywords: waste management, C&D waste, recycling, urban trasformation

Procedia PDF Downloads 213

Authors: Dena Alhaloul

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The Middle East and North Africa (MENA) region is characterized by diverse cultures, economies, and social structures. Fertility rates in MENA have seen significant changes over time, with variations among countries and subregions. Understanding fertility patterns in this region is essential due to its impact on demographic dynamics, healthcare, labor markets, and social policies. Rising or declining fertility rates have far-reaching consequences for the region's socioeconomic development. The main thrust of this study is to comprehensively examine fertility rates in the Middle East and North Africa (MENA) region. It aims to understand the distribution, determinants, and temporal trends of fertility rates in MENA countries. The study seeks to provide insights into the factors influencing fertility decisions, assess how fertility rates have evolved over time, and potentially develop statistical models to characterize these trends. As for the methodology of the study, the study uses descriptive statistics to summarize and visualize fertility rate data. It also uses regression analyses to identify determinants of fertility rates as well as statistical modeling to characterize temporal trends in fertility rates. The conclusion of this study The research will contribute to a deeper understanding of fertility dynamics in the MENA region, shedding light on the distribution of fertility rates, their determinants, and historical trends.

Keywords: fertility, distribution, modeling, regression

Procedia PDF Downloads 80

Authors: Thomas S. Abia II, Citlali Garcia-Saucedo

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A continuous copper precipitation treatment (CCPT) system was conceived at Intel Chandler Site to serve as a first-of-kind (FOK) facility-scale waste copper (Cu), nickel (Ni), and manganese (Mn) co-precipitation facility. The process was designed to treat highly variable wastewater discharged from a substrate packaging research factory. The paper discusses metals co-precipitation induced by internal changes for manufacturing facilities that lack the capacity for hardware expansion due to real estate restrictions, aggressive schedules, or budgetary constraints. Herein, operating parameters such as pH and oxidation reduction potential (ORP) were examined to analyze the ability of the CCPT System to immobilize various waste metals. Additionally, influential factors such as influent concentrations and retention times were investigated to quantify the environmental variability against system performance. A total of 2,027 samples were analyzed and statistically evaluated to measure the performance of CCPT that was internally retrofitted for Mn abatement to meet environmental regulations. In order to enhance the consistency of the influent, a separate holding tank was cannibalized from another system to collect and slow-feed the segregated Mn wastewater from the factory into CCPT. As a result, the baseline influent Mn decreased from 17.2+18.7 mg¹L^-1 at pre-pilot to 5.15+8.11 mg¹L^-1 post-pilot (70.1% reduction). Likewise, the pre-trial and post-trial average influent Cu values to CCPT were 52.0+54.6 mg¹L^-1 and 33.9+12.7 mg¹L^-1, respectively (34.8% reduction). However, the raw Ni content of 0.97+0.39 mg¹L^-1 at pre-pilot increased to 1.06+0.17 mg¹L^-1 at post-pilot. The average Mn output declined from 10.9+11.7 mg¹L^-1 at pre-pilot to 0.44+1.33 mg¹L^-1 at post-pilot (96.0% reduction) as a result of the pH and ORP operating setpoint changes. In similar fashion, the output Cu quality improved from 1.60+5.38 mg¹L^-1 to 0.55+1.02 mg¹L^-1 (65.6% reduction) while the Ni output sustained a 50% enhancement during the pilot study (0.22+0.19 mg¹L^-1 reduced to 0.11+0.06 mg¹L^-1). pH and ORP were shown to be significantly instrumental to the precipitative versatility of the CCPT System.

