Search results for: healthcare settings

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

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

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

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Authors: Ashwini Bhosale, Yogesh Patil

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Urban areas are extremely complicated environmental settings, where health and well-being of an individual and population are governed by a large number of bio-physical, socio-economical, and inclusive aspects. Although poverty and slums are the prime issues under UN-HABITAT agenda of environmental sustainability, slums, the inevitable part of urban environment, have not accounted for inclusive city planning. Developing nations, where about 60 % of world slum population resides, are increasingly under pressure to uplift the urban poor, particularly slum dwellers. From a point of advantage, these new slum redevelopment projects have succeeded in providing legitimized and more permanent and stable shelter for the low income people, as well as individualized sanitation and water supply. However, they unfortunately follow the “one type fits all" approach and exhibit no response to the climatic design needs on Mumbai. The thesis focuses on the study of environmental perspectives in the context of Daylight, natural ventilation and social aspects in the design process of Slum-Rehabilitation schemes (SRS) – case of Mumbai. It attempts to investigate into Indian approaches about SRS and concludes upon strategies to be incorporated in SRS to improve the overall SRS environment. The main objectives of this work have been to identify and study the spatial configuration and possibilities of daylight and natural ventilation in Slum Rehabilitated buildings. The performance of the proposed method was evaluated by comparison with the daylight luminance simulated by lighting software, namely ECOTECT, and with measurements under real skies whereas for the ventilation study purpose, software named FLOW DESIGN was used.

Keywords: urban environment, slum-rehabilitation, daylight, natural-ventilation, architectural consequences

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Authors: Saurav Dhawan, Sanchit Bansal

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

Keywords: ACS, discharges, ED, T-MACS

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

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

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

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Authors: Jo-Han Chang, Chung-Jung Wu

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This study involves a design proposal. The objective of is to create a seat arrangement model for public reading spaces that enable free arrangement without disturbing the users. Through a subjective perception scale, this study explored whether distance between seats and direction of seats influence individual subjective perceptions in a public reading space. This study also involves analysis of user subjective perceptions when reading in the settings on 3 seats at different directions and with 5 distances between seats. The results may be applied to public chair design. This study investigated that (a) whether different directions of seats and distances between seats influence individual subjective perceptions and (b) the acceptable personal space between 2 strangers in a public reading space. The results are shown as follows: (a) the directions of seats and distances between seats influenced individual subjective perceptions. (b) subjective evaluation scores were higher for back-to-back seat directions with Distances A (10 cm) and B (62 cm) compared with face-to-face and side-by-side seat directions; however, when the seat distance exceeded 114 cm (Distance C), no difference existed among the directions of seats. (c) regarding reading in public spaces, when the distance between seats is 10 cm only, we recommend arranging the seats in a back-to-back fashion to increase user comfort and arrangement of face-to-face and side- by-side seat directions should be avoided. When the seat arrangement is limited to face-to-face design, the distance between seats should be increased to at least 62 cm. Moreover, the distance between seats should be increased to at least 114 cm for side- by-side seats to elevate user comfort.

Keywords: individual subjective perceptions, personal space, seat arrangement, direction, distances

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Authors: Christoph Schuler, Oriana Ponta

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Public Financial Management (PFM) reforms are promoted by various international organizations such as the International Monetary Fund (IMF) or the World Bank, local development banks and the donor country community to strengthen governance and accountability in developing countries across the world. Reform efforts undertaken are often systematically measured against international best practice by the application of standardized analytical instruments such as the Public Expenditure and Financial Accountability Framework (PEFA) or the Poverty Reduction Action Plan (PARP). While those instruments analyze direct achievements of PFM reforms, the long-term benefits of such reforms for society remain untapped. This gives rise to the question why the concept of impact evaluation with its experimental or quasi-experimental settings in the form of randomized control trials has rarely been applied in the context of PFM reforms. To close this gap, this study provides examples where the concept of impact evaluation can be applied to PFM reforms and thereby shifting the focus from outcome towards a long-term impact. As it is a new approach, this study does not attempt to conduct a fully flagged impact evaluation of a certain PFM reform. However, it will outline, as a form of pre-test the applicability of the impact evaluation methodology in this context, for example, by more closely analyzing the commonly used indicators (for example within PEFA or PARP). This would mean to scrutinize these indicators as to how they were designed and how they are related to the long-term impact, they should be producing. The analysis of PFM reform indicators and their relation to long-term impacts should provide practitioners and scholars alike with new insights on how to strengthen the accountability of public service delivery through successful and sustainable PFM reforms.

