Search results for: comprehensive care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6184

Search results for: comprehensive care

4204 Beyond Chol Soo Lee’s Death Row Release: Transinstitutionalization, Mortification, and the Limits of Legal Activism in 20th Century America

Authors: Minhae Shim Roth

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The “Deinstitutionalization movement” refers to the spatial transition in the United States during the mid-20th century when the treatment of mental illness purportedly moved from long-term psychiatric institutions to community integrated care. Contrary to the accepted narrative of mental health care in the U.S., asylums did not close or empty. Some remained psychiatric hospitals, which came to be called forensic hospitals or state hospitals; others were converted into prisons or carceral institutions. During Deinstitutionalization, the asylum system became an appendage of the carceral system, with state hospitals becoming little more than holding centers for prisoners who were civilly committed, those incompetent to stand trial, offenders with mental health issues, and those found not guilty by reason of insanity. Psychiatric patients who became prisoners and prisoners who became patients became entangled in the phenomenon called transinstitutionalization. This paper investigates the relationship between psychiatric and criminal incarceration in 20th century California and focuses particularly on the case of Korean-American Chol Soo Lee, who fought detention in the psychiatric-prison system through the writ of habeas corpus. This study uses methodologies like critical theory, close reading, and archival research. This paper argues that during his psychiatric hospitalization at Napa State Hospital and incarceration in the California Department of Corrections, Lee underwent what sociologist Erving Goffman coined in his 1960 text Asylums as the process of “mortification.” After a burst of Asian American solidarity and legal aid that resulted in Lee’s triumphant release from Death Row in 1983 through a writ of habeas corpus, Lee struggled in the free world due to the long-lasting consequences of institutionalization, which led to alienation, recidivism, and an early death at the age of 62. This paper examines the trajectory of Lee’s trial and the legal activism behind it within the context of Goffman’s theory of total institutions and offer a nuanced reading of Lee’s case both during and after his incarceration.

Keywords: criminal justice, criminal law, law and mental capacity, habeas corpus, deinstitutionalization, mental health

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4203 Improving Preconception Health and Lifestyle Behaviours through Digital Health Intervention: The OptimalMe Program

Authors: Bonnie R. Brammall, Rhonda M. Garad, Helena J. Teede, Cheryce L. Harrison

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Introduction: Reproductive aged women are at high-risk for accelerated weight gain and obesity development, with pregnancy recognised as a critical contributory life phase. Healthy lifestyle interventions during the preconception and antenatal period improve maternal and infant health outcomes. Yet, interventions from preconception through to postpartum and translation and implementation into real-world healthcare settings remain limited. OptimalMe is a randomised, hybrid implementation effectiveness study of evidence-based healthy lifestyle intervention. Here, we report engagement, acceptability of the intervention during preconception, and self-reported behaviour change outcomes as a result of the preconception phase of the intervention. Methods: Reproductive aged women who upgraded their private health insurance to include pregnancy and birth cover, signalling a pregnancy intention, were invited to participate. Women received access to an online portal with preconception health and lifestyle modules, goal-setting and behaviour change tools, monthly SMS messages, and two coaching sessions (randomised to video or phone) prior to pregnancy. Results: Overall n=527 expressed interest in participating. Of these, n=33 did not meet inclusion criteria, n=8 were not contactable for eligibility screening, and n=177 failed to engage after the screening, leaving n=309 who were enrolled in OptimalMe and randomised to intervention delivery method. Engagement with coaching sessions dropped by 25% for session two, with no difference between intervention groups. Women had a mean (SD) age of 31.7 (4.3) years and, at baseline, a self-reported mean BMI of 25.7 (6.1) kg/m², with 55.8% (n=172) of a healthy BMI. Behaviour was sub-optimal with infrequent self-weighing (38.1%), alcohol consumption prevalent (57.1%), sub-optimal pre-pregnancy supplementation (61.5%), and incomplete medical screening. Post-intervention 73.2% of women reported engagement with a GP for preconception care and improved lifestyle behaviour (85.5%), since starting OptimalMe. Direct pre-and-post comparison of individual participant data showed that of 322 points of potential change (up-to-date cervical screening, elimination of high-risk behaviours [alcohol, drugs, smoking], uptake of preconception supplements and improved weighing habits) 158 (49.1%) points of change were achieved. Health coaching sessions were found to improve accountability and confidence, yet further personalisation and support were desired. Engagement with video and phone sessions was comparable, having similar impacts on behaviour change, and both methods were well accepted and increased women's accountability. Conclusion: A low-intensity digital health and lifestyle program with embedded health coaching can improve the uptake of preconception care and lead to self-reported behaviour change. This is the first program of its kind to reach an otherwise healthy population of women planning a pregnancy. Women who were otherwise healthy showed divergence from preconception health and lifestyle objectives and benefited from the intervention. OptimalMe shows promising results for population-based behaviour change interventions that can improve preconception lifestyle habits and increase engagement with clinical health care for pregnancy preparation.