Keywords: copper, co-precipitation, industrial wastewater treatment, manganese, optimization, pilot study

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Authors: Mona Nikidehaghani, Freda Hui

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In Australia, one-third of mental health carers provide 40 hours or more of unpaid care per week. These hidden workers contribute significantly to the Australian mental health workforce by providing unpaid services both direct and indirect to people in their care. However, carers are often neglected in the healthcare system because Government services focus on those with a mental health condition rather than those supporting them. The aim of this study is to evaluate the perceptions of mental health carers on the effectiveness of community services designed for carers and how these services could be improved. We collaborated with One Door Mental Health, a community organisation that supports mental health carers. Through semi-structured interviews with 27 mental health carers residing in the Illawarra region (NSW), we documented their daily challenges and evaluated outcomes of the current programs for carers. Our findings demonstrate that services such as education programs enable capacity building and improve the social life and mental health of carers. Drawing on the perceptions of mental health carers, this study maps pathways for making meaningful changes in the lives of carers and proposes an outcome framework to evaluate the impact of a community organisation on the lives of their clients. The framework prepared by this project would be replicable, allowing other community organisations to measure the outcomes and improve their services.

Keywords: capacity building, community development, community service, mental health carers

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Authors: David Lloyd, David Owen, Martin Jardine

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Introduction: European weight regulations with respect to food products require a full understanding of regulation guidelines to assure regulatory compliance. It is suggested that the complexity of regulation leads to practices which result to over filling of food packages by food processors. Purpose: To establish current practices by food processors and the financial, sustainable and societal impacts on the food supply chain of ineffective food production practices. Methods: An analysis of food packing controls with 10 companies of varying food categories and quantitative based research of a further 15 food processes on the confidence in weight control analysis of finished food packs within their organisation. Results: A process floor analysis of manufacturing operations focussing on 10 products found over fill of packages ranging from 4.8% to 20.2%. Standard deviation figures for all products showed a potential for reducing average weight of the pack whilst still retain the legal status of the product. In 20% of cases, an automatic weight analysis machine was in situ however weight packs were still significantly overweight. Collateral impacts noted included the effect of overfill on raw material purchase and added food miles often on a global basis with one raw material alone creating 10,000 extra food miles due to the poor weight control of the processing unit. A case study of a meat and bakery product will be discussed with the impact of poor controls resulting from complex legislation. The case studies will highlight extra energy costs in production and the impact of the extra weight on fuel usage. If successful a risk assessment model used primarily on food safety but adapted to identify waste /sustainability risks will be discussed within the presentation.

Keywords: legislation, overfill, profile, waste

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Authors: Mohammed Alruwaili‬

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Nowadays, renewable energy resources are playing an important role in replacing traditional energy resources such as fossil fuels by integrating solar energy with conventional energy. Concerns about the environment led to an intensive search for a renewable energy source. The Rapid growth of distributed energy resources will have prompted increasing interest in the integrated distributing network in the Kingdom of Saudi Arabia next few years, especially after the adoption of new laws and regulations in this regard. Photovoltaic energy is one of the promising renewable energy sources that has grown rapidly worldwide in the past few years and can be used to produce electrical energy through the photovoltaic process. The main objective of the research is to study the impact of PV in distribution networks based on real data and details. In this research, site survey and computer simulation will be dealt with using the well-known computer program software ETAB to simulate the input of electrical distribution lines with other variable inputs such as the levels of solar radiation and the field study that represent the prevailing conditions and conditions in Diriah, Riyadh region, Saudi Arabia. In addition, the impact of adding distributed generation units (DGs) to the distribution network, including solar photovoltaic (PV), will be studied and assessed for the impact of adding different power capacities. The result has been achieved with less power loss in the loop distribution network from the current condition by more than 69% increase in network power loss. However, the studied network contains 78 buses. It is hoped from this research that the efficiency, performance, quality and reliability by having an enhancement in power loss and voltage profile of the distribution networks in Riyadh City. Simulation results prove that the applied method can illustrate the positive impact of PV in loop distribution generation.

