Search results for: healthcare knowledge management

Authors: Wike Wike

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The aim of this study is to investigate the experience of mothers of autistic children in Indonesia in raising the children and obtaining services for them through the adequate of information. The study seeks to contribute to the knowledge emerging from the women as a mother of children with autism on health and disability area. There is silence in the Indonesian literature on this perspective, especially about the parents and/or mothers of autistic children that is the focus of this analysis. Therefore, in order to capture the points of view emerging from the mothers, a qualitative study design has been applied. The main data for this qualitative study was collected from interviews (semi-structured interview and focus group discussion) with the mothers of children with autism who are member of parenting group in autistic schools and rehabilitation centers in one of Indonesian regional cities. This study reveals that the mothers’ experience in raising a child who is diagnosed with autism is rooted in limited knowledge on autism, limited knowledge on availability of services and limited knowledge on service options. Compounding this is limited availability and accessibility of the services that are important to their child's development. An important contribution of this study is to show how tapping into the experience of mothers can provide much needed information to policy making and service planners and implementers that can improve the services for children with autism and their families.

Keywords: mothers, children with autism, disability services and policy, services

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Authors: Tuji Jemal Ahmed

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Food quality and safety challenges are prevalent in Ethiopia's food processing industry, which can have adverse effects on consumers' health and wellbeing. The country is known for its diverse range of agricultural products, which are essential to its economy. However, poor food quality and safety policies and management systems in the food processing industry have led to several health problems, foodborne illnesses, and economic losses. This paper aims to highlight the causes and effects of food safety and quality issues in the food processing industry of Ethiopia and discuss potential solutions to address these issues. One of the main causes of poor food quality and safety in Ethiopia's food processing industry is the lack of adequate regulations and enforcement mechanisms. The absence of comprehensive food safety and quality policies and guidelines has led to substandard practices in the food manufacturing process. Moreover, the lack of monitoring and enforcement of existing regulations has created a conducive environment for unscrupulous businesses to engage in unsafe practices that endanger the public's health. The effects of poor food quality and safety are significant, ranging from the loss of human lives, increased healthcare costs, and loss of consumer confidence in the food processing industry. Foodborne illnesses, such as diarrhea, typhoid fever, and cholera, are prevalent in Ethiopia, and poor food quality and safety practices contribute significantly to their prevalence. Additionally, food recalls due to contamination or mislabeling often result in significant economic losses for businesses in the food processing industry. To address these challenges, the Ethiopian government has begun to take steps to improve food quality and safety in the food processing industry. One of the most notable initiatives is the Ethiopian Food and Drug Administration (EFDA), which was established in 2010 to regulate and monitor the quality and safety of food and drug products in the country. The EFDA has implemented several measures to enhance food safety, such as conducting routine inspections, monitoring the importation of food products, and enforcing strict labeling requirements. Another potential solution to improve food quality and safety in Ethiopia's food processing industry is the implementation of food safety management systems (FSMS). An FSMS is a set of procedures and policies designed to identify, assess, and control food safety hazards throughout the food manufacturing process. Implementing an FSMS can help businesses in the food processing industry identify and address potential hazards before they cause harm to consumers. Additionally, the implementation of an FSMS can help businesses comply with existing food safety regulations and guidelines. In conclusion, improving food quality and safety policies and management systems in Ethiopia's food processing industry is critical to protecting public health and enhancing the country's economy. Addressing the root causes of poor food quality and safety and implementing effective solutions, such as the establishment of regulatory agencies and the implementation of food safety management systems, can help to improve the overall safety and quality of the country's food supply.

Keywords: food quality, food safety, policy, management system, food processing industry

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Authors: Chia-Jung Chen, Yu-Chi Hsu, June-Dong Lin, Kun-Chen Chan, Chieh-Tien Wang, Li-Ching Wu, Chung-Feng Liu

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With fast advances in healthcare technology, various total laboratory automation (TLA) processes have been proposed. However, adopting TLA needs quite high funding. This study explores an early adoption experience by Taiwan’s large-scale hospital group, the Chimei Hospital Group (CMG), which owns three branch hospitals (Yongkang, Liouying and Chiali, in order by service scale), based on the five stages of Everett Rogers’ Diffusion Decision Process. 1.Knowledge stage: Over the years, two weaknesses exists in laboratory department of CMG: 1) only a few examination categories (e.g., sugar testing and HbA1c) can now be completed and reported within a day during an outpatient clinical visit; 2) the Yongkang Hospital laboratory space is dispersed across three buildings, resulting in duplicated investment in analysis instruments and inconvenient artificial specimen transportation. Thus, the senior management of the department raised a crucial question, was it time to process the redesign of the laboratory department? 2.Persuasion stage: At the end of 2013, Yongkang Hospital’s new building and restructuring project created a great opportunity for the redesign of the laboratory department. However, not all laboratory colleagues had the consensus for change. Thus, the top managers arranged a series of benchmark visits to stimulate colleagues into being aware of and accepting TLA. Later, the director of the department proposed a formal report to the top management of CMG with the results of the benchmark visits, preliminary feasibility analysis, potential benefits and so on. 3.Decision stage: This TLA suggestion was well-supported by the top management of CMG and, finally, they made a decision to carry out the project with an instrument-leasing strategy. After the announcement of a request for proposal and several vendor briefings, CMG confirmed their laboratory automation architecture and finally completed the contracts. At the same time, a cross-department project team was formed and the laboratory department assigned a section leader to the National Taiwan University Hospital for one month of relevant training. 4.Implementation stage: During the implementation, the project team called for regular meetings to review the results of the operations and to offer an immediate response to the adjustment. The main project tasks included: 1) completion of the preparatory work for beginning the automation procedures; 2) ensuring information security and privacy protection; 3) formulating automated examination process protocols; 4) evaluating the performance of new instruments and the instrument connectivity; 5)ensuring good integration with hospital information systems (HIS)/laboratory information systems (LIS); and 6) ensuring continued compliance with ISO 15189 certification. 5.Confirmation stage: In short, the core process changes include: 1) cancellation of signature seals on the specimen tubes; 2) transfer of daily examination reports to a data warehouse; 3) routine pre-admission blood drawing and formal inpatient morning blood drawing can be incorporated into an automatically-prepared tube mechanism. The study summarizes below the continuous improvement orientations: (1) Flexible reference range set-up for new instruments in LIS. (2) Restructure of the specimen category. (3) Continuous review and improvements to the examination process. (4) Whether installing the tube (specimen) delivery tracks need further evaluation.

