Search results for: healthcare regulations

Authors: Samson Viulu, Hugo Hebala, Duddley Kopu

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Constituency Development Fund (CDF) is a controversial fund that has existed in the Solomon Islands since the early 90s to date. It is largely controversial because it is directly handled by members of parliament (MPs) of the Solomon Islands legislation chamber. It is commonly described as a political slash fund because only voters of MPs benefit from it to retain loyalty. The CDF was established by a legislative act in 2013; however, it does not have any subsidiary regulations to it, therefore, very weak governance. CDF is purposely to establish development projects in the rural areas of the Solomon Islands to spur economic growth. Although almost USD500M was spent in CDF in the last decade, there has been no growth in the economy of the Solomon Islands; rather, a regress. Solomon Islands has now formulated a first home-grown policy aimed at guiding the overall development of the fifty constituencies, improving delivery mechanisms of the CDF, and strengthening its governance through the regulation of the CDF Act 2013. The Solomon Islands Constituency Development Policy is the first for the country since gaining independence in 1978 and gives strong emphasis on a cross-sectoral approach through effective partnerships and collaborations and decentralizing government services to the isolated rural areas of the country. The new policy is driving the efforts of the political government to decentralize government services to isolated rural communities to encourage the participation of rural dwellers in economic activities. The decentralization will see the establishment of constituency offices within all constituencies and the piloting of townships in constituencies that have met the statutory requirements of the state. It also encourages constituencies to become development agents of the national government than being mere political boundaries. The decentralization will go in line with the establishment of the Solomon Islands Special Economic Zones (SEZ), where investors will be given special privileges and exemptions from government taxes and permits to attract tangible development to occur in rural constituencies. The design and formulation of the new development policy are supported by the UNDP office in the Solomon Islands. The new policy is promoting a reorientation on the allocation of resources more toward the productive and resource sectors, making access to finance easier for entrepreneurs and encouraging growth in rural entrepreneurship in the fields of agriculture, fisheries, down streaming, and tourism across the Solomon Islands. This new policy approach will greatly assist the country to graduate from the least developed countries status in a few years’ time.

Keywords: decentralization, constituency development fund, Solomon Islands constituency development policy, partnership, entrepreneurship

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Authors: Bertha Korang Gyimah, Obed Asamoah, Kenross, T. Asamoah

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In every human community, crimes or offenses cannot be eliminated, but as crimes are expected, there should be bodies that will control and prevent the crimes. There has been an increasing rate of crime, such as armed robbery, kidnapping, murder, and other forms of violence in the country. Community participation in crime control cannot be left out in Ghana. Several works have been conducted to deal with the importance of community participation in policing, but the causes of communities not fully participating in community policing have been left out. The main aim of the research was to assess the impact of community policing and why the communities are reluctant to partake in community policing to help control crime in Bia West. There have been perceptions about Police that, they expose informant after they give the police tip-off which put the whistleblower life in danger. This has made the community not to get involved in security issues in the community they live in. This situation has posed a serious threat to the Ghana Police Service and its ability to position itself strategically in order to carry out a perfect investigation to bring the perpetrators into custody and to protect their lives and property, as well as the maintenance of law and order. Due to less data on community participation in the Ghana Police Service, the research adopted an interpretative framework to assess the meaning connoted to community policing from the perspectives of the stakeholders themselves. The qualitative research method was used. There was an engagement of the police and community where focus group discussions and individual in-depth interviews were organized in the randomly selected communities in the district. Key informant interviews were used to solicit views of the people why they are reluctant to give information to the police to help them take the perpetrators to book. In the data collected, it was observed that most of the people have been under threats of offenders after they come back from the prisons, it was also observed that some of the unprofessional police personnel’s expose the whistleblowers who put their lives in danger. The data obtained were analyzed using simple Analytical tool SPSS and Excel. Based on the analysis, it was observed that a high number of people in the communities contacted had not made their mind to participate in any security issues. Based on the views of the community, there should be a high level of professionalism in the recruitment system of the Ghana police service to come out with professional police officers who can abide by the rules and regulations governing the profession.

Keywords: community, bia west, Ghana, participation, police

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Authors: Kangrij Roeksiripat

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Street vending is one of the informal economy activities which considered significance to Thai people in the economic and the day-to-day social life. It had been believed that the street vendor is a group of the poor and uneducated people. With the increasing numbers of the street vendor occupying space on public sidewalks especially in central business districts, it becomes unclear whether street vending continues as a solution to unemployment for access labors. This research attempts to study and analyze types of street vendors in Bangkok under the informal economy framework. The debate on the heterogeneous informal economy has categorized into four schools; the dualism, the structuralism, the legalism and the voluntarism. The examination also embodies with market concept with Porter’s Five Forces of Competitive Position Model analysis and the interviews with the street vendors in three case study areas: Inner zone (Pathumwan district - the sidewalk on the opposite side of Siam Paragon mall), Middle zone (Ramkhamhaeng district - the sidewalk on the opposite side of Ramkhamhaeng University) and Outer zone (Minburi district- the sidewalk of Sriburanukit Road). The result indicates that most of street vendors in Siam square are voluntarily choose to make a living in vending on a sidewalk and tend to take it as a long-term occupation even though they can be in formal wage employment. Moreover, average income and positive attitude towards self-employed are the important factors that drive them to operate street vending businesses. Meanwhile, street vending is often a family enterprise in Ramkhamhaeng area and most vendors do not wish to transform their businesses into the formal sectors. Whereas the survey conducted in Sriburankit Road reveals that almost all of street vendors migrated from other provinces and were previously paid as the unskilled workers in formal sectors. They moved to informal trades because of the uncertainty of employment in the mainstream sectors and the inconsistent income with knowledge support of friends and relatives from the same hometown. In particular, the result reveals a common pattern that street vending is the very first occupation of some group of vendors and they will continue to engage in this activity. Thus, it is important for the government to design optimal policy which not only integrating informal workers into the formal economy but also monitoring the enforcement of regulations on the modern informal economy.