Keywords: preconception, pregnancy, preventative health, weight gain prevention, self-management, behaviour change, digital health, telehealth, intervention, women's health

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4202 Designing an Automatic Mechanical System to Prevent Cancers Caused by Drinks

Authors: Ghasem Yazadani, Hamidreza Ahmadi, Masoud Ahmadi, Sajad Rezazadeh

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In this paper with designing and proposing a compound of a heating and cooling system has been tried to show effect of this system on preventing esophagus cancer that can be caused by hot and cold drinks such as tea, coffee and ice water. This system has been simulated mechanically by fluent software and also has been validated by experimental way and a comprehensive result has been presented. Both of solution ways show that this system can reduce or increase temperature of drink to safe very dramatically and it can be a huge step toward consuming drinks safely and also it can be efficient about time issues. The system consists of a temperature sensor and an electronic controller that has a computer program to act automatically this task. Also this system has been presented after many different simulations and has been tried to find the best one in the point view of velocity of heating and cooling.

Keywords: fluent, heat transfer, controller, esophagus cancer

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4201 Africa’s Political and Economic Transformation and the Role of the Disporas

Authors: Noah Yusuf

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The present paper examined the current level of socio-political and economic development in Africa. Models and experiences from other regions of the world, especially, developing ones with similar historical experience with Africa, were explored. The paper concluded that recommendations emanating from past conferences, seminars and symposia on the continent’s socio-economic and political challenges have been poorly implemented because of lack of strong political will; the donor syndrome; weak resource base; capacity constraints in institutions; and lack of accountability, transparency and poor governance. It is, therefore, recommended that African countries need implement sound policies and reforms on a comprehensive basis, if they are to achieve the desired socio-economic and political transformation; and the African in Diasporas represent critical instruments in attaining the socio-economic and political objectives of the continent.

Keywords: Africa, political transformation, economic transformation, Africans in diasporas

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4200 Assessing the Impact of High Fidelity Human Patient Simulation on Teamwork among Nursing, Medicine and Pharmacy Undergraduate Students

Authors: S. MacDonald, A. Manuel, R. Law, N. Bandruak, A. Dubrowski, V. Curran, J. Smith-Young, K. Simmons, A. Warren

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High fidelity human patient simulation has been used for many years by health sciences education programs to foster critical thinking, engage learners, improve confidence, improve communication, and enhance psychomotor skills. Unfortunately, there is a paucity of research on the use of high fidelity human patient simulation to foster teamwork among nursing, medicine and pharmacy undergraduate students. This study compared the impact of high fidelity and low fidelity simulation education on teamwork among nursing, medicine and pharmacy students. For the purpose of this study, two innovative teaching scenarios were developed based on the care of an adult patient experiencing acute anaphylaxis: one high fidelity using a human patient simulator and one low fidelity using case based discussions. A within subjects, pretest-posttest, repeated measures design was used with two-treatment levels and random assignment of individual subjects to teams of two or more professions. A convenience sample of twenty-four (n=24) undergraduate students participated, including: nursing (n=11), medicine (n=9), and pharmacy (n=4). The Interprofessional Teamwork Questionnaire was used to assess for changes in students’ perception of their functionality within the team, importance of interprofessional collaboration, comprehension of roles, and confidence in communication and collaboration. Student satisfaction was also assessed. Students reported significant improvements in their understanding of the importance of interprofessional teamwork and of the roles of nursing and medicine on the team after participation in both the high fidelity and the low fidelity simulation. However, only participants in the high fidelity simulation reported a significant improvement in their ability to function effectively as a member of the team. All students reported that both simulations were a meaningful learning experience and all students would recommend both experiences to other students. These findings suggest there is merit in both high fidelity and low fidelity simulation as a teaching and learning approach to foster teamwork among undergraduate nursing, medicine and pharmacy students. However, participation in high fidelity simulation may provide a more realistic opportunity to practice and function as an effective member of the interprofessional health care team.