Keywords: innovation decision process, total laboratory automation, health care

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Authors: Nancy Bartekian, Kaelan Vazquez, Christine Reyna

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Immigrants coming into the United States of America may justify the American system (political, economic, healthcare, criminal justice) and see it as functional. This may be explained because they may come from countries that are even more unstable than the U.S. and/or come here to benefit from the promise of the “American dream” -a narrative that they might be more likely to believe in if they were willing to undergo the costly and sometimes dangerous process to immigrate. Conversely, native-born Americans, as well as immigrants who may have lived in America for a longer period of time, would have more experiences with the various broken systems in America that are dysfunctional, fail to provide adequate services equitably, and/or are steeped in systemic racism and other biases that disadvantage lower-status groups. Thus, our research expects that system justification would decrease, and condemnation would increase with more time spent in the U.S. for immigrant groups. We predict that a) those not born in the U.S. will be more likely to justify the system, b) they will also be less likely to condemn the system, and c) the longer an immigrant has been in the U.S. the less likely they will to justify, and more they will to condemn the system. We will use a mixed-model multivariate analysis of covariance (MANCOVA) and control for race, income, and education. We will also run linear regression models to test if there is a relationship between the length of time in the United States and a decrease in system justification, and length of time and an increase in system condemnation for those not born in the U.S. We will also conduct exploratory analyses to see if the predicted patterns are more likely within certain systems over other systems (political, economic, healthcare, criminal justice).

Keywords: immigration, system justification, system condemnation, system qualification

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Authors: Suxiang Yu

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As an early childhood teacher in a socially and economically highly disadvantaged suburb in regional QLD, the author endeavors to find out effective positive approaches to behavior management for a classroom that is overwhelmed with challenging behaviors. After evaluating the first-hand data collected from the action research, the author summarizes a few innovative, positive behavior management strategies. The research also implies that behavior management opportunities are actually great social and emotional teachable moments, and by tapping into those teachable moments effectively, the teacher and children will have a closer relationship.

Keywords: action research, behavior management, classroom strategies, social and emotional teaching

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Authors: Krishna Gopal Lageju

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On 25th April 2015, a 7.6 magnitude earthquake struck Gorkha district of Nepal, which resulted over 8,790 deaths and 22,300 injuries. In addition, almost one-third of the country’s healthcare service has been disrupted. A total of 1,211 health facilities became non-operational, due to 446 completely and other 765 partially damaged. Nearly 84 percent (375 out of 446) of the completely damaged health facilities are in the 14 most affected districts. As a result, the ability of health facilities to respond to health care needs has been harshly affected. In addition, 18 health workers lost their lives and 75 are injured, which added further challenges in the delivery of health services. Thus, to address the immediate health needs in the most devastated areas, Nepal Red Cross Society (NRCS) in coordination with IFRC and Nepal Government, 8 Field hospitals established with surgical capacities, where around 492 international Emergency Response Units (ERUs) Members are mobilized for 3 months period. More than 54,000 patients have been treated in the Red Cross operated field hospitals. Trauma cases accounted 9,180 (17%) of the total patients off which 1,285 (14%) are major surgical cases. Most of the case loads 44,830 (83%) are outpatients and 9,180 patients got inpatients service. Similarly, 112 births have been performed in the field hospitals. Inpatient mortality rate remained 1.5% (21 deaths), many of them are presented with critical injuries or illnesses. No outbreak has been seen during the ERU operation. Deployment of ERUs together with national health workers are very important to address the immediate health needs of the affected communities. This will ease for transition and handover of emergency service and equipments to local provider. Likewise, capacity building of local staff as on the job training on various clinical teachings would be another important issue to look at before phasing out such services.