Keywords: accountability, impact evaluation, PFM reforms, public financial management

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Authors: Layla Mujahed

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

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

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Authors: Sofie Dewayani, Pratiwi Retnaningdyah

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Literacy practice is situated within the identity enactment in a particular time and space. The literacy practices in public places, ranging from city parks, urban slums to city roads are meeting places of discursive practices produced by dynamic interactions, and sometimes contestations, of social powers and capitals. The present paper examines the ways the literacy activists construct their sense of space in attempts to develop possibilities for literacy programs as they are sent to work with marginalized communities far away from their hometowns in Indonesia. In particular, this paper analyzes the activists’ reflections of identity enactment - othering, familiarity, and sense of comfort - as they are trying to make meaning of the communities’ literacy capitals and practices in the process of adapting with the communities. Data collected for this paper were travel diaries - serving as literacy narratives - obtained from a literacy residency program sponsored by the Indonesian Ministry of Education and Culture. The residency program itself involved 30 youths (18 to 30 years old) to work with marginalized communities in literacy activism programs. This paper analyzes the written narratives of four focal participants using Bakhtin’s chronotopes - the configurations of time and space - that figure into the youth’s meaning-making of literacy as well as their exercise of power and identity. Follow-up interviews were added to enrich the analysis. The analysis considers the youth’s ‘moment of departure’ a critical point in their reconstructions of self and space. This paper expands the discussions of literacy discourse and spatiality while lending its supports to literacy activism in highly diverse multicultural settings.

Keywords: chronotopes, discourse, identity, literacy activism

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Authors: M. A. Alqahtani, D. P. Coleman, N. D. Pugh, L. D. M. Nokes

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In diagnostic ultrasound, the echo graphic B-scan texture is an important area of investigation since it can be analyzed to characterize the histological state of internal tissues. An important factor requiring consideration when evaluating ultrasonic tissue texture is the depth. The effect of attenuation with depth of ultrasound, the size of the region of interest, gain, and dynamic range are important variables to consider as they can influence the analysis of texture features. These sources of variability have to be considered carefully when evaluating image texture as different settings might influence the resultant image. The aim of this study is to investigate the effect of depth on the texture features in-vivo using a 3D ultrasound probe. The left leg medial head of the gastrocnemius muscle of 10 healthy subjects were scanned. Two regions A and B were defined at different depth within the gastrocnemius muscle boundary. The size of both ROI’s was 280*20 pixels and the distance between region A and B was kept constant at 5 mm. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The paired t –test was used to test the depth effect for the normally distributed data and the Wilcoxon–Mann-Whitney test was used for the non-normally distributed data. The gray level, variance, and run length matrix were significantly lowered when the depth increased. The other texture parameters showed similar values at different depth. All the texture parameters showed no significant difference between depths A and B (p > 0.05) except for gray level, variance and run length matrix (p < 0.05). This indicates that gray level, variance, and run length matrix are depth dependent.

Keywords: ultrasound image, texture parameters, computational biology, biomedical engineering

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Authors: Tabugbo B. Ifeyinwa, Josephat O. Ogbuagu, Okeke A. Princewill, Victor C. Eze

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The increasing amount of plastic pollution in maritime settings poses a substantial risk to the functioning of ecosystems and the preservation of biodiversity. This comprehensive analysis combines the most recent data on the environmental effects of pollution from macroplastics, microplastics, and nanoplastics within marine ecosystems. Our goal is to provide a comprehensive understanding of the cumulative impacts that plastic waste accumulates on marine life by outlining the origins, processes, and ecological repercussions connected with each size category of plastic debris. Microplastics and nanoplastics have more sneaky effects that are controlled by chemicals. These effects can get through biological barriers and affect the health of cells and the whole body. Compared to macroplastics, which primarily contribute to physical harm through entanglement and ingestion by marine fauna, microplastics, and nanoplastics are associated with non-physical effects. The review underlines a vital need for research that crosses disciplinary boundaries to untangle the intricate interactions that the various sizes of plastic pollution have with marine animals, evaluate the long-term ecological repercussions, and identify effective measures for mitigating the effects of plastic pollution. Additionally, we urge governmental interventions and worldwide cooperation to solve this pervasive environmental concern. Specifically, we identify significant knowledge gaps in the detection and effect assessment of nanoplastics. To protect marine biodiversity and preserve ecosystem services, this review highlights how urgent it is to address the broad spectrum of plastic pollution.