Keywords: acute anaphylaxis, high fidelity human patient simulation, low fidelity simulation, interprofessional education

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4199 Problems and Challenges Facing Refugees and Internally Displaced Persons In Iraq

Authors: Rebin Kamal Hama Gharib

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This research paper aims to identify the common and current problems and challenges faced by refugees and internally displaced persons (IDPs) in Iraq. The objective of this research is to highlight the urgent need for policy measures and support to address these issues. The research methodology includes a review of academic literature, government reports, and data collected by international organizations such as the United Nations High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM). The main contribution of this research is to provide a comprehensive overview of the challenges faced by refugees and IDPs in Iraq, including their legal status, access to basic services, economic opportunities, and social integration.

Keywords: efugees, internally displaced persons, Iraq, challenges, policy measures

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4198 The New World Kirkpatrick Model as an Evaluation Tool for a Publication Writing Programme

Authors: Eleanor Nel

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Research output is an indicator of institutional performance (and quality), resulting in increased pressure on academic institutions to perform in the research arena. Research output is further utilised to obtain research funding. Resultantly, academic institutions face significant pressure from governing bodies to provide evidence on the return for research investments. Research output has thus become a substantial discourse within institutions, mainly due to the processes linked to evaluating research output and the associated allocation of research funding. This focus on research outputs often surpasses the development of robust, widely accepted tools to additionally measure research impact at institutions. A publication writing programme, for enhancing research output, was launched at a South African university in 2011. Significant amounts of time, money, and energy have since been invested in the programme. Although participants provided feedback after each session, no formal review was conducted to evaluate the research output directly associated with the programme. Concerns in higher education about training costs, learning results, and the effect on society have increased the focus on value for money and the need to improve training, research performance, and productivity. Furthermore, universities rely on efficient and reliable monitoring and evaluation systems, in addition to the need to demonstrate accountability. While publishing does not occur immediately, achieving a return on investment from the intervention is critical. A multi-method study, guided by the New World Kirkpatrick Model (NWKM), was conducted to determine the impact of the publication writing programme for the period of 2011 to 2018. Quantitative results indicated a total of 314 academics participating in 72 workshops over the study period. To better understand the quantitative results, an open-ended questionnaire and semi-structured interviews were conducted with nine participants from a particular faculty as a convenience sample. The purpose of the research was to collect information to develop a comprehensive framework for impact evaluation that could be used to enhance the current design and delivery of the programme. The qualitative findings highlighted the critical role of a multi-stakeholder strategy in strengthening support before, during, and after a publication writing programme to improve the impact and research outputs. Furthermore, monitoring on-the-job learning is critical to ingrain the new skills academics have learned during the writing workshops and to encourage them to be accountable and empowered. The NWKM additionally provided essential pointers on how to link the results more effectively from publication writing programmes to institutional strategic objectives to improve research performance and quality, as well as what should be included in a comprehensive evaluation framework.

Keywords: evaluation, framework, impact, research output

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4197 A Literature Review on Nutritional Supplements for the Treatment of Obesity

Authors: Monika Nuffer, Wesley Nuffer

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The problem of obesity is one that continues to be faced in the United States health care system and across the developing world. Prescription medications are available, but are often very expensive with minimal insurance coverage. The over-the-counter diet aid industry is a robust one, selling billions of dollars in products every year. It is important for clinicians to understand the myriad of different nutritional supplements marketed for obesity, and to weigh the evidence behind these products. This manuscript outlines the most commonly used nutritional supplements currently marketed for weight loss, reviewing the evidence with a focus on the efficacy and safety of these products.

Keywords: obesity, weight loss, herbal products, nutritional supplements

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4196 Transcultural Study on Social Intelligence

Authors: Martha Serrano-Arias, Martha Frías-Armenta

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Significant results have been found both supporting universality of emotion recognition and cultural background influence. Thus, the aim of this research was to test a Mexican version of the MTSI in different cultures to find differences in their performance. The MTSI-Mx assesses through a scenario approach were subjects must evaluate real persons. Two target persons were used for the construction, a man (FS) and a woman (AD). The items were grouped in four variables: Picture, Video, and FS and AD scenarios. The test was applied to 201 students from Mexico and Germany. T-test for picture and FS scenario show no significance. Video and AD had a significance at the 5% level. Results show slight differences between cultures, although a more comprehensive research is needed to conclude which culture can perform better in this kind of assessments.

