Search results for: antiracist healthcare delivery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3422

Search results for: antiracist healthcare delivery

1652 Optimisation of Intermodal Transport Chain of Supermarkets on Isle of Wight, UK

Authors: Jingya Liu, Yue Wu, Jiabin Luo

Abstract:

This work investigates an intermodal transportation system for delivering goods from a Regional Distribution Centre to supermarkets on the Isle of Wight (IOW) via the port of Southampton or Portsmouth in the UK. We consider this integrated logistics chain as a 3-echelon transportation system. In such a system, there are two types of transport methods used to deliver goods across the Solent Channel: one is accompanied transport, which is used by most supermarkets on the IOW, such as Spar, Lidl and Co-operative food; the other is unaccompanied transport, which is used by Aldi. Five transport scenarios are studied based on different transport modes and ferry routes. The aim is to determine an optimal delivery plan for supermarkets of different business scales on IOW, in order to minimise the total running cost, fuel consumptions and carbon emissions. The problem is modelled as a vehicle routing problem with time windows and solved by genetic algorithm. The computing results suggested that accompanied transport is more cost efficient for small and medium business-scale supermarket chains on IOW, while unaccompanied transport has the potential to improve the efficiency and effectiveness of large business scale supermarket chains.

Keywords: genetic algorithm, intermodal transport system, Isle of Wight, optimization, supermarket

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1651 Design and Development of Sustained Release Floating Tablet of Stavudine

Authors: Surajj Sarode, G. Vidya Sagar, G. P. Vadnere

Abstract:

The purpose of the present study was to prolong the gastric residence time of Stavudine by developing gastric floating drug delivery system (GFDDS). Moreover, to study influence of different polymers on its release rate using gas-forming agents, like sodium bicarbonate, citric acid. Floating tablets were prepared by wet granulation method using PVP K-30 as a binder and the other polymers include Pullulan Gum, HPMC K100M, six different formulations with the varying concentrations of polymers were prepared and the tablets were evaluated in terms of their pre-compression parameters like bulk density, tapped density, Haunsner ratio, angle of repose, compressibility index, post compression physical characteristics, in vitro release, buoyancy, floating lag time (FLT), total floating time (TFT) and swelling index. All the formulations showed good floating lag time i.e. less than 3 mins. The batch containing combination of Pullulan Gum and HPMC 100M (i.e. F-6) showed total floating lag time more than 12 h., the highest swelling index among all the prepared batches. The drug release was found to follow zero order kinetics.

Keywords: Suavudine, floating, total floating time (TFT), gastric residence

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1650 Service Blueprinting: A New Application for Evaluating Service Provision in the Hospice Sector

Authors: L. Sudbury-Riley, P. Hunter-Jones, L. Menzies, M. Pyrah, H. Knight

Abstract:

Just as manufacturing firms aim for zero defects, service providers strive to avoid service failures where customer expectations are not met. However, because services comprise unique human interactions, service failures are almost inevitable. Consequently, firms focus on service recovery strategies to fix problems and retain their customers for the future. Because a hospice offers care to terminally ill patients, it may not get the opportunity to correct a service failure. This situation makes the identification of what hospice users really need and want, and to ascertain perceptions of the hospice’s service delivery from the user’s perspective, even more important than for other service providers. A well-documented and fundamental barrier to improving end-of-life care is a lack of service quality measurement tools that capture the experiences of user’s from their own perspective. In palliative care, many quantitative measures are used and these focus on issues such as how quickly patients are assessed, whether they receive information leaflets, whether a discussion about their emotional needs is documented, and so on. Consequently, quality of service from the user’s perspective is overlooked. The current study was designed to overcome these limitations by adapting service blueprinting - never before used in the hospice sector - in order to undertake a ‘deep-dive’ to examine the impact of hospice services upon different users. Service blueprinting is a customer-focused approach for service innovation and improvement, where the ‘onstage’ visible service user and provider interactions must be supported by the ‘backstage’ employee actions and support processes. The study was conducted in conjunction with East Cheshire Hospice in England. The Hospice provides specialist palliative care for patients with progressive life-limiting illnesses, offering services to patients, carers and families via inpatient and outpatient units. Using service blueprinting to identify every service touchpoint, in-depth qualitative interviews with 38 in-patients, outpatients, visitors and bereaved families enabled a ‘deep-dive’ to uncover perceptions of the whole service experience among these diverse users. Interviews were recorded and transcribed, and thematic analysis of over 104,000 words of data revealed many excellent aspects of Hospice service. Staff frequently exceed people’s expectations. Striking gratifying comparisons to hospitals emerged. The Hospice makes people feel safe. Nevertheless, the technique uncovered many areas for improvement, including serendipity of referrals processes, the need for better communications with external agencies, improvements amid the daunting arrival and admissions process, a desperate need for more depression counselling, clarity of communication pertaining to actual end of life, and shortcomings in systems dealing with bereaved families. The study reveals that the adapted service blueprinting tool has major advantages of alternative quantitative evaluation techniques, including uncovering the complex nature of service user’s experiences in health-care service systems, highlighting more fully the interconnected configurations within the system and making greater sense of the impact of the service upon different service users. Unlike other tools, this in-depth examination reveals areas for improvement, many of which have already been implemented by the Hospice. The technique has potential to improve experiences of palliative and end-of-life care among patients and their families.