Keywords: informal economy, sidewalks, street vendors, occupation

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Authors: Seon-Young Lee, Harkiran Sagoo, Katherine Whitehurst, Georgina Wellstead, Alexander Fowler, Riaz Agha, Dennis Orgill

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Introduction: Systematic reviews attempt to answer research questions by synthesising the data within primary papers. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research and healthcare policy. We sought to determine the reporting quality of recent systematic reviews in plastic surgery. Methods: This systematic review was conducted in line with the Cochrane handbook, reported in line with the PRISMA statement and registered at the ResearchRegistry (UIN: reviewregistry18). MEDLINE and EMBASE databases were searched in 2013 and 2014 for systematic reviews by five major plastic surgery journals. Screening, identification and data extraction was performed independently by two teams. Results: From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 out of 27 items (59.3%; range 6-26, 95% CI 14-17). Compliance between individual PRISMA items showed high variability. It was poorest for items related to the use of review protocol (item 5; 5%) and presentation of data on risk of bias of each study (item 19; 18%), while being the highest for description of rationale (item 3; 99%) and sources of funding and other support (item 27; 95%), and for structured summary in the abstract (item 2; 95%). Conclusion: The reporting quality of systematic reviews in plastic surgery requires improvement. ‘Hard-wiring’ of compliance through journal submission systems, as well as improved education, awareness and a cohesive strategy among all stakeholders is called for.

Keywords: PRISMA, reporting quality, plastic surgery, systematic review, meta-analysis

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Authors: Aikaterini Tsalampouni

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The European Union has long been the most developed model of economic and political integration that has brought a common market, a common currency and a standardization of national policies in certain areas in consistent with EU values and principles. To this direction, there is a parallel process of social integration that effect public policy decisions of member states. Even though social policy, i.e. social protection and moreover healthcare policy, still remains in state's responsibility to develop, EU applies different mechanisms in order to influence health policy systems, since from a more federalist point of view, EU ought to expand its regulatory and legislative roles in as many policy areas as possible. Recently, the pandemic has become a turning point for health care provision and at the same time has also highlighted the need to strengthen the EU’s role in coordinating health care. This paper analyses the EU health policy in general, as well as the response to COVID-19 pandemic with an attempt to identify indications of interaction between EU policies and the promotion of sustainable and resilient health systems. More analytically, the paper investigates the EU binding legal instruments, non-binding legal instruments, monitoring and assessment instruments and instruments for co-financing concerning health care provision in member states and records the evolution of health policies before and during the COVID-19 pandemic. The paper concludes by articulating some remarks regarding the improvement of health policy in EU. Since the ability to deal with a pandemic depends on continuous and increased investment in health systems, the involvement of the EU can lead to a policy convergence, necessary for the resilience of the systems, maintaining at the same time, a strong health policy framework in Europe.

Keywords: EU health policy, EU response to COVID-19, European Health Union, health systems in Europe

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Authors: Samir Kumar Pal

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Background: Targeted rapid degradation of bilirubin has the potential to thwart incipient bilirubin encephalopathy. Uncontrolled hyperbilirubinemia is a potential problem in developing countries, including India, because of the lack of reliable healthcare institutes for conventional phototherapy. In India, most of the rural subjects duel in the exchange limit during transport, leading to a risk of kernicterus when they arrive at the treatment centre. Thus, an alternative pharmaceutical agent is needed for the hours. Objective: Exploration of a distinct therapeutic strategy for the control of neonatal hyperbilirubinemia compared to conventional phototherapy in a clinical setting. Method: We synthesized, characterized and investigated a spinel-structured Manganese citrate nanocomplex (C-Mn₃O₄ NC, the nanodrug) along with conventional phototherapy in neonatal subjects. We have also observed BIND scores in order to assess neurological dysfunctions. Results: Our observational study clearly reveals that the rate of declination of bilirubin in neonatal subjects with nanodrug oral administration and phototherapy is faster compared to that in the case of phototherapy only. The associated neural dysfunctions were also found to be significantly lower in the case of combined therapy. Conclusion: This study demonstrates that combined therapy works better than conventional phototherapy only for the control of hyperbilirubinemia. We have observed that a significant portion of neonatal subjects requiring blood exchange has been prevented with the combined therapeutic strategy. Further compilation of a drug-safety-dossier is warranted to translate this novel therapeutic chemo preventive approach to clinical settings.

Keywords: nanodrug, nanoparticle, Neonatal hyperbilirubinemia, alternative to phototherapy, redox modulation, redox medicine

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Authors: Svetlana Gudkova

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The Internet of Things experiences a rapid growth bringing inevitable changes into many spheres of human activities. As the Internet has changed the social and business landscape, IoT as its extension, can bring much more profound changes in economic value creation and competitiveness of the economies. It has been already recognized as the next industrial revolution. However, the development of IoT is in a great extent stimulated by the entrepreneurial activity. To expand and reach its full potential it requires proactive entrepreneurs, who explore the potential and create innovative ideas pushing the boundaries of IoT technologies' application further. The goal of the research is to analyze, how entrepreneurs utilize the opportunities created by IoT and how do they stimulate the development of IoT through discovering of new ways of generating economic value and creating opportunities, which attract other entrepreneurs. The qualitative research methods have been applied to prepare the case studies. Entrepreneurs are recognized as an engine of economic growth. They introduce innovative products and services into the market through the creation of a new combination of the existing resources and utilizing new knowledge. Entrepreneurs not only create economic value but what is more important, they challenge the existing business models and invent new ways of value creation. Through identification and exploitation of entrepreneurial opportunities, they create new opportunities for other entrepreneurs. It makes the industry more attractive to other profit/innovation-driven start-ups. IoT creates numerous opportunities for entrepreneurs in the different industries. Smart cities, healthcare, manufacturing, retail, agriculture, smart vehicles and smart buildings benefit a lot from IoT-based breakthrough innovations introduced by entrepreneurs. They reinvented successfully the business models and created new entrepreneurial opportunities for other start-ups to introduce next innovations.

