Search results for: healthcare delivery

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

Procedia PDF Downloads 550

Authors: K. C. Iyer, Yogita Manan Bindal, Sumit Kumar Bakshi

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The construction industry is plagued with disputes and litigation in India with many stalled projects seeking dispute resolution. This has an adverse effect on the performance and overall project delivery and impacts future investments within the industry. While construction industry is the major driver of growth, there has not been major reforms in the government construction contracts. The study is aimed at identifying the proactive means of dispute avoidance, focusing on reforms required within the construction contracts, by studying 49 arbitration awards of construction disputes. The claims presented in the awards are aggregated to study the causes linked to the contract document and are referred against the prospective recommendation and practices as surveyed from literature review of research papers. Within contract administration, record keeping has been a major concern as they are required by the parties to substantiate the claims or the counterclaims and therefore are essential in any dispute redressal process. The study also observes that the right judgment is inhibited when the record keeping is improper and due to lack of coherence between documents, the dispute resolution period is also prolonged. The finding of the research will be relevant to industry practitioners in contract drafting with a view to avoid disputes.

Keywords: construction contract, contract administration, contract management, dispute avoidance

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Authors: Norhanim Nordin, Rosnah Shamsudin, Azrina Azlan, Mohammad Effendy Ya’acob

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An environmental friendly approach for disposal of voluminous durian husk waste could be implemented by substituting them into various valuable commodities, such as healthcare and biofuel products. Thus, the study of composition value in each segment of durian husk was very crucial to determine the suitable proportions of nutrients that need to be added and mixed in the product. A total of 12 ‘Durian Kampung’ fruits from Sg Ruan, Pahang were selected and each fruit husk was divided into four segments and labelled as P-L (thin neck area of white inner husk), P-B (thick bottom area of white inner husk), H (green and thorny outer husk) and W (whole combination of P-B and H). Four experiments have been carried out to determine the dry matter, moisture, ash and crude fibre content. The results show that the H segment has the highest dry matter content (30.47%), while the P-B segment has the highest percentage in moisture (81.83%) and ash (6.95%) content. It was calculated that the ash content of the P-B segment has a higher rate of moisture level which causes the ash content to increase about 2.89% from the P-L segment. These data have proven that each segment of durian husk has a significant difference in terms of composition value, which might be useful information to fully utilize every part of the durian husk in the future.

Keywords: durian husk, crude fibre content, dry matter content, moisture content

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Authors: Wang Liguang, Zhang Xueqing

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The build-operate-transfer (BOT) project delivery system has provided effective routes to mobilize private sector funds, innovative technologies, management skills and operational efficiencies for public infrastructure development and have been widely used in China during the last 20 years. Many BOT projects in China will be smoothly transferred to the government soon and the transfer stage, which is considered as the last stage, must be studied carefully and handled well to achieve the overall success of BOT projects. There will be many issues faced by both the public sector and private sector in the transfer stage of BOT projects, including project post-assessment, technology and documents transfer, personal training and staff transition, etc. and sometimes additional legislation is needed for future operation and management of facilities. However, most previous studies focused on the bidding, financing, and building and operation stages instead of transfer stage. This research identifies nine key issues in the transfer stage of BOT projects through a comprehensive study on three cases in China, and the expert interview and expert discussion meetings are held to validate the key issues and give detail analysis. A proposed framework of transfer management is prepared based on the experiences derived and lessons drawn from the case studies and expert interview and discussions, which is expected to improve the transfer management of BOT projects in practice.

Keywords: BOT project, key issues, transfer management, transfer stage

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Authors: Sultan Alotaibi, Dmitri Roussinov

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Many governments recently started to change the ways of providing their services by allowing their citizens to access services from anywhere without the need of visiting the location of the service provider. Mobile government (M-government) is one of the techniques that fulfill that goal. It has been adopted by many governments. M-government can be defined as an implementation of Electronic Government (E-Government) by using mobile technology with the aim of improving service delivery to citizens, businesses and all government agencies. There have been several research projects developing models to understand the behavior of individuals towards the adoption of m-government. This paper proposes a model for adoption of m-government services in Saudi Arabia by extending Technology Acceptance Model (TAM) by introducing external factors. This paper also reports on the development of a survey instrument designed to measure user perception of mobile government acceptance. A survey instrument has been developed by using existing scales from prior instruments and a pilot study has been conducted by distributing the survey to 33 participants. As a result, a survey instrument has been refined to retain 43 items. The results also showed that the reliabilities of all the scales in the survey instrument are above the levels acceptable in current academic research, thus the instruments developed by us are capable of analyzing the factors in M-government adoption.