Keywords: hospices, end-of-life-care, service blueprinting, service delivery

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1649 A Rare Case of Dissection of Cervical Portion of Internal Carotid Artery, Diagnosed Postpartum

Authors: Bidisha Chatterjee, Sonal Grover, Rekha Gurung

Abstract:

Postpartum dissection of the internal carotid artery is a relatively rare condition and is considered as an underlying aetiology in 5% to 25% of strokes under the age of 30 to 45 years. However, 86% of these cases recover completely and 14% have mild focal neurological symptoms. Prognosis is generally good with early intervention. The risk quoted for a repeat carotid artery dissection in subsequent pregnancies is less than 2%. 36-year Caucasian primipara presented on postnatal day one of forceps delivery with tachycardia. In the intrapartum period she had a history of prolonged rupture of membranes and developed intrapartum sepsis and was treated with antibiotics. Postpartum ECG showed septal inferior T wave inversion and a troponin level of 19. Subsequently Echocardiogram ruled out post-partum cardiomyopathy. Repeat ECG showed improvement of the previous changes and in the absence of symptoms no intervention was warranted. On day 4 post-delivery, she had developed symptoms of droopy right eyelid, pain around the right eye and itching in the right ear. On examination, she had developed right sided ptosis, unequal pupils (Rt miotic pupil). Cranial nerve examination, reflexes, sensory examination and muscle power was normal. Apart from migraine, there was no medical or family history of note. In view of Horner’s on the right, she had a CT Angiogram and subsequently MR/MRA and was diagnosed with dissection of the cervical portion of the right internal carotid artery. She was discharged on a course of Aspirin 75mg. By 6 week post-natal follow up patient had recovered significantly with occasional episodes of unequal pupils and tingling of right toes which resolved spontaneously. Cervical artery dissection, including VAD and carotid artery dissection, are rare complications of pregnancy with an estimated annual incidence of 2.6–3 per 100,000 pregnancy hospitalizations. Aetiology remains unclear though trauma during straining at labour, underlying arterial disease and preeclampsia have been implicated. Hypercoagulable state during pregnancy and puerperium could also be an important factor. 60-90% cases present with severe headache and neck pain and generally precede neurological symptoms like ipsilateral Horner’s syndrome, retroorbital pain, tinnitus and cranial nerve palsy. Although rare, the consequences of delayed diagnosis and management can lead to severe and permanent neurological deficits. Patients with a strong index of suspicion should undergo an MRI or MRA of head and neck. Antithrombotic and antiplatelet therapy forms the mainstay of therapy with selected cases needing endovascular stenting. Long term prognosis is favourable with either complete resolution or minimal deficit if treatment is prompt. Patients should be counselled about the recurrence risk and possibility of stroke in future pregnancy. Coronary artery dissection is rare and treatable but needs early diagnosis and treatment. Post-partum headache and neck pain with neurological symptoms should prompt urgent imaging followed by antithrombotic and /or antiplatelet therapy. Most cases resolve completely or with minimal sequelae.

Keywords: postpartum, dissection of internal carotid artery, magnetic resonance angiogram, magnetic resonance imaging, antiplatelet, antithrombotic

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1648 Competencies and Training Needs for School Sport Managers in the North West Province, South Africa

Authors: Elriena Eksteen, Yolandi Willemse, Dawie D. J. Malan, Suria Ellis

Abstract:

It is important to understand which competencies are needed for managerial and administrative effectiveness of school sport managers with regard to the design, delivery and direction of school sport programmes. The purpose of this study was to determine the competencies and training needs for secondary school sport managers in the North West Province. Data were gathered from 79 school sport managers in the North West Province by means of a validated self-compiled questionnaire. Descriptive statistics, factor analysis and a dependent t-test were used to compare which competencies school sport managers perceive as important in their work with the competencies they actually perform. Functional competencies and core competencies were both found to be important for managing school sport effectively. There were statistically significant differences between the perceived importance of competencies and the frequency with which competencies were actually performed. Respondents attached greater importance to functional and core competencies than the proportion of time spent actually performing them. Furthermore, results indicated the need to train teachers in managing sport finance, sport facilities and human resources, as well as presenting workshops in public relations, sport marketing and sport organisation.

