Search results for: healthcare policy instruments

Authors: Ahmad Abdulkadir Ibrahim

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Observation of the methodology of Islamic economics laid down for the methods and instruments of analysis and even some of its basic assumptions in the modern world; is a matter that is of paramount importance. There is a need to examine the implications of different suggested definitions of Islamic economics, exploring its scope and attempting to outline its methodology. This paper attempts to deal with the definition of Islamic economics, its methodology, and its scope. It will outline the main methodological problem by addressing the question of whether Islamic economics calls for a methodology of its own or as an expanded economics. It also aims at drawing the attention of economists in the modern world to the obligation and consideration of the methodology of Islamic economics. The methodology adopted in this research is library research through the consultation of relevant literature, which focuses on the thematic study of the subject matter. This is followed by an analysis and discussion of the contents of the materials used. It is concluded that there is a certain degree of inconsistency in the way assumptions are incorporated that perhaps are alien to Islamic economics. The paper also observed that there is a difference between Islamic economists and other (conventional) economists in the profession. An important conclusion is that Islamic economists need to rethink what economics is all about and whether we really have to create an alternative to economics in the form of Islamic economics or simply have an Islamic perspective of the same discipline.

Keywords: methodology, Islamic economics, conventional economics, Muslim economists, framework, knowledge

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Authors: Seongho Han, Dongkwan Kim

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The focus of regional innovation policies is shifting from a central government to local governments. The central government demands that regions enforce autonomous and responsible regional innovation policies and that regional governments seek for innovation policies fit for regional characteristics. However, the central government and local governments have not arrived yet at a conclusion on what innovation policies are appropriate for regional circumstances. In particular, even if each local government is trying to find regional innovation strategies that are based on the needs of a region, its innovation strategies turn out to be similar with those of other regions. This leads to a consequence that is inefficient not only at a national level, but also at a regional level. Existing researches on regional innovation types point out that there are remarkable differences in the types or characteristics of innovation among the regions of a nation. In addition they imply that there would be no expected innovation output in cases in which policies are enforced with ignoring such differences. This means that it is undesirable to enforce regional innovation policies under a single standard. This research, given this problem, aims to find out the characteristics and differences in innovation types among the regions in Korea and suggests appropriate policy implications by classifying such characteristics and differences. This research, given these objectives, classified regions in consideration of the various indicators that comprise the innovation suggested by existing related researches and illustrated policies based on such characteristics and differences. This research used recent data, mainly from 2012, and as a methodology, clustering analysis based on multiple factor analysis was applied. Supplementary researches on dynamically analyzing stability in regional innovation types, establishing systematic indicators based on the regional innovation theory, and developing additional indicators are necessary in the future.

Keywords: regional innovation policy, regional innovation type, region-based innovation, multiple factor analysis, clustering analysis

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Authors: Babu Veeregowda, Rongfang Liu

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The current traffic impact assessment methodology and environmental quality review process for approval of land development project are conventional, stagnant, and one-dimensional. The environmental review policy and procedure lacks in providing the direction to regulate or seek alternative land uses and sizes that exploits the existing or surrounding elements of built environment (‘4 D’s’ of development – Density, Diversity, Design, and Distance to Transit) or smart growth principles which influence the travel behavior and have a significant effect in reducing vehicular traffic. Additionally, environmental review policy does not give directions on how to incorporate urban planning into the development in ways such as incorporating non-motorized roadway elements such as sidewalks, bus shelters, and access to community facilities. This research developed a methodology to optimize the mix of land uses and sizes using the heuristic optimization process to minimize the auto dependency development and to meet the interests of key stakeholders. A case study of Willets Point Mixed Use Development in Queens, New York, was used to assess the benefits of the methodology. The approved Willets Point Mixed Use project was based on maximum envelop of size and land use type allowed by current conventional urban renewal plans. This paper will also evaluate the parking accumulation for various land uses to explore the potential for shared parking to further optimize the mix of land uses and sizes. This research is very timely and useful to many stakeholders interested in understanding the benefits of integrated land uses and its development.

Keywords: traffic impact, mixed use, optimization, trip generation

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Authors: Douglas Nyathi, Mxolisi Sibanda, Joram Ndlovuu, Thulani Dube, Innocent T. Mahiya

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Communication of sexual matters between the parents and adolescents has been seen as one of the strategies that could play a cardinal role in encouraging adolescents to be responsible and delay sexual debut or avoid unprotected sexual intercourse. The increasing rate of teenage pregnancies and new HIV/AIDS infections among adolescents in Sub-Saharan Africa makes the phenomenon worth analysis. The purpose of this paper is to interrogate the dynamics of parent-adolescent communication on sexual and reproductive health in Sub-Sahara. Specifically the paper focuses on barriers to communication between parents and adolescents on sexual and reproductive health and its policy implications. It emanates from the paper that communication on sexual and reproductive health at household level is triggered by death of a relative from a sexual related illness, suspicion on sexual activity, radio programmes and in some instances fliers. Literature engagement reveals that communication between parents and adolescents on sexual and reproductive health is made difficult by economic factors (poverty, lack of privacy and low self-esteem), household demographics (age, sex, class, death), socio-cultural factors (beliefs and religious values) as well as social media. We argue that there is need to use broadcast mediato come up with radio and television programmes that create family environments in which sexual and reproductive health issues are discussed. We also recommend that government departments and Non-Governmental Organisations concerned with sexuality issues need to undertake studies that can help dismantle taboos, prejudices and stereotypes that impede sexual and reproductive health communication between parents and adolescents.