Keywords: TAM, m-government, e-government, model, acceptance, mobile government

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Authors: Habsah Mohamad Sabli, Mohammad Fardillah Wahi

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The main aim of this research study is to better understand and measure students' perceptions towards the effectiveness of mobile learning. This paper reports on the results of a survey of three hundred nineteen students at Polytechnic Mukah Sarawak (PMU) about their perception to the use of mobile technology in education. An analysis of the quantitative survey findings is presented focusing on the ramification for mobile-learning (m-learning) practices in higher learning and teaching environments. In this paper we present our research findings about the level of perception and gender correlations with perceived ease of use and perceived usefulness using M-Learning in learning activities among students in Polytechnic Mukah (PMU). Based on gender respondent, were 150 female (47.0%) and 169 male (53.0%). The survey findings further revealed that perception of students are in moderately high and agree for using m-learning. The perceived ease of use and perceived usefulness is significant with weak correlations between students to adapt m-learning for active learning activities. The outcome of this research can benefit the decision makers of higher institution in Mukah Sarawak regard to way to enhance m-learning and promote effective teaching and learning activities as well as strengthening the quality of learning delivery.

Keywords: M-learning, student attitudes, student perception, mobile technology

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Authors: Loredana Elena Nita, Maria Bercea, Aurica P. Chiriac, Iordana Neamtu

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The paper is devoted to the behavior of gels based on poly(itaconic anhydride-co-3, 9-divinyl-2, 4, 8, 10-tetraoxaspiro (5.5) undecane) copolymers, with different ratio between the comonomers, and hyaluronic acid (HA). The gel formation was investigated by small-amplitude oscillatory shear measurements following the viscoelastic behavior as a function of gel composition, temperature and shear conditions. Hyaluronic acid was investigated in the same conditions and its rheological behavior is typical to viscous fluids. In the case of the copolymers, the ratio between the two comonomers influences the viscoelastic behavior, a higher content of itaconic anhydride favoring the gel formation. Also, the sol-gel transition was evaluated according to Winter-Chambon criterion that identifies the gelation point when the viscoelastic moduli (G’ and G”) behave similarly as a function of oscillation frequency. From rheological measurements, an optimum composition was evidenced for which the system presents a typical gel-like behavior at 37 °C: the elastic modulus is higher than the viscous modulus and they are not dependent on the oscillation frequency. The formation of the 3D macroporous network was also evidenced by FTIR spectra, SEM microscopy and chemical imaging. These hydrogels present a high potential as drug delivery systems.

Keywords: copolymer, viscoelasticity, gelation, 3D network

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Authors: Katarzyna Niewiadomska

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Many technology startups fail to achieve a worthwhile return on investment for their funders, founders, and employees. Failures in product development, to-market strategy, sales, and delivery are commonly recognized. Founder failures are not as obvious and harder to identify. This paper explores six critical failure points that entrepreneurs and innovators are susceptible to and aims to link their emotional intelligence and behavioral profile to the points at which they experienced self-perceived failure. A model of six failure points from the perspective of the technology entrepreneur ranging from pre-startup to maturity is provided. By analyzing emotional and behavioral profile data from entrepreneurs and recording in-person accounts, certain key emotional and behavioral clusters contributing to each failure point are determined, and several underlying factors are defined and discussed. Recommendations that support entrepreneurs and innovators stalling at each failure point are given. This work can enable stakeholders to evaluate founder emotional and behavioral profiles and to take risk-mitigating action, either through coaching or through more robust team creation, to avoid founder-related company failure. The paper will be of interest to investors funding startups, executives leading them and mentors supporting them.

Keywords: behavior, emotional intelligence, entrepreneur, failure

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Authors: Mohammad H. Yarmohammadian, Fatemeh Rezaei

