Search results for: healthcare settings

Authors: Botshelo Rachel Sebola

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Unintended pregnancy often results in pregnancy termination. Most countries have legalised the termination of a pregnancy, and pregnant adolescents can visit designated clinics without their parents’ consent. In most African and Asian countries, certain cultural practices are performed following any form of childbirth, including abortion, and such practices are ingrained in societies. The aim of this paper was to understand how women who terminated a pregnancy during adolescence coped by embracing cultural practices. A descriptive multiple case study design was adopted for the study. In-depth, semi-structured interviews and reflective diaries were used for data collection. 13 women aged 20 to 35 years who had terminated a pregnancy in adolescence participated in the study. Three women kept their soiled sanitary pads, burned them to ash and waited for the rainy season to scatter the ash in a flowing stream. This ritual was performed to appease the ancestors, ask them for forgiveness and as a send-off for the aborted foetus. Five women secretly consulted Sangoma (traditional healers) to perform certain rituals. Three women isolated themselves to perform herbal cleansings, and the last two chose not to engage in any sexual activity for one year, which led to the loss of their partners. This study offers a unique contribution to understanding the solitary journey of women who terminate a pregnancy. The study challenges healthcare professionals who work in clinics that offer pregnancy termination services to look beyond releasing the foetus to advocating and providing women with the necessary care and support in performing cultural practices.

Keywords: adolescence, culture, case study, pregnancy

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Authors: Ahmad Shahin, Walid Moudani, Ali Bekraki

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This research aims at presenting a predictive data mining model to handle an accurate diagnosis of acute appendicitis with patients for the purpose of maximizing the health service quality, minimizing morbidity/mortality, and reducing cost. However, acute appendicitis is the most common disease which requires timely accurate diagnosis and needs surgical intervention. Although the treatment of acute appendicitis is simple and straightforward, its diagnosis is still difficult because no single sign, symptom, laboratory or image examination accurately confirms the diagnosis of acute appendicitis in all cases. This contributes in increasing morbidity and negative appendectomy. In this study, the authors propose to generate an accurate model in prediction of patients with acute appendicitis which is based, firstly, on the segmentation technique associated to ABC algorithm to segment the patients; secondly, on applying fuzzy logic to process the massive volume of heterogeneous and noisy data (age, sex, fever, white blood cell, neutrophilia, CRP, urine, ultrasound, CT, appendectomy, etc.) in order to express knowledge and analyze the relationships among data in a comprehensive manner; and thirdly, on applying dynamic programming technique to reduce the number of data attributes. The proposed model is evaluated based on a set of benchmark techniques and even on a set of benchmark classification problems of osteoporosis, diabetes and heart obtained from the UCI data and other data sources.

Keywords: healthcare management, acute appendicitis, data mining, classification, decision tree

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Authors: Mst Shapna Akter, Hossain Shahriar

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Neural network approaches are machine learning methods used in many domains, such as healthcare and cyber security. Neural networks are mostly known for dealing with image datasets. While training with the images, several fundamental mathematical operations are carried out in the Neural Network. The operation includes a number of algebraic and mathematical functions, including derivative, convolution, and matrix inversion and transposition. Such operations require higher processing power than is typically needed for computer usage. Central Processing Unit (CPU) is not appropriate for a large image size of the dataset as it is built with serial processing. While Graphics Processing Unit (GPU) has parallel processing capabilities and, therefore, has higher speed. This paper uses advanced Neural Network techniques such as VGG16, Resnet50, Densenet, Inceptionv3, Xception, Mobilenet, XGBOOST-VGG16, and our proposed models to compare CPU and GPU resources. A system for classifying autism disease using face images of an autistic and non-autistic child was used to compare performance during testing. We used evaluation matrices such as Accuracy, F1 score, Precision, Recall, and Execution time. It has been observed that GPU runs faster than the CPU in all tests performed. Moreover, the performance of the Neural Network models in terms of accuracy increases on GPU compared to CPU.

Keywords: autism disease, neural network, CPU, GPU, transfer learning

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Authors: Yuguang Gao, Qiang Yang, Yanpeng Zhang, Mingtao Deng

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To enhance the safety, quality and efficiency of healthcare services provided by surgical doctors, we propose a comprehensive approach to the performance evaluation of individual doctors by incorporating insights from performance data as well as views of different stakeholders in the hospital. Exploratory factor analysis was first performed on collective multidimensional performance data of surgical doctors, where key factors were extracted that encompass assessment of professional experience and service performance. A two-level indicator system was then constructed, for which we developed a weighted interval-valued spherical fuzzy analytic hierarchy process to analyze the relative importance of the indicators while handling subjectivity and disparity in the decision-making of multiple parties involved. Our analytical results reveal that, for the key factors identified as instrumental for evaluating surgical doctors’ performance, the overall importance of clinical workload and complexity of service are valued more than capacity of service and professional experience, while the efficiency of resource consumption ranks comparatively the lowest in importance. We also provide a retrospective case study to illustrate the effectiveness and robustness of our quantitative evaluation model by assigning meaningful performance ratings to individual doctors based on the weights developed through our approach.

