Search results for: interprofessional health care team

Authors: Shu-Hsi Ho

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The problems of aging and number of widowed peers gradually rise in Taiwan. It is worth to concern the related issues for elderly after the death of a spouse. Hence, this study is to examine the impact of spousal death on the surviving spouse’s self-perceived health and mental health for the elderly in Taiwan. A cross section data design and ordered logistic regression models are applied to investigate whether marriage is associated significantly to self-perceived health and mental health for the widowed older Taiwanese. The results indicate that widowed marriage shows significant negative effects on self-perceived health and mental health regardless of widows or widowers. Among them, widows might be more likely to show worse mental health than widowers. The belief confirms that marriage provides effective sources to promote self-perceived health and mental health, particularly for females. In addition, since the social welfare system is not perfect in Taiwan, the findings also suggest that family and social support reveal strongly association with the self-perceived health and mental health for the widows and widowers elderly.

Keywords: logistic regression models, self-perceived health, widow, widower

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Authors: Jaleh Shoshtarian Malak, Niloofar Mohamadzadeh

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Managing pre-hospital emergency patients requires real-time practices and efficient resource utilization. Since we are facing a distributed Network of healthcare providers, services and applications choosing the right resources and treatment protocol considering patient situation is a critical task. Delivering care to emergency patients at right time and with the suitable treatment settings can save ones live and prevent further complication. In recent years Multi Agent Systems (MAS) introduced great solutions to deal with real-time, distributed and complicated problems. In this paper we propose a multi agent based pre-hospital emergency management architecture in order to manage coordination, collaboration, treatment protocol and healthcare provider selection between different parties in pre-hospital emergency in a self-organizing manner. We used AnyLogic Agent Based Modeling (ABM) tool in order to simulate our proposed architecture. We have analyzed and described the functionality of EMS center, Ambulance, Consultation Center, EHR Repository and Quality of Care Monitoring as main collaborating agents. Future work includes implementation of the proposed architecture and evaluation of its impact on patient quality of care improvement.

Keywords: multi agent systems, pre-hospital emergency, simulation, software architecture

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Authors: T. Frawley, G. O'Kelly

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The UCD School of Nursing, Midwifery and Health Systems Higher Diploma in Mental Health (HDMH) nursing programme commenced in January 2017. Forty students successfully completed the programme. Programme evaluation was conducted from the outset. Research ethics approval was granted by the UCD Human Research Ethics Committee – Sciences in November 2016 (LS-E-16-163). Plan for Sustainability: Each iteration of the programme continues to be evaluated and adjusted accordingly. Aims: The ultimate purpose of the HDMH programme is to prepare registered nurses (registered children’s nurse (RCN), registered nurse in intellectual disability (RNID) and registered general nurse (RGN)) to function as effective registered psychiatric nurses in all settings which provide care and treatment for people experiencing mental health difficulties. Curriculum evaluation is essential to ensure that the programme achieves its purpose, that aims and expected outcomes are met and that required changes are highlighted for the programme’s continuing positive development. Methods: Both quantitative and qualitative methods were used in the evaluation. A series of questionnaires were used (the majority pre and post programme) to determine student perceptions of the programme, behaviour and attitudinal change from commencement to completion. These included the student assessment of learning gains (SALG); mental health knowledge schedule (MAKS); mental health clinician attitudes scale (MICA); reported and intended behaviour scale (RIBS); and community attitudes towards the mentally ill (CAMI). In addition, student and staff focus groups were conducted. Evaluation methods also incorporated module feedback. Outcome/Results: The evaluation highlighted a very positive response in relation to the achievement of programme outcomes and preparation for future work as registered psychiatric nursing. Some areas were highlighted for further development, which have been taken cognisance of in the 2019 iteration of the programme.

Keywords: learning gains, mental health, nursing, stigma

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Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

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Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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Authors: Hamad Albadr

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Joint Commission International (JCI) accreditation process intent to improve the safety and quality of care in the international community through the provision of education, publications, consultation, and evaluation services. These standards apply to the entire organization as well as to each department, unit, or service within the organization. Medical Technology that contains both medical equipment and devices, is an essential part of health care. Appropriate management of equipment maintenance for ensuring medical technology safe, the equipment life is maximized, and the total costs are minimized. JCI medical technology evaluation and accreditation use standards, intents, and measurable elements. The paper focuses on evaluation of JCI standards for medical technology in Saudi Arabian hospitals: a Study Case of PSMMC that define the performance expectation, structures, or functions that must be in place for a hospital to be accredited by JCI through measurable elements that indicate a score during the survey process that identify the requirements for full compliance with the standard specially through Facility Management and Safety (FMS) section that require the hospital establishes and implements a program for inspecting, testing, and maintaining medical technology and documenting the results, to ensure that medical technology is available for use and functioning properly, the hospital performs and documents; an inventory of medical technology; regular inspections of medical technology; testing of medical technology according to its use and manufacturers’ requirements; and performance of preventive maintenance.