Keywords: trauma management, critical injuries, earthquake, health

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Authors: Shreya Bokare, Sanjay Pawar, Shika Nema

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Growth in cloud applications is generating the tremendous amount of data, building load on traditional storage management systems. Software Defined Storage (SDS) is a new storage management concept becoming popular to handle this large amount of data. CoprHD is one of the open source SDS controller, available for experimentation and development in the storage industry. In this paper, the storage management techniques provided by CoprHD to manage heterogeneous storage platforms are experimented and analyzed. Various storage management parameters such as time to provision, storage capacity measurement, and heterogeneity are experimentally evaluated along with the theoretical expression to prove the completeness of CoprHD controller for storage management.

Keywords: software defined storage, SDS, CoprHD, open source, SMI-S simulator, clarion, Symmetrix

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Authors: Maciej Bialorudzki, Zbigniew Izdebski, Alicja Kozakiewicz, Joanna Mazur

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The quality of sleep is extremely important for physical and mental health, especially among professional groups exposed to the suffering of the people they serve. The aim of the study is to assess sleep quality and various aspects of physical and mental health. A nationwide cross-sectional survey conducted in the first quarter of 2022 included 2227 healthcare professionals from 114 Polish hospitals and specialized outpatient clinics. The following distribution for each professional group was obtained (22% doctors; 52.6% nurses; 7.3% paramedics; 10.1% other medical professionals; 7.9% other non-medical professionals). The mean age of the respondents was 46.24 (SD=11.53). The Jenkins Sleep Scale with four items (JSS-4) was used to assess sleep quality, yielding a mean value of 5.35 (SD=5.20) in the study group and 13.7% of subjects with poor sleep quality using the cutoff point of the mean JSS-4 sum score as >11. More often, women than men reported poorer sleep quality (14,8% vs. 9,1% p=0,002). Respondents with poor sleep quality were more likely to report occupational burnout as measured by the BAT-12 (43.1% vs. 12.9% p<0.001) and high levels of stress as measured by the PSS-4 (72.5% vs. 27.5% p<0.001). In addition, those who declare experiencing a traumatic event compared to those who have not experienced it has an almost two times higher risk of poorer sleep quality (OR:1.958; 95% CI:1.509-2.542; p<0.001). In contrast, those with occupational burnout had more than five times the risk of those without occupational burnout (OR:5.092; 95% CI: 3.763-6.889; p<0.001). Sleep quality remains an important predictor of stress levels, job burnout, and quality of life assessment.

Keywords: quality of sleep, medical staff, mental health, physical health, occupational burnout, stress

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Authors: Dana Weimann-Saks, Inbal Peleg-Koriat

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The perception of relative power within a couple relies on the resources (emotional-social, materialistic) each partner perceives to have. The present study examines a model in which the perceived power of the couple predicts the spouses’ conflict management. In addition, we examined whether this relationship is mediated by the perceived quality of the relationship. It was found that the perception of social-emotional power predicts cooperative conflict management styles of the couple. It was also found that this correlation is mediated by the perceived quality of the relationship. Contrary to the hypothesis, perception of social-emotional power did not predict the use of non-cooperative conflict management styles.

Keywords: spouses’ conflict management, conflict management, perceived quality of the relationship, social-emotional power

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Authors: Beatriz Cortés, Andrés Boza, David Pérez, Llanos Cuenca

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The Internet of Things (IoT) field is been applied in industries with different purposes. Sensing Enterprise (SE) is an attribute of an enterprise or a network that allows it to react to business stimuli originating on the internet. These fields have come into focus recently on the enterprises and there is some evidence of the use and implications in supply chain management while finding it as an interesting aspect to work on. This paper presents a revision and proposals of IoT applications in supply chain management.

Keywords: industrial, internet of things, production systems, sensing enterprises, sensor, supply chain management

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Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate and even exceed some benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. A common facet of many ITS is their use of Bayesian Knowledge Tracing (BKT) to estimate parameters necessary for the implementation of the artificial intelligence component, and for the probability of mastery of a knowledge component relevant to the ITS. While various techniques exist to estimate these parameters and probability of mastery, none directly and reliably ask the user to self-assess these. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course for which detailed transaction-level observations were recorded, and users were also routinely asked direct questions that would lead to such a self-assessment. Comparisons were made between these self-assessed values and those obtained using commonly used estimation techniques. Our findings show that such self-assessments are particularly relevant at the early stages of ITS usage while transaction level data are scant. Once a user’s transaction level data become available after sufficient ITS usage, these can replace the self-assessments in order to eliminate the identifiability problem in BKT. We discuss how these findings are relevant to the number of exercises necessary to lead to mastery of a knowledge component, the associated implications on learning curves, and its relevance to instruction time.

Keywords: Bayesian Knowledge Tracing, Intelligent Tutoring System, in vivo study, parameter estimation

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Authors: Oualid Kherbach, Marian Liviu Mocan, Amine Ghoumrassi, Cristian Dumitrache

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The Globalization system and the development of economy, e-business, and introduction of new technologies formation create new challenges to all organizations particularly for small and medium enterprises (SMEs). Many studies on supply chain management (SCM) focus on large companies with universal operations employing high-stage information technology. These make a gap in the knowing of how SMEs use and practice supply chain management. In this screenplay, successful practices of supply chain management (SCM) can give SMEs an edge over their competitors. However, SMEs in Romania and Balkan countries face problems in SCM implementation and practices due to lack of resources and direction. The objectives of this research highlight the supply chain management practices of the small and medium enterprise strip in Romania and understand how SMEs manage and use SCM. This study Checks the potential existence of systematic differences between small businesses and medium-sized businesses with regard to supply chain management practices and the application of supply management has contributed to the improvement performance and increase the profitability of companies such as increasing the market share and improving the level of clients.