Keywords: macroplastic pollution, marine ecosystem, microplastic pollution, nanoplastic pollution

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Authors: Dingiswayo Likhona, Arko-Cobbah Emmanuel, Carolina Pohl, Nthabiseng Z. Mokoena, Jolly Musoke

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A distinct strain of Klebsiella pneumoniae (K. pneumoniae), referred to as hypervirulent (hvKp), is associated with invasive infections such as an invasive pyogenic liver abscess in young and healthy individuals. In South Africa, limited information is known about the prevalence and virulence of this hvKp strain. Thus, this study aimed to determine the prevalence of hvKp and virulence-associated factors in K. pneumoniae isolates from one of the largest Tertiary hospitals in a South African province. A total of 74 K. pneumoniae isolates were received from Pelonomi National Health Laboratory Services (NHLS), Bloemfontein. Virulence-associated genes (rmpA, capsule serotype K1/K2, iroB, and irp2) were screened, and the virulence of hvKp vs. classical Klebsiella pneumoniae (cKp) was investigated using Caenorhabditis elegans nematode model. The iutA (aerobactin transporter) gene was used as a primary biomarker of hvKp. An average of 12% (9/74) of cases were defined as hvKp. Moreover, hvKp was found to be significantly more virulent in vivo Caenorhabditis elegans relative to cKp. The virulence-associated genes (rmpA, iroB, hmv phenotype, and capsule K1/K2) were significantly (p< 0.05) associated with hvKp. Findings from this study confirm the presence of hvKp in one large Tertiary hospital in South Africa. However, the low prevalence and mild to moderate clinical presentation suggest a marginal threat to public health. Further studies in different settings are required to establish the true potential impact of hvKp in developing countries.

Keywords: hypervirulent klebsiella pneumoniae, virulence, caenorhabditis elegans, aerobactin (iutA)

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Authors: Sameh El Mahdy

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Recording and documenting archaeological collections, especially photographic documentation, is considered one of the very important matters that museums care about and give great priority, as photographic documentation is of great importance. We monitor some of them for example, Photographs of collectibles are considered evidence and an archival record that proves the condition of the collectibles at various stages. A photo of the possessions is placed on the paper record of the possessions registration. These photos are used in inventorying archaeological collections. These pictures are viewed by researchers and scholars interested in studying these collections. These images are used in advertising campaigns for museum displays of archaeological collections. The Grand Egyptian Museum is considered one of the museums that is a unique model in terms of establishing a specific system that is used when photographing archaeological collections. The Grand Egyptian Museum sets standards for the photos that are taken inside the Grand Egyptian Museum. We mention some of them for example, Pictures must be of high quality. It is necessary to set a color scale for the drawing in order to clarify the dimensions of the collectibles in the picture and also in order to clarify the natural colors of the collectibles without any additions. Putting the numbers of the collectibles in the pictures, especially the number of the Grand Egyptian Museum. To take a good photo of the artifacts in the Grand Egyptian Museum, there are many steps: (1) Create a good location, (2) How to handle the Artifacts. (3) Choose the best position for the artifact, (4) Make the light to create a good photo without shadows to make the photo represent all the artifact details. (5) Be sure of the camera settings, and their quality. All of these steps and other ones are the best criteria for taking the best photo, which helps us in the database to represent the details of the artifact in our interface.

Keywords: grand egyptian museum, photographing, museum collections, registration and documentation

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Authors: Md. Shakhawat Hossain, Jimma Hossain, Md. Naushad Ali

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Acute pancreatitis is a dangerous medical emergency in the practice of gastroenterology. Management of acute pancreatitis needs multidisciplinary approach with support starts from emergency to ICU. So, there is a chance of mismanagement in every steps, especially in low resource settings. Other factors such as patient’s financial condition, education, social custom, transport facility, referral system from periphery may also challenge the current guidelines for management. The present study is intended to determine the clinico-pathological profile, severity assessment and challenges of management of acute pancreatitis in a government laid tertiary care hospital to image the real scenario of management in a low resource place. A total 100 patients of acute pancreatitis were studied in this prospective study, held in the Department of Gastroenterology, Rangpur medical college hospital, Bangladesh from July 2017 to July 2018 within one year. Regarding severity, 85 % of the patients were mild, whereas 13 were moderately severe, and 2 had severe acute pancreatitis according to the revised Atlanta criteria. The most common etiologies of acute pancreatitis in our study were gall stone (15%) and biliary sludge (15%), whereas 54% were idiopathic. The most common challenges we faced were delay in hospital admission (59%) and delay in hospital diagnosis (20%). Others are non-adherence of patient party, and lack of investigation facility, physician’s poor knowledge about current guidelines. We were able to give early aggressive fluid to only 18% of patients as per current guideline. Conclusion: Management of acute pancreatitis as per guideline is challenging when optimum facility is lacking. So, modified guidelines for assessment and management of acute pancreatitis should be prepared for low resource setting.