Keywords: parent, adolecsent, communication, sexual and reproductive health

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Authors: Vasudha Thapa, Kiran Chappa

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There is a pressing need to prepare cities in the developing countries of the global south such as India against the chaos created by COVID 19 pandemic and future disaster risks. This pandemic posed the nation with an unprecedented challenge of dealing with a wave of stranded migrant workers. These workers comprise the most vulnerable section of the society in case of any pandemic or disaster risks. The COVID 19 pandemic exposed the vulnerability of migrant workers in the urban form and the need for capacity-building strategies against future pandemics. This paper highlights the challenges of these migrant workers in the case of Mumbai city in lockdown, post lockdown, and the current uncertain scenarios. The paper deals with a thorough investigation of the existing and the recent policies and strategies taken by the Urban Local Bodies (ULBs), state, and central government to assist these migrants in the city during this mayhem of uncertainties. The paper looks further deep into the challenges and opportunities presented in the current scenario through the assessment of existing data and response to policy measures taken by the government organizations. The ULBs are at the forefront in the response to any disaster risk, hence the paper assesses the capacity gaps of the Urban local bodies in mitigating the risks posed by any pandemic-like situation. The study further recommends capacity-building strategies at various levels of governance and uniform policy measures to assist the migrant population of the city.

Keywords: urban resilience, covid 19, migrant population, India, capacity building, governance

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Authors: Abid Kousay

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Appeared and developed essentially in large companies and multinationals, Talent Management (TM) in Small and Medium-Sized Enterprises (SMEs) has remained an under-explored subject till today. Although the literature on TM in the Anglo-Saxon context is developing, it remains monopolized in non-European contexts, especially in France. Therefore, this article aims to address these shortcomings through contributing to TM issues by adopting a multilevel approach holding the goal of reaching a global holistic vision of interactions between various levels while applying TM. A qualitative research study carried out within 12 SMEs in France, built on the methodological perspective of grounded theory, will be used in order to go beyond description, to generate or discover a theory or even a unified theoretical explanation. Our theoretical contributions are the results of the grounded theory, the fruit of context considerations and the dynamic of the multilevel approach. We aim firstly to determine the perception of talent and TM in SMEs. Secondly, we formalize TM in SME through the empowerment of all 3 levels in the organization (individual, collective, and organizational). And we generate a multilevel dynamic system model, highlighting the institutionalization dimension in SMEs and the managerial conviction characterized by the domination of the leader’s role. Thirdly, this first study sheds light on the importance of rigorous implementation of TM in SMEs in France by directing CEO and HR and TM managers to focus on elements that upstream TM implementation and influence the system internally. Indeed, our systematic multilevel approach policy reminds them of the importance of strategic alignment while translating TM policy into strategies and practices in SMEs.

Keywords: French context, multilevel approach, talent management, , TM system

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Authors: Shweta Singh, Sudaman Katti

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The most well-known sequence models make use of complex recurrent neural networks in an encoder-decoder configuration. The model used in this research makes use of a transformer, which is based purely on a self-attention mechanism, without relying on recurrence at all. More specifically, encoders and decoders which make use of self-attention and operate based on a memory, are used. In this research work, results for various 3D visual and non-visual reinforcement learning tasks designed in Unity software were obtained. Convolutional neural networks, more specifically, nature CNN architecture, are used for input processing in visual tasks, and comparison with standard long short-term memory (LSTM) architecture is performed for both visual tasks based on CNNs and non-visual tasks based on coordinate inputs. This research work combines the transformer architecture with the proximal policy optimization technique used popularly in reinforcement learning for stability and better policy updates while training, especially for continuous action spaces, which are used in this research work. Certain tasks in this paper are long horizon tasks that carry on for a longer duration and require extensive use of memory-based functionalities like storage of experiences and choosing appropriate actions based on recall. The transformer, which makes use of memory and self-attention mechanism in an encoder-decoder configuration proved to have better performance when compared to LSTM in terms of exploration and rewards achieved. Such memory based architectures can be used extensively in the field of cognitive robotics and reinforcement learning.