Keywords: joint commission international (JCI) accreditation, medical technology, Saudi Arabia, Saudi Arabian hospitals

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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The COVID-19 pandemic has presented an opportune time for China to deploy its health diplomacy around the world. This paper focused on China’s health diplomacy along the path of its Health Silk Road, with particular emphasis on the Middle East and Europe amid COVID-19. This paper employed a retrospective literature review, analyzed China’s health diplomacy in such regions to cultivate bilateral and multilateral relationships. And findings argued that such health diplomacy is a success, and Beijing has assumed a leadership role in the world’s health governance. This research contributes to the literature in health diplomacy and suggests that amid the ever changing international order, China has exerted great effort in its health diplomacy and established itself as a responsible world power.

Keywords: china’s health silk road, COVID-19, europe, middle east

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Authors: Anthony El Hachem, Hosam Salman

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Selecting the most effective construction method for drilled shafts under the high phreatic surface can be a challenging task that requires effective communication between the design and construction teams. Slurry placement, temporary casing, and permanent casing are the three most commonly used installation techniques to ensure the stability of the drilled hole before casting the concrete. Each one of these methods has its implications on the installation and performance of the drilled piers. Drilled shafts were designed to support a fire wall for an Energy project in Central Texas. The subsurface consisted of interlayers of sands and clays of varying shear strengths. The design recommended that the shafts be installed with temporary casing or slurry displacement due to the anticipated groundwater seepage through granular soils. During the foundation construction, it was very difficult to maintain the stability of the hole, and the contractor requested to install the shafts using permanent casings. Therefore, the foundation design was modified to ensure that the cased shafts achieve the required load capacity. Effective and continuous communications between the owner, contractor and design team during field shaft installations to mitigate the unforeseen challenges helped the team to successfully complete the project.

Keywords: construction challenges, deep foundations, drilled shafts, loose sands underwater table, permanent casing

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Authors: Ram Sharan Mehta

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Continuing changes in health and social care policy and practice have affected and changed the way in which nursing is practiced. One of the greatest challenges facing nursing today is to build on the essence of nursing as a caring profession whilst incorporating new technologies, ideas and approaches to future healthcare. The objective of this study was to find out the socio-demographic characteristics of the M.Sc. Nursing students and calculate the association between specialty subjects, caste, age group, and residence with SLC division, BN/BSN division, entrance score, and total nursing experience. Descriptive cross-sectional study design was used to conduct the study among all the 25 M.Sc. Nursing students studying at BPKIHS in 2012. Most of the students (56%) were of age group of 25-30 years, completed his academic courses with first division and succeeded in entrance test in first attempt (96%). Based on the results, it can conclude that most of the subjects were of young age, having high score achievers in SLC, I.Sc., CN, BN/BSN and Entrance test. The demographic characteristics do not influence in the academic scores of the students.

Keywords: profile, postgraduate nursing students, Nepal, influence

Procedia PDF Downloads 256

Authors: Nuchjaree Kidjawan, Orapan Thosingha, Pawinee Vaipatama, Prakrankiat Youngkong, Sirinapha Malangputhong, Kitti Thamrongaphichartkul, Phatcharaporn Phetcharat

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NPI uses technology sensorization of things and processed by AI system. The main features are an individual interface pressure sensor system in contact with the mattress and a position management system where the sensor detects the determined pressure with automatic pressure reduction and distribution. The role of NPI is to monitor, identify the risk and manage the interface pressure automatically when the determined pressure is detected. This study aims to evaluate the effects of “Never Pressure Injury (NPI),” an innovative mattress, on the incidence of pressure injuries in critically ill patients. An observational case-control study was employed to compare the incidence of pressure injury between the case and the control group. The control group comprised 80 critically ill patients admitted to a critical care unit of Phyathai3 Hospital, receiving standard care with the use of memory foam according to intensive care unit guidelines. The case group comprised 80 critically ill patients receiving standard care and with the use of the Never Pressure Injury (NPI) innovation mattress. The patients who were over 20 years old and showed scores of less than 18 on the Risk Assessment Pressure Ulcer Scale – ICU and stayed in ICU for more than 24 hours were selected for the study. The patients’ skin was assessed for the occurrence of pressure injury once a day for five consecutive days or until the patients were discharged from ICU. The sample comprised 160 patients with ages ranging from 30-102 (mean = 70.1 years), and the Body Mass Index ranged from 13.69- 49.01 (mean = 24.63). The case and the control group were not different in their sex, age, Body Mass Index, Pressure Ulcer Risk Scores, and length of ICU stay. Twenty-two patients (27.5%) in the control group had pressure injuries, while no pressure injury was found in the case group.