Keywords: analytic hierarchy processes, factor analysis, fuzzy logic, performance evaluation

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Authors: Samuel Reisman

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Background: Comparative rankings are increasingly used to evaluate health care systems. These rankings combine discrete attribute rankings into a composite overall ranking. Health care equity is a component of overall rankings, but excelling in other categories can counterbalance low inequity grades. Highly ranked inequitable health care would commend systems that disregard human rights. We simulated the ranking of a maximally inequitable health care system using a published, influential ranking methodology. Methods: We used The Commonwealth Fund’s ranking of eleven health care systems to simulate the rank of a maximally inequitable system. Eighty performance indicators were simulated, assuming maximal ineptitude in equity benchmarks. Maximal rankings in all non-equity subcategories were assumed. Subsequent stepwise simulations lowered all non-equity rank positions by one. Results: The maximally non-equitable health care system ranked first overall. Three subsequent stepwise simulations, lowering non-equity rankings by one, each resulted in an overall ranking within the top three. Discussion: Our results demonstrate that grossly inequitable health care systems can rank highly in comparative health care system rankings. These findings challenge the validity of ranking methodologies that subsume equity under broader benchmarks. We advocate limiting maximum overall rankings of health care systems to their individual equity rankings. Such limits are logical given the insignificance of health care system improvements to those lacking adequate health care.

Keywords: global health, health equity, healthcare systems, international health

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Authors: June Tay, Ivy Chia

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There are numerous changes, both mental and physical, taking place when people age. We need to understand the different aspects required for healthy living, including meeting nutritional needs, regular physical activities to keep agility, sufficient rest and sleep to have physical and mental well-being, social engagement to avoid the risk of social isolation and depression, and access to healthcare to detect and manage chronic conditions. Promoting physical activities for an ageing population is necessary as many may have enjoyed sedentary lifestyles for some time. In our study, we evaluate the considerations when designing a computer vision video game for the elderly. We need to design some low-impact activities, such as stretching and gentle movements, because some elderly individuals may have joint pains or mobility issues. The exercise game should consist of simple movements that are easy to follow and remember. It should be fun and enjoyable so that they can be motivated to do some exercise. Social engagement can keep the elderly motivated and competitive, and they are more willing to engage in game exercises. Elderly citizens can compare their game scores and try to improve them. We propose a computer vision-based video game for the elderly that will capture and track the movement of the elderly hand pushing a ball on the screen into a circle. It can be easily set up using a PC laptop with a webcam. Our video game adhered to the design framework we employed, and it encompassed ease of use, a simple graphical interface, easy-to-play game exercise, and fun gameplay.

Keywords: about computer vision, video games, gerontology technology, caregiving

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Authors: Suresh Hettiarachchi, Conrad Wasko, Ashish Sharma

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The ever changing and expanding urban landscape increases the stress on urban systems to support and maintain safe and functional living spaces. Flooding presents one of the more serious threats to this safety, putting a larger number of people in harm’s way in congested urban settings. Climate change is adding to this stress by creating a dichotomy in the urban flood response. On the one hand, climate change is causing storms to intensify, resulting in more destructive, rarer floods, while on the other hand, longer dry periods are decreasing the severity of more frequent, less intense floods. This variability is creating a need to be more agile and innovative in how we design for and manage urban flooding. Here, we argue that to cope with this challenge climate change brings, we need to move towards urban flood management through resilience rather than flood prevention. We also argue that dealing with the larger variation in flood response to climate change means that we need to look at flooding from all aspects rather than the single-dimensional focus of flood depths and extents. In essence, we need to rethink how we manage flooding in the urban space. This change in our thought process and approach to flood management requires a practical way to assess and quantify resilience that is built into the urban landscape so that informed decision-making can support the required changes in planning and infrastructure design. Towards that end, we propose a Simple Urban Flood Resilience Index (SUFRI) based on a robust definition of resilience as a tool to assess flood resilience. The application of a simple resilience index such as the SUFRI can provide a practical tool that considers urban flood management in a multi-dimensional way and can present solutions that were not previously considered. When such an index is grounded on a clear and relevant definition of resilience, it can be a reliable and defensible way to assess and assist the process of adapting to the increasing challenges in urban flood management with climate change.

Keywords: urban flood resilience, climate change, flood management, flood modelling

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Authors: Kofi Nkonkonya Mpuangnan, Samantha Govender, Hlengiwe Romualda Mhlongo

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Educational leaders are skilled architects crafting a vibrant environment where growth, creativity, and adaptability can flourish within schools. Their journey is one of transformation, urging them to explore administrative strategies that align seamlessly with evolving educational models and cater to the specific needs of students, educators, and stakeholders. Through this committed effort to innovate, they seek to enhance the effectiveness and influence of educational systems, paving the way for a more inclusive and forward-thinking educational environment. In this context, the authors explored the concept of transforming educational leadership with administrative strategies in alignment with the following research objectives. To find the strategies that can be adopted by transformation leaders to promote effective administrative practices in an educational setting and to explore the roles of educational leaders in promoting collaboration in education. To find answers to these questions, a systematic literature review underpinned by the transformational leadership model was adopted. Therefore, concepts integrated from a variety of outlets, including academic journals, conference proceedings, and reports found within SCOPUS, WoS, and IBSS databases. A search was aided using specific themes like innovative administrative practices, the roles of educational leaders, and interdisciplinary approaches to administrative practices. The process of conducting the search adhered to the five-step framework, which was subjected to inclusion and exclusion of studies. It was found that transformational leadership, agile methodologies, employee wellbeing, seminars and workshops could foster a culture of innovation and creativity among teachers and staff to transform administrative practices in education settings. It was recommended that professional development programs be organized periodically for educational leaders in educational institutions to help them revitalize their knowledge and skills in educational administration.