Keywords: competencies, functional competencies, core competencies, school sport manager, training needs

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1647 Enhancing Protein Incorporation in Calcium Phosphate Coating on Titanium by Rapid Biomimetic Co-Precipitation Technique

Authors: J. Suwanprateeb, F. Thammarakcharoen

Abstract:

Calcium phosphate coating (CaP) has been employed for protein delivery, but the typical direct protein adsorption on the coating led to low incorporation content and fast release of the protein from the coating. By using bovine serum albumin (BSA) as a model protein, rapid biomimetic co-precipitation between calcium phosphate and BSA was employed to control the distribution of BSA within calcium phosphate coating during biomimetic formation on titanium surface for only 6 h at 50 oC in an accelerated calcium phosphate solution. As a result, the amount of BSA incorporation and release duration could be increased by using a rapid biomimetic co-precipitation technique. Up to 43 fold increases in the BSA incorporation content and the increase from 6 h to more than 360 h in release duration compared to typical direct adsorption technique were observed depending on the initial BSA concentration used during co-precipitation (1, 10, and 100 microgram/ml). From X-ray diffraction and Fourier transform infrared spectroscopy studies, the coating composition was not altered with the incorporation of BSA by this rapid biomimetic co-precipitation and mainly comprised octacalcium phosphate and hydroxyapatite. However, the microstructure of calcium phosphate crystals changed from straight, plate-like units to curved, plate-like units with increasing BSA content.

Keywords: biomimetic, Calcium Phosphate Coating, protein, titanium

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1646 Experimental Characterization and Modelling of Microfluidic Radial Diffusers

Authors: Eric Chappel, Dimitry Dumont-Fillon, Hugo Musard, Harald van Lintel

Abstract:

A microfluidic radial diffuser typically comprises a hole in a membrane, a small gap and pillar centred with the hole. The fluid is forced to flow radially in this gap between the membrane and the pillar. Such diffusers are notably used to form flow control valves, wherein several holes are machined into a flexible membrane progressively deflecting against pillars as the pressure increases. The fluidic modelling of such diffuser is made difficult by the presence of a transition region between the hole and the diffuser itself. An experimental investigation has been conducted using SOI wafers to form membranes with only one centred hole and Pyrex wafers for the substrate and pillars, both wafers being anodically bonded after alignment. A simple fluidic model accounting for the specific geometry of the diffuser is proposed and compared to experimental results. A good match is obtained, for Reynolds number in the range 0.5 to 35 using the analytical formula of a radial diffuser in the laminar regime with an effective inner radius that is 40% smaller than the real radius, in order to simulate correctly the flow constriction at the entrance of the diffuser.

Keywords: radial diffuser, flow control valve, numerical modelling, drug delivery

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1645 Barriers and Drivers Towards the Use of Childhood Vaccination Services by Undocumented Migrant Caregivers in Sabah, Malaysia: A Qualitative Analysis

Authors: Michal Christina Steven, Mohd. Yusof Hj Ibrahim, Haryati Abdul Karim, Prabakaran Dhanaraj, Kelly Alexius Mansin

Abstract:

After 27 years, Malaysia reported polio cases in 2019 involving the children of the undocumented migrants living in Sabah. These undocumented migrants present a significant challenge in achieving the elimination of vaccine-preventable diseases (VPD). Due to the recent polio outbreak among the undocumented migrant children in Sabah, an in-depth interview was conducted among the caregivers of undocumented migrant children to identify the barriers and drivers towards vaccinating their children. Financial barriers, legal citizenship status, language barrier, the COVID-19 pandemic, and physical barriers have been the barriers to access vaccination services by undocumented migrants. Five significant drivers for undocumented migrants to vaccinate their children are social influence, fear of disease, parental trust in healthcare providers, good support, and vaccine availability. Necessary action should be taken immediately to address the problems of vaccinating the children of undocumented migrants to prevent the re-emergence of VPD.

Keywords: Malaysia, polio, Sabah, undocumented migrants

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1644 Feature Evaluation and Applications of Various Advanced Conductors with High Conductivity and Low Flash in Overhead Lines

Authors: Atefeh Pourshafie, Homayoun Bakhtiari

Abstract:

In power transmission lines, electricity conductors are main tools to carry electric power. Thus, other devices such as shield wires, insulators, towers, foundations etc. should be designed in a way that the conductors be able to successfully do their task which is appropriate power delivery to the customers. Non-stop increase of energy demand has led to saturated capacity of transmission lines which, in turn, causing line flash to exceed acceptable limits in some points. An approach which may be used to solve this issue is replacement of current conductors with new ones having the capability of withstanding higher heating such that reduced flash would be observed when heating increases. These novel conductors are able to transfer higher currents and operate in higher heating conditions while line flash will remain within standard limits. In this paper, we will attempt to introduce three types of advanced overhead conductors and analyze the replacement of current conductors by new ones technically and economically in transmission lines. In this regard, progressive conductors of transmission lines are introduced such as ACC (Aluminum Conductor Composite Core), AAAC-UHC (Ultra High Conductivity, All Aluminum Alloy Conductors), and G(Z)TACSR-Gap Type.