Keywords: convolutional neural networks, reinforcement learning, self-attention, transformers, unity

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Authors: Karla Lebedoff, Susan Walsh, Michelle Bain

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Eczema is a chronic atopy condition requiring long-term daily management in children. Written action plans for other chronic atopic conditions, such as asthma and food allergies, are widely recommended and distributed to pediatric patients' parents and caregivers, seeking to improve clinical outcomes and become empowered to manage the patient's ever-changing symptoms. Written action plans for eczema, referred to as "asthma of the skin," are not routinely used in practice. Parents of children suffering from eczema rarely receive a written action plan to follow, and commendations supporting eczema action plans are inconsistent. Pediatric patients between birth and 18 years old who were followed for eczema at an urban Midwest community hospital were eligible to participate in this quality improvement project. At the initial visit, parents received instructions on individualized eczema action plans for their child and completed two validated surveys: Health Confidence Score (HCS) and Patient-Oriented Eczema Measure (POEM). Pre- and post-survey responses were collected, and clinical symptom presentation at follow-up were outcome determinants. Project implementation was guided by Institute for Healthcare Improvement's Step-up Framework and the Plan-Do-Study-Act cycle. This project measured clinical outcomes and parent confidence in self-management of their child's eczema symptoms with the responses from 26 participant surveys. Pre-survey responses were collected from 36 participants, though ten were lost to follow-up. Average POEM scores improved by 53%, while average HCS scores remained unchanged. Of seven completed in-person follow-up visits, six clinical progress notes documented improvement. Individualized eczema action plans can be seamlessly incorporated into primary and specialty care visits for pediatric patients suffering from eczema. Following a patient-specific eczema action plan may lessen the daily physical and mental burdens of uncontrolled eczema for children and parents, managing symptoms that chronically flare and recede. Furthermore, incorporating eczema action plans into practice potentially reduces the likely underestimated $5.3 billion economic disease burden of eczema on the U.S. healthcare system.

Keywords: atopic dermatitis, eczema action plan, eczema symptom management, pediatric eczema

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Authors: Abid Kousay

Abstract:

Appeared and developed essentially in large companies and multinationals, Talent Management (TM) in Small and Medium-Sized Enterprises (SMEs) has remained an under-explored subject till today. Although the literature on TM in the Anglo-Saxon context is developing, it remains monopolized in non-European contexts, especially in France. Therefore, this article aims to address these shortcomings through contributing to TM issues, by adopting a multilevel approach holding the goal of reaching a global holistic vision of interactions between various levels, while applying TM. A qualitative research study carried out within 12 SMEs in France, built on the methodological perspective of grounded theory, will be used in order to go beyond description, to generate or discover a theory or even a unified theoretical explanation. Our theoretical contributions are the results of the grounded theory, the fruit of context considerations and the dynamic of the multilevel approach. We aim firstly to determine the perception of talent and TM in SMEs. Secondly, we formalize TM in SME through the empowerment of all 3 levels in the organization (individual, collective, and organizational). And we generate a multilevel dynamic system model, highlighting the institutionalization dimension in SMEs and the managerial conviction characterized by the domination of the leader's role. Thirdly, this first study shed the light on the importance of rigorous implementation of TM in SMEs in France by directing CEO and HR and TM managers to focus on elements that upstream TM implementation and influence the system internally. Indeed, our systematic multilevel approach policy reminds them of the importance of the strategic alignment while translating TM policy into strategies and practices in SMEs.

Keywords: French context, institutionalization, talent, multilevel approach, talent management system

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Authors: Okpu Enoh Ndip Nkongho

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The type of political leadership in place impacts a state's economic development or underdevelopment directly and indirectly. One of the main challenges to Cameroon's economic development may be ineffective or misguided political leadership. The economy of the Cameroon state has declined significantly due to a number of factors, including a lack of effective and feasible economic policies, a reliance on crude oil that is excessive, tribal politics, the threat of insurgency, bribery, and corruption, violations of human rights, neglect of other sectors like science, technology, education, and transportation, and a careless attitude on the part of the administrators toward the general public. As a result, the standard of living has decreased, foreign exchange has decreased, and the value of the Cameroonian currency has depreciated. Therefore, from 2000 to 2023, this paper focused on the relationship between political leadership and economic development in Cameroon and offered suggestions for improving political leadership that will, in turn, lead to the country's economy getting back on track. The study employed a qualitative technique, with the framework for the investigation derived from the trait theory of leadership. According to the information provided above, the paper was able to conclude that there is a lack of cooperation between the three branches of government in Cameroon. This is shown in situations when one branch operates independently of the others and refuses to function as a backup when needed. The study recommended that the Executive collaborate closely with the National Assembly to speed action on some key legislation required to stimulate economic development. On the other hand, there is a need for more clarity and consistency in the government's policy orientation. There is no doubt that our current economic troubles are at least partially the result of a lack of economic policy leadership and confidence.