Keywords: pressure injury, never pressure injury, innovation mattress, critically ill patients, prevent pressure injury

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Authors: Ha Hai Duong, Amnon Levy Livermore, Kankesu Jayanthakumaran, Oleg Yerokhin

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The issues of economic development, the environment and human health have been investigated since 1990s. Previous researchers have found different empirical evidences of the relationship between income and environmental pollution, health as determinant of economic growth, and the effects of income and environmental pollution on health in various regions of the world. This paper concentrates on integrative relationship analysis of GDP, carbon dioxide emissions, and health services and population health in context of Vietnam. We applied the dynamic generalized method of moments (GMM) estimation on datasets of Vietnam’s sixty-three provinces for the years 2000-2010. Our results show the significant positive effect of GDP on emissions and the dependence of population health on emissions and health services. We find the significant relationship between population health and GDP. Additionally, health services are significantly affected by population health and GDP. Finally, the population size too is other important determinant of both emissions and GDP.

Keywords: economic development, emissions, environmental pollution, health

Procedia PDF Downloads 626

Authors: J. F. Pollo Gaspary, F. Peron Gaspary, E. M. Simão, R. Concatto Beltrame, G. Orengo de Oliveira, M. S. Ristow Ferreira, F. Sartori Thies, I. F. Minello, F. dos Santos de Oliveira

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Background: The immune system has evolved several mechanisms to protect the host against cancer, and it has now been suggested that the expansion of its functions may prevent tumor growth and control the symptoms of cancer patients. Two techniques, ozone therapy and pulsed electromagnetic fields (PEMF), are independently associated with an increase in the immune system functions and they maybe help palliative care of patients in these conditions. Case Report: A patient with rectal adenocarcinoma with metastases decides to interrupt the clinical chemotherapy protocol due to refractoriness and side effects. As a palliative care alternative treatment it is suggested to the patient the use of ozone therapy associated with PEMF techniques. Results: The patient reports an improvement in well-being, in autonomy and in pain control. Imaging tests confirm a pause in tumor growth despite more than 60 days without using classic treatment. These results associated with palliative care alternative treatment stimulate the return to the chemotherapy protocol. Discussion: This case illustrates that these two techniques can contribute to the control of tumor growth and refractory symptoms, such as pain, probably by enhancing the immune system. Conclusions: The potential use of the combination of these two therapies, ozone therapy and PEMF therapy, can contribute to palliation of cancer patients, alone or in combination with pharmacological therapies. The conduct of future investigations on this paradigm can elucidate how much these techniques contribute to the survival and well-being of these patients.

Keywords: cancer, complementary and alternative medicine , ozone therapy, palliative care, PEMF therapy

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Authors: Adolfo Cangas, Noelia Navarro

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The current study shows the assessment made by university students of a video game entitled Stigma-Stop where the characters present different mental disorders. The objective is that players have more real information about mental disorders and empathize with them and thus reduce stigma. The sample consisted of 169 university students studying degrees related to education, social care and welfare (i.e., Social Education, Psychology, Early Childhood Education, Special Education, and Social Work). The participants valued the video game positively, especially in relation to utility, being somewhat lower the score awarded to the degree of entertainment. They detect the disorders and point out that in many occasions they felt the same (particularly in the case of depression, being lower in agoraphobia and bipolar disorder, and even lower in the case of schizophrenia), most students recommend the use of the video game. They emphasize that Stigma-Stop offers intervention strategies, information regarding the symptomatology and sensitizes against stigma.

Keywords: schizophrenia, social stigma, students, mental health

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Authors: Mahnaz Khalafehnilsaz, Rozina Rahnama