Keywords: globalization, small and medium enterprises, supply chain management, practices

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Authors: Naziema Begum Jappie

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The internationalization of higher education has become a focal point for academic institutions worldwide, including those in South Africa. This paper explores the multifaceted implications of internationalization on management and practice within the South African higher education landscape. Universities all over the world are increasingly recognizing the challenges of globalization and the pressures towards internationalization. Internationalization in higher education encompasses a range of activities, including academic exchange programs, research collaborations, joint degree programs, and the recruitment of international students and faculty. In South Africa, this process is driven by various factors, including the quest for global competitiveness, the pursuit of academic excellence, and the promotion of cultural diversity. However, while internationalization presents numerous opportunities, it also brings forth significant challenges that require careful consideration by management and practitioners in higher education institutions. Furthermore, the internationalization of higher education in South Africa has significant implications for teaching and learning practices. With an increasingly diverse student body, educators must employ innovative pedagogical approaches that cater to the needs and preferences of a multicultural cohort. This may involve the integration of global perspectives into the curriculum, the use of technology-enhanced learning platforms, and the promotion of intercultural competence among students and faculty. Additionally, the exchange of knowledge and ideas with international partners can enrich research activities and contribute to the advancement of knowledge in various fields. The internationalization of higher education in South Africa has profound implications for management and practice within academic institutions. While it offers opportunities for enhancing academic quality, promoting cultural exchange, and advancing research agendas, it also presents challenges that require strategic planning, resource allocation, and stakeholder engagement. By addressing these challenges proactively and leveraging the opportunities presented by internationalization, South African universities can position themselves as global leaders in higher education while contributing to the socio-economic development of the country and the continent at large. This paper draws together the international experience in South Africa to explore the emerging patterns of strategy and practice in internationalizing Higher Education and will highlight some critical notions of how the concepts of internationalization and globalization in the context of higher education are understood by those who lead universities and what new challenges are being created as universities seek to become more international. Institutions cannot simply have bullet points in the strategic plan for the recruitment of international students; there has to be a complete commitment to a national strategy of inclusivity. This paper will further examine the leadership styles that ensure transformation together with the goals set out for internationalization. Discussions around adding the international relations dimension to the curriculum. Addressing the issues relevant to cross-border delivery of higher education.

Keywords: challenges, higher education, internationalization, strategic focus

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Authors: R. Maher, D. Marchant, F. Fazel

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The initial aim of the study was to capitalize on the depth of athletes’ and coaches’ knowledge pertaining to the phenomenon of choking in basketball, free-throw shooting in particular, from an ‘insiders’ perspective. The findings of this study have developed a deeper understanding of how basketball players and coaches deal with choking and potentially contribute new knowledge relevant to designing useful interventions for alleviating choking. A key element was thus, knowledge, transfer, and exchange (KTE). KTE is the process of acquiring, developing, sharing and applying knowledge. Semi-structured interviews were conducted employing a composed sample of eight elite basketball players and four elite coaches who have been experiencing the choking episode previously. All interviews have been digitally recorded and later transcribed verbatim. Then the interviews have been content analyzed. Participants of the present study have provided useful information regarding the underlying mechanisms and antecedents of choking and also suggested applicable antidotes to conquer the phenomenon of choking. According to the results of the present study, self-confidence, mental and physical preparation, and coping styles should be considered as influential factors in athletes’ performance under pressure. Moreover, using all noteworthy information and preventative strategies suggested by participants of the present study, an effective multi-modal intervention has been introduced that should be taken into account by sports psychologists, coaches and athletes.

Keywords: anxiety, basketball, choking, free-throw shooting, psychological intervention

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Authors: Knol Hester, Müller Swantje, Danchenko Natalya

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Objective: Falls in older people cause an autonomy loss and result in an economic burden. LCare is an AI-based application to manage fall risks. The study's aim was to assess the effect of LCare use on patient outcomes in nursing homes in Germany. Methods: LCare identifies and monitors fall risks through a 3D-gait analysis and a digital questionnaire, resulting in tailored recommendations on fall prevention. A study was conducted with AOK Baden-Württemberg (01.09.2019- 31.05.2021) in 16 care facilities. Assessments at baseline and follow-up included: a fall risk score; falls (baseline: fall history in the past 12 months; follow-up: a fall record since the last analysis); fall-related injuries and hospitalizations; gait speed; fear of falling; psychological stress; nurses experience on app use. Results: 94 seniors were aged 65-99 years at the initial analysis (average 84±7 years); 566 mobility analyses were carried out in total. On average, the fall risk was reduced by 17.8 % as compared to the baseline (p<0.05). The risk of falling decreased across all subgroups, including a trend in dementia patients (p=0.06), constituting 43% of analyzed patients, and patients with walking aids (p<0.05), constituting 76% of analyzed patients. There was a trend (p<0.1) towards fewer falls and fall-related injuries and hospitalizations (baseline: 23 seniors who fell, 13 injury consequences, 9 hospitalizations; follow-up: 14 seniors who fell, 2 injury consequences, 0 hospitalizations). There was a 16% improvement in gait speed (p<0.05). Residents reported less fear of falling and psychological stress by 38% in both outcomes (p<0.05). 81% of nurses found LCare effective. Conclusions: In the presented study, the use of LCare app was associated with a reduction of fall risk among nursing home residents, improvement of health-related outcomes, and a trend toward reduction in injuries and hospitalizations. LCare may help to improve senior resident care and save healthcare costs.