Keywords: educational leadership, innovative strategies, administrative practices, professional development, stakeholder engaement, student outcome

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Authors: Jeonghyun Chang, Taegeun Lee, Heungsup Sung, Yoon-Seon Lee, Youn-Jung Kim, Mi-Na Kim

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Background: Safety device has been applied to improve safety and performance of blood culture practice. BD vacutainer® Safety-Lokᵀᴹ blood collection sets with pre-attached holder (Safety-Lok) (BD, USA) was evaluated in the emergency room (ER) of a tertiary care hospital. Methods: From April to June 2017, interns and nurses in ER were surveyed for blood culture practices with a questionnaire before and after 2 or 3 weeks of experience of Safety-Lok. All of them participated in exercise workshop for 1 hour combined with video education prior to the initial survey. The blood volume, positive and contamination rates of Safety-Lok-drawn (SD) blood cultures were compared to those of overall blood cultures. Results: Eighteen interns and 30 nurses were enrolled. As a result of the initial survey, interns had higher rates of needlestick incidence (27.8%), carriage of the blood-filled syringe with needle (88.9%) and lower rates of vacutainer use (38.9%) than nurses (13.3%, 53.3%, and 60.0%). Interns preferred to use safety devices (88.9%) rather than nurses (40.0%). The number of overall blood cultures and SD blood cultures was 9,053 and 555, respectively. While the overall blood volume of aerobic bottles was 2.6±2.1 mL, those of SD blood cultures were 5.0±3.0 mL in aerobic bottles and 6.0±3.0 mL in anaerobic bottles. Positive and contamination rates were 6.5% and 0.72% with SD blood cultures and 6.2% and 0.3% with overall blood cultures. Conclusions: The introduction of the safety device would encourage healthcare workers to collect adequate blood volume as well as lead to safer practices in the ER.

Keywords: blood culture, needlestick, safety device, volume

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Authors: Oluwayemisi Femi-Pius, Kazeem Arogundade, Eberechukwu Eke, Jimmy Eko

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Introduction: Globally, community involvement in improving their own health has been widely adopted as a strategy in Sub-Saharan Africa principally to ensure equitable access to essential health care as well as improve the uptake of maternal and newborn health services especially in poor-resource settings. Method: The Saving Mother Giving Life (SMGL) Initiative implemented by Pathfinder International with funding support from USAID conducted a Health Facility Assessment (HFA) and found out that maternal mortality ratio in Cross River State was 812 per 100,000 live birth and perinatal mortality was 160 per 1000 live birth. To reduce maternal and perinatal mortality, Pathfinder International mobilized, selected and trained community members as community volunteers, traditional birth attendants, and emergency transport service volunteer drivers mainly to address the delay in decision making and reaching the health facility among pregnant women. Results: The results showed that maternal mortality ratio in Cross River State decrease by 25% from 812 per 100,000 live birth at baseline to 206 per 100,000 live birth at June 2018 and perinatal mortality reduced by 35% from 160 per 100,000 at baseline to 58 per 1000 live birth at June 2018. Data also show that ANC visit increased from 7,451 to 11,344; institutional delivery increased from 8,931 at baseline to 10,784 in June 2018. There was also a remarkable uptake of post-partum family planning from 0 at baseline to 233 in June 2018. Conclusion: There is clear evidence that community involvement yields positive maternal outcomes and is pivotal for sustaining most health interventions.

Keywords: maternal mortality, Nigeria, pathfinder international, perinatal mortality, saving mother giving life

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Authors: Mohammad Faheem, M. Tabish Rehman, Mohd Danishuddin, Asad U. Khan

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The worldwide dissemination of CTX-M type β-lactamases is a threat to human health. Previously, we have reported the spread of blaCTX-M-15 gene in different clinical strains of Enterobacteriaceae from the hospital settings of Aligarh in north India. In view of the varying resistance pattern against cephalosporins and other β-lactam antibiotics, we intended to understand the correlation between MICs and catalytic activity of CTX-M-15. In this study, steady-state kinetic parameters and MICs were determined on E. coli DH5α transformed with blaCTX-M-15 gene that was cloned from Enterobacter cloacae (EC-15) strain of clinical background. The effect of conventional β-lactamase inhibitors (clavulanic acid, sulbactam and tazobactam) on CTX-M-15 was also studied. We have found that tazobactam is the best among these inhibitors against CTX-M-15. The inhibition characteristic of tazobactam is defined by its very low IC50 value (6 nM), high affinity (Ki = 0.017 µM) and better acylation efficiency (k+2/K9 = 0.44 µM-1s-1). It forms an acyl-enzyme covalent complex, which is quite stable (k+3 = 0.0057 s-1). Since increasing resistance has been reported against conventional b-lactam antibiotic-inhibitor combinations, we aspire to design a non-b-lactam core containing b-lactamase inhibitor. For this, we screened ZINC database and performed molecular docking to identify a potential non-β-lactam based inhibitor (ZINC03787097). The MICs of cephalosporin antibiotics in combination with this inhibitor gave promising results. Steady-state kinetics and molecular docking studies showed that ZINC03787097 is a reversible inhibitor which binds non-covalently to the active site of the enzyme through hydrogen bonds and hydrophobic interactions. Though, it’s IC50 (180 nM) is much higher than tazobactam, it has good affinity for CTX-M-15 (Ki = 0.388 µM). This study concludes that ZINC03787097 compound can be used as seed molecule to design more efficient non-b-lactam containing b-lactamase inhibitor that could evade pre-existing bacterial resistance mechanisms.