Keywords: politics, leadership, economic, development, Cameroon

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Authors: Pankaj Negi

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Nowadays the demand for receiving the high quality electrical energy is being increasing as consumer wants not only reliable but also quality power. Custom power instruments are of the most well-known compensators of power quality in distributed network. This paper present a comprehensive review of compensating custom power devices mainly DSTATCOM (distribution static compensator),DVR (dynamic voltage restorer), and UPQC (unified power quality compensator) and also deals with sliding mode control and its applications to custom power devices. The sliding mode control strategy provides robustness to custom power device and enhances the dynamic response for compensating voltage sag, swell, voltage flicker, and voltage harmonics. The aim of this paper is to provide a broad perspective on the status of compensating devices in electric power distribution system and sliding mode control strategies to researchers and application engineers who are dealing with power quality and stability issues.

Keywords: active power filters(APF), custom power device(CPD), DSTATCOM, DVR, UPQC, sliding mode control (SMC), power quality

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Authors: Ashan Wijekoon, Abi Beane, Subashini Jayawardana

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Background: Soldiers' physical rehabilitation and long term health status has been hindered due to limited investment in and access to rehabilitation services. Home-based rehabilitation programmes could offer a potentially feasible alternative to facilitate long-term recovery. Objectives: To explore Sri Lankan soldiers' perceptions of barriers and facilitators to a home-based physical rehabilitation programme.Methods and Materials: We conducted qualitative semi-structured interviews with community re-integrated army veterans who had undergone unilateral lower limb amputation following war related trauma. Veterans were identified from five districts of Sri Lanka, based on a priori knowledge of veteran community settlements (Disabled Category Registry) obtained from Directorate of Rehabilitation, MoD, Sri Lanka. Individuals were stratified for purposive selection. The interview guide was developed from existing methods and adapted for context. Verbatim transcripts of interviews were analyzed for emerging themes using an inductive approach. Following consent, participants met the researcher (AW- a trained physiotherapist fluent in Sinhalese). Results: Twenty-five Interviews were conducted, totaling 7.2 hours of new data (Mean±SD: 0.28±0.11). All participants were male, aged 30-55 years (Mean±SD: 46.1±7.4), and had experienced traumatic amputation as a result of conflict. Twenty-four sub themes were identified. Inadequate space for exercises, absence of equipment and assistance to conduct the exercises at home, alongside absence of community healthcare services were all barriers. Burden of comorbidities, including chronic pain and disability level, were also barriers. Social support systems, including soldier societies, family, and kinship with other amputees, were seen as facilitators to an at-home programme. Motivation for independence was a strong indicator of engagement. Conclusion: Environment, chronic pain, and absence of well-established community health services were key barriers. Family and soldier support was a facilitator. Engagement with community healthcare providers (physiotherapist and primary care physicians) will be essential to the success of an at-home rehabilitation program.

Keywords: physical rehabilitation, home-based, soldiers, disability, lower-limb amputation, qualitative

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Authors: S. O. Okoro

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Some words become the catch phrase of a particular decade. Globalization, Openness, and Privatization are certainly among the most frequently encapsulation of 1990’s; the market is ‘in’, ‘the state is out’. In the 1970’s, there were many political economists who spoke of autarky as one possible response to global economic forces. Be self-contained, go it alone, put up barriers to trans-nationalities, put in place import-substitution industrialization policy and grow domestic industries. In 1990’s, the emasculation of the state is by no means complete, but there is an acceptance that the state’s power is circumscribed by forces beyond its control and potential leverage. Autarky is no longer as a policy option. Nigeria, since its emergence as an independent nation, has evolved two macroeconomic management regimes of the interventionist and market friendly styles. This paper investigates Nigeria’s growth performance over the periods incorporating these two regimes and finds that there is no structural break in Total Factor Productivity, (TFP) growth and besides, the TFP growth over the entire period of study 1970-2012 is very negligible and hence growth can only be achieved by the unsustainable factor accumulation. Another important finding of this work is that the openness-human capital interaction term has a significant impact on the TFP growth, but the sign of the estimated coefficient does not meet it a theoretical expectation. This is because the negative coefficient on the human capital outweighs the positive openness effect. The poor quality of human capital is considered to have given rise to this. Given these results a massive investment in the education sector is required. The investment should be targeted at reforms that go beyond mere structural reforms to a reform agenda that will improve the quality of human capital in Nigeria.

Keywords: globalization, emasculation, openness and privatization, total factor productivity

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Authors: Sofia Mylona, Dale Hume

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The main scope of this work is to compare the experimental thermal conductivity results of fluids between devices using transient techniques. A range of different liquids within a range of viscosities was measured with two or more devices, and the results were compared between the different methods and the reference equations wherever it was available. The liquids selected are the most commonly used in academic or industrial laboratories to calibrate their thermal conductivity instruments having a variety of thermal conductivity, viscosity, and density. Three transient methods (Transient Hot Wire, Transient Plane Source, and Transient Line Source) were compared for the thermal conductivity measurements taken by using them. These methods have been chosen as the most accurate and because they all follow the same idea; as a function of the logarithm of time, the thermal conductivity is calculated from the slope of a plot of sensor temperature rise. For all measurements, the selected temperature range was at the atmospheric level from 10 to 40 ° C. Our results are coming with an agreement with the objections of several scientists over the reliability of the results of a few popular devices. The observation was surprising that the device used in many laboratories for fast measurements of liquid thermal conductivity display deviations of 500 percent which can be very poorly reproduced.