Keywords: entrepreneurship, internet of things, breakthrough innovations, start-ups

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Authors: Samawi Zepure, Beck Christine, Gallagher Peg

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This community immersion employs the NLN Excellence Model which challenges nursing programs to create student-centered, interactive, and innovative experiences to prepare students for roles in providing high quality care, effective teaching, and leadership in the delivery of nursing services to individuals, families, and communities (NLN, 2006). Senior nursing students collaborate with ethnically and linguistically diverse participants at community-based sites and develop leadership roles of coordination of care linkage within the larger healthcare system, adherence, and self-care management. The immersion encourages students to develop competencies of the NLN Nursing Education Competencies Model (NLN, 2012), proposed to address fast changes in health care delivery, which include values of caring, diversity, and holism; and integrating concepts of context and environment, relationship, and teamwork. Students engage in critical thinking and leadership as they: 1) assess health/illness beliefs, values, attitudes, and practices, explore community resources, interview key informants, and collaborate with community participants to identify learning goals, 2) develop and implement appropriate holistic health promotion and disease prevention teaching interventions promoting continuity, sustainability, and innovation, 3) evaluate interventions through participant feedback and focus groups and, 4) reflect on the immersion experience and future professional role as advocate and citizen.

Keywords: quality of care, health of communities, students as leaders, health promotion

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Authors: Sumit Kumar Das, Laishram Ladusingh

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Aim: The aim of the study is to examine the differential of epidemiological transition across fifteen agro-climatic zones of India and its effect on health-seeking behavior. Data and Methods: Unit level data on consumption expenditure on health of India from three decadal rounds conducted by National Sample Survey Organization are used for the analysis. These three rounds are 52nd (1995-96), 60th (2004-05) and 71st (2014-15). The age-adjusted prevalence rate for communicable diseases and non-communicable diseases are estimated for fifteen agro-climatic zones of India for three time periods. Bivariate analysis is used to find out determinants of health-seeking behavior. Multilevel logistic regression is used to examine factors effecting on household health-seeking behavior. Result: The prevalence of communicable diseases is increasing in most of the zones of India. Every South Indian zones, Gujarat plains, and lower Gangetic plain are facing the severe attack of dual burden of diseases. Demand for medical advice has increased in southern zones, and east zones, reliance on private healthcare facilities are increasing in most of the zone. Demographic characteristics of the household head have a significant impact on health-seeking behavior. Conclusion: Proper program implementation is required considering the disease prevalence and differential in the pattern of health seeking behavior. Along with initiation and strengthening of programs for non-communicable, existing programs for communicable diseases need to monitor and supervised strictly.

Keywords: agro-climatic zone, epidemiological transition, health-seeking behavior, multilevel regression

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Authors: Freda Adomaa, Samuel Oppong Boampong, Charles Gyamfi Rahman

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The living and working environment of migrants and their access to healthcare services induce good or poor health. This study was conducted to assess the factors associated with rural-urban migration and its associated health hazards among female adolescents. A sample size of two hundred (200) was chosen in which all responded to questionnaires comprising closed-ended questions, which were distributed to gather data from the respondents, after which it was analyzed using the Statistical Package for Social Sciences (SPSS) version 20. The utilized three causes of rural-urban migration thus political, economic and socio-cultural. The study revealed that political situations such as regional inequality (65.4%) and ethnic conflicts (78.2%) whereas economic factors such as lack of amenities (82.3%), lack of employment in rural communities (77.4%), lack of education (74%), and poverty (85.3%) as well as socio-cultural factors such as divorced parents (65.6%), media influence (79.1%), family conflicts (59.4%) and appealing urban informal sector (65.2%) are major causes of migration. Respondents’ encountered challenges such as poor remuneration for services (87.2%), being maltreated by a colleague or worker (69%), sleeping in open space (73.3%), and harassment by the task force (71.4%) and teenage pregnancies (58.5%). The study concluded that the three variables play a key role in adolescent migration and when they travel they end up getting involved in serious health hazardous behaviors such as rapes as well as physical and psychological harassments’. The study, therefore, recommends that vocational training of the rural people on small scale industries (non-farm) activities that could generate an income for the rural household should be introduced.