Keywords: ESBL, non-b-lactam-b-lactamase inhibitor, bioinformatics, biomedicine

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Authors: Olayide Ogunsiji, Glenda McDonald

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Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

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Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

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Authors: Melake Kuflom

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European power networks involve the use of multiple overhead transmission lines to construct a highly duplicated system that delivers reliable and stable electrical energy to the distribution level. The transmission line protection applied in the existing GB transmission network are normally independent unit differential and time stepped distance protection schemes, referred to as main-1 & main-2 respectively, with overcurrent protection as a backup. The increasing penetration of renewable energy sources, commonly referred as “weak sources,” into the power network resulted in the decline of fault level. Traditionally, the fault level of the GB transmission network has been strong; hence the fault current contribution is more than sufficient to ensure the correct operation of the protection schemes. However, numerous conventional coal and nuclear generators have been or about to shut down due to the societal requirement for CO2 emission reduction, and this has resulted in a reduction in the fault level on some transmission lines, and therefore an adaptive transmission line protection is required. Generally, greater utilization of renewable energy sources generated from wind or direct solar energy results in a reduction of CO2 carbon emission and can increase the system security and reliability but reduces the fault level, which has an adverse effect on protection. Consequently, the effectiveness of conventional protection schemes under low fault levels needs to be reviewed, particularly for future GB transmission network operating scenarios. The proposed paper will evaluate the transmission line challenges under high penetration of renewable energy sources andprovides alternative viable protection solutions based on the problem observed. The paper will consider the assessment ofrenewable energy sources (RES) based on a fully rated converter technology. The DIgSILENT Power Factory software tool will be used to model the network.

Keywords: fault level, protection schemes, relay settings, relay coordination, renewable energy sources

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Authors: Abrar Noorain, Zeinab Amara, Sulaf Abdelaziz

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Background: Diabetic foot disease imposes a financial burden on diabetic patients and healthcare services. In Sudan, diabetic foot ulcer prevalence reached 18.1%. This study aims to assess the knowledge, attitudes, and practices and the correlation between the level of foot care knowledge and self-care practices among diabetic patients in Sudan. Methodology: In a cross-sectional study involving 262 patients with type 1 and type 2 diabetes attending diabetic clinics in three primary care centers in Khartoum, Sudan, during September to November 2022, information regarding participants sociodemographic status, foot care knowledge, attitudes, and practices was gathered using a validated, structured questionnaire in a face-to-face interview method. These data were analyzed using the statistical package for the social sciences (SPSS) 22. Results: The patients’ mean age was 54.9 years, with a female predominance (56%). Of the participants, 37% had diabetes mellitus for over ten years. On the topic of foot care, 35.5% of patients showed good knowledge, and 76% were aware of the risk of reduced foot sensation. In relation to nail care, only 19% knew how to cut nails correctly. Conclusion: Knowledge, attitudes, and practices about diabetic foot care are substandard. There is a positive correlation between foot care knowledge and self-care practices. Hence, educating diabetic patients with foot care knowledge through an awareness program and the characteristics of diabetic shoes may improve self-care practices.

Keywords: DM, DFD, DFU, PHC, SPSS

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Authors: Li Hoon Lim, Nur Farhanah Said, Katie Simmons, Eric Pei Ping Pang, Sharon Mei Mei Wong

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Background and Purpose: Research regarding the sexual impact of breast cancer treatment on Asian women is both sensitive and scarce. This study aims to assess and evaluate the sexual health needs and concerns of breast cancer radiotherapy patients. It is hoped that awareness will be increased and an appropriate intervention can be developed to address the needs of future breast cancer patients. Methods: 110 consecutive unselected breast cancer patients were recruited prospectively. Questionnaires were administered once for patient undergoing radiotherapy to the breast. This study employed an anonymous questionnaire; any breast radiotherapy patient who can read English can voluntarily receive and complete the survey. The questionnaire consisted of items addressing demographics, potential informational needs, and educational preferences. Results: Patients’ interest to address sexual concerns decreases with age (p=0.024). Coherently, sexual concerns of patients are reported to decrease with age (p=0.015) where 70% of all respondents below age 50 [age 20-29 (60%); 30-39 (56.3%); 40-49(55.1%)] have started to have sexual concerns regarding their treatment effects on their sexual health. Patients who underwent breast conservation surgery (42.2%) and reconstruction surgery (83.3%) were more likely to have concerns about sexual health versus patients who underwent mastectomy (36.7%) (p=0.032). 74.2% of patients with sexual concern regardless of age would initiate conversation with their healthcare providers (p < 0.001). Conclusions: The results showed a staggering interest of female patients wanting information on this area which would not only boost their confidence and body image but also address concerns of the effect of breast radiotherapy on sexual health during their treatment.