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Introduction: The elderly population is growing rapidly, and with this growth comes an increased demand for healthcare services. Artificial intelligence (AI) has the potential to revolutionize the delivery of healthcare services to the elderly population. In this study, the various ways in which AI is used to create health content for elderly people and its transformative impact on the healthcare industry will be explored. Method: A systematic review of the literature was conducted to identify studies that have investigated the role of AI in creating health content specifically for elderly people. Several databases, including PubMed, Scopus, and Web of Science, were searched for relevant articles published between 2000 and 2022. The search strategy employed a combination of keywords related to AI, personalized health content, and the elderly. Studies that utilized AI to create health content for elderly individuals were included, while those that did not meet the inclusion criteria were excluded. A total of 20 articles that met the inclusion criteria were identified. Finding: The findings of this review highlight the diverse applications of AI in creating health content for elderly people. One significant application is the use of natural language processing (NLP), which involves the creation of chatbots and virtual assistants capable of providing personalized health information and advice to elderly patients. AI is also utilized in the field of medical imaging, where algorithms analyze medical images such as X-rays, CT scans, and MRIs to detect diseases and abnormalities. Additionally, AI enables the development of personalized health content for elderly patients by analyzing large amounts of patient data to identify patterns and trends that can inform healthcare providers in developing tailored treatment plans. Conclusion: AI is transforming the healthcare industry by providing a wide range of applications that can improve patient outcomes and reduce healthcare costs. From creating chatbots and virtual assistants to analyzing medical images and developing personalized treatment plans, AI is revolutionizing the way healthcare is delivered to elderly patients. Continued investment in this field is essential to ensure that elderly patients receive the best possible care.

Keywords: artificial intelligence, health content, older adult, healthcare

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Authors: A. Calabrese, V. F. Uricchio, D. di Noia, S. Favale, C. Caiati, G. P. Maggi, G. Donvito, D. Diacono, S. Tangaro, A. Italiano, E. Riezzo, M. Zippitelli, M. Toriello, E. Celiberti, D. Festa, A. Colaianni

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Climate change has a severe impact on human health. There is a vast literature demonstrating temperature increase is causally related to cardiovascular problem and represents a high risk for human health, but there are not study that improve a solution. In this work, it is studied how the clime influenced the human parameter through the analysis of climatic conditions in an area of the Apulia Region: Capurso Municipality. At the same time, medical personnel involved identified a set of variables useful to define an index describing health condition. These scientific studies are the base of an innovative alert system, IPPOCRATE, whose aim is to asses climate risk and share information to population at risk to support prevention and mitigation actions. IPPOCRATE is an e-health system, it is designed to provide technological support to analysis of health risk related to climate and provide tools for prevention and management of critical events. It is the first integrated system of prevention of human risk caused by climate change. IPPOCRATE calculates risk weighting meteorological data with the vulnerability of monitored subjects and uses mobile and cloud technologies to acquire and share information on different data channels. It is composed of four components: Multichannel Hub. Multichannel Hub is the ICT infrastructure used to feed IPPOCRATE cloud with a different type of data coming from remote monitoring devices, or imported from meteorological databases. Such data are ingested, transformed and elaborated in order to be dispatched towards mobile app and VoIP phone systems. IPPOCRATE Multichannel Hub uses open communication protocols to create a set of APIs useful to interface IPPOCRATE with 3rd party applications. Internally, it uses non-relational paradigm to create flexible and highly scalable database. WeHeart and Smart Application The wearable device WeHeart is equipped with sensors designed to measure following biometric variables: heart rate, systolic blood pressure and diastolic blood pressure, blood oxygen saturation, body temperature and blood glucose for diabetic subjects. WeHeart is designed to be easy of use and non-invasive. For data acquisition, users need only to wear it and connect it to Smart Application by Bluetooth protocol. Easy Box was designed to take advantage from new technologies related to e-health care. EasyBox allows user to fully exploit all IPPOCRATE features. Its name, Easy Box, reveals its purpose of container for various devices that may be included depending on user needs. Territorial Registry is the IPPOCRATE web module reserved to medical personnel for monitoring, research and analysis activities. Territorial Registry allows to access to all information gathered by IPPOCRATE using GIS system in order to execute spatial analysis combining geographical data (climatological information and monitored data) with information regarding the clinical history of users and their personal details. Territorial Registry was designed for different type of users: control rooms managed by wide area health facilities, single health care center or single doctor. Territorial registry manages such hierarchy diversifying the access to system functionalities. IPPOCRATE is the first e-Health system focused on climate risk prevention.

Keywords: climate change, health risk, new technological system

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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The outbreak of the COVID-19 epidemic has caused great difficulties for South-South cooperation, but there are also opportunities. China’s health diplomacy has changed from dispatching medical teams, assisting in the construction of hospitals, and encouraging medical investment in the Africa health sector. This paper adopted a retrospective review of China’s health diplomacy in Africa from 1963 to 2020. Findings suggested that China has a preference for aiding Africa health infrastructure and sending medical teams to African countries. China’s health diplomacy in Africa is a success and has established secure diplomatic relations with African countries, thanks to the medical and health assistance to Africa over 60 years. This research contributes to the literature of health diplomacy and foreign relations and indicates that China’s health aid has fostered cooperation at the medical and diplomatic levels.