Keywords: renewable energy, smart grid, efficiency, distribution network

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Authors: Mahshid Davoodpoor, Zahra Shamohammadi Ghahsareh, Saeid Razfar, Alaleh Dabbaghi

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Nowadays, air pollution has become a topic of great concern all over the world. One of the main sources of air pollution is automobile exhaust gas, which introduces a large number of toxic gases, including CO, unburned hydrocarbons (HCs), NOx, and non-methane hydrocarbons (NMHCs), into the air. The application of three-way catalysts (TWCs) is still the most effective strategy to mitigate the emission of these pollutants. Due to the stringent environmental regulations which continuously become stricter, studies on the TWCs are ongoing despite several years of research and development. This arises from the washcoat complexity and the several numbers of parameters involved in the redox reactions. The main objectives of these studies are the optimization of washcoat formulation and the investigation of different coating modes. Perovskite (ABO₃), as a promising class of materials, has unique features that make it versatile to use as an alternative to commonly mixed oxides in washcoats. High catalytic activity for oxidation reactions and its relatively high oxygen storage capacity are important properties of perovskites in catalytic applications. Herein, La₀.₈Ba₀.₂FeO₃ perovskite material was synthesized using the co-precipitation method and characterized by XRD, ICP, and BET analysis. The effect of synthesis conditions, including B site metal (Fe and Co), metal precursor concentration, and dopant (Ba), were examined on the phase purity of the products. The selected perovskite sample was used as one of the components in the TWC formulation to evaluate its catalytic performance through Light-off, oxygen storage capacity, and emission analysis. Results showed a remarkable increment in oxygen storage capacity and also revealed that T50 and emission of CO, HC, and NOx reduced in the presence of perovskite structure which approves the enhancement of catalytic performance for the new washcoat formulation. This study shows the brilliant future of advanced oxide structures in the TWCs.

Keywords: Perovskite, three-way catalyst, PGMs, PGMs reduction

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Authors: Evelyn Castle, Adam Thompson

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Background: In 2013, the Kano State Primary Health Care Management Board redesigned its Routine immunization supply chain from diffused pull to direct delivery push. It addressed issues around stockouts and reduced time spent by health facility staff collecting, and reporting on vaccine usage. The health care board sought the help of a 3PL for twice-monthly deliveries from its cold store to 484 facilities across 44 local governments. eHA’s Health Delivery Systems group formed a 3PL to serve 326 of these new facilities in partnership with the State. We focused on designing and implementing a technology system throughout. Basic methodologies: GIS Mapping: - Planning the delivery of vaccines to hundreds of health facilities requires detailed route planning for delivery vehicles. Mapping the road networks across Kano and Bauchi with a custom routing tool provided information for the optimization of deliveries. Reducing the number of kilometers driven each round by 20%, - reducing cost and delivery time. Direct Delivery Information System: - Vaccine Direct Deliveries are facilitated through pre-round planning (driven by health facility database, extensive GIS, and inventory workflow rules), manager and driver control panel customizing delivery routines and reporting, progress dashboard, schedules/routes, packing lists, delivery reports, and driver data collection applications. Move: Last Mile Logistics Management System: - MOVE has improved vaccine supply information management to be timely, accurate and actionable. Provides stock management workflow support, alerts management for cold chain exceptions/stock outs, and on-device analytics for health and supply chain staff. Software was built to be offline-first with user-validated interface and experience. Deployed to hundreds of vaccine storage site the improved information tools helps facilitate the process of system redesign and change management. Findings: - Stock-outs reduced from 90% to 33% - Redesigned current health systems and managing vaccine supply for 68% of Kano’s wards. - Near real time reporting and data availability to track stock. - Paperwork burdens of health staff have been dramatically reduced. - Medicine available when the community needs it. - Consistent vaccination dates for children under one to prevent polio, yellow fever, tetanus. - Higher immunization rates = Lower infection rates. - Hundreds of millions of Naira worth of vaccines successfully transported. - Fortnightly service to 326 facilities in 326 wards across 30 Local Government areas. - 6,031 cumulative deliveries. - Over 3.44 million doses transported. - Minimum travel distance covered in a round of delivery is 2000 kms & maximum of 6297 kms. - 153,409 kms travelled by 6 drivers. - 500 facilities in 326 wards. - Data captured and synchronized for the first time. - Data driven decision making now possible. Conclusion: eHA’s Vaccine Direct delivery has met challenges in Kano and Bauchi State and provided a reliable delivery service of vaccinations that ensure t health facilities can run vaccination clinics for children under one. eHA uses innovative technology that delivers vaccines from Northern Nigerian zonal stores straight to healthcare facilities. Helped healthcare workers spend less time managing supplies and more time delivering care, and will be rolled out nationally across Nigeria.