Keywords: breast cancer, breast radiotherapy, sexual health, sexual impact

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Authors: Denis Duagi, Ben Carter, Maria Farrelly, Stephen Lisk, June S. L. Brown

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Background: Adolescence represents a distinctive phase of development, and variables linked to this developmental period could affect the efficiency of prevention and treatment for depression and anxiety, as well as the long-term prognosis. The objectives of this study were to investigate the long-term effectiveness of psychosocial interventions for adolescents on depression and anxiety symptoms and to assess the influence of different intervention parameters on the long-term effects. Methods: Searches were carried out on the 11ᵗʰ of August 2022 using five databases (Cochrane Library, Embase, Medline, PsychInfo, Web of Science), as well as trial registers. Randomized controlled trials of psychosocial interventions targeting specifically adolescents were included if they assessed outcomes at 1-year post-intervention or more. The Cochrane risk of bias-2 quality assessment tool was used. The primary outcome was depression, and studies were pooled using a standardised mean difference, with an associated 95% confidence interval, p-value, and I². The study protocol was pre-registered (CRD42022348668). Findings: A total of 57 reports (n= 46,678 participants) were included in the review. Psychosocial interventions led to small reductions in depressive symptoms, with a standardised mean difference (SMD) at 1-year of -0.08 (95%CI -0.20, -0.03, p=0.002, I²=72%), 18-months SMD=-0.12, 95% CI -0.22, -0.01, p=0.03, I²=63%) and 2-years SMD=-0.12 (95% CI -0.20, -0.03, p=0.01, I²=68%). Sub-group analyses indicated that targeted interventions produced stronger effects, particularly when delivered by trained mental health professionals (K=18, SMD=-0.24, 95% CI -0.38, -0.10, p=0.001, I²=60%). No effects were detected for anxiety at any assessment. Conclusion: Psychosocial interventions specifically targeting adolescents were shown to have small but positive effects on depression symptoms but not anxiety symptoms, which were sustained for up to 2 years. These findings highlight the potential population-level preventive effects if such psychosocial interventions become widely implemented in accessible settings such as schools.

Keywords: psychosocial, adolescent, interventions, depression, anxiety, meta-analysis, randomized controlled trial

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Authors: Chung Danbi, Linton Oliver, Whang Yoon-Jae

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Supermodularity, or complementarity, is a popular concept in economics which can characterize many objective functions such as utility, social welfare, and production functions. Further, supermodular dominance captures a preference for greater interdependence among inputs of those functions, and it can be applied to examine which input set would produce higher expected utility, social welfare, or production. Therefore, we propose and justify a consistent testing for a useful implication of supermodular dominance. We also conduct Monte Carlo simulations to explore the finite sample performance of our test, with critical values obtained from the recentered bootstrap method, with and without the selective recentering, and the subsampling method. Under various parameter settings, we confirmed that our test has reasonably good size and power performance. Finally, we apply our test to compare the geographic and distant knowledge spillover in terms of their effects on social welfare using the National Bureau of Economic Research (NBER) patent data. We expect localized citing to supermodularly dominate distant citing if the geographic knowledge spillover engenders greater social welfare than distant knowledge spillover. Taking subgroups based on firm and patent characteristics, we found that there is industry-wise and patent subclass-wise difference in the pattern of supermodular dominance between localized and distant citing. We also compare the results from analyzing different time periods to see if the development of Internet and communication technology has changed the pattern of the dominance. In addition, to appropriately deal with the sparse nature of the data, we apply high-dimensional methods to efficiently select relevant data.

Keywords: supermodularity, supermodular dominance, stochastic dominance, Monte Carlo simulation, bootstrap, subsampling

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Authors: Temitope O. Tokosi

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Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: clinician, electronic content management, hospital, perception, technology

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Authors: Nur Aziza Luxfiati

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Clustering is partitioning data sets into sub-sets or groups in such a way that elements certain properties have shared property settings with a high level of similarity within one group and a low level of similarity between groups. . The K-Means algorithm is one of thealgorithmsclustering as a grouping tool that is most widely used in scientific and industrial applications because the basic idea of the kalgorithm is-means very simple. In this research, applying the technique of clustering using the k-means algorithm as a method of solving the problem of national development imbalances between regions in Central Java Province based on macroeconomic indicators. The data sample used is secondary data obtained from the Central Java Provincial Statistics Agency regarding macroeconomic indicator data which is part of the publication of the 2019 National Socio-Economic Survey (Susenas) data. score and determine the number of clusters (k) using the elbow method. After the clustering process is carried out, the validation is tested using themethodsBetween-Class Variation (BCV) and Within-Class Variation (WCV). The results showed that detection outlier using z-score normalization showed no outliers. In addition, the results of the clustering test obtained a ratio value that was not high, namely 0.011%. There are two district/city clusters in Central Java Province which have economic similarities based on the variables used, namely the first cluster with a high economic level consisting of 13 districts/cities and theclustersecondwith a low economic level consisting of 22 districts/cities. And in the cluster second, namely, between low economies, the authors grouped districts/cities based on similarities to macroeconomic indicators such as 20 districts of Gross Regional Domestic Product, with a Poverty Depth Index of 19 districts, with 5 districts in Human Development, and as many as Open Unemployment Rate. 10 districts.