Keywords: emotion recognition, MTSI, social intelligence, transcultural study

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4195 Making a Resilient Livable City: Explorations of Smart Management Mechanism for Aging Society’s Disaster Prevention

Authors: Wei-Kuang Liu, Ya-Hsu Chiang

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In the coming of an aging society, the issues of living quality, health care, and social security for the elderly have been gradually taken seriously. In order to maintain favorable living condition, urban societies are also facing the challenge of disasters caused by extreme climate change. However, in the practice of disaster prevention, elderly people are always weak due to their physiological conditions. That is to say, in the planning of resilient urbanism, the aging society is relatively in need of more care. Thus, this research aims to map areas where have high-density elderly population and fragile environmental condition in Taiwan, and to understand the actual situation of disaster prevention management in these areas, so as to provide suggestions for the development of intellectual resilient urban management. The research takes the cities of Taoyuan and Taichung as examples for explorations. According to GIS mapping of areas with high aging index, high-density population and high flooding potential, the communities of Sihai and Fuyuan in Taoyuan and the communities of Taichang and Nanshih in Taichung are highlighted. In these communities, it can be found that there are more elderly population and less labor population with high-density living condition. In addition, they are located in the areas where they have experienced severe flooding in the recent past. Based on a series of interviews with community organizations, there is only one community out of the four using flood information mobile app and Line messages for the management of disaster prevention, and the others still rely on the traditional approaches that manage the works of disaster prevention by their community security patrol teams and community volunteers. The interview outcome shows that most elderly people are not interested in learning the use of intellectual devices. Therefore, this research suggests to keep doing the GIS mapping of areas with high aging index, high-density population and high flooding potential for grasping the high-risk communities and to help develop smart monitor and forecast systems for disaster prevention practice in these areas. Based on case-study explorations, the research also advises that it is important to develop easy-to-use bottom-up and two-way immediate communication mechanism for the management of aging society’s disaster prevention.

Keywords: aging society, disaster prevention, GIS, resilient, Taiwan

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4194 Comprehensive Study of Renewable Energy Resources and Present Scenario in India

Authors: Aparna Bhat, Rajeshwari Hegde

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Renewable energy sources also called non-conventional energy sources that are continuously replenished by natural processes. For example, solar energy, wind energy, bio-energy- bio-fuels grown sustain ably), hydropower etc., are some of the examples of renewable energy sources. A renewable energy system converts the energy found in sunlight, wind, falling-water, sea-waves, geothermal heat, or biomass into a form, we can use such as heat or electricity. Most of the renewable energy comes either directly or indirectly from sun and wind and can never be exhausted, and therefore they are called renewable. This paper presents a review about conventional and renewable energy scenario of India. The paper also presents current status, major achievements and future aspects of renewable energy in India and implementing renewable for the future is also been presented.

Keywords: solar energy, renewabe energy, wind energy, bio-diesel, biomass, feedin

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4193 Emergency Physician Performance for Hydronephrosis Diagnosis and Grading Compared with Radiologist Assessment in Renal Colic: The EPHyDRA Study

Authors: Sameer A. Pathan, Biswadev Mitra, Salman Mirza, Umais Momin, Zahoor Ahmed, Lubna G. Andraous, Dharmesh Shukla, Mohammed Y. Shariff, Magid M. Makki, Tinsy T. George, Saad S. Khan, Stephen H. Thomas, Peter A. Cameron

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Study objective: Emergency physician’s (EP) ability to identify hydronephrosis on point-of-care ultrasound (POCUS) has been assessed in the past using CT scan as the reference standard. We aimed to assess EP interpretation of POCUS to identify and grade the hydronephrosis in a direct comparison with the consensus-interpretation of POCUS by radiologists, and also to compare the EP and radiologist performance using CT scan as the criterion standard. Methods: Using data from a POCUS databank, a prospective interpretation study was conducted at an urban academic emergency department. All POCUS exams were performed on patients presenting with renal colic to the ED. Institutional approval was obtained for conducting this study. All the analyses were performed using Stata MP 14.0 (Stata Corp, College Station, Texas). Results: A total of 651 patients were included, with paired sets of renal POCUS video clips and the CT scan performed at the same ED visit. Hydronephrosis was reported in 69.6% of POCUS exams by radiologists and 72.7% of CT scans (p=0.22). The κ for consensus interpretation of POCUS between the radiologists to detect hydronephrosis was 0.77 (0.72 to 0.82) and weighted κ for grading the hydronephrosis was 0.82 (0.72 to 0.90), interpreted as good to very good. Using CT scan findings as the criterion standard, Eps had an overall sensitivity of 81.1% (95% CI: 79.6% to 82.5%), specificity of 59.4% (95% CI: 56.4% to 62.5%), PPV of 84.3% (95% CI: 82.9% to 85.7%), and NPV of 53.8% (95% CI: 50.8% to 56.7%); compared to radiologist sensitivity of 85.0% (95% CI: 82.5% to 87.2%), specificity of 79.7% (95% CI: 75.1% to 83.7%), PPV of 91.8% (95% CI: 89.8% to 93.5%), and NPV of 66.5% (95% CI: 61.8% to 71.0%). Testing for a report of moderate or high degree of hydronephrosis, specificity of EP was 94.6% (95% CI: 93.7% to 95.4%) and to 99.2% (95% CI: 98.9% to 99.5%) for identifying severe hydronephrosis alone. Conclusion: EP POCUS interpretations were comparable to the radiologists for identifying moderate to severe hydronephrosis using CT scan results as the criterion standard. Among patients with moderate or high pre-test probability of ureteric calculi, as calculated by the STONE-score, the presence of moderate to severe (+LR 6.3 and –LR 0.69) or severe hydronephrosis (+LR 54.4 and –LR 0.57) was highly diagnostic of the stone disease. Low dose CT is indicated in such patients for evaluation of stone size and location.