Keywords: ACC, AAAC-UHC, gap type, transmission lines

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1643 Lipid-polymer Nanocarrier Platform Enables X-Ray Induced Photodynamic Therapy against Human Colorectal Cancer Cells

Authors: Rui Sang, Fei Deng, Alexander Engel, Ewa M. Goldys, Wei Deng

Abstract:

In this study, we brought together X-ray induced photodynamic therapy (X-PDT) and chemo-drug (5-FU) for the treatment on colorectal cancer cells. This was achieved by developing a lipid-polymer hybrid nanoparticle delivery system (FA-LPNPs-VP-5-FU). It was prepared by incorporating a photosensitizer (verteporfin), chemotherapy drug (5-FU), and a targeting moiety (folic acid) into one platform. The average size of these nanoparticles was around 100 nm with low polydispersity. When exposed to clinical doses of 4 Gy X-ray radiation, FA-LPNPs-VP-5-FU generated sufficient amounts of reactive oxygen species, triggering the apoptosis and necrosis pathway of cancer cells. Our combined X-PDT and chemo-drug strategy was effective in inhibiting cancer cells’ growth and proliferation. Cell cycle analyses revealed that our treatment induced G2/M and S phase arrest in HCT116 cells. Our results indicate that this combined treatment provides better antitumour effect in colorectal cancer cells than each of these modalities alone. This may offer a novel approach for effective colorectal cancer treatment with reduced off-target effect and drug toxicity.

Keywords: pdt, targeted lipid-polymer nanoparticles, verteporfin, colorectal cancer

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1642 Mentees’ Agency in Practicum: A Qualitative Study of Two Teacher Education Programs in Vietnam

Authors: Tien Nguyen

Abstract:

The relationship between mentors and mentees in teaching practicum has received the attention of researchers and been widely investigated. Mentors’ authority and power have captured a large and growing body of the literature in the field of teaching practicum. This article revisits mentor-mentee relationship and shifts the focus to mentees’ agency in planning and delivering lessons, an area which has been under-researched. Drawing on Vygotsky’s Zone of Proximal Development and Harré’s Positioning Theory, this qualitative study examines how mentees responded to mentors’ instructions in practicum. Interviews and classroom observations were conducted with 20 participants including both mentors and mentees across two English language teacher education programs in two different geographical locations in Vietnam. The result indicates that regardless of the similarities and/or differences of the programs, mentees’ agency varied in accordance with their identities in specific contexts. Specifically, mentees follow or resist to mentors’ feedback and instruction in revising their lesson plans and delivery these lessons, depending on their professional identities and institutional conditions. This study contributes to the importance of supporting the agency of mentees in teacher education.

Keywords: mentors, mentees, relationship, agency, professional identity, teacher education

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1641 Value-Based Management Education Need of the Hour

Authors: Surendar Vaddepalli

Abstract:

Management education plays a crucial role to enable industry to cope with emerging challenges. It has spread in the last fifteen-twenty years in India and gained popularity as it was aimed at imbibing versatility and multi-tasking abilities in student community. Several management institutions started looking at upgrading their competencies in terms of faculty, research and industry interaction. The competitive business environment has been one of the drivers that paved the way for growing demand for management graduates in the employment market. Industry expects their executives to be engaged in a constant learning process. The ever-increasing demand for managers has led to establish more management institutions; however, the growth was not in line with the expectations from the industry. While top Business Schools are continuously changing the contents and delivery methodologies, academic standards of most of the other Business Schools are not up to the mark and quality of service provided by these institutes has opened various issues for discussion. On this back ground it is important to address the concerns of Indian management education experiencing with time and we have to rethink about the management education and efforts should be made to create a dynamic environment. This paper ties to study the current trends and tries to find out need for value based management education in India to rejuvenate it.

Keywords: management education, management, value based management education, business school, India

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1640 Polyhydroxybutyrate (PHB): Highly Porous Scaffold for Biomedicine

Authors: Neda Sinaei, Davood Zare, Mehrdad Azin

Abstract:

Polyhydroxyalkanoates (PHAs) are biocompatible and biodegradable polymers produced by a wide range of bacterial strains. These biopolymers are significantly studied for drug delivery and tissue engineering applications because of their fascinating physicochemical properties. Polyhydroxybutyrate (PHB) scaffold that has been extracted from a novel bacteria using oil wastewater was selected to study. Some physical parameters affecting scaffold properties such as PHB concentration, solvent evaporation speed, and ultrasonic time were investigated. Scanning electron microscopy was used to evaluate the porosity. Afterward, the biocompatibility of PHB scaffold was assessed. Initial results showed the highly porous PHB scaffold structure with a variety of pore sizes. Subsequent results indicated that more unique pore sizes can be obtained by optimizing physical factors. It would be noticed that the morphology of the pore structure was accordingly affected by ultrasonic time. Hence, In vitro cell viability tests on the PHB scaffold using human foreskin fibroblasts revealed strong cell attachment and proliferation supports. Therefore, it can be concluded that the cost-effective PHB scaffold has the potential using as a biomaterial cell adhesion substrate in therapeutic applications.