Keywords: clustering, K-Means algorithm, macroeconomic indicators, inequality, national development

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Authors: Noimot A. Bakare, Rotimi S. Olaleye, Bolaji O. Adeniji

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The study examined the effectiveness of selected coping strategies for poverty alleviation among smallholder farmers in Niger State, Nigeria. Data were collected with the aid of interview schedule. A multistage random sampling technique was used to select 225 respondents from 3 geographical zones in the State. Data were analyzed using descriptive and inferential statistics. The results showed that majority (83.1%) of the respondents were within the age of 21-50 years, mostly male (76.0%) and married (77.8%). The highest educational level attained was quranic education. Findings showed that coping strategies commonly adopted by the farmers were; use of food stuff (94.2%), money savings(76.6%), reduction in expenditure(74.2%) and food consumption (65.2%). Also, there was high awareness of primary healthcare and fadama development poverty alleviation programmes by Government and non-governmental organizations. Regression model indicated a significant and positive relationship between the educational level of farmers, farm size, contact with extension and effectiveness of poverty coping strategies. Pearson correlation coefficient shows a correlation between coping strategies adopted and their effectiveness(r = 0.599, P < 0.01). However, t- test shows a significant difference between coping strategies adopted by the male and female farmers (t= -2.63, P < 0.01). It is recommended that awareness on poverty alleviation programmes aimed at improving the productivity of farming activities should be intensified while farmers should be involved in the planning and implementation of these programmes.

Keywords: coping strategies, effectiveness, farmers, poverty alleviation.

Procedia PDF Downloads 363

Authors: Diksha Sapkota, Kathleen Baird, Amornrat Saito, Debra Anderson

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Background: Violence during pregnancy is global public health problem incurring huge amount of social, economic and human costs. It is of particular concern as it affects health of mother, neonates and also disrupt family functioning. Mental illness is one of its commonest consequences affecting both mother and baby and likely to be chronic if left unattended. Past decade has seen advances in knowledge about different forms of violence, its health impacts and intervention/s helping to confront the violence. However, limited range and lack of consistency in measurable outcomes undermine overall effect of interventions, and available evidence are largely slanted towards high-income countries. Despite recognition of integrating screening and counselling for abused pregnant women in health settings, there is a dearth of evidence on its effectiveness from developing countries limiting its applicability and feasibility. This study intends to summarise the high-quality evidence on intimate partner violence interventions in reducing violence and improving mental health and implement the promising intervention in our context. Methods: Quantitative systematic review will be done using PRISMA statement and based on its finding; randomised controlled intervention will be carried out. The study will be conducted among women attending ANC clinic of Dhulikhel Hospital, Nepal. Being the pilot study, samples just adequate to draw the inferences i.e. not less than 30 in each arm will be taken. Phenomological approach will be used to explore the strengths and weaknesses of tested intervention and recommendations for better planning in future. Conclusion: This study intends to provide concrete evidence on what works best in our context and will assist policymakers, programme planners, donors in informed decision making.

Keywords: intimate partner violence/prevention and control, mental health, Nepal, pregnant

Procedia PDF Downloads 261

Authors: Al Asyary, Meita Veruswati, Dian Ayyubi

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Sukabumi municipal has highest rank for maternal mortality in Indonesia with 102 by 100,000 live birth with almost 80% of birth were not attended by skilled birth attendant (SBA). Although universal health coverage has been implemented, availability and sufficiency of SBA, such as midwife in this developing country, are problematic agenda for the quality of public healthcare as well as decreasing maternal mortality rate. This study aims to describe the equal distribution of midwives in Sukabumi municipal as support of government’s program named Millennium Development Goals (MDGs) that suppressed maternal mortality rate in Indonesia. We conducted an observational study with Workload Indicator of Staffing Need (WISN) analysis to present the dispersion of midwives by their activities and workloads in 37 Puskesmas. We also generated in-depth interview with several executive chief of health sections, including chief of health offices in Sukabumi municipal. It resulted inferentially that several activities in midwives’ program were differed at once of existing than needed condition ideally (ρ value = 0.002 < 0.05). Meanwhile, decision for midwives’ procurement and placement were held by un-systematically procedure such as based on where the midwife was staying, and it also progressed by neighborhood issue priorities. The absence of formal regulation in local government is a serious problem that indicated poor political commitment, while access to SBA shall be focused carefully.