Keywords: Africa, china’s health diplomacy, COVID-19, bilateral relations

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Authors: Melvin Chan, Chew Lee Teo

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There has been a growing emphasis in elevating the teachers’ proficiency and competencies through continuing professional development (CPD) opportunities. In this era of a Volatile, Uncertain, Complex, Ambiguous (VUCA) world, teachers are expected to be collaborative designers, critical thinkers and creative builders. However, many of the CPD structures are still revolving in the model of transmission, which stands in contradiction to the cultivation of future-ready teachers for the innovative world of emerging technologies. This article puts forward the framing of CPD through a Principle-Based, Technological-Driven Knowledge Building Approach grounded in the essence of andragogy and progressive learning theories where growth is best exemplified through an authentic immersion in a social/community experience-based setting. Putting this Knowledge Building Professional Development Model (KBPDM) in operation via a Professional Learning Team (PLT) situated in a Secondary School in Singapore, research findings reveal that the intervention has led to a fundamental change in the learning paradigm of the teachers, henceforth equipping and empowering them successfully in their pedagogical design and practices for a 21^st century classroom experience. This article concludes with the possibility in leveraging the Learning Analytics to deepen the CPD experiences for educators.

Keywords: continual professional development, knowledge building, learning paradigm, principle-based

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Authors: Uwe C. Fischer

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Mental health and well-being for employees working in the human service system are getting more and more important given the increasing rate of absenteeism at work. Besides individual capacities, social and community factors seem to be important in the working setting. Starting from a demand resource framework including the classical demand control aspects, social support systems, specific demands and resources of the client work, and work-family conflict were considered in the present study. We state hypothetically, that these factors have a meaningful association with the mental quality of life of employees working in the field of social, educational and health sectors. 1140 employees, working in human service organizations (education, youth care, nursing etc.) were asked for strains and resources at work (selected scales from Salutogenetic Subjective Work Assessment SALSA and own new scales for client work), work-family conflict, and mental quality of life from the German Short Form Health Survey. Considering the complex influences of the variables, we conducted a multiple hierarchical regression analysis. One third of the whole variance of the mental quality of life can be declared by the different variables of the model. When the variables concerning social influences were included in the hierarchical regression, the influence of work related control resource decreased. Excessive workload, work-family conflict, social support by supervisors, co-workers and other persons outside work, as well as strains and resources associated with client work had significant regression coefficients. Conclusions: Social support systems are crucial in the social, educational and health related service sector, regarding the influence on mental well-being. Especially the work-family conflict focuses on the importance of the work-life balance. Also the specific strains and resources of the client work, measured with new constructed scales, showed great impact on mental health. Therefore occupational health promotion should focus more on the social factors within and outside the working place.

Keywords: client interaction, human service system, mental health, social support, work-family conflict

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Authors: Farah Naja, Mohamad Alameddine

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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.

Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy

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Authors: K. Bensafia, A. Mansour, G. Le Maillot, B. Clement, O. Reynet, P. Ariès, S. Haddab

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This paper presents a system designed for wireless acquisition, the recording of electrocardiogram (ECG) signals and the monitoring of the heart’s health during surgery. This wireless recording system allows us to visualize and monitor the state of the heart’s health during a surgery, even if the patient is moved from the operating theater to post anesthesia care unit. The acquired signal is transmitted via a Bluetooth unit to a PC where the data are displayed, stored and processed. To test the reliability of our system, a comparison between ECG signals processed by a conventional ECG monitoring system (Datex-Ohmeda) and by our wireless system is made. The comparison is based on the shape of the ECG signal, the duration of the QRS complex, the P and T waves, as well as the position of the ST segments with respect to the isoelectric line. The proposed system is presented and discussed. The results have confirmed that the use of Bluetooth during surgery does not affect the devices used and vice versa. Pre- and post-processing steps are briefly discussed. Experimental results are also provided.

Keywords: electrocardiography, monitoring, surgery, wireless system

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Authors: Rula D. Alshareef, Safa S. Alqathmi, Ghadah K. Alkhouldi, Reem O. Bagabas, Farheen B. Hasan

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Safety engineering is among the most crucial considerations in any work environment. Providing mentally, physically, and environmentally safe work conditions must be the top priority of any successful organization. Company X is a local paint production company in Saudi Arabia; in a month, the factory experienced two significant accidents, which indicates that workers’ safety is overlooked. The aim of the research is to examine the risks, assess the root causes and recommend control measures that will eventually contribute to providing a safe workplace. The methodology used is sectioned into three phases, risk identification, assessment, and finally, mitigation. In the identification phase, the team used Rapid Entire Body Assessment (REBA) and National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) tools to holistically establish knowledge about the current risk posed to the factory. The physical hazards in the factory were assessed in two different operations, which are mixing and filling/packaging. For the risk assessment phase, the hazards were deeply analyzed through their severity and impact. Additionally, through risk mitigation, the Rapid Entire Body Assessment (REBA) score decreased from 11 to 7, and the National Institute for Occupational Safety and Health Lifting Index (NIOSH LI) has been reduced from 5.27 to 1.85.