Keywords: Polyhydroxybutyrate, biocompatible, scaffold, porous, tissue engineering

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1639 Hybrid Inventory Model Optimization under Uncertainties: A Case Study in a Manufacturing Plant

Authors: E. Benga, T. Tengen, A. Alugongo

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Periodic and continuous inventory models are the two classical management tools used to handle inventories. These models have advantages and disadvantages. The implementation of both continuous (r,Q) inventory and periodic (R, S) inventory models in most manufacturing plants comes with higher cost. Such high inventory costs are due to the fact that most manufacturing plants are not flexible enough. Since demand and lead-time are two important variables of every inventory models, their effect on the flexibility of the manufacturing plant matter most. Unfortunately, these effects are not clearly understood by managers. The reason is that the decision parameters of the continuous (r, Q) inventory and periodic (R, S) inventory models are not designed to effectively deal with the issues of uncertainties such as poor manufacturing performances, delivery performance supplies performances. There is, therefore, a need to come up with a predictive and hybrid inventory model that can combine in some sense the feature of the aforementioned inventory models. A linear combination technique is used to hybridize both continuous (r, Q) inventory and periodic (R, S) inventory models. The behavior of such hybrid inventory model is described by a differential equation and then optimized. From the results obtained after simulation, the continuous (r, Q) inventory model is more effective than the periodic (R, S) inventory models in the short run, but this difference changes as time goes by. Because the hybrid inventory model is more cost effective than the continuous (r,Q) inventory and periodic (R, S) inventory models in long run, it should be implemented for strategic decisions.

Keywords: periodic inventory, continuous inventory, hybrid inventory, optimization, manufacturing plant

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1638 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance

Authors: Yuguang Gao, Mingtao Deng

Abstract:

The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.

Keywords: collaborative medical alliance, disease related group, patient referral, simulation

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1637 Development and Evaluation of an Internet-Based Transdiagnostic Therapy Intervention in the Arab World

Authors: Mariam Fishere

Abstract:

The proposed research study aims at developing an Internet-based transdiagnostic treatment and evaluating its efficacy. Based on the Common Elements Treatment Approach (CETA), a combined low-intensity and technology supported transdiagnostic treatment protocol will be culturally adapted for usage by nonprofessional therapists in Arabic-speaking countries. This Internet-based CETA intervention will target individuals suffering from one or more of the following disorders: depression, anxiety and posttraumatic stress disorder (PTSD), which are all major contributors to the global burden of mental illness. The growing body of research in the area of transdiagnostic treatment has proven to be effective in high-income countries (HICs), but there remain questions about its efficacy, cultural appropriateness, and validity for low- to middle-income countries (LMICs). The aim of this dissertation project is to investigate the efficacy of a newly developed Internet-delivery of an evidence-based transdiagnostic treatment – CETA – for a sample of Arabic-speaking individuals suffering from at least one of the following disorders; depression, anxiety, and PTSD.

Keywords: transdiagnostic, internet-based interventions, mental health, Arab world

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1636 The Impact of E-Learning on Medication Administration of Nursing Students

Authors: Z. Karakus, Z. Ozer

Abstract:

Nurses are responsible for the care and treatment of individuals, as well as health maintenance and education. Medication administration is an important part of health promotion. The administration of a medicine is a common but important clinical procedure for nurses because of its complex structure. Therefore, medication errors are inevitable for nurses or nursing students. Medication errors can cause ineffective treatment, patient’s prolonged hospital stay, disablement, or death. Additionally, medication errors affect the global economy adversely by increasing health costs. Hence, preventing or decreasing of medication errors is a critical and essential issue in nursing. Nurse educators are in pursuit of new teaching methods to teach students significance of medication application. In the light of technological developments of this age, e-learning has started to be accepted as an important teaching method. E-learning is the use of electronic media and information and communication technologies in education. It has advantages such as flexibility of time and place, lower costs, faster delivery, and lower environmental impact. Students can make their own schedule and decide the learning method. This study is conducted to determine the impact of e-learning on medication administration of nursing students.

Keywords: e-learning, medication administration, nursing, nursing students

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1635 IT Workforce Enablement: How Cloud Computing Changes the Competence Mix of the IT Workforce

Authors: Dominik Krimpmann

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Cloud computing has provided the impetus for change in the demand, sourcing, and consumption of IT-enabled services. The technology developed from an emerging trend towards a ‘must-have’. Many organizations harnessed on the quick-wins of cloud computing within the last five years but nowadays reach a plateau when it comes to sustainable savings and performance. This study aims to investigate what is needed from an organizational perspective to make cloud computing a sustainable success. The study was carried out in Germany among senior IT professionals, both in management and delivery positions. Our research shows that IT executives must be prepared to realign their IT workforce to sustain the advantage of cloud computing for today and the near future. While new roles will undoubtedly emerge, roles alone cannot ensure the success of cloud deployments. What is needed is a change in the IT workforce’s business behaviour, or put more simply, the ways in which the IT personnel works. It gives clear guidance on which dimensions of an employees’ working behaviour need to be adapted. The practical implications are drawn from a series of semi-structured interviews, resulting in a high-level workforce enablement plan. Lastly, it elaborates on tools and gives clear guidance on which pitfalls might arise along the proposed workforce enablement process.