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Introduction: Improving patient safety in health systems is one of the main priorities in healthcare systems, so clinical risk management in organizations has become increasingly significant. Although several tools have been developed for clinical risk management, each has its own limitations. Aims: This study aims to develop a comprehensive tool that can complete the limitations of each risk assessment and management tools with the advantage of other tools. Methods: Procedure was determined in two main stages included development of an initial model during meetings with the professors and literature review, then implementation and verification of final model. Subjects and Methods: This study is a quantitative − qualitative research. In terms of qualitative dimension, method of focus groups with inductive approach is used. To evaluate the results of the qualitative study, quantitative assessment of the two parts of the fourth phase and seven phases of the research was conducted. Purposive and stratification sampling of various responsible teams for the selected process was conducted in the operating room. Final model verified in eight phases through application of activity breakdown structure, failure mode and effects analysis (FMEA), healthcare risk priority number (RPN), root cause analysis (RCA), FT, and Eindhoven Classification model (ECM) tools. This model has been conducted typically on patients admitted in a day-clinic ward of a public hospital for surgery in October 2012 to June. Statistical Analysis Used: Qualitative data analysis was done through content analysis and quantitative analysis done through checklist and edited RPN tables. Results: After verification the final model in eight-step, patient's admission process for surgery was developed by focus discussion group (FDG) members in five main phases. Then with adopted methodology of FMEA, 85 failure modes along with its causes, effects, and preventive capabilities was set in the tables. Developed tables to calculate RPN index contain three criteria for severity, two criteria for probability, and two criteria for preventability. Tree failure modes were above determined significant risk limitation (RPN > 250). After a 3-month period, patient's misidentification incidents were the most frequent reported events. Each RPN criterion of misidentification events compared and found that various RPN number for tree misidentification reported events could be determine against predicted score in previous phase. Identified root causes through fault tree categorized with ECM. Wrong side surgery event was selected by focus discussion group to purpose improvement action. The most important causes were lack of planning for number and priority of surgical procedures. After prioritization of the suggested interventions, computerized registration system in health information system (HIS) was adopted to prepare the action plan in the final phase. Conclusion: Complexity of health care industry requires risk managers to have a multifaceted vision. Therefore, applying only one of retrospective or prospective tools for risk management does not work and each organization must provide conditions for potential application of these methods in its organization. The results of this study showed that the integrated clinical risk management model can be used in hospitals as an efficient tool in order to improve clinical governance.

Keywords: failure modes and effective analysis, risk management, root cause analysis, model

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Authors: Ramin Vafadary, Maryam Khanbaghi

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Forecasting electricity load is important for various purposes like planning, operation, and control. Forecasts can save operating and maintenance costs, increase the reliability of power supply and delivery systems, and correct decisions for future development. This paper compares various time series methods to forecast 24 hours ahead of electricity load. The methods considered are the Holt-Winters smoothing, SARIMA Modeling, LSTM Network, Fbprophet, and Tensorflow probability. The performance of each method is evaluated by using the forecasting accuracy criteria, namely, the mean absolute error and root mean square error. The National Renewable Energy Laboratory (NREL) residential energy consumption data is used to train the models. The results of this study show that the SARIMA model is superior to the others for 24 hours ahead forecasts. Furthermore, a Bagging technique is used to make the predictions more robust. The obtained results show that by Bagging multiple time-series forecasts, we can improve the robustness of the models for 24 hours ahead of electricity load forecasting.

Keywords: bagging, Fbprophet, Holt-Winters, LSTM, load forecast, SARIMA, TensorFlow probability, time series

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Authors: Huayang Yu, Nicola Ingram, David C. Green, Paul D. Thornton

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The dual stimuli-controlled release of doxorubicin from gel-embedded nanoparticles is reported. Non-cytotoxic polymer nanoparticles are formed from poly(ethylene glycol)-b-poly(benzyl glutamate) that, uniquely, contain a central ester link. This connection renders the nanoparticles pH-responsive, enabling extensive doxorubicin release in acidic solutions (pH 6.5), but not in solutions of physiological pH (pH 7.4). Doxorubicin loaded nanoparticles were found to be stable for at least 31 days and lethal against the three breast cancer cell lines tested. Furthermore, doxorubicin-loaded nanoparticles could be incorporated within a thermoresponsive poly(2-hydroxypropyl methacrylate) gel depot, which forms immediately upon injection of poly(2-hydroxypropyl methacrylate) into aqueous solution. The combination of the poly(2-hydroxypropyl methacrylate) gel and poly(ethylene glycol)-b-poly(benzyl glutamate) nanoparticles yields an injectable doxorubicin delivery system that facilities near-complete drug release when maintained at elevated temperatures (37 °C) in acidic solution (pH 6.5). In contrast, negligible payload release occurs when the material is stored at room temperature in a non-acidic solution (pH 7.4). The system has great potential as a vehicle for the prolonged, site-specific release of chemotherapeutics.