Keywords: accurate data, liquids, thermal conductivity, transient methods.

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Authors: Eisa M. Al-Balhan, Mamdouh M. Soliman

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This study introduced learning styles techniques into mathematics teaching to improve mathematics achievement and motivation among Kuwaiti fourth- and fifth-grade low achievers. The study consisted of two groups. The control group (N = 212) received traditional math tutoring based on a textbook and the tutor’s knowledge of math. The experimental group (N = 209) received math tutoring from instructors trained in the Learning Style™ approach. Three instruments were used: Motivation Scale towards Mathematics; Achievement in Mathematics Test; and the manual of learning style approach indicating the individual’s preferred learning style: AKV, AVK, KAV, KVA, VAK, or VKA. The participating teachers taught to the detected learning style of each student or group. The findings show significant improvement in achievement and motivation towards mathematics in the experimental group. The outcome offers information to variables affecting achievement and motivation towards mathematics and demonstrates the leading role of Kuwait in education within the region.

Keywords: elementary school, learning style, math low achievers, SmartWired™, math instruction, motivation

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Authors: Demet Ozgur-Unluakin, Busenur Turkali, Ayse Karacaorenli

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Maintenance strategies can be classified into two types, which are reactive and proactive, with respect to the time of the failure and maintenance. If the maintenance activity is done after a breakdown, it is called reactive maintenance. On the other hand, proactive maintenance, which is further divided as preventive and predictive, focuses on maintaining components before a failure occurs to prevent expensive halts. Recently, the number of interacting components in a system has increased rapidly and therefore, the structure of the systems have become more complex. This situation has made it difficult to provide the right maintenance decisions. Herewith, determining effective decisions has played a significant role. In multi-component systems, many methodologies and strategies can be applied when a component or a system has already broken down or when it is desired to identify and avoid proactively defects that could lead to future failure. This study focuses on the comparison of various maintenance strategies on a multi-component dynamic system. Components in the system are hidden, although there exists partial observability to the decision maker and they deteriorate in time. Several predefined policies under corrective, preventive and predictive maintenance strategies are considered to minimize the total maintenance cost in a planning horizon. The policies are simulated via Dynamic Bayesian Networks on a multi-component system with different policy parameters and cost scenarios, and their performances are evaluated. Results show that when the difference between the corrective and proactive maintenance cost is low, none of the proactive maintenance policies is significantly better than the corrective maintenance. However, when the difference is increased, at least one policy parameter for each proactive maintenance strategy gives significantly lower cost than the corrective maintenance.

Keywords: decision making, dynamic Bayesian networks, maintenance, multi-component systems, reliability

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Authors: Philip A. Szlosek, M. Susan Guyer, Mary G. Barnum, Elizabeth M. Mullin

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In the United States, athletic training is a healthcare profession that encompasses the prevention, examination, diagnosis, treatment, and rehabilitation of injuries and medical conditions. Athletic trainers work under the direction of or in collaboration with a physician and are recognized by the American Medical Association as allied healthcare professionals. Internationally, this profession is often known as athletic therapy. As healthcare professionals, athletic trainers must be prepared for autonomous practice immediately after graduation. However, new athletic trainers have been shown to have clinical areas of strength and weakness.To better assess professional readiness and improve the preparedness of new athletic trainers, the factors of athletic training professional readiness must be defined. Limited research exists defining the holistic aspects of professional readiness needed for athletic trainers. Confirming the factors of professional readiness in athletic training could enhance the professional preparation of athletic trainers and result in more highly prepared new professionals. The objective of this study was to further explore and confirm the factors of professional readiness in athletic training. Authors useda qualitative design based in grounded theory. Participants included athletic trainers with greater than 24 months of experience from a variety of work settings from each district of the National Athletic Trainer’s Association. Participants took the demographic questionnaire electronically using Qualtrics Survey Software (Provo UT). After completing the demographic questionnaire, 20 participants were selected to complete one-on-one interviews using GoToMeeting audiovisual web conferencing software. IBM Statistical Package for the Social Sciences (SPSS, v. 21.0) was used to calculate descriptive statistics for participant demographics. The first author transcribed all interviews verbatim and utilized a grounded theory approach during qualitative data analysis. Data were analyzed using a constant comparative analysis and open and axial coding. Trustworthiness was established using reflexivity, member checks, and peer reviews. Analysis revealed four overarching themes, including management, interpersonal relations, clinical decision-making, and confidence. Management was categorized as athletic training services not involving direct patient care and was divided into three subthemes, including administration skills, advocacy, and time management. Interpersonal Relations was categorized as the need and ability of the athletic trainer to properly interact with others. Interpersonal relations was divided into three subthemes, including personality traits, communication, and collaborative practice. Clinical decision-making was categorized as the skills and attributes required by the athletic trainer whenmaking clinical decisions related to patient care. Clinical decision-making was divided into three subthemes including clinical skills, continuing education, and reflective practice. The final theme was confidence. Participants discussed the importance of confidence regarding relationships building, clinical and administrative duties, and clinical decision-making. Overall, participants explained the value of a well-rounded athletic trainer and emphasized that athletic trainers need communication and organizational skills, the ability to collaborate, and must value self-reflection and continuing education in addition to having clinical expertise. Future research should finalize a comprehensive model of professional readiness for athletic training, develop a holistic assessment instrument for athletic training professional readiness, and explore the preparedness of new athletic trainers.