Keywords: renal colic, point-of-care, ultrasound, bedside, emergency physician

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4192 The Effect of Information Technologies on Business Performance: An Application on Small Hotels

Authors: Abdullah Karaman, Kursad Sayin

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In this research, which information technologies are used in small hotel businesses, and the information technologies-performance perception of the managers are pointed out. During the research, the questionnaire was prepared and the small scale hotel managers were interviewed face to face and they filled out the questionnaire and the answers acquired were evaluated. As the result of the research, it was obtained that the managers do not care much about the information technologies usage in practice even though they accepted that the information technologies are important in terms of performance.

Keywords: information technologies, managers, performance, small hotels

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4191 The Legal Position of the Sporting Directors in Saudi Football Clubs

Authors: Ammar Alrefaei

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Sporting directors in football clubs plays a prominent and important role in managing and controlling many issues related to the affairs of professional players. In view of this great importance of the role of the sporting directors, the Saudi regulation of the professional players and their transfers took over the organization and control of many aspects related to the conditions that must be met by the sporting director and the obligations that fall on his responsibility with the sport club or the Saudi Football Association. However, this regulation does not avoid ambiguity at times and shortcomings at other times in many places, as some of the texts contained in regulation raise many questions, some of which point out to the need to find more comprehensive and accurate treatment than those in the current regulations, accordingly this study comes to shed light on the aspects related to the sporting directors in sport clubs and the development of provisions.

Keywords: professional contract, sporting directors, professional player, labor law

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4190 Model Predictive Control (MPC) and Proportional-Integral-Derivative (PID) Control of Quadcopters: A Comparative Analysis

Authors: Anel Hasić, Naser Prljača

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In the domain of autonomous or piloted flights, the accurate control of quadrotor trajectories is of paramount significance for large numbers of tasks. These adaptable aerial platforms find applications that span from high-precision aerial photography and surveillance to demanding search and rescue missions. Among the fundamental challenges confronting quadrotor operation is the demand for accurate following of desired flight paths. To address this control challenge, among others, two celebrated well-established control strategies have emerged as noteworthy contenders: Model Predictive Control (MPC) and Proportional-Integral-Derivative (PID) control. In this work, we focus on the extensive examination of MPC and PID control techniques by using comprehensive simulation studies in MATLAB/Simulink. Intensive simulation results demonstrate the performance of the studied control algorithms.

Keywords: MATLAB, MPC, PID, quadcopter, simulink

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4189 Stroke Prevention in Patients with Atrial Fibrillation and Co-Morbid Physical and Mental Health Problems