Keywords: acute pancreatitis, challenges of management, severity, prognosis

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Authors: Sohail Ahmed, Ke Xing

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This research theoretically explored the evolution mechanism of enterprise technological innovation capability system (ETICS) from the perspective of complex adaptive systems (CAS). Starting from CAS theory, this study proposed an analytical framework for ETICS, its concepts and theory by integrating CAS methodology into the management of technological innovation capability of enterprises and discusses how to use the principles of complexity to analyze the composition, evolution and realization of the technological innovation capabilities in complex dynamic environment. This paper introduces the concept and interaction of multi-agent, the theoretical background of CAS and summarizes the sources of technological innovation, the elements of each subject and the main clusters of adaptive interactions and innovation activities. The concept of multi-agents is applied through the linkages of enterprises, research institutions and government agencies with the leading enterprises in industrial settings. The study was exploratory based on CAS theory. Theoretical model is built by considering technological and innovation literature from foundational to state of the art projects of technological enterprises. On this basis, the theoretical model is developed to measure the evolution mechanism of enterprise technological innovation capability system. This paper concludes that the main characteristics for evolution in technological systems are based on enterprise’s research and development personal, investments in technological processes and innovation resources are responsible for the evolution of enterprise technological innovation performance. The research specifically enriched the application process of technological innovation in institutional networks related to enterprises.

Keywords: complex adaptive system, echo model, enterprise knowledge system, research institutions, multi-agents.

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Authors: Pinqiao Wang

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Mindfulness, derived from Buddhism, has been developed to improve individuals' well-being, first in the West and then gaining growing popularity in Asia. Numerous research studies have proven the effectiveness of mindfulness among clinical groups and the public all over the world. However, as enthusiasm surges, reflections on mindfulness and its commodification and instrumentalization arise. Hong Kong was seen as the model of a free market by neoliberal economists. The relationships between its socioeconomic neoliberalism, Western-inspired democracy aspiration, and political harmonization with China Mainland have been fraught with tensions, which have been further exacerbated by socio-political changes since the 2010s. Under such circumstances, mental health problems have come into the spotlight in Hong Kong recently. Mindfulness has gained growing popularity in Hong Kong, with its influence reaching from primary schools to corporate settings. A more comprehensive socio-political analysis of mindfulness within the Hong Kong context warrants further exploration. Drawing on interview responses from mindfulness practitioners, we examine the connections between the ideologies underlying mindfulness and contemporary capitalist society. On the one hand, mindfulness focuses on the present moment and self-improvement, representing neoliberal capitalist spirituality and reinforcing existing power relations. On the other hand, mindfulness fosters the acceptance of difference, which is argued to demonstrate the potential for advancing democracy at both the individual and community levels. Academically, this research provides empirical evidence to advance the current discussions and debates surrounding the socio-political potential of mindfulness. Practically, it serves as a reflection on mindfulness practices to optimize their impact on individuals and society.

Keywords: neoliberal subjectivity, qualitative analysis, social construction, technologies of the self, therapeutic culture

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Authors: Amin Nakhostin-Ansari, Samaneh Akbarour, Khosro Sadeghniiat Haghighi, Zahra Banafsheh Alemohammad, Farnaz Etesam, Arezu Najafi, Mahnaz Khalafehnilsaz

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Introduction: The outbreak of coronavirus disease has considerably burdened the healthcare system in Iran. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. Method: A scale(FCV-19) was used for Fear of COVID-19, Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its patterns Results: In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in this study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). Conclusion: fear of COVID-19 is a major factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.