Keywords: developing country, health professional resources, health policy, need assessment

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Authors: Khairani Binti Supyan, Fatimah Khalid, Mas Rina Mustaffa, Azreen Bin Azman, Amirul Azuani Romle

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Perennial plant classification plays a significant role in various agricultural and environmental applications, assisting in plant identification, disease detection, and biodiversity monitoring. Nevertheless, attaining high accuracy in perennial plant image classification remains challenging due to the complex variations in plant appearance, the diverse range of environmental conditions under which images are captured, and the inherent variability in image quality stemming from various factors such as lighting conditions, camera settings, and focus. This paper proposes an adaptation approach to optimize perennial plant image classification by fine-tuning the pre-trained DNNs model. This paper explores the efficacy of fine-tuning prevalent architectures, namely VGG16, ResNet50, and InceptionV3, leveraging transfer learning to tailor the models to the specific characteristics of perennial plant datasets. A subset of the MYLPHerbs dataset consisted of 6 perennial plant species of 13481 images under various environmental conditions that were used in the experiments. Different strategies for fine-tuning, including adjusting learning rates, training set sizes, data augmentation, and architectural modifications, were investigated. The experimental outcomes underscore the effectiveness of fine-tuning deep neural networks for perennial plant image classification, with ResNet50 showcasing the highest accuracy of 99.78%. Despite ResNet50's superior performance, both VGG16 and InceptionV3 achieved commendable accuracy of 99.67% and 99.37%, respectively. The overall outcomes reaffirm the robustness of the fine-tuning approach across different deep neural network architectures, offering insights into strategies for optimizing model performance in the domain of perennial plant image classification.

Keywords: perennial plants, image classification, deep neural networks, fine-tuning, transfer learning, VGG16, ResNet50, InceptionV3

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Authors: Adekunle O. Afolabi, Pekka Toivanen

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The world is expected to experience growth in the number of ageing population, and this will bring about high cost of providing care for these valuable citizens. In addition, many of these live with chronic diseases that come with old age. Providing adequate care in the face of rising costs and dwindling personnel can be challenging. However, advances in technologies and emergence of the Internet of Things are providing a way to address these challenges while improving care giving. This study proposes the integration of recommendation systems into homecare to provide real-time recommendations for effective management of people receiving care at home and those living with chronic diseases. Using the simplified Training Logic Concept, stakeholders and requirements were identified. Specific requirements were gathered from people living with cancer. The solution designed has two components namely home and community, to enhance recommendations sharing for effective care giving. The community component of the design was implemented with the development of a mobile app called Recommendations Sharing Community for Aged and Chronically Ill People (ReSCAP). This component has illustrated the possibility of real-time recommendations, improved recommendations sharing among care receivers and between a physician and care receivers. Full implementation will increase access to health data for better care decision making.

Keywords: recommendation systems, Internet of Things, healthcare, homecare, real-time

Procedia PDF Downloads 154

Authors: Hankyu Lee, Seoung Bum Kim

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The issue with imbalance and overlapping in the class distribution becomes important in various applications of data mining. The imbalanced dataset is a special case in classification problems in which the number of observations of one class (i.e., major class) heavily exceeds the number of observations of the other class (i.e., minor class). Overlapped dataset is the case where many observations are shared together between the two classes. Imbalanced and overlapped data can be frequently found in many real examples including fraud and abuse patients in healthcare, quality prediction in manufacturing, text classification, oil spill detection, remote sensing, and so on. The class imbalance and overlap problem is the challenging issue because this situation degrades the performance of most of the standard classification algorithms. In this study, we propose a classification procedure that can effectively handle imbalanced and overlapped datasets by splitting data space into three parts: nonoverlapping, light overlapping, and severe overlapping and applying the classification algorithm in each part. These three parts were determined based on the Hausdorff distance and the margin of the modified support vector machine. An experiments study was conducted to examine the properties of the proposed method and compared it with other classification algorithms. The results showed that the proposed method outperformed the competitors under various imbalanced and overlapped situations. Moreover, the applicability of the proposed method was demonstrated through the experiment with real data.

Keywords: classification, imbalanced data with class overlap, split data space, support vector machine

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Authors: Getaneh Berie Tarekegn

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A precise localization system is crucial for many artificial intelligence Internet of Things (AI-IoT) applications in the era of smart cities. Their applications include traffic monitoring, emergency alarming, environmental monitoring, location-based advertising, intelligent transportation, and smart health care. The most common method for providing continuous positioning services in outdoor environments is by using a global navigation satellite system (GNSS). Due to nonline-of-sight, multipath, and weather conditions, GNSS systems do not perform well in dense urban, urban, and suburban areas.This paper proposes a generative AI-based positioning scheme for large-scale wireless settings using fingerprinting techniques. In this article, we presented a novel semi-supervised deep convolutional generative adversarial network (S-DCGAN)-based radio map construction method for real-time device localization. We also employed a reliable signal fingerprint feature extraction method with t-distributed stochastic neighbor embedding (t-SNE), which extracts dominant features while eliminating noise from hybrid WLAN and long-term evolution (LTE) fingerprints. The proposed scheme reduced the workload of site surveying required to build the fingerprint database by up to 78.5% and significantly improved positioning accuracy. The results show that the average positioning error of GAILoc is less than 39 cm, and more than 90% of the errors are less than 82 cm. That is, numerical results proved that, in comparison to traditional methods, the proposed SRCLoc method can significantly improve positioning performance and reduce radio map construction costs.