Keywords: biodegradable, nanoparticle, polymer, thermoresponsive

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Authors: Amit Kumar Jain, Surbhi Jain

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The urban freight in a city constitutes 10 to 18 per cent of all city road traffic, and 40 per cent of air pollution and noise emissions, are directly related to commercial transport. The policy measures implemented by urban planners have sought to restrict rather than assist goods-vehicle operations. This approach has temporarily controlled the urban transport demand during peak hours of traffic but has not effectively solved transport congestion. The solution discussed in the paper envisages the development of a comprehensive network of Urban Freight Stations (UFS) connected through underground conveyor belts in the city in line with baggage segregation and distribution in any of the major airports. The transportation of freight shall be done in standard size containers/cars through rail borne carts. The freight can be despatched or received from any of the UFS. Once freight is booked for a destination from any of the UFS, it would be stuffed in the container and digitally tagged for the destination. The container would reach the destination UFS through a network of rail borne carts. The container would be de-stuffed at the destination UFS and sent for further delivery, or the consignee may be asked to collect the consignment from urban freight station. The obvious benefits would be decongestion of roads, reduction in air and noise pollution, saving in manpower used for freight transportation.

Keywords: congestion, urban freight, intelligent transport system, pollution

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Authors: Abdelkadir Muzey Mohammed, Habtu Alemayehu Atsbaha, Yohannes Yirga Kefela, Woldegebriel Assefa Woldegerima, Kiros Tedla Gebrehiwot

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The circumstances of war and conflict have long been associated with concerns about heightening HIV infection due to the use of sexual violence and rape as a weapon of war and lack of health services access to the patients with HIV as well as sexual violence and rape victims. This paper examines the impact of war related mass rape on HIV incidence and prevalence in the war ravaged Tigray, Ethiopia. Risk equation model and uncertainty analyses with sampled ranges of parameters were employed using data from WHO, Ethiopian Public Health Institute and Ethiopian Central Statistical Agency was used. Our analysis indicated that the mass rape committed in Tigray could cause an increase of incidence and prevalence by a median of 63.01% and 1.14% respectively. The significant increase in HIV incidence and prevalence due to mass rape demands a special attention including region wide improved surveillance and tracing of rape survivors. Furthermore, HIV prevention and treatment strategies such as delivery of emergency health service, providing pre and post exposure treatments on the basis of human rights should priority of governmental and nongovernmental organizations in a conflict situation.

Keywords: conflict situation, mass rape, HIV, mathematical model, uncertainty analysis

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: data integrity, data integrity challenges, hospital information systems, South Africa

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Authors: Beatrice Adeoye

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Studies have associated social and demographic characteristics as strong determinants of utilization of health care services; however, not much has been done to explore the dynamics of these variables in Nigeria. This empirical study explores the link between demographic factors and the future use of health care services in Nsukka, southeast Nigeria. A total of 543 respondents were selected using multi-stage sampling technique. The findings of the study showed that majority (56.9%) of the respondents were female while 43.1% were male. More of the respondents were married (50.3%) while 41.80/0 of the respondents were between ages 26-35. Testing the demographic characteristics regarding where people will prefer to go first for treatment with multiple regression, It is only Sex as a demographic variable that indicates positive association for future occurrence to where people will prefer to go first for treatment with 0.08 significance. Age and education indicates no association considering their level of significance. This result shows that sex is one of the determinant factors of where and when people will go for treatment. This is pointing out the realities regarding African society where in the family setting, it is the father that dictates the cause of action. Also to buttress these findings, cross tabulating age with who determines where and when to go for treatment, findings show that majority (58.9%) within age 26-35 said their spouses decide on where and when to go for treatment. Findings showed that patriarchy still plays an important role in the utilization of health care delivery among the people studied.

Keywords: Demographic characters, Determinant, Health Care, treatment, self-medication, symptom,

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Authors: S. Alfalah, J. Falah, T. Alfalah, M. Elfalah, O. Falah

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The field of education is an ever-evolving area constantly enriched by newly discovered techniques provided by active research in all areas of technologies. The recent years have witnessed the introduction of a number of promising technologies and applications to enhance the teaching and learning experience. Virtual Reality (VR) applications are considered one of the evolving methods that have contributed to enhancing education in many fields. VR creates an artificial environment, using computer hardware and software, which is similar to the real world. This simulation provides a solution to improve the delivery of materials, which facilitates the teaching process by providing a useful aid to instructors, and enhances the learning experience by providing a beneficial learning aid. In order to assure future utilization of such systems, students’ perceptions were examined toward utilizing VR as an educational tool in the Faculty of Information Technology (IT) in The University of Jordan. A questionnaire was administered to IT undergraduates investigating students’ opinions about the potential opportunities that VR technology could offer and its implications as learning and teaching aid. The results confirmed the end users’ willingness to adopt VR systems as a learning aid. The result of this research forms a solid base for investing in a VR system for IT education.