Keywords: autonomous practice, newly certified athletic trainer, preparedness for professional practice, transition to practice skills

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Authors: Martyn Queen, Diane Crone, Andrew Parker, Saul Bloxham

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Rationale: There is a growing body of evidence that supports the use of physical activity during and after cancer treatment. However, activity levels for patients remain low. As more cancer patients are treated successfully, and treatment costs continue to escalate, physical activity may be a promising adjunct to a person-centred healthcare approach to recovery. Aim: The aim was to further understand how physical activity may enhance the recovery process for a group of mixed-site cancer patients. Objectives: The research investigated longitudinal changes in physical activity and perceived the quality of life between two and six month’s post-exercise interventions. It also investigated support systems that enabled patients to sustain these perceived changes. Method: The respondent cohort comprised 14 mixed-site cancer patients aged 43-70 (11 women, 3 men), who participated in a two-phase physical activity intervention that took place at a university in the South West of England. Phase 1 consisted of an eight-week structured physical activity programme; Phase 2 consisted of four months of non-supervised physical activity. Semi-structured interviews took place three times over six months with each participant. Grounded theory informed the data collection and analysis which, in turn, facilitated theoretical development. Findings: Our findings propose three theories on the impact of physical activity for recovering cancer patients: 1) Knowledge gained through a structured exercise programme can enable recovering cancer patients to independently sustain physical activity to four-month follow-up. 2) Sustaining physical activity for six months promotes positive changes in the quality of life indicators of chronic fatigue, self-efficacy, the ability to self-manage and energy levels. 3) Peer support from patients facilitates adherence to a structured exercise programme and support from a spouse, or life partner facilitates independently sustained physical activity to four-month follow-up. Conclusions: This study demonstrates that qualitative research can provide an evidence base that could be used to support future care plans for cancer patients. Findings also demonstrate that a physical activity intervention can be effective at helping cancer patients recover from the side effects of their treatment, and recommends that physical activity should become an adjunct therapy alongside traditional cancer treatments.

Keywords: physical activity, health, cancer recovery, quality of life, support systems, qualitative, grounded theory, person-centred healthcare

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

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

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

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Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

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The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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Authors: Tholaine Matadi

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South Africa is a democratic country with a historical record of racially-motivated marginalisation and exclusion of the majority. During the apartheid era the country was run along pieces of legislation and policies based on racial segregation. The system held a tight clamp on interracial mixing which forced people to remain in segregated areas. For example, a citizen from the Indian community could not own property in an area allocated to white people. In this way, a great majority of people were denied basic human rights. Now, there is a supreme constitution with an entrenched justiciable Bill of Rights founded on democratic values of social justice, human dignity, equality and the advancement of human rights and freedoms. The Constitution also enshrines the values of non-racialism and non-sexism. The Constitutional Court has the power to declare unconstitutional any law or conduct considered to be inconsistent with it. Now, more than two decades down the line, despite the abolition of apartheid, there is evidence that South Africa still experiences hate crimes which violate the entrenched right of vulnerable groups not to be discriminated against on the basis of race, sexual orientation, gender, national origin, occupation, or disability. To remedy this mischief parliament has responded by drafting the Prevention and Combatting of Hate Crimes and Hate Speech Bill. The Bill has been disseminated for public comment and suggestions. It is intended to combat hate crimes and hate speech based on sheer prejudice. The other purpose of the Bill is to bring South Africa in line with international human rights instruments against racism, racial discrimination, xenophobia and related expressions of intolerance identified in several international instruments. It is against this backdrop that this paper intends to analyse the impact of the Bill on the rights to human dignity, equality, and freedom. This study is significant because the Bill was highly contested and creates a huge debate. This study relies on a qualitative evaluative approach based on desktop and library research. The article recurs to primary and secondary sources. For comparative purpose, the paper compares South Africa with countries such as Australia, Canada, Kenya, Cuba, and United Kingdom which have criminalised hate crimes and hate speech. The finding from this study is that despite the Bill’s expressed positive intentions, this draft legislation is problematic for several reasons. The main reason is that it generates considerable controversy mostly because it is considered to infringe the right to freedom of expression. Though the author suggests that the Bill should not be rejected in its entirety, she notes the brutal psychological effect of hate crimes on their direct victims and the writer emphasises that a legislature can succeed to combat hate-crimes only if it provides for them as a separate stand-alone category of offences. In view of these findings, the study recommended that since hate speech clauses have a negative impact on freedom of expression it can be promulgated, subject to the legislature enacting the Prevention and Combatting of Hate-Crimes Bill as a stand-alone law which criminalises hate crimes.