Keywords: insomnia, difficulty maintaining sleep, COVID-19, Coronavirus

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Authors: Blessing Ojeme, Frederick Quinn, Russell Karls, Shannon Quinn

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The detection and segmentation of mitochondria from fluorescence microscopy are crucial for understanding the complex structure of the nervous system. However, the constant fission and fusion of mitochondria and image distortion in the background make the task of detection and segmentation challenging. In the literature, a number of open-source software tools and artificial intelligence (AI) methods have been described for analyzing mitochondrial images, achieving remarkable classification and quantitation results. However, the availability of combined expertise in the medical field and AI required to utilize these tools poses a challenge to its full adoption and use in clinical settings. Motivated by the advantages of automated methods in terms of good performance, minimum detection time, ease of implementation, and cross-platform compatibility, this study proposes a fully automated framework for the detection and segmentation of mitochondria using both image shape information and descriptive statistics. Using the low-cost, open-source python and openCV library, the algorithms are implemented in three stages: pre-processing, image binarization, and coarse-to-fine segmentation. The proposed model is validated using the mitochondrial fluorescence dataset. Ground truth labels generated using a Lab kit were also used to evaluate the performance of our detection and segmentation model. The study produces good detection and segmentation results and reports the challenges encountered during the image analysis of mitochondrial morphology from the fluorescence mitochondrial dataset. A discussion on the methods and future perspectives of fully automated frameworks conclude the paper.

Keywords: 2D, binarization, CLAHE, detection, fluorescence microscopy, mitochondria, segmentation

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Authors: Kenji Gwee

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The Mental Capacity Act is a new legislation that allows for lasting powers of attorney and court-appointed deputies, in respect of people who lack legal capacity. While the UK Act, after which the Singapore Act is modeled, has been shown to be therapeutic to donors, the Singapore Act differs from its UK counterpart and it is unclear if the Singapore Act can be beneficial to donors as purported. The purpose of this study was to determine what the perceptions of three groups of stakeholders (patients, caregivers and psychiatrists) are about the aspects of the Mental Capacity Act that are therapeutic to donors. In addition, ways to increase the therapeutic value of the Act to donors are sought. A qualitative methodology was used and the research was guided by two theoretical frameworks: therapeutic jurisprudence and an interpretive constructive framework. Interviews with 12 psychiatrists, and focus groups with twenty three patients and seven caregivers showed agreement that, allowing donors to nominate more than one decision- maker, and whistle-blowing mechanisms for recourse for abuse, were therapeutic to donors. To further increase the therapeutic value of the Act, 2 suggestions were made: the Act should provide for (i) advanced healthcare directives- allowing donors to make advance decisions to refuse treatment, or cease existing treatment, and (ii) independent advocacy services- to have a case worker to represent people who have no family or friends and are thus unable to find suitable donees.

Keywords: Mental Capacity Act, therapeutic jurisprudence, qualitative methodology, the UK Act

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Authors: Abdul Kadir, L. Meily Kurniawidjaja

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Batik Madura workers are exposed to many Musculoskeletal Disorders risk factors, particularly Low Back Pain (LBP). This study was conducted as an early detection of ergonomic risk level on Workers Industrial Sentra Batik Madura in Dusun Banyumas, Klampar Subdistrict, Proppo Pamekasan, Madura, East Java. This study includes 12 workers who 11 workers had pain in the upper and lower part of the neck, back, wrist right hand, also 10 workers had pain in the right shoulder. This is a descriptive observational study with cross-sectional approach. Qualitative research by observing workers activity such as draw and putting the wax motif, fabric dyeing, fabric painting, discoloration, washing, and drying. The results are workers have identified ergonomic hazards such as awkward postures, twisting movements, repetitive, and static work postures. Using the method of REBA and QEC, the results get a very high-risk level of activity in each of Madura batik making process is the draw and putting the wax motif, coloring, painting, discoloration, washing, and drying. The level of risk can be reduced by improvement of work equipment include the provision of seats, strut fabric, high settings furnaces, drums, coloring basin, and washing tub.

Keywords: activities of Madura's batik, ergonomic risk level, equipment, QEC (Quick Exposure Checklist), REBA (Rapid Entire Body Assessment)

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Authors: Monique Palma, Isabel Amaral

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This paper aims at mapping medical places in Oporto in the twentieth century in order to bring the urban history of medicine and healthcare in Portugal to a large audience, using Oporto as a case study. This analysis is consistent with the SDS's 2030 goals for policy guidance for heritage and development actors. As a result, it is critical to begin this research in order to place on the political agenda the preservation of Portuguese culture's history, memory, and heritage, particularly the medical culture, which is one of the most important drivers of civilizational development. To understand the evolution of medical care in urban history, we will conduct archive research (manuals, treatises, reports, periodic journals, newspapers, etc.) and interviews with key actors from medical institutions and medical museums. The findings of this study will be used to develop medical itineraries for inclusion in touristic agendas in Portugal and abroad, to include Portuguese medicine in global roadmaps, and to promote the preservation of the most iconic places of health care and medical heritage, as well as tools to promote social cohesion, dialogue among people, and "sense of place" globally.