Keywords: falls, digital healthcare, falls prevention, nursing homes, seniors, AI, digital assessment

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Authors: Germans Natuhwera, Peter Ellis, Acuda Wilson, Anne Merriman, Martha Rabwoni

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Objective: The aim of the study was to diagnose the socio-economic burden and impact of a diagnosis of cervical cancer (CC) in rural women in the context of low-resourced country Uganda, using a phenomenological enquiry. Methods: This was a multi-site phenomenological inquiry, conducted at three hospice settings; Mobile Hospice Mbarara in southwestern, Little Hospice Hoima in Western, and Hospice Africa Uganda Kampala in central Uganda. A purposive sample of women with a histologically confirmed diagnosis of CC was recruited. Data was collected using open-ended audio-recorded interviews conducted in the native languages of participants. Interviews were transcribed verbatim in English, and Braun and Clarke’s (2019) framework of thematic analysis was used. Results: 13 women with a mean age of 49.2 and age range 29-71 participated in the study. All participants were of low socioeconomic status. The majority (84.6%) had advanced disease at diagnosis. A fuller reading of transcripts produced four major themes clustered under; (1) socioeconomic characteristics of women, (2) impact of CC on women’s relationships, (3) disrupted and impaired activities of daily living (ADLs), and (4) economic disruptions. Conclusions: A diagnosis of CC introduces significant socio-economic disruptions in a woman’s and her family’s life. CC causes disability, impairs the woman and her family’s productivity hence exacerbating levels of poverty in the home. High and expensive out-of-pocket expenditure on treatment, investigations, and transport costs further compound the socio-economic burden. Decentralizing cancer care services to regional centers, scaling up screening services, subsidizing costs of cancer care services, or making cervical cancer care treatment free of charge, strengthening monitoring mechanisms in public facilities to curb the vice of healthcare workers soliciting bribes from patients, increased mass awareness campaigns about cancer, training more healthcare professionals in cancer investigation and management, and palliative care, and introducing an introductory course on gynecologic cancers into all health training institutions are recommended.

Keywords: activities of daily living, cervical cancer, out-of-pocket, expenditure, phenomenology, socioeconomic

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Authors: Bernard Igoche Igoche, Olumuyiwa Matthew, Peter Bednar, Alexander Gegov

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This study presents an ontology-driven approach for knowledge discovery and validation from admission databases in Nigerian polytechnic institutions. The research aims to address the challenges of extracting meaningful insights from vast amounts of admission data and utilizing them for decision-making and process improvement. The proposed methodology combines the knowledge discovery in databases (KDD) process with a structural causal model (SCM) ontological framework. The admission database of Benue State Polytechnic Ugbokolo (Benpoly) is used as a case study. The KDD process is employed to mine and distill knowledge from the database, while the SCM ontology is designed to identify and validate the important features of the admission process. The SCM validation is performed using the conditional independence test (CIT) criteria, and an algorithm is developed to implement the validation process. The identified features are then used for machine learning (ML) modeling and prediction of admission status. The results demonstrate the adequacy of the SCM ontological framework in representing the admission process and the high predictive accuracies achieved by the ML models, with k-nearest neighbors (KNN) and support vector machine (SVM) achieving 92% accuracy. The study concludes that the proposed ontology-driven approach contributes to the advancement of educational data mining and provides a foundation for future research in this domain.

Keywords: admission databases, educational data mining, machine learning, ontology-driven knowledge discovery, polytechnic education, structural causal model

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Authors: Pouya Vakili

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The aim of present paper is to have a rough comparison between language proficiency and communicative competence, moreover, how different scholars in the field of second language acquisition/assessment have defined competence in different paradigms. Researchers differ, however, in how they view 'competence'. Those who are dealing with generative tradition associated with Chomsky have defined it as linguistic competence (knowledge of the grammar of L2). Other researchers have adopted a broader perspective that is examining how learners acquire communicative competence (knowledge of both the L2 grammar and of how this system is put to use in actual communication).

Keywords: communicative competence, competence, language proficiency, linguistic competence

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Authors: Farina Maqbool

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Background: It is well said that children are considered the future masons of the country and a healthy brain is found in a healthy body. Therefore, a healthy generation can be produced by giving knowledge of immunization to mothers. Immunization is the most lucrative public health intrusion that has placed the greatest effect on the health of the people. The main objective of the present study was to find out the mother’s knowledge, attitude, and practices towards childhood immunization. Methods: Multistage sampling technique was used. One hundred and sixty mothers were selected conveniently who have at least one child up to two years. Data were collected through the face to face interview. The chi-square test was used to test the significance of the association between independent and dependent variables. Data were analyzed using the Statistical Package for Social Science. Results: A higher percentage of mothers (85.0%) knew vaccine-preventable diseases. Major proportion (82.5%) of the mothers had thought that immunization is important for their child’s health. A majority (66.3%) of the respondents’ children were fully immunized, whereas 26.3 percent of them were replied negatively. Remaining 7.5 percent of the respondents’ child un-immunized Chi-square value (39.14) shows a highly significant association between the education of the respondents and receiving of all recommended vaccines for children. Gamma value shows a strong positive relationship between the variables.