Keywords: location-aware services, feature extraction technique, generative adversarial network, long short-term memory, support vector machine

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Authors: D. Berg, N. Hartley, L. Nasr

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This paper presents a conceptual model of human-robot interaction within service encounters and the effect on the well-being of both consumers and service providers. In this paper, service providers are those employees who work alongside frontline service robots. The significance of this paper lies in the knowledge created which outlines how frontline service robots can be effectively utilized in service encounters for the benefit of organizations and society as a whole. As this paper is conceptual in nature, the main methodologies employed are theoretical, namely problematization and theory building. The significance of this paper is underpinned by the shift of service robots from manufacturing plants and factory floors to consumer-facing service environments. This service environment places robots in direct contact with frontline employees and consumers creating a hybrid workplace where humans work alongside service robots. This change from back-end to front-end roles may have implications not only on the physical environment, servicescape, design, and strategy of service offerings and encounters but also on the human parties of the service encounter itself. Questions such as ‘how are frontline service robots impacting and changing the service encounter?’ and ‘what effect are such changes having on the well-being of the human actors in a service encounter?’ spring to mind. These questions form the research question of this paper. To truly understand social service robots, an interdisciplinary perspective is required. Besides understanding the function, system, design or mechanics of a service robot, it is also necessary to understand human-robot interaction. However not simply human-robot interaction, but particularly what happens when such robots are placed in commercial settings and when human-robot interaction becomes consumer-robot interaction and employee-robot interaction? A service robot in this paper is characterized by two main factors; its social characteristics and the consumer-facing environment within which it operates. The conceptual framework presented in this paper contributes to interdisciplinary discussions surrounding social robotics, service, and technology’s impact on consumer and service provider well-being, and hopes that such knowledge will help improve services, as well as the prosperity and well-being of society.

Keywords: frontline service robots, human-robot interaction, service encounters, well-being

Procedia PDF Downloads 207

Authors: Gabriela Macera DiFilippo

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The world watched in disbelief as George Floyd was killed by a policeman. The images from the scene were made more memorable by Mr. Floyd’s pleas and cries for his mother. In the aftermath of this tragedy, the Black Lives Matter movement gained momentum. Weeks and months after the protests, global interest in learning about tackling systemic racism erupted. One must wonder how school children of color viewed and processed this trauma. This study will examine the kinds of trauma experienced by children of color and the opportunity for school mental health providers to support these children. This study used literature searches that were previously conducted for proven and practical assessment methods that can help deal with racial trauma for children. As part of the assessment, trauma symptoms experienced by children of color were summarized and characterized in a non-imperial manner. The research was also will be done in practical ways to make adequate and effective mental health services available in schools and lessen the stigma. This research study found that there is a need to provide an analysis of the ongoing racial trauma of children of color after the death of George Floyd. Impactful and appropriate assessment methods, such as surveys, were presented to all school professionals. Lastly, this paper attempted to provide mental health professionals with the tools to screen and provide guidance based on unequivocal, unbiased methods for helping these children. There is a need for both schools and community leaders to ensure that every child has access to mental health care and is being assessed for their overall well-being. There is a need to educate the communities about racial trauma and its impact on individuals, especially children. School mental health professionals are encouraged to offer and educate schools and communities about racial trauma awareness, its importance, and ways to cope with it in different settings. The delivery of these informed services should focus on behavioral health and must be sensitive to children of color and different ways of self-care.

Keywords: trauma, children, black psychology, students

Procedia PDF Downloads 58

Authors: Mariam Azam, Sajjad Ur Rahman, Mukarram Bashir, Muhammad Tahir, Seemal Javaid, Jawad, Aoun Muhammad, Muhammad Zohaib, Hannan Khan

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Products of microbial origin are of great importance as they have proved their value in healthcare and nutrition, use of these microbial metabolites acquired from partially fermented soya hulls and wheat bran along with Saccharomyces cerevisiae (DL-22 S/N) substantiates to be a great source for an increase in the total milk production and quality yield.1×109 CFU/ml cells of Saccharomyces cerevisiae (DL-22 S/N) were further grown under in-vivo conditions for the assessment of quality milk production. Two groups with twelve cows, each having the same physical characteristics (Group A and Group B), were under study, Group A was daily fed with 12gm of biological metabolites and 22% protein-pelleted feed. On the other hand, the animals of Group B were provided with no metabolites in their feed. In thirty days of trial, improvement in the overall health, body score, milk protein, milk fat, yield, incidence rate of mastitis, ash, and solid not fat (SNF) was observed. The collected data showed that the average quality milk production was elevated up to 0.45 liter/h/d. However, a reduction in the milk fats up to 0.45% and uplift in the SNF value up to 0.53% of cow milk was also observed. At the same time, the incidence rate of mastitis recorded for the animals under trial was reduced to half, and improved non specific immunity was reported.

Keywords: microbial metabolites, post-biotics, animal supplements, animal nutrition, proteins, animal production, fermentation

Procedia PDF Downloads 101