Authors: Dina Farran, Mark Ashworth, Fiona Gaughran

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Atrial fibrillation (AF), the most prevalent cardiac arrhythmia, is associated with an increased risk of stroke, contributing to heart failure and death. In this project, we aim to improve patient safety by screening for stroke risk among people with AF and co-morbid mental illness. To do so, we started by conducting a systematic review and meta-analysis on prevalence, management, and outcomes of AF in people with Serious Mental Illness (SMI) versus the general population. We then evaluated oral anticoagulation (OAC) prescription trends in people with AF and co-morbid SMI in King’s College Hospital. We also evaluated the association between mental illness severity and OAC prescription in eligible patients in South London and Maudsley (SLaM) NHS Foundation Trust. Next, we implemented an electronic clinical decision support system (eCDSS) consisting of a visual prompt on patient electronic Personal Health Records to screen for AF-related stroke risk in three Mental Health of Older Adults wards at SLaM. Finally, we assessed the feasibility and acceptability of the eCDSS by qualitatively investigating clinicians’ perspectives of the potential usefulness of the eCDSS (pre-intervention) and their experiences and their views regarding its impact on clinicians and patients (post-intervention). The systematic review showed that people with SMI had low reported rates of AF. AF patients with SMI were less likely to receive OAC than the general population. When receiving warfarin, people with SMI, particularly bipolar disorder, experienced poor anticoagulation control compared to the general population. Meta-analysis showed that SMI was not significantly associated with an increased risk of stroke or major bleeding when adjusting for underlying risk factors. The main findings of the first observational study were that among AF patients having a high stroke risk, those with co-morbid SMI were less likely than non-SMI to be prescribed any OAC, particularly warfarin. After 2019, there was no significant difference between the two groups. In the second observational study, patients with AF and co-morbid SMI were less likely to be prescribed any OAC compared to those with dementia, substance use disorders, or common mental disorders, adjusting for age, sex, stroke, and bleeding risk scores. Among AF patients with co-morbid SMI, warfarin was less likely to be prescribed to those having alcohol or substance dependency, serious self-injury, hallucinations or delusions, and activities of daily living impairment. In the intervention, clinicians were asked to confirm the presence of AF, clinically assess stroke and bleeding risks, record risk scores in clinical notes, and refer patients at high risk of stroke to OAC clinics. Clinicians reported many potential benefits for the eCDSS, including improving clinical effectiveness, better identification of patients at risk, safer and more comprehensive care, consistency in decision making and saving time. Identified potential risks included rigidity in decision-making, overreliance, reduced critical thinking, false positive recommendations, annoyance, and increased workload. This study presents a unique opportunity to quantify AF patients with mental illness who are at high risk of severe outcomes using electronic health records. This has the potential to improve health outcomes and, therefore patients' quality of life.

Keywords: atrial fibrillation, stroke, mental health conditions, electronic clinical decision support systems

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4188 Simultaneous Relationship among Strategic Corporate Social Responsibility, Corporate Governance, and Firm Performance: Evidence from Indonesia

Authors: Ayu Diar Sari, Sidharta Utama

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The main objective of this study is to examine the empirical association among strategic corporate social responsibility (Strategic CSR), corporate governance (CG), and firm performance by investigating their causal effects. In order to get the comprehensive result, this study uses CSR variables which consist of Strategic CSR, Non-Strategic CSR and CSR as a whole. Exerting the two stage least square (2SLS) method, the result showed that CG mechanism positively influences CSR, Non-Strategic CSR, and firm performance (both ROA and PBV). CSR and Non-Strategic CSR positively influence ROA. Meanwhile CSR, Strategic and Non-Strategic CSR positively influence PBV. Firm’s Strategic CSR engagement plays a significantly positive role in enhancing PBV. The results supported the social impact hypothesis, agency theory, and conflict resolution theory.

Keywords: corporate financial performance, corporate governance, corporate social responsibility, strategic corporate social responsibility

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4187 Academic Freedom Policy: A Case Study

Authors: Marlin Killen

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The American Association of University Professors (AAUP) describes academic freedom as essential to the purposes of research and teaching. The importance of academic freedom as a bedrock foundation that supports the work of the professoriate cannot be overstated, and there have been innumerable challenges that have attempted to curtail it. These challenges come from a variety of sources that span legal, ethical, cultural, institutional, and professional perspective and are amplified by social media, traditional media, and political action efforts. Because of these challenges, the development of a comprehensive institutional policy on academic freedom that addresses the principles, practices, and appropriate responses to modern challenges can be a daunting task. This presentation will focus on a case study of a university’s effort to develop an updated, evolving policy on academic freedom that provides a framework and remedies for contemporary challenges to this critical function in higher education.

Keywords: academic freedom, academic freedom policy, higher education policy

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4186 Numerical Analysis of End Plate Bolted Connection with Corrugated Beam

Authors: M. A. Sadeghian, J. Yang, Q. F. Liu

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Steel extended end plate bolted connections are recommended to be widely utilized in special moment-resisting frame subjected to monotonic loading. Improper design of steel beam to column connection can lead to the collapse and fatality of structures. Therefore comprehensive research studies of beam to column connection design should be carried out. Also the performance and effect of corrugated on the strength of beam column end plate connection up to failure under monotonic loading in horizontal direction is presented in this paper. The non-linear elastic–plastic behavior has been considered through a finite element analysis using the multi-purpose software package LUSAS. The effect of vertically and horizontally types of corrugated web was also investigated.