Keywords: attitude, childhood, immunization, knowledge, practices

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Muneshia Maheshwar, Kanwal Gul, Shakira Fareed, Ume-Amama Areeb Gul

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Organic food is commonly known for its healthier content without the use of pesticides, herbicides, inorganic fertilizers, antibiotics and growth hormones. The aim of this research is to examine the effect of health consciousness, environmental concern and organic food knowledge on both the intention to buy organic foods and the attitude towards organic foods and the effect of attitude towards organic foods on the intention to buy organic foods in Pakistan. Primary data was used which was collected through adopted questionnaire from previous research. Non- probability convenience sampling was used to select sample size of 200 consumers based on Karachi. The data was analyzed through Descriptive statistics and Multi regression method. The findings of the study showed that the attitude and the intention to buy organic food were affected by health consciousness, environmental concern, and organic food knowledge. The results also revealed that attitude also affects the intention to buy organic food.

Keywords: health consciousness, attitude, intention to purchase, environmental concern, organic food knowledge

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Authors: Klaus Peter Scherer, Daniel Knöll, Constantin Rieder

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Problem and Purpose: Intelligent systems are available and helpful to support the human being decision process, especially when complex surgical eye interventions are necessary and must be performed. Normally, such a decision support system consists of a knowledge-based module, which is responsible for the real assistance power, given by an explanation and logical reasoning processes. The interview based acquisition and generation of the complex knowledge itself is very crucial, because there are different correlations between the complex parameters. So, in this project (semi)automated self-learning methods are researched and developed for an enhancement of the quality of such a decision support system. Methods: For ophthalmic data sets of real patients in a hospital, advanced data mining procedures seem to be very helpful. Especially subgroup analysis methods are developed, extended and used to analyze and find out the correlations and conditional dependencies between the structured patient data. After finding causal dependencies, a ranking must be performed for the generation of rule-based representations. For this, anonymous patient data are transformed into a special machine language format. The imported data are used as input for algorithms of conditioned probability methods to calculate the parameter distributions concerning a special given goal parameter. Results: In the field of knowledge discovery advanced methods and applications could be performed to produce operation and patient related correlations. So, new knowledge was generated by finding causal relations between the operational equipment, the medical instances and patient specific history by a dependency ranking process. After transformation in association rules logically based representations were available for the clinical experts to evaluate the new knowledge. The structured data sets take account of about 80 parameters as special characteristic features per patient. For different extended patient groups (100, 300, 500), as well one target value as well multi-target values were set for the subgroup analysis. So the newly generated hypotheses could be interpreted regarding the dependency or independency of patient number. Conclusions: The aim and the advantage of such a semi-automatically self-learning process are the extensions of the knowledge base by finding new parameter correlations. The discovered knowledge is transformed into association rules and serves as rule-based representation of the knowledge in the knowledge base. Even more, than one goal parameter of interest can be considered by the semi-automated learning process. With ranking procedures, the most strong premises and also conjunctive associated conditions can be found to conclude the interested goal parameter. So the knowledge, hidden in structured tables or lists can be extracted as rule-based representation. This is a real assistance power for the communication with the clinical experts.

Keywords: an expert system, knowledge-based support, ophthalmic decision support, self-learning methods

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Authors: Wageeh A. Nafei

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This paper explores the role of Paradoxical Leadership (PL) in enhancing Organizational Success (OS) at private hospitals in Egypt. Based on the collected data from employees in private hospitals (doctors, nursing staff, and administrative staff). The researcher has adopted a sampling method to collect data for the study. The appropriate statistical methods, such as Alpha Correlation Coefficient (ACC), Confirmatory Factor Analysis (CFA), and Multiple Regression Analysis (MRA), are used to analyze the data and test the hypotheses. The research has reached a number of results, the most important of which are (1) there is a statistical relationship between the independent variable represented by PL and the dependent variable represented by Organizational Success (OS). The paradoxical leader encourages employees to express their opinions and builds a work environment characterized by flexibility and independence. Also, the paradoxical leader works to support specialized work teams, which leads to the creation of new ideas, on the one hand, and contributes to the achievement of outstanding performance on the other hand. (2) the mentality of the paradoxical leader is flexible and capable of absorbing all suggestions from all employees. Also, the paradoxical leader is interested in enhancing cooperation among them and provides an opportunity to transfer experience and increase knowledge-sharing. Also, the sharing of knowledge creates the necessary diversity that helps the organization to obtain rich external information and enables the organization to deal with a rapidly changing environment. (3) The PL approach helps in facing the paradoxical demands of employees. A paradoxical leader plays an important role in reducing the feeling of instability in the work environment and lack of job security, reducing negative feelings for employees, restoring balance in the work environment, improving the well-being of employees, and increasing the degree of job satisfaction of employees in the organization. The study referred to a number of recommendations, the most important of which are (1) the leaders of the organizations must listen to the views of employees and their needs and move away from the official method of control. The leader should give sufficient freedom to employees to participate in decision-making and maintain enough space among them. The treatment between the leaders and employees must be based on friendliness, (2) the need for organizational leaders to pay attention to sharing knowledge among employees through training courses. The leader should make sure that every information provided by the employee is valuable and useful, which can be used to solve a problem that may face his/her colleagues at work, (3) the need for organizational leaders to pay attention to sharing knowledge among employees through brainstorming sessions. The leader should ensure that employees obtain knowledge from their colleagues and share ideas and information among them. This is in addition to motivating employees to complete their work in a new creative way, which leads to employees’ not feeling bored of repeating the same routine procedures in the organization.