Keywords: medical itineraries, history of medicine, urban history, Oporto

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Authors: Anne Gesare Timu, Megan Sheahan, Andrew Gache Mude, Rupsha Banerjee

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Women headed households are among the most vulnerable to negative climatic shocks and are often left poorer as a result. Credit provision has been recognized as one way of alleviating rural poverty and developing poor rural households’ resilience to shocks. Much has been documented about credit demand in small-holder agriculture settings in Kenya. However, little is known about demand for credit among pastoral women. This paper analyzes the determinants of demand for credit in the pastoral regions of Marsabit District of Northern Kenya. Using a five wave balanced panel data set of 820 households, a double hurdle model is employed to analyze if shocks, financial literacy and risk aversion affect credit demand among female and male headed households differently. The results show that borrowing goods on credit and monetary credit from informal market segments are the most common sources of credit in the study area. The impact of livestock loss and financial literacy on the decision to borrow and how much to borrow vary with gender. While the paper suggests that provision of credit is particularly valuable in the aftermath of a negative shock and more so for female-headed households, it also explores alternatives to the provision of credit where credit access is a constraint. It recommends further understanding of systems and institutions which could enhance access to credit, and particularly during times of stress, to enable households in the study area in particular and Northern Kenya in general to invest, engage in meaningful development and growth, and be resilient to persistent shocks.

Keywords: female headed households, pastoralism, rural financing, double hurdle model

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Authors: Jacob Nortey

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Introduction: In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. According to the Ibero – American Study of Adverse Effects (IBEAS), about 10% of hospital patients suffer from secondary damage during the care process, and approximately 2% die from this process. Many clinical decision support systems have been developed to help mitigate some healthcare medical errors. Method: Relevant databases were searched, including ones that were peculiar to the clinical decision support system (that is, using google scholar, Pub Med and general google searches). The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of Dxplain Clinical decision support systems. Results: Inferences drawn from the articles showed high usage of Dxplain clinical decision support system for problem-based learning among students in developed countries as against little or no usage among students in Low – and Middle – income Countries. The results also indicated high usage among general practitioners. Conclusion: Despite the challenges Dxplain presents, the benefits of its usage to clinicians and students are enormous.

Keywords: dxplain, clinical decision support sytem, diagnosis, support systems

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Authors: Arezoo Fallahi

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We aimed at investigating the association between health beliefs and exercise behavior in infertile women who were at risk of developing osteoporosis. This cross-sectional study was conducted in Sanandaj city, west of Iran in 2018. From 35 comprehensive healthcare centers, 483 infertile women were included in the study through convenience sampling. Standardized face-to-face interviews were conducted using established, reliable instruments for the assessment of exercise behavior behavior and health beliefs. Logistic regression models were applied to assess the association between exercise behavior and health beliefs. Estimates were adjusted for age, job status, income, literacy, and duration and type of infertility. We reported estimated logits and Odds Ratios (OR) with corresponding 95% confidence intervals (95% CI). Employed women compared to housewives had substantially higher odds of adopting exercise behavior behaviors (OR=3.19, 95% CI=1.53-6.66, p<0.01). Moreover, the odds of exercise behavior adoption increased with self-efficacy (OR=1.35, 95% CI=1.20-1.52, p<0.01), and decreased with perceived barriers (OR=0.90, 95% CI=0.84-0.97, p<0.01). It is essential to increase perceived self-efficacy and reduce perceived barriers to promote EB in infertile women. Consequently, health professionals should develop or adopt appropriate strategies to decrease barriers and increase self-efficacy to enhance exercise behavior in this group of women.