Keywords: ergonomics, safety, workplace risks, hazards, awkward posture, fatigue, work environment

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Authors: Franciska Weise, Ralph Bruder

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Due to the demographic change in Germany along with the declining birth rate and the increasing age of population, the share of older people in society is rising. This development is also reflected in the work force of German companies. Therefore companies should focus on improving ergonomics, especially in the area of age-related work design. Literature shows that studies on age-related work design have been carried out in the past, some of whose results have been put into practice. However, there is still a need for further research. One of the most important methods for taking into account the needs of an aging population is job rotation. This method aims at preventing or reducing health risks and inappropriate physical strain. It is conceived as a systematic change of workplaces within a group. Existing literature does not cover any methods for the investigation of the attitudes of employees towards job rotation. However, in order to evaluate job rotation, it is essential to have knowledge of the views of people towards rotation. In addition to an investigation of attitudes, the design of rotation plays a crucial role. The sequence of activities and the rotation frequency influence the worker and as well the work result. The evaluation of preliminary talks on the shop floor showed that team speakers and foremen share a common understanding of job rotation. In practice, different varieties of job rotation exist. One important aspect is the frequency of rotation. It is possible to rotate never, more than one time or even during every break, or more often than every break. It depends on the opportunity or possibility to rotate whenever workers want to rotate. From the preliminary talks some challenges can be derived. For example a rotation in the whole team is not possible, if a team member requires to be trained for a new task. In order to be able to determine the relation of the design and the attitude towards job rotation, a questionnaire is carried out in the vehicle manufacturing. The questionnaire will be employed to determine the different varieties of job rotation that exist in production, as well as the attitudes of workers towards those different frequencies of job rotation. In addition, younger and older employees will be compared with regard to their rotation frequency and their attitudes towards rotation. There are three kinds of age groups. Three questions are under examination. The first question is whether older employees rotate less frequently than younger employees. Also it is investigated to know whether the frequency of job rotation and the attitude towards the frequency of job rotation are interconnected. Moreover, the attitudes of the different age groups towards the frequency of rotation will be examined. Up to now 144 employees, all working in production, took part in the survey. 36.8 % were younger than thirty, 37.5 % were between thirty und forty-four and 25.7 % were above forty-five years old. The data shows no difference between the three age groups in relation to the frequency of job rotation (N=139, median=4, Chi²=.859, df=2, p=.651). Most employees rotate between six and seven workplaces per day. In addition there is a statistically significant correlation between the frequency of job rotation and the attitude towards the frequency (Spearman-Rho: 2-sided=.008, correlation coefficient=.223). Less than four workplaces per day are not enough for the employees. The third question, which differences can be found between older and younger people who rotate in a different way and with different attitudes towards job rotation, cannot be possible answered. Till now the data shows that younger people would like to rotate very often. Regarding to older people no correlation can be found with acceptable significance. The results of the survey will be used to improve the current practice of job rotation. In addition, the discussions during the survey are expected to help sensitize the employees with respect to rotation issues, and to contribute to optimizing rotation by means of qualification and an improved design of job rotation. Together with the employees and the results of the survey there must be found standards which show how to rotate in an ergonomic way while consider the attitude towards job rotation.

Keywords: job rotation, age-related work design, questionnaire, automotive industry

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Authors: Rajlakshmi Banerjee, Sujoy Banerjee