Keywords: cloud computing, organization design, organizational change, workforce enablement

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1634 The Role of E-Learning in Science, Technology, Engineering, and Math Education

Authors: Annette McArthur

Abstract:

The traditional model of teaching and learning, where ICT sits as a separate entity is not a model for a 21st century school. It is imperative that teaching and learning embraces technological advancements. The challenge in schools lies in shifting the mindset of teachers so they see ICT as integral to their teaching, learning and curriculum rather than a separate E-Learning curriculum stream. This research project investigates how the effective, planned, intentional integration of ICT into a STEM curriculum, can enable the shift in the teacher mindset. The project incorporated: • Developing a professional coaching relationship with key STEM teachers. • Facilitating staff professional development involving student centered project based learning pedagogy in the context of a STEM curriculum. • Facilitating staff professional development involving digital literacy. • Establishing a professional community where collaboration; sharing and reflection were part of the culture of the STEM community. • Facilitating classroom support for the effective delivery innovative STEM curriculum. • Developing STEM learning spaces where technologies were used to empower and engage learners to participate in student-centered, project-based learning.

Keywords: e-learning, ICT, project based learning, STEM

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1633 Household Water Practices in a Rapidly Urbanizing City and Its Implications for the Future of Potable Water: A Case Study of Abuja Nigeria

Authors: Emmanuel Maiyanga

Abstract:

Access to sufficiently good quality freshwater has been a global challenge, but more notably in low-income countries, particularly in the Sub-Saharan countries, which Nigeria is one. Urban population is soaring, especially in many low-income countries, the existing centralised water supply infrastructures are ageing and inadequate, moreover in households peoples’ lifestyles have become more water-demanding. So, people mostly device coping strategies where municipal supply is perceived to have failed. This development threatens the futures of groundwater and calls for a review of management strategy and research approach. The various issues associated with water demand management in low-income countries and Nigeria, in particular, are well documented in the literature. However, the way people use water daily in households and the reasons they do so, and how the situation is constructing demand among the middle-class population in Abuja Nigeria is poorly understood. This is what this research aims to unpack. This is achieved by using the social practices research approach (which is based on the Theory of Practices) to understand how this situation impacts on the shared groundwater resource. A qualitative method was used for data gathering. This involved audio-recorded interviews of householders and water professionals in the private and public sectors. It also involved observation, note-taking, and document study. The data were analysed thematically using NVIVO software. The research reveals the major household practices that draw on the water on a domestic scale, and they include water sourcing, body hygiene and sanitation, laundry, kitchen, and outdoor practices (car washing, domestic livestock farming, and gardening). Among all the practices, water sourcing, body hygiene, kitchen, and laundry practices, are identified to impact most on groundwater, with impact scale varying with household peculiarities. Water sourcing practices involve people sourcing mostly from personal boreholes because the municipal water supply is perceived inadequate and unreliable in terms of service delivery and water quality, and people prefer easier and unlimited access and control using boreholes. Body hygiene practices reveal that every respondent prefers bucket bathing at least once daily, and the majority bathe twice or more every day. Frequency is determined by the feeling of hotness and dirt on the skin. Thus, people bathe to cool down, stay clean, and satisfy perceived social, religious, and hygiene demand. Kitchen practice consumes water significantly as people run the tap for vegetable washing in daily food preparation and dishwashing after each meal. Laundry practice reveals that most people wash clothes most frequently (twice in a week) during hot and dusty weather, and washing with hands in basins and buckets is the most prevalent and water wasting due to soap overdose. The research also reveals poor water governance as a major cause of current inadequate municipal water delivery. The implication poor governance and widespread use of boreholes is an uncontrolled abstraction of groundwater to satisfy desired household practices, thereby putting the future of the shared aquifer at great risk of total depletion with attendant multiplying effects on the people and the environment and population continues to soar.

Keywords: boreholes, groundwater, household water practices, self-supply

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1632 Angiopermissive Foamed and Fibrillar Scaffolds for Vascular Graft Applications

Authors: Deon Bezuidenhout

Abstract:

Pre-seeding with autologous endothelial cells improves the long-term patency of synthetic vascular grafts levels obtained with autografts, but is limited to a single centre due to resource, time and other constraints. Spontaneous in vivo endothelialization would obviate the need for pre-seeding, but has been shown to be absent in man due to limited transanastomotic and fallout healing, and the lack of transmural ingrowth due to insufficient porosity. Two types of graft scaffolds with increased interconnected porosity for improved tissue ingrowth and healing are thus proposed and described. Foam-type polyurethane (PU) scaffolds with small, medium and large, interconnected pores were made by phase inversion and spherical porogen extraction, with and without additional surface modification with covalently attached heparin and subsequent loading with and delivery of growth factors. Fibrillar scaffolds were made either by standard electrospinning using degradable PU (Degrapol®), or by dual electrospinning using non-degradable PU. The latter process involves sacrificial fibres that are co-spun with structural fibres and subsequently removed to increased porosity and pore size. Degrapol samples were subjected to in vitro degradation, and all scaffold types were evaluated in vivo for tissue ingrowth and vascularization using rat subcutaneous model. The foam scaffolds were additionally evaluated in a circulatory (rat infrarenal aortic interposition) model that allows for the grafts to be anastomotically and/or ablumenally isolated to discern and determine endothelialization mode. Foam-type grafts with large (150 µm) pores showed improved subcutaneous healing in terms of vascularization and inflammatory response over smaller pore sizes (60 and 90µm), and vascularization of the large porosity scaffolds was significantly increased by more than 70% by heparin modification alone, and by 150% to 400% when combined with growth factors. In the circulatory model, extensive transmural endothelialization (95±10% at 12 w) was achieved. Fallout healing was shown to be sporadic and limited in groups that were ablumenally isolated to prevent transmural ingrowth (16±30% wrapped vs. 80±20% control; p<0.002). Heparinization and GF delivery improved both mural vascularization and lumenal endothelialization. Degrapol electrospun scaffolds showed decrease in molecular mass and corresponding tensile strength over the first 2 weeks, but very little decrease in mass over the 4w test period. Studies on the effect of tissue ingrowth with and without concomitant degradation of the scaffolds, are being used to develop material models for the finite element modelling. In the case of the dual-spun scaffolds, the PU fibre fraction could be controlled shown to vary linearly with porosity (P = −0.18FF +93.5, r2=0.91), which in turn showed inverse linear correlation with tensile strength and elastic modulus (r2 > 0.96). Calculated compliance and burst pressures of the scaffolds increased with fibre fraction, and compliances matching the human popliteal artery (5-10 %/100 mmHg), and high burst pressures (> 2000 mmHg) could be achieved. Increasing porosity (76 to 82 and 90%) resulted in increased tissue ingrowth from 33±7 to 77±20 and 98±1% after 28d. Transmural endothelialization of highly porous foamed grafts is achievable in a circulatory model, and the enhancement of porosity and tissue ingrowth may hold the key the development of spontaneously endothelializing electrospun grafts.