Keywords: freedom of expression, hate crimes, hate speech, human dignity

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Authors: Ugochukwu D. Abasilim, Aize I. Obayan, Adedayo J. Odukoya, Godwyns Agube, Power A. I. Wogu, Nchekwube Excellence-Oluye

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This paper examines the effect of transformational leadership style on organizational commitment among Private University employees in Nigeria. A quantitative methodology was adopted for this study. A structured Multi-factor Leadership Questionnaire (MLQ) developed by Bass and Avolio (1997) and Organizational Commitment Questionnaire (OCQ) developed by Meyer and Allen (1997) were the major instruments used for data collection. Simple linear regression was used for testing the hypothesis. The results indicated that there was no significant positive effect of transformational leadership style on organizational commitment among employees of the Nigerian private university studied. Though the respondents rated their leaders high on transformational leadership style, their organizational commitment rating was average for majority, which implies that employees’ level of commitment could be accounted for by transformational leadership style existing in the institution. This finding is antithetical to the common submission in literature that transformational leadership style has a significant effect on organizational commitment. It was therefore recommended that further studies may want to further explore the reasons for this variance.

Keywords: leadership style, Nigeria, organizational, commitment, transformational leadership

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Authors: Phenphak Horadee, Rodchares Hanrinth, Saithip Suttiruksa

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Inappropriate use of antibiotics has happened in several hospitals, Thailand. Drug use evaluation (DUE) is one strategy to overcome this difficulty. However, most community hospitals still encounter incomplete evaluation resulting overuse of antibiotics with high cost. Consequently, drug-resistant bacteria have been rising due to inappropriate antibiotic use. The aim of this study was to involve stakeholders in conceptualizing, developing, and prioritizing a feasible intervention strategy to promote and support appropriate antibiotic prescribing in a community hospital, Thailand. Study antibiotics included four antibiotics such as Meropenem, Piperacillin/tazobactam, Amoxicillin/clavulanic acid, and Vancomycin. The study was conducted for the 1-year period between March 1, 2018, and March 31, 2019, in a community hospital in the northeastern part of Thailand. Concept mapping was used in a purposive sample, including doctors (one was an administrator), pharmacists, and nurses who involving drug use evaluation of antibiotics. In-depth interviews for each participant and survey research were conducted to seek the problems for inappropriate use of antibiotics based on drug use evaluation system. Seventy-seven percent of DUE reported appropriate antibiotic prescribing, which still did not reach the goal of 80 percent appropriateness. Meropenem led other antibiotics for inappropriate prescribing. The causes of the unsuccessful DUE program were classified into three themes such as personnel, lack of public relation and communication, and unsupported policy and impractical regulations. During the first meeting, stakeholders (n = 21) expressed the generation of interventions. During the second meeting, participants who were almost the same group of people in the first meeting (n = 21) were requested to independently rate the feasibility and importance of each idea and to categorize them into relevant clusters to facilitate multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the idealist, cluster list, point map, point rating map, cluster map, and cluster rating map. All of these were distributed to participants (n = 21) during the third meeting to reach consensus on an intervention model. The final proposed intervention strategy included 29 feasible and crucial interventions in seven clusters: development of information technology system, establishing policy and taking it into the action plan, proactive public relations of the policy, action plan and workflow, in cooperation of multidisciplinary teams in drug use evaluation, work review and evaluation with performance reporting, promoting and developing professional and clinical skill for staff with training programs, and developing practical drug use evaluation guideline for antibiotics. These interventions are relevant and fit to several intervention strategies for antibiotic stewardship program in many international organizations such as participation of the multidisciplinary team, developing information technology to support antibiotic smart use, and communication. These interventions were prioritized for implementation over a 1-year period. Once the possibility of each activity or plan is set up, the proposed program could be applied and integrated into hospital policy after evaluating plans. Effectiveness of each intervention could be promoted to other community hospitals to promote and support antibiotic smart use.