Keywords: corrugated beam, monotonic loading, finite element analysis, end plate connection

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4185 Comprehensive Microstructural and Thermal Analysis of Nano Intumescent Fire Retardant Coating for Structural Applications

Authors: Hammad Aziz

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Intumescent fire retardant coating (IFRC) is applied on the surface of material requiring fire protection. In this research work, IFRC’s were developed using ammonium polyphosphate, expandable graphite, melamine, boric acid, zinc borate, mica, magnesium oxide, and bisphenol A BE-188 with polyamide polyamine H-4014 as curing agent. Formulations were prepared using nano size MgO and compared with control formulation i.e. without nano size MgO. Small scale hydrocarbon fire test was conducted to scrutinize the thermal performance of the coating. Char and coating were further characterized by using FESEM, FTIR, EDS, TGA and DTGA. Thus, Intumescent coatings reinforced with 2 wt. % of nano-MgO (rod shaped particles) provide superior thermal performance and uniform microstructure of char due to well dispersion of nano particles.

Keywords: intumescent coating, char, SEM, TGA

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4184 The Knowledge, Attitude, and Practice About Health Information Technology Among First-Generation Muslim Immigrant Women in Atlanta City During the Pandemic

Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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4183 Sustainable Rehabilitation of Concrete Buildings in Iran: Harnessing Sunlight and Navigating Limited Water Resources

Authors: Amin Khamoosh, Hamed Faramarzifar

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In the capital of Iran, Tehran, numerous buildings constructed when extreme climates were not prevalent now face the need for rehabilitation, typically within their first decade. Our data delves into the performance metrics and economic advantages of sustainable rehabilitation practices compared to traditional methods. With a focus on the scarcity of water resources, we specifically scrutinize water-efficient techniques throughout construction, rehabilitation, and usage. Examining design elements that optimize natural light while efficiently managing heat transmission is crucial, given the reliance on water for cooling devices in this region. The data aims to present a comprehensive strategy, addressing immediate structural concerns while harmonizing with Iran's unique environmental conditions.

Keywords: sustainable rehabilitation, concrete buildings, iran, solar energy, water-efficient techniques

Procedia PDF Downloads 43
4182 Foot Self-Monitoring Knowledge, Attitude, Practice, and Related Factors among Diabetic Patients: A Descriptive and Correlational Study in a Taiwan Teaching Hospital

Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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4181 Optimizing Resource Management in Cloud Computing through Blockchain-Enabled Cost Transparency

Authors: Raghava Satya SaiKrishna Dittakavi

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Cloud computing has revolutionized how businesses and individuals store, access, and process data, increasing efficiency and reducing infrastructure costs. However, the need for more transparency in cloud service billing often raises concerns about overcharging and hidden fees, hindering the realization of the full potential of cloud computing. This research paper explores how blockchain technology can be leveraged to introduce cost transparency and accountability in cloud computing services. We present a comprehensive analysis of blockchain-enabled solutions that enhance cost visibility, facilitate auditability, and promote trust in cloud service providers. Through this study, we aim to provide insights into the potential benefits and challenges of implementing blockchain in the cloud computing domain, leading to improved cost management and customer satisfaction.

Keywords: blockchain, cloud computing, cost transparency, blockchain technology

Procedia PDF Downloads 73
4180 Diabetic Screening in Rural Lesotho, Southern Africa

Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

Procedia PDF Downloads 275
4179 Simulating the Hot Hand Phenomenon in Basketball with Bayesian Hidden Markov Models

Authors: Gabriel Calvo, Carmen Armero, Luigi Spezia

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A basketball player is said to have a hot hand if his/her performance is better than expected in different periods of time. A way to deal with this phenomenon is to make use of latent variables, which can indicate whether the player is ‘on fire’ or not. This work aims to model the hot hand phenomenon through a Bayesian hidden Markov model (HMM) with two states (cold and hot) and two different probability of success depending on the corresponding hidden state. This task is illustrated through a comprehensive simulation study. The simulated data sets emulate the field goal attempts in an NBA season from different profile players. This model can be a powerful tool to assess the ‘streakiness’ of each player, and it provides information about the general performance of the players during the match. Finally, the Bayesian HMM allows computing the posterior probability of any type of streak.