Keywords: electrospinning, endothelialization, porosity, scaffold, vascular graft

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1631 A Hybrid Digital Watermarking Scheme

Authors: Nazish Saleem Abbas, Muhammad Haris Jamil, Hamid Sharif

Abstract:

Digital watermarking is a technique that allows an individual to add and hide secret information, copyright notice, or other verification message inside a digital audio, video, or image. Today, with the advancement of technology, modern healthcare systems manage patients’ diagnostic information in a digital way in many countries. When transmitted between hospitals through the internet, the medical data becomes vulnerable to attacks and requires security and confidentiality. Digital watermarking techniques are used in order to ensure the authenticity, security and management of medical images and related information. This paper proposes a watermarking technique that embeds a watermark in medical images imperceptibly and securely. In this work, digital watermarking on medical images is carried out using the Least Significant Bit (LSB) with the Discrete Cosine Transform (DCT). The proposed methods of embedding and extraction of a watermark in a watermarked image are performed in the frequency domain using LSB by XOR operation. The quality of the watermarked medical image is measured by the Peak signal-to-noise ratio (PSNR). It was observed that the watermarked medical image obtained performing XOR operation between DCT and LSB survived compression attack having a PSNR up to 38.98.

Keywords: watermarking, image processing, DCT, LSB, PSNR

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1630 Constructability Driven Engineering in Oil and Gas Projects

Authors: Srikanth Nagarajan, P. Parthasarathy, Frits Lagers

Abstract:

Lower crude oil prices increased the pressure on oil and gas projects. Being competitive becomes very important and critical for the success in any industry. Increase in size of the project multiplies the magnitude of the issue. Timely completion of projects within the budget and schedule is very important for any project to succeed. A simple idea makes a larger impact on the total cost of the plant. In this robust world, the phases of engineering right from licensing technology, feed, different phases of detail engineering, procurement and construction has been so much compressed that they overlap with each other. Hence constructability techniques have become very important. Here in this paper, the focus will be on how these techniques can be implemented and reduce cost with the help of a case study. Constructability is a process driven by the need to impact project’s construction phase resulting in improved project delivery, costs and schedule. In construction phase of one of our fast-track mega project, it was noticed that there was an opportunity to reduce significant amount of cost and schedule by implementing Constructability study processes. In this case study, the actual methodology adopted during engineering and construction and the way for doing it better by implementing Constructability techniques with collaborative engineering efforts will be explained.

Keywords: being competitive, collaborative engineering, constructability, cost reduction

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1629 The Reflections of the K-12 English Language Teachers on the Implementation of the K-12 Basic Education Program in the Philippines

Authors: Dennis Infante

Abstract:

This paper examined the reflections of teachers on curriculum reforms, the implementation of the K-12 Basic Education Program in the Philippines. The results revealed that problems and concerns raised by teachers could be classified into curriculum materials and design; competence, readiness and motivation of the teachers; the learning environment, and support systems; readiness, competence and motivation of students; and other relevant factors. The best features of the K-12 curriculum reforms included (1) the components, curriculum materials; (2) the design, structure and delivery of the lessons; (3) the framework and theoretical approach; (3) the qualities of the teaching-learning activities; (4) and other relevant features. With the demanding task of implementing the new curriculum, the teachers expressed their needs which included (1) making the curriculum materials available to achieve the goals of the curriculum reforms; (2) enrichment of the learning environments; (3) motivating and encouraging the teachers to embrace change; (4) providing appropriate support systems; (5) re-tooling, and empowering teachers to implement the curriculum reforms; and (6) other relevant factors. The research concluded with a synthesis that provided a paradigm for implementing curriculum reforms which recognizes the needs of the teachers and the features of the new curriculum.