Keywords: information, technology, virtual reality, education

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Authors: Sejuti Malakar

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Textile sensors have gained a lot of interest in recent years as it is instrumental in monitoring physiological and environmental changes, for a better diagnosis that can be useful in various fields like medical textiles, sports textiles, protective textiles, agro textiles, and geo-textiles. Moreover, with the development of flexible textile-based wearable sensors, the functionality of smart clothing is augmented for a more improved user experience when it comes to technical textiles. In this context, conductive textiles using new composites and nanomaterials are being developed while considering its compatibility with the textile manufacturing processes. This review aims to provide a comprehensive and detailed overview of the contemporary advancements in textile-based wearable physical sensors, used in the field of medical, security, surveillance, and protection, from a global perspective. The methodology used is through analysing various examples of integration of wearable textile-based sensors with clothing for daily use, keeping in mind the technological advances in the same. By comparing various case studies, we come across various challenges textile sensors, in terms of stability, the comfort of movement, and reliable sensing components to enable accurate measurements, in spite of progress in the engineering of the wearable. Addressing such concerns is critical for the future success of wearable sensors.

Keywords: flexible textile-based wearable sensors, contemporary advancements, conductive textiles, body conformal design

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Authors: Garba Iliyasu, Lamaran Dattijo

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Introduction: Ebola virus disease (EVD) is a disease of humans and other primates caused by Ebola viruses. The most widespread epidemic of EVD in history occurred recently in several West African countries. The burden and outcome of EVD in pregnant women remains uncertain. There are very few studies to date reporting on maternal and fetal outcomes among pregnant women with EVD, hence the justification for this comprehensive review of these published studies. Methods: Published studies in English that reported on maternal and or fetal outcome among pregnant women with EVD up to May 2016 were searched in electronic databases (Google Scholar, Medline, Embase, PubMed, AJOL, and Scopus). Studies that did not satisfy the inclusion criteria were excluded. We extracted the following variables from each study: geographical location, year of the study, settings of the study, participants, maternal and fetal outcome.Result: There were 12 studies that reported on 108 pregnant women and 110 fetal outcomes. Six of the studies were case reports, 3 retrospective studies, 2 cross-sectional studies and 1 was a technical report. There were 91(84.3%) deaths out of the 108 pregnant women, while only 1(0.9%) fetal survival was reported out of 110. Survival rate among the 15 patients that had spontaneous abortion/stillbirth or induced delivery was 100%. Conclusion: There was a poor maternal and fetal outcome among pregnant women with EVD, and fetal evacuation significantly improves maternal survival.

Keywords: Africa, ebola, maternofetal, outcome

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Authors: Kulsoom S. Bughio, Naeem K. Janjua, Gordana Dermody, Leslie F. Sikos, Shamsul Islam

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The advancement in information and communication technologies (ICT) and wireless sensor networks have played a pivotal role in the design and development of real-time healthcare solutions, mainly targeting the elderly living in health-assistive smart homes. Such smart homes are equipped with sensor technologies to detect and record activities of daily living (ADL). This survey reviews and evaluates existing approaches and techniques based on real-time sensor-based modeling and reasoning in single-user and multi-user environments. It classifies the approaches into three main categories: learning-based, knowledge-based, and hybrid, and evaluates how they handle temporal relations, granularity, and uncertainty. The survey also highlights open challenges across various disciplines (including computer and information sciences and health sciences) to encourage interdisciplinary research for the detection and recognition of ADLs and discusses future directions.

Keywords: daily living activities, smart homes, single-user environment, multi-user environment

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Authors: Mihai Liviu Despa

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The paper tackles the topic of determining the cost of innovation in software development projects. Innovation can be achieved either in a planned or unplanned manner. The paper approaches the scenarios were innovation is planned for. As a starting point an innovative software development project is analyzed. The project is depicted step by step as it was implemented, from inception to delivery. Costs that are proprietary to innovation in software development are isolated based on the author’s personal experience in managing the above mentioned project. Innovation costs components identified by the author are then validated using open discussions with software development professionals and projects managers on LinkedIn groups. In order to receive relevant feedback only groups that focus on software development and innovation management are targeted. Additional innovation cost components suggested by software development professionals and projects managers are also considered. Based on the identified cost components an indicator is built. The indicator is meant to formalize the process of determining the cost of innovation in a software development project. The indicator aggregates all the innovation cost components that are identified in the research process. The process of calculating each cost component is also described. Conclusions are formulated and new related research topics are submitted for debate.