Keywords: rural, urban, migration, female health hazards

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Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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Authors: Najmeh Jafari, Sona Rostampour Yasouri

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Crimean-Congo hemorrhagic fever (CCHF) is an acute hemorrhagic disease. This disease is one of the common diseases between humans and animals, transmitted through tick bites or contact with the blood and secretions or carcasses of infected animals and humans. CCHF is more common in people who work with livestock, such as ranchers, butchers, farmers, slaughterhouse workers, healthcare workers, etc. Its hospital prevalence is also very high. Considering that CCHF can be transmitted through the consumption of food such as beef and sheep meat, this study aims to quickly identify and diagnose the Crimean-Congo fever virus in suspected patients through real-time PCR technique. In the summer of 1402, 20 blood samples were collected separately from Ahvaz and Gilan hospitals. An extraction kit was used to extract the virus RNA. Primers and probes were designed based on the S genomic region, the conserved region in CCHFV. Then, a real-time PCR technique was performed with specific primers and probes. It should be noted that the mentioned technique was repeated several times. The number of 4 samples from the examined samples was determined positive by real-time PCR. This technique has high sensitivity and specificity and the possibility of rapid detection of CCHFV. Therefore, the above method is a good candidate for quick disease diagnosis. By diagnosing the disease, the treatment process can be done faster, and the best prevention methods can be used to control the disease and prevent the death of patients.

Keywords: ahvaz, crimean-congo hemorrhagic fever, gilan, real time PCR

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Authors: Siavash Ostovar

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The Iranian national Law on the Ramsar Convention (officially known as the Convention of International Wetlands and Aquatic Birds' Habitat Wetlands) was approved by the Senate and became a law in 1974 after the ratification of the National Council. There are other national laws with the aim of preservation of environment in the country. However, Lake Urmia which is declared a wetland of international importance by the Ramsar Convention in 1971 and designated a UNESCO Biosphere Reserve in 1976 is now at the brink of total disappearance due mainly to the climate change, water mismanagement, dam construction, and agricultural deficiencies. Lake Urmia is located in the north western corner of Iran. It is the third largest salt water lake in the world and the largest lake in the Middle East. Locally, it is designated as a National Park. It is, indeed, a unique lake both nationally and internationally. This study investigated how effective the national legal regulation of the ecosystem of Lake Urmia is in Iran. To do so, the Iranian national laws as Enforcement of Ramsar Convention in the country including three nationally established laws of (i) Five sets of laws for the programme of economic, social and cultural development of Islamic Republic of Iran, (ii) The Iranian Penal Code, (iii) law of conservation, restoration and management of the country were investigated. Using black letter law methods, it was revealed that (i) regarding the national five sets of laws; the benchmark to force the implementation of the legislations and policies is not set clearly. In other words, there is no clear guarantee to enforce these legislations and policies at the time of deviation and violation; (ii) regarding the Penal Code, there is lack of determining the environmental crimes, determining appropriate penalties for the environmental crimes, implementing those penalties appropriately, monitoring and training programmes precisely; (iii) regarding the law of conservation, restoration and management, implementation of this regulation is adjourned to preparation, announcement and approval of several categories of enactments and guidelines. In fact, this study used a national environmental catastrophe caused by drying up of Lake Urmia as an excuse to direct the attention to the weaknesses of the existing national rules and regulations. Finally, as we all depend on the natural world for our survival, this study recommended further research on every environmental issue including the Lake Urmia.

Keywords: conservation, environmental law, Lake Urmia, national laws, Ramsar Convention, water management, wetlands

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Authors: Berfu Guley Goren, Ayse Lale Berkoz

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The aim of the study is to analyze the concept of universal design and accessibility to make the city which allows equality and independence for individuals. In the content of the study, literature researches and observations of samples in Istanbul, Turkey are analyzed. As a result proposals are going to be developed to create the cities which are designed for everyone. In globalization process, in cities, population have been increasing dramatically with social and economic activities. Medical developments have been effective in prolonging human life and the disability that comes with aging has also increased in parallel with the disabled population. Nowadays disability is an important phenomenon. Because approximately 1 billion people live with disabilities. The heterogeneous structure formed by the rapid gathering of individuals with different social, economic and physical characteristics in the cities creates great spatial diversity and richness in the cities with different needs brought together. Unlike the cultural and physical wealth in these places and the potential to integrate and diversify the urban people, unfortunately, the designs in practice cause the urban areas to break apart, the urbanities to tear themselves apart, to interfere with their communication and interactions. The social and physical structure of the city is important to feel belonging to the urban society. In most cities when an observation is made, obstructions for people with disabilities can be seen in urban physical structure and design. With these obstructions, people with disabilities cannot live in urban space, and they are desolated in urban life. The city, which offers equal opportunity, the relation between economic development, social justice and built environment must be planned synchronous. Isolation and stigmatization must be abolished by regulations, activities of awareness and universal urban design. Without regard to social, economical and physical features every individual has the same right, which is using the freedom of movement. Supporting freedom of movement of every individual may be ensured by universal design and its principles. So urban spaces are going to be for every individual. For equal opportunity in urban services, urban design must be the focus on every individual including people with disabilities. In built environment practices, democratic suitable spaces should be created. In this respect, urban planners, architects, political decision-makers and other relevant actors should work together and should think very versatile.

Keywords: disability, equality, universal design, urban design

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Authors: Sharifah Sumayyah Engku Alwi, Masrah Azrifah Azmi Murad

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The development of the information technology and Internet has been transforming the healthcare industry. The internet is continuously accessed to seek for health information and there are variety of sources, including search engines, health websites, and social networking sites. Providing more and better information on health may empower individuals, however, ensuring a high quality and trusted health information could pose a challenge. Moreover, there is an ever-increasing amount of information available, but they are not necessarily accurate and up to date. Thus, this paper aims to provide an insight of the models and frameworks related to online health information seeking of consumers. It begins by exploring the definition of information behavior and information seeking to provide a better understanding of the concept of information seeking. In this study, critical factors such as performance expectancy, effort expectancy, and social influence will be studied in relation to the value of seeking health information. It also aims to analyze the effect of age, gender, and health status as the moderator on the factors that influence online health information seeking, i.e. trust and information quality. A preliminary survey will be carried out among the health professionals to clarify the research problems which exist in the real world, at the same time producing a conceptual framework. A final survey will be distributed to five states of Malaysia, to solicit the feedback on the framework. Data will be analyzed using SPSS and SmartPLS 3.0 analysis tools. It is hoped that at the end of this study, a novel framework that can improve online health information seeking is developed. Finally, this paper concludes with some suggestions on the models and frameworks that could improve online health information seeking.