Keywords: Bernoulli trials, field goals, latent variables, posterior distribution

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4178 A Survey Proposal towards Holistic Management of Schizophrenia

Authors: Pronab Ganguly, Ahmed A. Moustafa

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Holistic management of schizophrenia involves mainstream pharmacological intervention, complimentary medicine intervention, therapeutic intervention and other psychosocial factors such as accommodation, education, job training, employment, relationship, friendship, exercise, overall well-being, smoking, substance abuse, suicide prevention, stigmatisation, recreation, entertainment, violent behaviour, arrangement of public trusteeship and guardianship, day-day-living skill, integration with community, and management of overweight due to medications and other health complications related to medications amongst others. Our review shows that there is no integrated survey by combining all these factors. An international web-based survey was conducted to evaluate the significance of all these factors and present them in a unified manner. It is believed this investigation will contribute positively towards holistic management of schizophrenia. There will be two surveys. In the pharmacological intervention survey, five popular drugs for schizophrenia will be chosen and their efficacy as well as harmful side effects will be evaluated on a scale of 0 -10. This survey will be done by psychiatrists. In the second survey, each element of therapeutic intervention and psychosocial factors will be evaluated according to their significance on a scale of 0 - 10. This survey will be done by care givers, psychologists, case managers and case workers. For the first survey, professional bodies of psychiatrists in English speaking countries will be contacted to request them to ask their members to participate in the survey. For the second survey, professional bodies of clinical psychologist and care givers in English speaking countries will be contacted to request them to ask their members to participate in the survey. Additionally, for both the surveys, relevant professionals will be contacted through personal contact networks. For both the surveys, mean, mode, median, standard deviation and net promoter score will be calculated for each factor and then presented in a statistically significant manner. Subsequently each factor will be ranked according to their statistical significance. Additionally, country specific variation will be highlighted to identify the variation pattern. The results of these surveys will identify the relative significance of each type of pharmacological intervention, each type of therapeutic intervention and each type of psychosocial factor. The determination of this relative importance will definitely contribute to the improvement in quality of life for individuals with schizophrenia.

Keywords: schizophrenia, holistic management, antipsychotics, quality of life

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4177 Attributes of Employee Engagement Best Practices: A Guideline for SMEs

Authors: Ghazanfar Bozai, Kanwal Gul

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In Pakistan, SMEs are the major source of contribution to the economy, but due to lack of proper HR practices (lack of employee engagement), these fast growing business shut down with in few years of startup. The purpose of this study is to conduct a comprehensive literature survy of the major best practices used for employee engagement globally. This paper could be used as employee engagement best practices guide for SME’s in developing countries. This article is focused on identifying the attributes of employee engagement in different countries/ cultures and organizations. It will provide a summary of employee engagement models used globally and how SMEs could pick suitable attributes of employee engagement as per their structural culture. This article will add valuable literature on employee engagement in developing countries for new startups and small, medium business.

Keywords: attributes, employee engagement, human resources practices, small medium enterprises

Procedia PDF Downloads 238
4176 Educational Sport and Quality of Life for Children and Teenagers from Brazilian Northeast

Authors: Ricardo Hugo Gonzalez, Amanda Figueiredo Vasconcelos, Francisco Loureiro Neto Monteiro, Yara Luiza Freitas Silva, Ana Cristina Lindsay, Márcia Maria Tavares Machado

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The use of sport as an integration mean is a very important tool regarding the social involvement of children and teenagers in a vulnerability situation. This study aims to report the experiences of a multidisciplinary program that intends to improve the quality of life of children and teenagers in Fortaleza, in the Northeast of Brazil. More than 400 children and teenagers aging 11 and 16 years participated in this study. Poor communities experience many particular difficulties in the urban centers such as violence, poor housing conditions, unemployment, lack in health care and deficient physical education in school. Physical education, physiotherapy, odontology, medicine and pharmacy students are responsible for the activities in the project supervised by a general coordinator and a counselor teacher of each academic unit. There are classes about team sports like basketball and soccer. Lectures about sexual behavior and sexually transmitted diseases are ministered beside the ones about oral health education, basic life support education, first aids, use and care with pharmaceuticals and orientations about healthy nutrition. In order to get the children’s family closer, monthly informative lectures are ministered. There is also the concern about reflecting the actions and producing academic paperwork such as graduation final projects and books. The number of participants has oscillated lately, and one of the causes is the lack of practicing physical activities and sports regularly. However, 250 teenagers have participated regularly for at least two years. These teenagers have shown a healthier lifestyle and a better physical fitness profile. The resources for maintaining the project come from the Pro-Reitoria of Extension, Federal University of Ceara, as well as from the PROEXT/MEC, Federal Government. Actions of this nature need to be done thinking for long periods so the effects results can become effective. Public and private investments are needed due to low socioeconomic families who are most vulnerable and have fewer opportunities to enhance to health prevention services.

Keywords: children and teenagers, health, multidisciplinary program, quality of life

Procedia PDF Downloads 223
4175 AI-based Digital Healthcare Application to Assess and Reduce Fall Risks in Residents of Nursing Homes in Germany

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

Procedia PDF Downloads 123