Keywords: innovation cost, IT project management, software development, innovation management

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Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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Authors: Oluwaseun Adeleke, Samuel O. Ikani, Fidelis Edet, Anthony Nwala, Mopelola Raji, Simeon Christian Chukwu

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Background: The DISC project collaborated with partners to implement demand creation and service delivery interventions, including the MoT (Moment of Truth) innovation, in over 500 health facilities across 15 states. This has increased the voluntary conversion rate to self-injection among women who opt for injectable contraception. While some facilities recorded an increasing trend in key performance indicators, few others persistently performed sub-optimally due to provider and system-related barriers. Methodology: Twenty-two facilities performing sub-optimally were selected purposively from three Nigerian states. Low productivity was appraised using low reporting rates and poor SI conversion rates as indicators. Interviews were conducted with health providers across these health facilities using a rapid diagnosis tool. The project also conducted a data quality assessment that evaluated the veracity of data elements reported across the three major sources of family planning data in the facility. Findings: The inability and sometimes refusal of providers to support clients to self-inject effectively was associated with the misunderstanding of its value to their work experience. It was also observed that providers still held a strong influence over clients’ method choices. Furthermore, providers held biases and misconceptions about DMPA-SC that restricted the access of obese clients and new acceptors to services – a clear departure from the recommendations of the national guidelines. Additionally, quality of care standards was compromised because job aids were not used to inform service delivery. Facilities performing sub-optimally often under-reported DMPA-SC utilization data, and there were multiple uncoordinated responsibilities for recording and reporting. Additionally, data validation meetings were not regularly convened, and these meetings were ineffective in authenticating data received from health facilities. Other reasons for sub-optimal performance included poor documentation and tracking of stock inventory resulting in commodity stockouts, low client flow because of poor positioning of health facilities, and ineffective messaging. Some facilities lacked adequate human and material resources to provide services effectively and received very few supportive supervision visits. Supportive supervision visits and Data Quality Audits have been useful to address the aforementioned performance barriers. The project has deployed digital DMPA-SC self-injection checklists that have been aligned with nationally approved templates. During visits, each provider and community mobilizer is accorded special attention by the supervisor until he/she can perform procedures in line with best practice (protocol). Conclusion: This narrative provides a summary of a range of factors that identify health facilities performing sub-optimally in their provision of DMPA-SC services. Findings from this assessment will be useful during project design to inform effective strategies. As the project enters its final stages of implementation, it is transitioning high-impact activities to state institutions in the quest to sustain the quality of service beyond the tenure of the project. The project has flagged activities, as well as created protocols and tools aimed at placing state-level stakeholders at the forefront of improving productivity in health facilities.

Keywords: family planning, contraception, DMPA-SC, self-care, self-injection, barriers, opportunities, performance

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Authors: Genevieve Zingg

Abstract:

Since the onset of the 2015 ‘refugee crisis’ in the European Union (EU), migrant deaths have overwhelmingly occurred in the Mediterranean Sea. However, far less attention has been paid to the startling number of injuries, deaths, and allegations of systematic human rights violations occurring within European refugee camps. Most troubling is the assertion that injuries and deaths in EU refugee camps have occurred as a result of negligent management and poor access to healthcare, food, water and sanitation, and other elements that comprise an adequate standard of living under international human rights law. Using available evidence and documentation, this paper will conduct a thorough examination of the causes of death and injury in EU refugee camps, with a specific focus on Greece, in order to identify instances of negligence or conditions that amount to potential breaches of human rights law. Based on its analysis, this paper will subsequently explore potential legal avenues to achieving justice and accountability under international human rights law in order to effectively address and remedy inadequate standards of living causing wrongful death or injury in European refugee camps.