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The prevalence of malnutrition, as the most common cause of morbidity and mortality increases with old age, especially in developing countries like India, because of many factors out of which dentate status is one. It affects diet, nutritional status and general health due to reduced chewing ability and poor food choices. Aim and Objective: This study aimed to evaluate the effect of nutritional status, dietary intake on the Oral Health-related Quality of life (OHRQoL) of elderly edentulous complete denture wearing patients and to know whether they are at a higher risk of malnutrition. The objective was to assess the need to include dietary and nutritional counselling during Prosthodontic rehabilitation of elderly edentulous patients. Materials and method: A cross-sectional study was conducted among 200 elderly denture wearing patients above 60 yrs of age from Nagpur, Maharashtra. The majority of study subjects (60%) were between the age group 60 and 75 years. Mini-Nutritional Assessment (MNA) Questionnaire was used to assess nutritional status and General Oral Health Assessment Index (GOHAI) questionnaire was used to determine the Oral health related Quality of life of these patients.Descriptive statistics was used to analyze data using SPSS version 21. Results: Among the assessed subjects, nearly 80% of them had total scores of GOHAI between 12 and 57 which require ‘needed dental care.’ As per MNA, 10.5% had adequate nutrition, 70 % were at risk of malnutrition, and remaining 19.5 % of subjects were malnourished. There was a significant correlation between GOHAI and MNA scores. A strong association was found between mean GOHAI and MNA scores and thereby nutritional status and OHRQOL.Conclusion: The use of conventional dentures increases the risk of malnutrition in the elderly due to inability to eat and chew food properly and therefore severely affecting the quality of life. Dietary analysis and counselling should be strictly incorporated into geriatric treatment planning during Prosthetic rehabilitation.

Keywords: general oral health assessment index, General Oral Health Assessment Index (GOHAI), nutritional assessment, mini-nutritional assessment, Mini-Nutritional Assessment (MNA), quality of life

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Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell

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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.

Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use

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Authors: Kouorsh Zarea, Fatemeh Hassani, Samira Beiranvand, Akram Mohamadi

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Background and Objectives: Medication error in hospitals is a major cause of the errors which disrupt the health care system. The aim of this study was to assess the nurses’ medication errors and related factors. Material and methods: This was a descriptive study on 225 nurses in various hospitals, selected through multistage random sampling. Data was collected by three researcher made tools; demographic, medication error and related factors questionnaires. Data was analyzed by descriptive statistics, Chi-square, Kruskal-Wallis, One-way analysis of variance. Results: Based on the results obtained, the type of medication errors giving drugs to patients later or earlier (55.6%), multiple oral medication together regardless of their interactions (36%) and the postoperative analgesic without a prescription (34.2%), respectively. In addition, factors such as the shortage of nurses to patients’ ratio (57.3%), high load functions (51.1%) and fatigue caused by the extra work (40.4%), were the most important factors affecting the incidence of medication errors. The fear of legal issues (40%) are the most important factor is the lack of reported medication errors. Conclusions: Based on the results, effective management and promotion motivate nurses. Therefore, increasing scientific and clinical expertise in the field of nursing medication orders is recommended to prevent medication errors in various states of nursing intervention. Employing experienced staff in areas with high risk of medication errors and also supervising less-experienced staff through competent personnel are also suggested.

Keywords: medication error, nurse, clinical care, drug errors

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Authors: Fadzilah Abdul Rahman

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Emotional development is developed between the parents and their child. Behavioural development is also developed between the parents and their child. Social Development is how parents can help their special needs child to adapt to society and to face challenges. In promoting a lifelong learning mindset, enhancing skill sets and readiness to face challenges, parents would be able to counter balance these challenges during their care giving process and better manage their expectations through understanding the hierarchy of needs modality towards a positive attitude, and in turn, improve their quality of life and participation in society. This paper aims to demonstrate how the hierarchy of needs can be applied in various situations of caregiving for parents with a special needs child.

Keywords: hierarchy of needs, parents, special needs, care-giving

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Authors: Abigail Ekeigwe, Bethany McGowan, Loran C. Parker, Stephen Byrn, Kari L. Clase

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There are growing calls in the literature to develop and implement competency-based regulatory sciences education (CBRSE) in sub-Saharan Africa to expand and create a pipeline of a competent workforce of regulatory scientists. A defined competence framework is an essential component in developing competency-based education. However, such a competence framework is not available for regulatory scientists in sub-Saharan Africa. The purpose of this research is to identify entry-level competencies for inclusion in a competency framework for regulatory scientists in sub-Saharan Africa as a first step in developing CBRSE. The team systematically reviewed the literature following the PRISMA guidelines for systematic reviews and based on a pre-registered protocol on Open Science Framework (OSF). The protocol has the search strategy and the inclusion and exclusion criteria for publications. All included publications were coded to identify entry-level competencies for regulatory scientists. The team deductively coded the publications included in the study using the 'framework synthesis' model for systematic literature review. The World Health Organization’s conceptualization of competence guided the review and thematic synthesis. Topic and thematic codings were done using NVivo 12™ software. Based on the search strategy in the protocol, 2345 publications were retrieved. Twenty-two (n=22) of the retrieved publications met all the inclusion criteria for the research. Topic and thematic coding of the publications yielded three main domains of competence: knowledge, skills, and enabling behaviors. The knowledge domain has three sub-domains: administrative, regulatory governance/framework, and scientific knowledge. The skills domain has two sub-domains: functional and technical skills. Identification of competencies is the primal step that serves as a bedrock for curriculum development and competency-based education. The competencies identified in this research will help policymakers, educators, institutions, and international development partners design and implement competence-based regulatory science education in sub-Saharan Africa, ultimately leading to access to safe, quality, and effective medical products.