Keywords: information behavior, information seeking, online health information, technology acceptance model, the theory of planned behavior, UTAUT

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Authors: Mehrdad Akbarzadeh, Afsaneh Abrisham

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Introduction: Critical thinking skills are crucial for nurses, particularly those working in neonatal care, where quick and informed decision-making is essential. This study aims to evaluate the effectiveness of critical thinking skills on job performance among neonatal nurses. Methods: A cross-sectional study was conducted with 450 neonatal nurses from a hospital in Mashhad. Participants were assessed using the Critical Thinking Questionnaire (CThQ) to measure their critical thinking abilities across various subscales, including Analyzing, Evaluating, Creating, Remembering, Understanding, and Applying. Additionally, a custom Job Performance Checklist completed by supervising nurses, was used to evaluate job performance across several dimensions. Data were collected and analyzed using SPSS V.23. Correlation analysis was conducted to determine the relationship between critical thinking skills and job performance. Results: The mean age of the nurses was 33.46 ± 14.2 years, with 79.15% being female. The nurses demonstrated high proficiency in critical thinking, with notable scores in the Creating (23.98 ± 4.8), Applying (17.35 ± 3.2), and Evaluating (16.67 ± 3.4) subscales. The results indicate a significant positive correlation between several critical thinking subscales and job performance. The Creating subscale exhibited the strongest correlation (R = 0.79, p < 0.001), followed by Overall CThQ (R = 0.68, p = 0.039) and Evaluating (R = 0.67, p = 0.041). Analyzing (R = 0.45, p = 0.013) and Understanding (R = 0.41, p = 0.015) also showed significant correlations with job performance. Remembering (R = 0.29, p = 0.061) and Applying (R = 0.43, p = 0.057) were not significantly correlated with job performance. Conclusion: The findings indicate that critical thinking skills, especially in creating and evaluating, are strongly associated with job performance in neonatal nurses. Enhancing these skills through targeted training programs could improve job performance, particularly in decision-making and time management. This study underscores the importance of critical thinking in neonatal care and its impact on nursing efficacy and patient outcomes.

Keywords: critical thinking, job performance, neonatal nurses, healthcare quality

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Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere

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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.

Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Sophie Lemoussu, Jean-Charles Chaudemar, Robertus A. Vingerhoeds

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Many innovative projects exist in the field of aeronautics, each addressing specific areas so to reduce weight, increase autonomy, reduction of CO2, etc. In many cases, such innovative developments are being carried out by very small enterprises (VSE’s) or small and medium sized-enterprises (SME’s). A good example concerns airships that are being studied as a real alternative to passenger and cargo transportation. Today, no international regulations propose a precise and sufficiently detailed framework for the development and certification of airships. The absence of such a regulatory framework requires a very close contact with regulatory instances. However, VSE’s/SME’s do not always have sufficient resources and internal knowledge to handle this complexity and to discuss these issues. This poses an additional challenge for those VSE’s/SME’s, in particular those that have system integration responsibilities and that must provide all the necessary evidence to demonstrate their ability to design, produce, and operate airships with the expected level of safety and reliability. The main objective of this research is to provide a methodological framework enabling VSE’s/SME’s with limited resources to organize the development of airships while taking into account the constraints of safety, cost, time and performance. This paper proposes to provide a contribution to this problematic by proposing a Model-Based Systems Engineering approach. Through a comprehensive process modeling approach applied to the development processes, the regulatory constraints, existing best practices, etc., a good image can be obtained as to the process landscape that may influence the development of airships. To this effect, not only the necessary regulatory information is taken on board, also other international standards and norms on systems engineering and project management are being modeled and taken into account. In a next step, the model can be used for analysis of the specific situation for given developments, derive critical paths for the development, identify eventual conflicting aspects between the norms, standards, and regulatory expectations, or also identify those areas where not enough information is available. Once critical paths are known, optimization approaches can be used and decision support techniques can be applied so to better support VSE’s/SME’s in their innovative developments. This paper reports on the adopted modeling approach, the retained modeling languages, and how they all fit together.

Keywords: aeronautics, certification, process modeling, project management, regulation, SME, systems engineering, VSE

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Authors: Thomas Trouton, Sebastian Tanner, Manvir Sandher

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The use of simulation in undergraduate and postgraduate medical curricula is ever-growing, is a useful addition to the traditional apprenticeship model of learning within medical education, and better prepares graduates for the team-based approach to healthcare seen in real-life clinical practice. As a learning tool, however, undergraduate medical students often have little understanding of the theory behind the use of medical simulation and have little experience in planning and delivering their own simulated teaching sessions. We designed and implemented a student-selected component (SSC) as part of the undergraduate medical curriculum at the University of Buckingham Medical School to introduce students to the concepts behind the use of medical simulation in education and allow them to plan and deliver their own simulated medical scenario to their peers. The SSC took place over a 2-week period in the 3rd year of the undergraduate course. There was a mix of lectures, seminars and interactive group work sessions, as well as hands-on experience in the simulation suite, to introduce key concepts related to medical simulation, including technical considerations in simulation, human factors, debriefing and troubleshooting scenarios. We evaluated the success of our SSC using “Net Promotor Scores” (NPS) to assess students’ confidence in planning and facilitating a simulation-based teaching session, as well as leading a debrief session. In all three domains, we showed an increase in the confidence of the students. We also showed an increase in confidence in the management of common medical emergencies as a result of the SSC. Overall, the students who chose our SSC had the opportunity to learn new skills in medical education, with a particular focus on the use of simulation-based teaching, and feedback highlighted that a number of students would take these skills forward in their own practice. We demonstrated an increase in confidence in several domains related to the use of medical simulation in education and have hopefully inspired a new generation of medical educators.