Keywords: European Union, Greece, human rights, international human rights law, migration, refugees

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Authors: Ghada E. Esheba, Ghufran Kheshaifaty, Kholoud Al-Harbi, Wafa'a Al-Harbi, Ala'a Al-Orabi, Moayad Turkistani

Abstract:

Krukenberg tumor is a rare metastatic ovarian carcinoma that usually occurs in female between 30 - 40 year old and rarely seen after menopause. Stomach is the most common primary site. Histopathological features of krukenberg tumors appear as diffuse stromal proliferation, mucus-production, and numerous signet-cells and these tumors spread mostly by lymphatic route. Treatment and prognostic factors are not well established. This study describes a 34 year old female with a unilateral ovarian mass discovered accidentally during cesarean section delivery and it was misdiagnosed as luteoma of pregnancy, but histopathological examination showed a diffuse infiltration of the ovary and omentum by signet ring cells. These findings were not correlated with luteoma of pregnancy or any other types of primary ovarian tumors like surface epithelial tumor, sex cord stromal tumor or germ cell tumor. However, after the analysis of immunohistochemical results (negative CK7, positive CK20 and CDX-2), the finding was the diagnostic of metastatic krukenberg tumor. Two weeks later, the patient was evaluated and a large gastric tumor was found in her stomach and she underwent gastrectomy.

Keywords: CK7, CK20, CDX-2, Krukenburg tumor, metastatic ovarian tumor

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Authors: Mohd Mudasir Shafi, Zafrul Hasan, Talat Saleem

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Information and communication Technology (ICT) services have been defined as a route to good governance. Introduction of ICT into Governance has given rise to the idea of e-governance which helps in enhancing transparency, generating accountability and responsiveness in the system in order to provide faster and quality service to the citizen. Advancement in ICT has provided governments all over the world to speed up the delivery of information and services to citizens and businesses and increase their participation in governance. There has been varying degree of success over the past decade into providing services to the citizens using internet and different web services. These e-government initiatives have been extensively researched. Our research is aimed at the transition from electronic government to mobile government (m-government) initiatives implementing the mobile services and concerned to understand the major factors which will aid to adoption and distribution of these services. There must be some amount of research done in the integration process between e-government and m-government. There must also be enough amount of investigation done all the factors that could affect the transition process. Such factors differ between different places and the advancement in information and technology available there. In this paper, we have discussed why mobile communication system can be used for effective e-governance and the areas where m-governance can be implemented. The paper will examine some of the reasons as well as the main opportunities for improving effective governance through mobile phones.

Keywords: e-governance, mobile phones, information technology, m-government

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Authors: M. Aladwani, Y. Alarfaj

Abstract:

The construction industry is currently experiencing a shift towards digitisation. This transformation is driven by adopting technologies like Building Information Modelling (BIM), drones, and augmented reality (AR). These advancements are revolutionizing the process of designing, constructing, and operating projects. BIM, for instance, is a new way of communicating and exploiting technology such as software and machinery. It enables the creation of a replica or virtual model of buildings or infrastructure projects. It facilitates simulating construction procedures, identifying issues beforehand, and optimizing designs accordingly. Drones are another tool in this revolution, as they can be utilized for site surveys, inspections, and even deliveries. Moreover, AR technology provides real-time information to workers involved in the project. Implementing these technologies in the construction industry has brought about improvements in efficiency, safety measures, and sustainable practices. BIM helps minimize rework and waste materials, while drones contribute to safety by reducing workers' exposure to areas. Additionally, AR plays a role in worker safety by delivering instructions and guidance during operations. Although the digital transformation within the construction industry is still in its early stages, it holds the potential to reshape project delivery methods entirely. By embracing these technologies, construction companies can boost their profitability while simultaneously reducing their environmental impact and ensuring safer practices.

Keywords: BIM, digital construction, construction technologies, digital transformation

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Authors: Shokoufeh Abrisham, Seyed Mahmoud Hossieni, Elham Pishbin

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In this paper, a hybrid method based on the fault tree analysis (FTA) and Bayesian networks (BNs) are employed to evaluate the team performance quality of advanced cardiac life support (ACLS) procedures in emergency department. According to American Heart Association (AHA) guidelines, a category relying on staff action leading to clinical incidents and also some discussions with emergency medicine experts, a fault tree model for ACLS procedure is obtained based on the human performance. The obtained FTA model is converted into BNs, and some different scenarios are defined to demonstrate the efficiency and flexibility of the presented model of BNs. Also, a sensitivity analysis is conducted to indicate the effects of team leader presence and uncertainty knowledge of experts on the quality of ACLS. The proposed model based on BNs shows that how the results of risk analysis can be closed to reality comparing to the obtained results based on only FTA in medical procedures.