Keywords: competence-based regulatory science education, competencies, systematic review, sub-Saharan Africa

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Authors: Alex Knighton, Roba Khundkar, Michael Dunn

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Neo-colonialism is defined as the use of economic, political, cultural, or other pressures to control or influence other countries, especially former dependencies, and concerns have been raised about its presence in surgical missions. Surgical missions aim to rectify the huge disparity in surgical access worldwide, but their ethics must be carefully considered. This is especially in light of colonial history which affects international relations and global health today, to ensure that colonial attitudes are not influencing efforts to promote equity. This review examines the history of colonial global health, demonstrating that global health initiatives have consistently been used to benefit those providing them, and then asks whether elements of colonialism are still pervasive in surgical missions today. Data was collected from the literature using specified search terms and snowball searching, as well as from international expert web-based conferences on global surgery ethics. A thematic analysis was then conducted on this data, resulting in the identification of six themes which are identifiable in both past and present global health initiatives. These six themes are power, lack of understanding or respect, feelings of superiority, exploitation, enabling of dependency, and acceptance of poorer standards of care. An ethical analysis follows, concluding that the concerns of power and neo-colonialism in global surgery would be addressed by adopting a framework of procedural justice that promotes a refined governance process in which stakeholders are able to propose and reject decisions that affect them. The paper argues that adopting this model would address concerns of the power disparity in the field directly, as well as promoting an ethical framework to enable the other concerns of power disparity and neo-colonialism identified in the present analysis to be addressed.

Keywords: medical ethics, global surgery, global health, neocolonialism, surgical missions

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Authors: Miao Yang

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PPCPs (pharmaceutical and personal care products) in water, as an environmental pollutant, becomes an issue of increasing concern. Therefore, the techniques for degradation of PPCPs has been a hotspot in water pollution control field. Since there are several disadvantages for common degradation techniques of PPCPs, such as low degradation efficiency for certain PPCPs (ibuprofen and Carbamazepine) this proposal will adopt a combined technique by using CDs (carbon nanodots)/C₃N₄ composite and ultrasonic irradiation to mitigate or overcome these shortages. There is a significant scientific problem that the mechanism including PPCPs, major reactants, and interfacial active sites is not clear yet in the study of PPCPs degradation. This work aims to solve this problem by using both theoretical and experimental methodologies. Firstly, optimized parameters will be obtained by evaluating the kinetics and oxidation efficiency under different conditions. The competition between H₂O₂ and PPCPs with HO• will be elucidated, after which the degradation mechanism of PPCPs by the synergy of CDs/C₃N₄ composite and ultrasonic irradiation will be proposed. Finally, a sonolysis-adsorption-catalysis coupling mechanism will be established which is the theoretical basis and technical support for developing new efficient degradation techniques for PPCPs in the future.

Keywords: carbon nanodots/C₃N₄, pharmaceutical and personal care products, ultrasonic irradiation, hydroxyl radical, heterogeneous catalysis

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Authors: Chiao-Wen Lan, David Gere

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Background and Significance: Performance has a rich history of imparting information and encouraging reflection, yet there is a paucity of literature on applying performance as a method of analysis and not as a medium for health education. This study aimed to apply ethnodrama strategies to the issue of HIV-related stigma in rural China and to use a critical performance as a vehicle for communication of health research. Methods: The program, titled 'STOP STIGMA,' included dance, narratives and original quotes from people living with HIV/AIDS in China, and spectacle such as photographs, set, and props corresponding to the history of HIV in rural China. Results: The performance represented a step away from a completely textual interpretation of data towards a theatrical style that begins to privilege what arts-based research scholars Rossiter and colleagues have termed 'an embodied, theatrical representation of data.' It offered an opportunity to deliver individual and collective stories that represent how HIV-positive people experience living with HIV/AIDS in China, which could play an integral part in the formulation of actions to effect change. Discussion: This method of communicating health research has implications for fostering dialogue among researchers, community members, and medical practitioners. Although arts-based approaches are not new to the scientific community, the integration of dance, video, ethnodrama, and sciences provides opportunities to innovate in non-traditional research dissemination and communication.

Keywords: health communication, HIV/AIDS, stigma, vulnerable populations

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Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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