Keywords: direct delivery information system, health delivery system, GIS mapping, Northern Nigeria, vaccines

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Authors: Arezoo Fallahi‎

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Background: Exercise behavior (EB) has a significant impact on infertility, but the magnitude of the effect is not easily determined. The aim of the present study was to assess the effect of social support and self-regulation, as external and internal factors, on changes in exercise behavior among infertile women. Methods: For a cross-sectional study conducted in Sanandaj (Iran) in 2020, we recruited infertile women (n=483) from 35 comprehensive healthcare centers by means of convenience sampling. Standardized face-to-face interviews were conducted using established and reliable instruments for the assessment of EB, social support, and self-regulation. Logistic regression models were applied to assess the association between EB, social support and self-regulation. Results: The majority of the participants (56.7%) had secondary infertility, while 70.8% of them did not perform any exercise. Self-regulation and social support were significantly higher in women with secondary infertility than in those with primary infertility (p < 0.01). Self-regulation was significantly lower in women whose height was below 160 centimeters (cm) (p<0.05). Social support was significantly higher among participants aged ≥ 35 years and weighing ≥ 60 kilograms (kg) (p < 0.01). The odds of EB adoption increased with self-regulation and social support (OR=1.05, 95% CI=1.02-1.09, p <0.01), (OR=1.06, 95% CI=1.02-1.11, p <0.01). Conclusion: Social support and self-regulation almost equally influenced EB in infertile women. Designing support and consultation programs can be considered in encouraging infertile women to do exercise in future research.

Keywords: social support, regulation, infertility, women, exercise

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Authors: Husam Mohammed Saleh Alziyadi

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The drilling fluid has a significant impact on drilling efficiency. Drilling fluids have several functions which make them most important within the drilling process, such as lubricating and cooling the drill bit, removing cuttings from down of hole, preventing formation damage, suspending drill bit cuttings, , and also removing permeable formation as a result, the flow of fluid into the formation process is delayed. In the oil and gas sector, unconventional shale reserves have been a central player in meeting world energy demands. Oil-based drilling fluids (OBM) are generally favored for drilling shale plays due to negligible chemical interactions. Nevertheless, the industry has been inspired by strict environmental regulations to design water-based drilling fluids (WBM) capable of regulating shale-water interactions to boost their efficiency. However, traditional additives are too large to plug the micro-fractures and nanopores of the shale. Recently, nanotechnology in the oil and gas industries has shown a lot of promise, especially with drilling fluids based on nanoparticles. Nanotechnology has already made a huge contribution to technical developments in the energy sector. In the drilling industry, nanotechnology can make revolutionary changes. Nanotechnology creates nanomaterials with many attractive properties that can play an important role in improving the consistency of mud cake, reducing friction, preventing differential pipe sticking, preserving the stability of the borehole, protecting reservoirs, and improving the recovery of oil and gas. The selection of suitable nanomaterials should be based on the shale formation characteristics intended for drilling. The size, concentration, and stability of the NPs are three more important considerations. The effects of the environment are highly sensitive to these materials, such as changes in ionic strength, temperature, or pH, all of which occur under downhole conditions. This review paper focused on the previous research and recent development of environmentally friendly drilling fluids according to the regulatory environment and cost challenges.