Keywords: paradoxical leadership, organizational success, human resourece, management

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Authors: Myoungsoon You, Heejung Son

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During a pandemic, hospital workers should protect not only their vulnerable patients but also themselves from the consequences of rapidly spreading infection. However, the evidence on the psychological impact of an outbreak on hospital workers is limited. In this study, we aim to assess hospital workers’ psychological well-being and function at the workplace after an outbreak, by focusing on ‘psychological resilience’. Specifically, the effects of risk appraisal, emotional experience, and coping ability on resilience indicated by the likelihood of post-traumatic syndrome disorder and willingness to work were investigated. Such role and position of each factor were analyzed using a path model, and the result was compared between the healthcare worker and non-healthcare worker groups. In the investigation, 280 hospital workers who experienced the 2015 Middle East Respiratory Syndrome outbreak in South Korea have participated. The result presented, in both groups, the role of the appraisal of risk and coping ability appeared consistent with a previous research, that was, the former interrupted resilience while the latter facilitated it. In addition, the role of emotional experience was highlighted as, in both groups, emotional disruption not only directly associated with low resilience but mediated the effect of perceived risk on resilience. The differences between the groups were also identified, which were, the role of emotional experience and coping ability was more prominent in the non-HCW group in explaining resilience. From the results, implications on how to support hospital personnel during an outbreak in a way to facilitate their resilience after the outbreak were drawn.

Keywords: hospital workers, emotions, infectious disease outbreak, psychological resilience

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Authors: Roberta Gentry

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A mixed methods study that examined candidate’s perceptions of the use of computerized simulation as an effective tool to learn classroom management will be presented. The development, implementation, and assessment of the simulation and candidate data on the feasibility of the approach in comparison to other methods will be presented.

Keywords: behavior management, simulations, teacher preparation, teacher education

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Authors: Rebecca Quinlan

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Background: The pandemic has caused a surge in eating disorders (ED). The prevalence of ED is higher in athletes than in the general population. It would therefore be expected that there will be a rise in ED among athletic populations. Coaches regularly work with athletes and should be in a position to identify signs of ED in their athletes. However, there is limited awareness of ED among coaches. Given the effects of the pandemic, it is crucial that coaches have the skills and knowledge to identify ED. This research will explore the effects of the pandemic on athletes, current knowledge of ED among coaches, and possible solutions for building back better from the pandemic. Methods: Freedom of Information requests were conducted, and a systematic review of the literature was undertaken regarding ED in sports and following the pandemic. Results: The systematic review of the literature showed that there had been a rise in ED in athletes due to the pandemic. Freedom of Information results revealed that ED is not covered in level 1 coaching courses. This lack of education has resulted in many coaches stating they feel unable to identify ED. Discussion: The increased prevalence of ED in athletes, coupled with the negative effects of the pandemic, highlight the need for action. Recommendations are provided, which include Level 1 coaching courses to include compulsory ED education, including signs and symptoms, what to do if an athlete has an ED, and resources/contacts. It is anticipated that the findings will be used to improve coaching knowledge of ED and support offered to athletes, with the overarching aim of building back better and faster from the pandemic.

Keywords: eating disorders, sport, athletes, pandemic

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Authors: Shana Malio-Satele, Lemalu Silao Vaisola Sefo