Keywords: infertility, women, exercise, osteoporosis

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Authors: Catherine Thompson, Maryam Jalali, Peter Hills

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The allocation of visual attention is critical when driving and anything that limits attention will have a detrimental impact on safety. Engaging in a secondary task reduces the amount of attention directed to the road because drivers allocate resources towards this task, leaving fewer resources to process driving-relevant information. Yet the dangers associated with a secondary task do not end when the driver returns their attention to the road. Instead, the attentional settings adopted to complete a secondary task may persist to the road, affecting attention, and therefore affecting driver performance. This 'attentional inertia' effect was investigated in the current work. Forty drivers searched for hazards in driving video clips while their eye-movements were recorded. At varying intervals they were instructed to attend to a secondary task displayed on a tablet situated to their left-hand side. The secondary task consisted of three separate computer games that induced horizontal, vertical, and random eye movements. Visual search and hazard detection in the driving clips were compared across the three conditions of the secondary task. Results showed that the layout of information in the secondary task, and therefore the allocation of attention in this task, had an impact on subsequent search in the driving clips. Vertically presented information reduced the wide horizontal spread of search usually associated with accurate driving and had a negative influence on the detection of hazards. The findings show the additional dangers of engaging in a secondary task while driving. The attentional inertia effect has significant implications for semi-autonomous and autonomous vehicles in which drivers have greater opportunity to direct their attention away from the driving task.

Keywords: attention, eye-movements, hazard perception, visual search

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Authors: Deepen Sharma, Eugene F. Hill

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For nearly 100 years, hydro-turbine governors have operated with only a frequency set point. This natural governor action means that the governor responds with changing megawatt output to disturbances in system frequency. More and more, power system managers are demanding that governors operate with constant megawatt output. One way of doing this is to introduce a second set point in the control structure called a power set point. The control structure investigated and analyzed in this paper is unique in the way that it utilizes a power reference set point in addition to the conventional frequency reference set point. An optimum set of temporary droop parameters derived based on the turbine-generator inertia constant and the penstock water start time for stable islanded operation are shown to be also equally applicable for a satisfactory rate of generator loading during its grid connected mode. A theoretical development shows why this is the case. The performance of the control structure has been investigated and established based on the simulation study made in MATLAB/Simulink as well as through testing the real time controller performance on a 15 MW Kaplan Turbine and generator. Recordings have been made using the labVIEW data acquisition platform. The hydro-turbine governor control structure and its performance investigated in this paper thus eliminates the need to have a separate set of temporary droop parameters, one valid for islanded mode and the other for interconnected operations mode.

Keywords: frequency set point, hydro governor, interconnected operation, isolated operation, power set point

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Authors: Hiba El Assibi

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This study aims to weakly solve Kalah, a two-player board game, by developing a start-to-finish winning strategy using an optimized Minimax algorithm with Alpha-Beta Pruning. In weakly solving Kalah, our focus is on creating an optimal strategy from the game's beginning rather than analyzing every possible position. The project will explore additional enhancements like symmetry checking and code optimizations to speed up the decision-making process. This approach is expected to give insights into efficient strategy formulation in board games and potentially help create games with a fair distribution of outcomes. Furthermore, this research provides a unique perspective on human versus Artificial Intelligence decision-making in strategic games. By comparing the AI-generated optimal moves with human choices, we can explore how seemingly advantageous moves can, in the long run, be harmful, thereby offering a deeper understanding of strategic thinking and foresight in games. Moreover, this paper discusses the evaluation of our strategy against existing methods, providing insights on performance and computational efficiency. We also discuss the scalability of our approach to the game, considering different board sizes (number of pits and stones) and rules (different variations) and studying how that affects performance and complexity. The findings have potential implications for the development of AI applications in strategic game planning, enhancing our understanding of human cognitive processes in game settings, and offer insights into creating balanced and engaging game experiences.

Keywords: minimax, alpha beta pruning, transposition tables, weakly solving, game theory

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Authors: Eugene Muambeh Muntoh

Abstract:

Corruption has a destructive effect on State institutions and on the capacity of States to respect, protect and fulfil human rights, particularly of those persons and groups in situation of vulnerability and marginalization. In Cameroon, corruption pose a major challenge as it divert public revenues and cripple public budgets that should provide healthcare, housing, education, and other essential services. Corruption has undermined the States’ ability to meet the minimum core obligations and pre-existing legal obligations to maximize all available resources to respect, protect and fulfil Economic, Social and Cultural Rights. This study therefore makes use of the qualitative research design, ranging from interviews, observations and content analysis of vital documents to provide evidence and associations between corruption and human rights concerns in Cameroon. The study made use of research material from both primary and secondary sources. Findings from the study reveals that the impact of corruption in Cameroon is especially pronounced regarding economic, social and cultural rights. In most cases, the right to be treated equally is violated, for example, when someone is requested to pay a bribe to obtain a public service. There is an urgent need for sustainable measures to counter corruption in order to protect and promote human rights.