Keywords: simulation, SSC, teaching, medical students

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Authors: Muhammad Bilal Qadir, Danish Umer, Amir Shahzad

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The use of conductive materials in smart and interactive textiles is gaining significant importance for creating value addition, innovation, and functional product development. These products find their potential applications in health monitoring, military, protection, communication, sensing, monitoring, actuation, fashion, and lifestyles. The materials which are most commonly employed in such type of interactive textile include intrinsically conducting polymers, conductive inks, and metallic coating on textile fabrics and inherently conducting metallic fibre yarns. In this study, silver coated polyester filament yarn is explored for the development of multifunctional interactive gloves. The composite yarn was developed by covering the silver coated polyester filament around the polyester spun yarn using hollow spindle technique. The electrical and tensile properties of the yarn were studied. This novel yarn was used to manufacture a smart glove to explore the antibacterial, functional, and interactive properties of the yarn. The change in electrical resistance due to finger movement at different bending positions and antimicrobial properties were studied. This glove was also found useful as an interactive tool to operate the commonly used touch screen devices due to its conductive nature. The yarn can also be used to develop the sensing elements like stretch, strain, and piezoresistive sensors. Such sensor can be effectively used in medical and sports textile for performance monitoring, vital signs monitoring and development of antibacterial textile for healthcare and hygiene.

Keywords: conductive yarn, interactive textiles, piezoresistive sensors, smart gloves

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Authors: Abdolghani Ebrahimi, Diego Klabjan, Chenxi Ge, Daniela Ladner, Parker Stride

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In this work, we use machine learning and novel data analysis techniques to predict the one-year mortality of cirrhotic patients. Data from 2,322 patients with liver cirrhosis are collected at a single medical center. Different machine learning models are applied to predict one-year mortality. A comprehensive feature space including demographic information, comorbidity, clinical procedure and laboratory tests is being analyzed. A temporal pattern mining technic called Frequent Subgraph Mining (FSM) is being used. Model for End-stage liver disease (MELD) prediction of mortality is used as a comparator. All of our models statistically significantly outperform the MELD-score model and show an average 10% improvement of the area under the curve (AUC). The FSM technic itself does not improve the model significantly, but FSM, together with a machine learning technique called an ensemble, further improves the model performance. With the abundance of data available in healthcare through electronic health records (EHR), existing predictive models can be refined to identify and treat patients at risk for higher mortality. However, due to the sparsity of the temporal information needed by FSM, the FSM model does not yield significant improvements. To the best of our knowledge, this is the first work to apply modern machine learning algorithms and data analysis methods on predicting one-year mortality of cirrhotic patients and builds a model that predicts one-year mortality significantly more accurate than the MELD score. We have also tested the potential of FSM and provided a new perspective of the importance of clinical features.

Keywords: machine learning, liver cirrhosis, subgraph mining, supervised learning

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Authors: Okhee Woo

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Purpose: The aim of this study is to evaluate 2-year cumulative effective radiation dose and cumulative organ dose on regular follow-up computed tomography (CT) scans in patients with breast cancer and to establish personalized low-dose CT protocol. Methods and Materials: A retrospective study was performed on the patients with breast cancer who were diagnosed and managed consistently on the basis of routine breast cancer follow-up protocol between 2012-01 and 2016-06. Based on ICRP (International Commission on Radiological Protection) 103, the cumulative effective radiation doses of each patient for 2-year follow-up were analyzed using the commercial radiation management software (Radimetrics, Bayer healthcare). The personalized effective doses on each organ were analyzed in detail by the software-providing Monte Carlo simulation. Results: A total of 3822 CT scans on 490 patients was evaluated (age: 52.32±10.69). The mean scan number for each patient was 7.8±4.54. Each patient was exposed 95.54±63.24 mSv of radiation for 2 years. The cumulative CT radiation dose was significantly higher in patients with lymph node metastasis (p = 0.00). The HER-2 positive patients were more exposed to radiation compared to estrogen or progesterone receptor positive patient (p = 0.00). There was no difference in the cumulative effective radiation dose with different age groups. Conclusion: To acknowledge how much radiation exposed to a patient is a starting point of management of radiation exposure for patients with long-term CT follow-up. The precise and personalized protocol, as well as iterative reconstruction, may reduce hazard from unnecessary radiation exposure.