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Introductory Statement: South Seas Healthcare is Ōtara’s largest Pacific health provider in South Auckland, New Zealand. Our vision is excellent health and well-being for Pacific people and all communities through strong Pacific values. During the DELTA and Omicron outbreak of COVID-19, our Pacific people, indigenous Māori, and the community of South Auckland were disproportionately affected and faced significant hardship with existing inequities magnified. This study highlights the community-based learnings of harnessing community-based strengths such as indigenous resilience, family-informed experiences and stories that provide critical insights that inform health reform changes that will be sustainable and equitable for all indigenous populations. This study is based on critical learnings acquired during COVID-19 that challenge the deficit narrative common in healthcare about indigenous populations. This study shares case studies of marginalised groups and religious groups and the successful application of indigenous cultural strengths, such as collectivism, positive protective factors, and using trusted relationships to create meaningful change in the way healthcare is delivered. The significance of this study highlights the critical conditions needed to adopt a community-informed way of creating integrated healthcare that works and the role that the community can play in being part of the solution. Methodologies: Key methodologies utilised are indigenous and Pacific-informed. To achieve critical learnings from the community, Pacific research methodologies, heavily informed by the Polynesian practice, were applied. Specifically, this includes; Teu Le Va (Understanding the importance of trusted relationships as a way of creating positive health solutions); The Fonofale Methodology (A way of understanding how health incorporates culture, family, the physical, spiritual, mental and other dimensions of health, as well as time, context and environment; The Fonua Methodology – Understanding the overall wellbeing and health of communities, families and individuals and their holistic needs and environmental factors and the Talanoa methodology (Researching through conversation, where understanding the individual and community is through understanding their history and future through stories). Major Findings: Key findings in the study included: 1. The collectivist approach in the community is a strengths-based response specific to populations, which highlights the importance of trusted relationships and cultural values to achieve meaningful outcomes. 2. The development of a “village model” which identified critical components to achieving health reform change; system navigation, a sense of service that was culturally responsive, critical leadership roles, culturally appropriate support, and the ability to influence the system enablers to support an alternative way of working. Concluding Statement: There is a strong connection between community-based strengths being implemented into healthcare strategies and reforms and the sustainable success of indigenous populations and marginalised communities accessing services that are cohesive, equitably resourced, accessible and meaningful for families. This study highlights the successful community-informed approaches and practices used during the COVID-19 response in New Zealand that are now being implemented in the current health reform.

Keywords: indigenous voice, community voice, health reform, New Zealand

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Authors: Joel C. Navarez

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The current study investigated the Filipino school counselor’s knowledge, attitudes, and competencies in suicide intervention as well as their experiences and practices in suicide intervention. The study also aimed to develop and standardize suicide intervention guidelines. The study has two (2) phases. Phase 1 utilized the descriptive and generic qualitative inquiry methods of research. Purposive and convenience sampling was applied, and participants were college counselors from the National Capital Region (NCR), Luzon, Visayas, and Mindanao. Results revealed that counselors do not have high level of knowledge on suicidal behaviors, have some negative attitudes toward suicidal behavior, and need to acquire better intervention skills. The findings also showed that the trainings received by counselors are not enough to advance their suicide intervention skills, which would help enhance positive attitudes towards suicide risk assessment and management. Some common experiences of the counselors in suicide intervention were focused on the areas of accountability, stigmatizing attitudes of parents, and confidentiality issues. Phase 2 of the study was the development of suicide intervention practice guidelines using the Delphi process. The tentative guideline was based on the content analysis of interventions taken from literature and from the actual intervention practices of counselors, as seen from the findings of the qualitative study of Phase 1. After three (3) Delphi rounds and the consensus from sixteen (16) mental health experts, 145 recommended actions can be implemented by school counselors in suicide.

Keywords: counselor competencies, counselor development, suicide, suicide intervention

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Authors: Mershack O. Tetteh, Albert P. C. Chan, Amos Darko, Gabriel Nani

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International construction joint ventures (ICJVs) have evolved as an effective approach to sustainable development, given their myriad socio-economic and environmental benefits. Yet, they are not free of barriers and risks. In many studies, it is termed as risks for convenience’s sake. While the barriers and risks continue to affect the success of ICJVs, a systematic and reliable approach for managing them has yet to be developed. This study aims to identify and classify the barriers and risks factors affecting ICJVs through a systematic literature review. Based on a critical review of 54 papers published in peer-reviewed journals from 1990 to 2019, a conceptual framework was proposed for managing the barriers and risks in ICJV operations. The review showed that the barriers can be grouped into six including inter-organizational differences, lack of expertise and confidence, lack of effective planning and strategies, lack of knowledge of ICJV’s fundamentals, conflicts among ICJV entities, and management difficulties. The risks were also categorized into six: policy and political risks, legal risks, financial risks, management risks, project and technical risks, and market risks. The developed model would help practitioners achieve more efficient resource allocation and bring new perspectives for managerial practices in ICJVs. Moreover, it is positioned to alleviate the negligence of previous studies that combined the barriers and risks factors as one checklist.

Keywords: barriers, construction, international construction joint venture, risks, sustainable development

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Authors: Siti Fatimah Kader Maideen, Abdul Rashid, Nur Indah Ahmad

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Introduction: Indigenous people have an increased risk of contracting zoonotic infections due to their practices. Similarly, the aborigines in Peninsular Malaysia, the Orang Asli, have a higher risk too. This study aimed to empower the Jahai children on the prevention of zoonotic infections by implementing a health promotion intervention program. Methods: A non-experimental pre and post-test interventional study was conducted among the indigenous primary school children aged between nine and 12 years in Perak, Malaysia. A structured questionnaire was used to assess the pre-and post-knowledge and attitudes towards zoonotic infections and hand hygiene practice. This is followed by three sessions of the health promotion program. Ethical approval was obtained prior to the data collection. Data were analysed using SPSS software. Results: The knowledge on whether diseases can spread from animals to humans, transmission via saliva and faeces, types of organisms that can infect, and signs and symptoms increased significantly between pre and post. Significant improvements were observed in the attitude and practices too. Conclusion: The intervention program demonstrated improvement in the knowledge, attitude, and practice among the children. The continuous program needs to be conducted for a sustainable outcome.

Keywords: health promotion, zoonotic infections, aborigines, knowledge, practice

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