Keywords: curriculum reforms, K-12, teachers' reflections, implementing curriculum change

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1628 An Alternative Stratified Cox Model for Correlated Variables in Infant Mortality

Authors: K. A. Adeleke

Abstract:

Often in epidemiological research, introducing stratified Cox model can account for the existence of interactions of some inherent factors with some major/noticeable factors. This research work aimed at modelling correlated variables in infant mortality with the existence of some inherent factors affecting the infant survival function. An alternative semiparametric Stratified Cox model is proposed with a view to take care of multilevel factors that have interactions with others. This, however, was used as a tool to model infant mortality data from Nigeria Demographic and Health Survey (NDHS) with some multilevel factors (Tetanus, Polio, and Breastfeeding) having correlation with main factors (Sex, Size, and Mode of Delivery). Asymptotic properties of the estimators are also studied via simulation. The tested model via data showed good fit and performed differently depending on the levels of the interaction of the strata variable Z*. An evidence that the baseline hazard functions and regression coefficients are not the same from stratum to stratum provides a gain in information as against the usage of Cox model. Simulation result showed that the present method produced better estimates in terms of bias, lower standard errors, and or mean square errors.

Keywords: stratified Cox, semiparametric model, infant mortality, multilevel factors, cofounding variables

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1627 Optimizing Telehealth Internet of Things Integration: A Sustainable Approach through Fog and Cloud Computing Platforms for Energy Efficiency

Authors: Yunyong Guo, Sudhakar Ganti, Bryan Guo

Abstract:

The swift proliferation of telehealth Internet of Things (IoT) devices has sparked concerns regarding energy consumption and the need for streamlined data processing. This paper presents an energy-efficient model that integrates telehealth IoT devices into a platform based on fog and cloud computing. This integrated system provides a sustainable and robust solution to address the challenges. Our model strategically utilizes fog computing as a localized data processing layer and leverages cloud computing for resource-intensive tasks, resulting in a significant reduction in overall energy consumption. The incorporation of adaptive energy-saving strategies further enhances the efficiency of our approach. Simulation analysis validates the effectiveness of our model in improving energy efficiency for telehealth IoT systems, particularly when integrated with localized fog nodes and both private and public cloud infrastructures. Subsequent research endeavors will concentrate on refining the energy-saving model, exploring additional functional enhancements, and assessing its broader applicability across various healthcare and industry sectors.

Keywords: energy-efficient, fog computing, IoT, telehealth

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1626 Seismic Vulnerability Mitigation of Non-Engineered Buildings

Authors: Muhammad Tariq A. Chaudhary

Abstract:

The tremendous loss of life that resulted in the aftermath of recent earthquakes in developing countries is mostly due to the collapse of non-engineered and semi-engineered building structures. Such structures are used as houses, schools, primary healthcare centres and government offices. These building are classified structurally into two categories viz. non-engineered and semi-engineered. Non-engineered structures include: adobe, Unreinforced Masonry (URM) and wood buildings. Semi-engineered buildings are mostly low-rise (up to 3 story) light concrete frame structures or masonry bearing walls with reinforced concrete slab. This paper presents an overview of the typical damage observed in non-engineered structures and their most likely causes in the past earthquakes with specific emphasis on the performance of such structures in the 2005 Kashmir earthquake. It is demonstrated that seismic performance of these structures can be improved from life-safety viewpoint by adopting simple low-cost modifications to the existing construction practices. Incorporation of some of these practices in the reconstruction efforts after the 2005 Kashmir earthquake are examined in the last section for mitigating seismic risk hazard.

Keywords: Kashmir earthquake, non-engineered buildings, seismic hazard, structural details, structural strengthening

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1625 Observations of Conformity in the Health Professions

Authors: Tanya Beran, Michelle Drefs, Ghazwan Altabbaa, Nouf Al Harbi, Noof Al Baz, Elizabeth Oddone Paolucci

Abstract:

Although research shows that interprofessional practice has desirable effects on patient care, its implementation can present challenges to its team members. In particular, they may feel pressured to agree with or conform to other members who share information that is contrary to their own understanding. Obtaining evidence of this phenomenon is challenging, as team members may underreport their conformity behaviors due to reasons such as social desirability. In this paper, a series of studies are reviewed in which several approaches to assessing conformity in the health care professions are tested. Simulations, questionnaires, and behavior checklists were developed to measure conformity behaviors. Insights from these studies show that a significant proportion of people conform either in the presence or absence of others, express a variety of verbal and nonverbal behaviors when considering whether to conform to others, may shift between conforming and moments later not conforming (and vice versa), and may not accurately report whether they conformed. A new method of measuring conformity using the implicit bias test is also discussed. People at all levels in the healthcare system are encouraged to develop both formal and informal.

Keywords: conformity, decision-making, inter-professional teams, simulation

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1624 Evaluating and Reflecting on Virtual Exercise Programs during the COVID-19 Pandemic

Authors: Teng Minnie Y., Jarus Tal, Wong Anita

Abstract:

Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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1623 Analysis of Patient No-Shows According to Health Conditions

Authors: Sangbok Lee

Abstract:

There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

Procedia PDF Downloads 233