Keywords: nanotechnology, WBM, Drilling Fluid, nanofluids

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Authors: Abdullah Tahir

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The omission of regular medications in surgical patients poses a significant challenge in healthcare settings and is associated with increased morbidity during hospital stays. Human factors such as high workload, poor communication, and emotional stress are known to contribute to these omissions, particularly evident in the surgical assessment unit (SAU) due to its high patient burden and long wait times. This study aimed to quantify and address the issue by implementing targeted interventions to enhance compliance in prescribing regular medications for surgical patients at Stoke Mandeville Hospital, United Kingdom. Data were collected on 14 spontaneous days between April and May 2023, and the frequency of prescription omissions was recorded using a tally chart. Subsequently, informative posters were introduced in the SAU, and presentations were given to the surgical team to emphasize the importance of compliance in this area. The interventions were assessed using a second data collection cycle, again over 14 spontaneous days in May 2023. Results demonstrated an improvement from 40% (60 out of 150) to 74% (93 out of 126) of patients having regular medications prescribed at the point of clerking. These findings highlight the efficacy of frequent prompts and awareness-raising interventions in increasing workforce compliance and addressing the issue of prescription omissions in the SAU.

Keywords: prescription omissions, quality improvement, regular medication, surgical assessment unit

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Authors: Hassan Sher

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Agriculture has a pivotal role in Pakistan’s economy, accounting for about one-fourth of the GDP and employing almost half the population. However, the competitiveness, productivity, growth, employment potential, export opportunity, and contribution to GDP of the sector is significantly hampered by agriculture marketing laws/regulations at the provincial level that reward rent seeking behavior, promote monopoly power, artificially reduce farmer incomes while inflating prices to consumers, and act as disincentives to investment. Although of more recent vintage than some other provincial agricultural marketing laws, the NWFP Agricultural and Livestock Produce Markets Act, 2007 is a throwback to a colonial paradigm, where restrictions on agricultural produce marketing and Government control of distribution channels is the norm. The Swat Valley (in which we include its tributary valleys) is an area of Pakistan in which there is poverty is both extreme and pervasive. For many, a significant portion of the family’s income comes from selling plants that are used as herbs, medicines, and perfumes. Earlier studies have shown that the benefit they derive from this work is less than they might because of: Lack of knowledge concerning which plants and which plant parts are valuable, Lack of knowledge concerning optimal preservation and storage of material, illiteracy. Another concern that much of the plant material sold from the valley is collected in the wild, without an appreciation of the negative impact continued collecting has on wild populations. We propose: Creating colored cards to help inhabitants recognize the 25 most valuable plants in their area; Developing and sharing protocols for growing the 25 most valuable plants in a home garden; Developing and sharing efficient mechanisms for drying plants so they do not lose value; Encouraging increased literacy by incorporating numbers and a few words in the handouts.

Keywords: food security, medicinal plants, industrial plants, economic development

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Authors: Despoina Andrioti Bygvraa, Ida-Maja Hassellöv, George Charalambous

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Exhaust gas cleaning systems, also known as scrubbers, are today widely used to allow for the use of High Sulphur Heavy Fuel Oil and still comply with the regulations limiting sulphur content in marine fuels. There are extensive concerns about environmental consequences, especially in the Baltic Sea, from the wide-scale use of scrubbers, as the wash water is acidic (ca pH 3) and contains high concentrations of toxic, carcinogenic, and mutagenic substances. The aim of this feasibility study is to investigate the potential adverse effects on seafarers’ health with the ultimate goal of raising awareness of chemical-related health and safety issues in the shipping environment. The project got funding from the Swedish Foundation. The team will extend previously compiled data on scrubber wash water concentrations of hazardous substances and pH to include the use of strong base in closed-loop scrubbers, and scoping assessment on handling and disposing practices. Based on the findings (a), a systematic review of risk assessment will follow to show the risk of exposures, the establishment of the hazardous levels for human health as well as the respective prevention practices. In addition, the researchers will perform (b) a systematic review to identify facilitators and barriers of the crew on compliance with the safe handling of chemicals. The study will run for 12 months, delivering (a) a risk assessment inventory with risk exposures and (b) a course description of safe handling practices. This feasibility study could provide valuable knowledge on how pollutants found in scrubbers should be considered from a human health perspective to facilitate evidence-based informed decisions in future technology- and policy development to make shipping a safer, healthier, and more attractive workplace.

Keywords: health and safety, seafarers, scrubbers, chemicals, risk exposures

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