Keywords: advanced cardiac life support, fault tree analysis, Bayesian belief networks, numan performance, healthcare systems

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Authors: Zeineb Deymi-Gheriani

Abstract:

In the last two decades, one can clearly observe a boom of interest for e-learning and web-supported programs. However, one can also notice that many of these programs focus on the accumulation and delivery of content generally as a business industry with no much concern for theoretical underpinnings. The existing research, at least in online English language teaching (ELT), has demonstrated a lack of an effective online teaching pedagogy anchored in a well-defined theoretical framework. Hence, this paper comes as an attempt to present constructivism as one of the theoretical bases for the design of an effective online language teaching pedagogy which is at the same time technologically intelligent and theoretically informed to help envision how education can best take advantage of the information and communication technology (ICT) tools. The present paper discusses the key principles underlying constructivism, its implications for online language teaching design, as well as its limitations that should be avoided in the e-learning instructional design. Although the paper is theoretical in nature, essentially based on an extensive literature survey on constructivism, it does have practical illustrations from an action research conducted by the author both as an e-tutor of English using Moodle online educational platform at the Virtual University of Tunis (VUT) from 2007 up to 2010 and as a face-to-face (F2F) English teaching practitioner in the Professional Certificate of English Language Teaching Training (PCELT) at AMIDEAST, Tunisia (April-May, 2013).

Keywords: active learning, constructivism, experiential learning, Piaget, Vygotsky

Procedia PDF Downloads 351

Authors: Feng Ju Chuang, Yu Wen Wang, Tai Jung Hsieh, Shyh Ming Kuo

Abstract:

Polylactic acid is a synthetic polymer with good biocompatibility and degradability, is widely used in clinical applications. In this study, we utilized Polylactic acid particles as stimulants for macrophages and the collagen synthesis of co-cultured fibroblasts was evaluated. The results indicated that Polylactic acid particles were nontoxic to cells from 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. No obvious inflammation effect was observed (under the PLLA concentration of 1 mg/mL) after 24-h co-culture of Raw264.7 and NIH3T3 cells (from TNF-α assay). The addition of PLLA particles to the Raw264.7 and NIH3T3 co-cultures increased the synthesis of collagen, the highest collagen synthesis from the fibroblast was the 0.2 mg/mL (approximately 60% increased as compared with without addition Polylactic acid particles). Moreover, a co-axial atomization delivery device was used to percutaneously introduce Polylactic acid particles into the dermis layer and stimulating macrophages to secrete growth factors promoting fibroblasts to produce collagen. The preliminary results demonstrated the synthesis of collagen was increased mildly after the introduction of Polylactic acid particles for 28-d post implantation. The Polylactic acid particles could be successfully introduced into the dermis layer from H&E staining examination, however, the optimum concentration of Polylactic acid particles and the time-period for collagen synthesis still need to be evaluated.

Keywords: collagen synthesis, macrophage, NIH3T3 cells, polylactic acid particles

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Authors: K. M. Saif Ur Rahman, Razib Mamun, Himica Arjuman, Fida Al Shams

Abstract:

Introduction: Autism spectrum disorder (ASD) has become an emerging neurodevelopmental disorder with increasing prevalence. It has become an important public health issue globally. Many approaches including speech and language therapy (SLT), occupational therapy, behavioral therapy etc. are being applied for the betterment of the ASD patients. This study aims to describe the characteristics of ASD patients and perception of caregiver regarding SLT in Bangladesh. Methods: This cross-sectional study was conducted in a therapy and rehabilitation center at Dhaka city. Caregivers of 48 ASD patients responded regarding their perception of SLT and characteristics of patients. Results: Among 48 ASD patients, 56.3% were between 3 to 5 years age group with a male predominance (87.5%). More than half of the participants (56.3%) initiated SLT at the age of 1-3 years and the majority (43.8%) were taking SLT for less than 1 year. Majority of the patients (64.6%) were taken to a physician for healthcare as a first contact of which 29.2% were referred to SLT by physicians. More than half (56.3%) of the caregivers were moderately satisfied with SLT and most of them (62.5%) mentioned moderate improvement through SLT. Improvement rate was 10-15% in specific symptoms such as eye contact, complex mannerism, pointing, imitation etc. Conclusion: This study reveals the self-reported perception of caregivers on SLT. Despite reported improvements, more exploration of different approaches and intervention for management of ASD is recommended.

Keywords: ASD, characteristics, SLT, Bangladesh

Procedia PDF Downloads 181