Keywords: computed tomography, breast cancer, effective radiation dose, cumulative organ dose

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Authors: Vishwajit Ghatge, David Looper

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Over the last few decades, oilfield service rolling equipment has significantly increased in weight, primarily because of emissions regulations, which require larger/heavier engines, larger cooling systems, and emissions after-treatment systems, in some cases, etc. Larger engines cause more vibration and shock loads, leading to failure of electronics and control systems. If the vibrating frequency of the engine matches the system frequency, high resonance is observed on structural parts and mounts. One such existing automated control equipment system comprising wire rope mounts used for mounting computers was designed approximately 12 years ago. This includes the use of an industrial- grade computer to control the system operation. The original computer had a smaller, lighter enclosure. After a few years, a newer computer version was introduced, which was 10 lbm heavier. Some failures of internal computer parts have been documented for cases in which the old mounts were used. Because of the added weight, there is a possibility of having the two brackets impact each other under off-road conditions, which causes a high shock input to the computer parts. This added failure mode requires validating the existing mount design to suit the new heavy-weight computer. This paper discusses the modal finite element method (FEM) analysis and experimental modal analysis conducted to study the effects of vibration on the wire rope mounts and the computer. The existing mount was modelled in ANSYS software, and resultant mode shapes and frequencies were obtained. The experimental modal analysis was conducted, and actual frequency responses were observed and recorded. Results clearly revealed that at resonance frequency, the brackets were colliding and potentially causing damage to computer parts. To solve this issue, spring mounts of different stiffness were modeled in ANSYS software, and the resonant frequency was determined. Increasing the stiffness of the system increased the resonant frequency zone away from the frequency window at which the engine showed heavy vibrations or resonance. After multiple iterations in ANSYS software, the stiffness of the spring mount was finalized, which was again experimentally validated.

Keywords: experimental modal analysis, FEM Modal Analysis, frequency, modal analysis, resonance, vibration

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Authors: Nathen A. Spitz, Dennis Martin Kivlighan III, Arwa Aburizik

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Background and Purpose: Presently, there is a paucity of naturalistic studies that directly compare the effectiveness of psychotherapy versus concurrent psychotherapy and psychiatric care for the treatment of depression and anxiety in cancer patients. Informed by previous clinical trials examining the efficacy of concurrent approaches, this study sought to test the hypothesis that a combined approach would result in the greatest reduction of depression and anxiety symptoms. Methods: Data for this study consisted of 433 adult cancer patients, with 252 receiving only psychotherapy and 181 receiving concurrent psychotherapy and psychiatric care at the University of Iowa Hospitals and Clinics. Longitudinal PHQ9 and GAD7 data were analyzed between both groups using latent growth curve analyses. Results: After controlling for treatment length and provider effects, results indicated that concurrent care was more effective than psychotherapy alone for depressive symptoms (γ₁₂ = -0.12, p = .037). Specifically, the simple slope for concurrent care was -0.25 (p = .022), and the simple slope for psychotherapy alone was -0.13 (p = .006), suggesting that patients receiving concurrent care experienced a greater reduction in depressive symptoms compared to patients receiving psychotherapy alone. In contrast, there were no significant differences between psychotherapy alone and concurrent psychotherapy and psychiatric care in the reduction of anxious symptoms. Conclusions: Overall, as both psychotherapy and psychiatric care may address unique aspects of mental health conditions, in addition to potentially providing synergetic support to each other, a combinatorial approach to mental healthcare for cancer patients may improve outcomes.

Keywords: psychiatry, psychology, psycho-oncology, combined care, psychotherapy, behavioral psychology

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Authors: Hassan Ibrahim

Abstract:

The prevalence of hyperacusis, an auditory condition characterized by heightened sensitivity to sounds, continues to rise, posing challenges for effective diagnosis and intervention. It is believed that this work deepens will deepens the understanding of hyperacusis etiology by employing graph theory as a novel analytical framework. We constructed a comprehensive graph wherein nodes represent various factors associated with hyperacusis, including aging, head or neck trauma, infection/virus, depression, migraines, ear infection, anxiety, and other potential contributors. Relationships between factors are modeled as edges, allowing us to visualize and quantify the interactions within the etiological landscape of hyperacusis. it employ the concept of the metric dimension of a connected graph to identify key nodes (landmarks) that serve as critical influencers in the interconnected web of hyperacusis causes. This approach offers a unique perspective on the relative importance and centrality of different factors, shedding light on the complex interplay between physiological, psychological, and environmental determinants. Visualization techniques were also employed to enhance the interpretation and facilitate the identification of the central nodes. This research contributes to the growing body of knowledge surrounding hyperacusis by offering a network-centric perspective on its multifaceted causes. The outcomes hold the potential to inform clinical practices, guiding healthcare professionals in prioritizing interventions and personalized treatment plans based on the identified landmarks within the etiological network. Through the integration of graph theory into hyperacusis research, the complexity of this auditory condition was unraveled and pave the way for more effective approaches to its management.

Keywords: auditory condition, connected graph, hyperacusis, metric dimension

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Authors: Atif Alenezi

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The low global oil price poses economic challenges for Saudi Arabia, as oil revenues still make up a great percentage of its Gross Domestic Product (GDP). At the end of 2014, the Consultative Assembly considered a report from the Committee on Economic Affairs and Energy which highlights that the economy had not been successfully diversified. There thus exist ample reasons for modernising the Foreign Direct Investment (FDI) regime, primarily to achieve and maintain prosperity and facilitate peace in the region. Therefore, this paper aims at identifying specific problems with the existing FDI regime in Saudi Arabia and subsequently some solutions to those problems. Saudi Arabia adopted its first specific legislation in 1956, which imposed significant restrictions on foreign ownership. Since then, Saudi Arabia has modernised its FDI framework with the passing of the Foreign Capital Investment Act 1979 and the Foreign Investment Law2000 and the accompanying Executive Rules 2000 and the recently adopted Implementing Regulations 2014.Nonetheless, the legislative provisions contain various gaps and the failure to address these gaps creates risks and uncertainty for investors. For instance, the important topic of mergers and acquisitions has not been addressed in the Foreign Investment Law 2000. The circumstances in which expropriation can be considered to be in the public interest have not been defined. Moreover, Saudi Arabia has not entered into many bilateral investment treaties (BITs). This has an effect on the investment climate, as foreign investors are not afforded typical rights. An analysis of the BITs which have been entered into reveals that the national treatment standard and stabilisation, umbrella or renegotiation provisions have not been included. This is problematic since the 2000 Act does not spell out the applicable standard in accordance with which foreign investors should be treated. Moreover, the most-favoured-nation (MFN) or fair and equitable treatment (FET) standards have not been put on a statutory footing. Whilst the Arbitration Act 2012 permits that investment disputes can be internationalised, restrictions have been retained. The effectiveness of international arbitration is further undermined because Saudi Arabia does not enforce non-domestic arbitral awards which contravene public policy. Furthermore, the reservation to the Convention on the Settlement of Investment Disputes allows Saudi Arabia to exclude petroleum and sovereign disputes. Interviews with foreign investors, who operate in Saudi Arabia highlight additional issues. Saudi Arabia ought not to procrastinate far-reaching structural reforms.