Keywords: corruption, governance, human rights, law

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Authors: Anja Kurz, Marc Flynn, Tobias Good, Marco Caversaccio, Martin Kompis

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Bone Anchored Hearing Implants (BAHI) are routinely used in patients with conductive or mixed hearing loss, e.g. if conventional air conduction hearing aids cannot be used. New sound processors and new fitting software now allow the adjustment of parameters such as loudness compression ratios or maximum power output separately. Today it is unclear, how the choice of these parameters influences aided speech understanding in BAHI users. In this prospective experimental study, the effect of varying the compression ratio and lowering the maximum power output in a BAHI were investigated. Twelve experienced adult subjects with a mixed hearing loss participated in this study. Four different compression ratios (1.0; 1.3; 1.6; 2.0) were tested along with two different maximum power output settings, resulting in a total of eight different programs. Each participant tested each program during two weeks. A blinded Latin square design was used to minimize bias. For each of the eight programs, speech understanding in quiet and in noise was assessed. For speech in quiet, the Freiburg number test and the Freiburg monosyllabic word test at 50, 65, and 80 dB SPL were used. For speech in noise, the Oldenburg sentence test was administered. Speech understanding in quiet and in noise was improved significantly in the aided condition in any program, when compared to the unaided condition. However, no significant differences were found between any of the eight programs. In contrast, on a subjective level there was a significant preference for medium compression ratios of 1.3 to 1.6 and higher maximum power output.

Keywords: Bone Anchored Hearing Implant, baha, compression, maximum power output, speech understanding

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Authors: Francis Zerd, Brian E. Moore, Atuganile E. Malango, Patrick W. Hosokawa, Kevin O. Lillehei, Laurence Lemery Mchome, D. Ryan Ormond

Abstract:

Introduction: Since neuropathologic diagnosis in the developing world is hampered by limitations in technical infrastructure, trained laboratory personnel, and subspecialty-trained pathologists, the use of telepathology for diagnostic support, second-opinion consultations, and ongoing training holds promise as a means of addressing these challenges. This research aims to assess the utility of static teleneuropathology in improving neuropathologic diagnoses in low- and middle-income countries. Methods: Consecutive neurosurgical biopsy and resection specimens obtained at Muhimbili National Hospital in Tanzania between July 1, 2018, and June 30, 2019, were selected for retrospective, blinded static-image neuropathologic review followed by on-site review by an expert neuropathologist. Results: A total of 75 neuropathologic cases were reviewed. The agreement of static images and on-site glass diagnosis was 71% with strict criteria and 88% with less stringent criteria. This represents an overall improvement in diagnostic accuracy from 36% by general pathologists to 71% by a neuropathologist using static telepathology (or 76% to 88% with less stringent criteria). Conclusions: Telepathology offers a suitable means of providing diagnostic support, second-opinion consultations, and ongoing training to pathologists practicing in resource-limited countries. Moreover, static digital teleneuropathology is an uncomplicated, cost-effective, and reliable way to achieve these goals.

Keywords: neuropathology, resource-limited settings, static image, Tanzania, teleneuropathology

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Authors: Megan Burfoot, Shanta Budha-Magar, Ali Ghaffarianhoseini, Amirhoseini Ghaffarianhoseini

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Domestic backyards offer a valuable opportunity to contribute to biodiversity conservation efforts and promote ecological sustainability by cultivating native plant species. This study focuses on assessing the presence and maintenance of native plants in New Zealand's residential gardens through an online questionnaire. The survey was designed to collect data on the presence of native, exotic, and lawn plants in New Zealand backyards, alongside the allocation of maintenance resources for each category. Targeting a diverse range of residents and property sizes from different regions of New Zealand, this study sought to gain essential insights into practices related to native plant cultivation. Results reveal there is a collective inclination to reduce lawn coverage and introduce a higher abundance of native and exotic species. A thorough analysis of maintenance practices reveals a significant portion of respondents embracing environmentally friendly gardening, characterized by low-intensity fertilizer usage. Homeowners, especially those residing in their properties, demonstrate proactive engagement in backyard maintenance. Native plants were found to require more time, money and fertilizer for maintenance than those of exotic and lawn species. The insights gained from this study can guide targeted efforts to enhance urban biodiversity, making a significant contribution to the preservation and enrichment of New Zealand's unique biodiversity and ecological heritage in urban settings.

Keywords: biodiversity, backyards, planting behaviour, backyard maintenance, native planting

Procedia PDF Downloads 69