Keywords: FDI, Saudi, BITs, law

Procedia PDF Downloads 409

Authors: Hassan Ibrahim

Abstract:

The prevalence of hyperacusis, an auditory condition characterized by heightened sensitivity to sounds, continues to rise, posing challenges for effective diagnosis and intervention. It is believed that this work deepens will deepens the understanding of hyperacusis etiology by employing graph theory as a novel analytical framework. it constructed a comprehensive graph wherein nodes represent various factors associated with hyperacusis, including aging, head or neck trauma, infection/virus, depression, migraines, ear infection, anxiety, and other potential contributors. Relationships between factors are modeled as edges, allowing us to visualize and quantify the interactions within the etiological landscape of hyperacusis. it employ the concept of the metric dimension of a connected graph to identify key nodes (landmarks) that serve as critical influencers in the interconnected web of hyperacusis causes. This approach offers a unique perspective on the relative importance and centrality of different factors, shedding light on the complex interplay between physiological, psychological, and environmental determinants. Visualization techniques were also employed to enhance the interpretation and facilitate the identification of the central nodes. This research contributes to the growing body of knowledge surrounding hyperacusis by offering a network-centric perspective on its multifaceted causes. The outcomes hold the potential to inform clinical practices, guiding healthcare professionals in prioritizing interventions and personalized treatment plans based on the identified landmarks within the etiological network. Through the integration of graph theory into hyperacusis research, the complexity of this auditory condition was unraveled and pave the way for more effective approaches to its management.

Keywords: auditory condition, connected graph, hyperacusis, metric dimension

Procedia PDF Downloads 22

Authors: S. S. Adamu, H. S. Muhammad, D. S. Shuaibu

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Poor power quality in electrical power systems can lead to medical equipment at healthcare centres to malfunction and present wrong medical diagnosis. Equipment such as X-rays, computerized axial tomography, etc. can pollute the system due to their high level of harmonics production, which may cause a number of undesirable effects like heating, equipment damages and electromagnetic interferences. The conventional approach of mitigation uses passive inductor/capacitor (LC) filters, which has some drawbacks such as, large sizes, resonance problems and fixed compensation behaviours. The current trends of solutions generally employ active power filters using suitable control algorithms. This work focuses on assessing the level of Total Harmonic Distortion (THD) on medical facilities and various ways of mitigation, using radiology unit of an existing hospital as a case study. The measurement of the harmonics is conducted with a power quality analyzer at the point of common coupling (PCC). The levels of measured THD are found to be higher than the IEEE 519-1992 standard limits. The system is then modelled as a harmonic current source using MATLAB/SIMULINK. To mitigate the unwanted harmonic currents a shunt active filter is developed using synchronous detection algorithm to extract the fundamental component of the source currents. Fuzzy logic controller is then developed to control the filter. The THD without the active power filter are validated using the measured values. The THD with the developed filter show that the harmonics are now within the recommended limits.

Keywords: power quality, total harmonics distortion, shunt active filters, fuzzy logic

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Authors: Faizan Sultan

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Non-government organizations (NGOs) in Pakistan have the potential to deliver services such as health, education, and rural development through targeting the most vulnerable communities of society. Having this significant importance, NGOs are facing numerous challenges in service delivery. So, there is a need to identify the challenges NGOs face in community development, particularly post-conflict development. The current study has analyzed the social and political constraints in development projects in the post-conflict region of the Swat district of Khyber Pakhtunkhwa. The objectives of this study are “What are the social and political constraints faced by the nongovernmental organizations in the implementation of development aid Projects in post-conflict development of Swat and to examine the challenges in coordination mechanism between government departments, NGOs, and community in reconstruction activities”. This research is based upon both the quantitative and qualitative data that is being gathered from the NGO representatives, government officials, and community members who were involved in post-conflict development interventions in the Swat region. A purposive sampling technique was used to select respondents from the community members/activists (25 in number) and government and NGO officials (10 in number). Based on analysis against our objectives, NGOs have faced numerous constraints such as Insecurity, Negative Perceptions about NGOs, restrictions on women's mobility, government policies and regulations, lack of coordination and networking, trust deficit, and political interference while implementing their project interventions. These findings concluded that constraints have affected project implementation to a greater extent, including women's participation, involvement of marginalized populations, and equal distribution of resources. In the Swat region, NGOs cannot openly discuss sensitive projects such as human rights, gender-based projects, or women empowerment as these issues are very sensitive to the local community due to their cultural values. The community may not allow their females to go outside their homes as this region is a male-dominated society. Similarly, lack of communication and poor networking for the arrangements of the project meetings were also the major constraints.

Keywords: national disaster management authority, millennium development goals, provincial disaster management authority, provincial reconstruction, rehabilitation and settlement authority

Procedia PDF Downloads 59