Keywords: antibiotic, concept mapping, drug use evaluation, multidisciplinary teams

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Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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Authors: Francesco Lubrano, Fabrizio Bertone, Federico Stirano

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Modern societies strongly depend on Critical Infrastructures (CI). Hospitals, power supplies, water supplies, telecommunications are just few examples of CIs that provide vital functions to societies. CIs like hospitals are very complex environments, characterized by a huge number of cyber and physical systems that are becoming increasingly integrated. Ensuring a high level of security within such critical infrastructure requires a deep knowledge of vulnerabilities, threats, and potential attacks that may occur, as well as defence and prevention or mitigation strategies. The possibility to remotely monitor and control almost everything is pushing the adoption of network-connected devices. This implicitly introduces new threats and potential vulnerabilities, posing a risk, especially to those devices connected to the Internet. Modern medical devices used in hospitals are not an exception and are more and more being connected to enhance their functionalities and easing the management. Moreover, hospitals are environments with high flows of people, that are difficult to monitor and can somehow easily have access to the same places used by the staff, potentially creating damages. It is therefore clear that physical and cyber threats should be considered, analysed, and treated together as cyber-physical threats. This means that an integrated approach is required. SAFECARE, an integrated cyber-physical security solution, tries to respond to the presented issues within healthcare infrastructures. The challenge is to bring together the most advanced technologies from the physical and cyber security spheres, to achieve a global optimum for systemic security and for the management of combined cyber and physical threats and incidents and their interconnections. Moreover, potential impacts and cascading effects are evaluated through impact propagation models that rely on modular ontologies and a rule-based engine. Indeed, SAFECARE architecture foresees i) a macroblock related to cyber security field, where innovative tools are deployed to monitor network traffic, systems and medical devices; ii) a physical security macroblock, where video management systems are coupled with access control management, building management systems and innovative AI algorithms to detect behavior anomalies; iii) an integration system that collects all the incoming incidents, simulating their potential cascading effects, providing alerts and updated information regarding assets availability.

Keywords: cyber security, defence strategies, impact propagation, integrated security, physical security

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Authors: Bishoy Abouelsoud Saad Amin

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This paper examines the use of computer and its related health hazard among computer users in South-Western zone of Nigeria. Two hundred and eighteen (218) computer users constituted the population used to evaluate association between posture, extensive computer use and related health hazard. The instruments for the study are a questionnaire on demographics, lifestyle, body features and work ability index while mean rating, standard deviation and t test were used for data analysis. Identified health related hazard include damages to the eyesight, bad posture, arthritis, musculoskeletal disorders, headache, stress and so on. The results showed that factors such as work demand, posture, closeness to computer screen and excessive working hours on computers constitute health hazards in both old and young computer users of various gender. It is therefore recommended that total number of hours spent with computer should be monitored and controlled.

Keywords: computer game, metaphor, middle school students, virtual environments computer auditing, risk, measures to prevent, information management computer-related health hazard, musculoskeletal disorders, computer usage, work ability index

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Authors: Arafat A. A. Shabaneh

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Harsh environments demand a developed detection of an optical communication system to ensure a high level of security and safety. Fiber Bragg gratings (FBG) are emerging sensing instruments that respond to variations in strain and temperature via varying wavelengths. In this paper, cascaded uniform FBG as a strain sensor for 6 km length at 1550 nm wavelength with 30 oC is designed with analyzing of dynamic strain and wavelength shifts. FBG is placed in a small segment of optical fiber, which reflects light of a specific wavelength and passes the remaining wavelengths. This makes a periodic alteration in the refractive index within the fiber core. The alteration in the modal index of fiber produced due to strain consequences in a Bragg wavelength. When the developed sensor exposure to a strain of cascaded uniform FBG by 0.01, the wavelength is shifted to 0.0000144383 μm. The sensing accuracy of the developed sensor is 0.0012. Simulation results show reliable and effective strain monitoring sensors for remote sensing applications.

Keywords: Cascaded fiber Bragg gratings, Strain sensor, Remote sensing, Wavelength shift

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Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

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Authors: Widayat Widayat

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Nowday, in the modern investment era, household behavior on investment is a topic that is quite warm. The development of the modern investment, indicated by the emergence of a variety of investment instruments, such as stocks, bonds and various forms of derivatives, affected on the complexity of choosing an investment, especially for traditional societies. Various studies show that there is more than one factor acting as a behavioral antesenden decide to choose an investment instrument. One of the factors, which contribute in determining the investment option is ethnic. Society with a particular sub-culture tend to prefer investing their particular instrument. This is because they have the values, norms and different social environmental. This article is designed to test the impact of sub-cultures between Osing-Java as moderator, in investing. The study was conducted in Banyuwangi, East Java Province of Indonesia. Data were collected using questionnaires, which is given to the head of the household respondents were selected as samples. Sample of households selected by multistage sampling method. The data have been collected processed using SmartPLS software and testing moderating effects using grouped sample test. The result showed that sub-ethnic and has a significant role in determining the investment.

Keywords: investment behaviour, household, moderating, sub ethnic

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Authors: Harvey Hyman, Thomas Hull

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As one of the largest cancer treatment centers in the United States, we continuously confront the challenge of how to leverage the best possible technological solutions, in order to provide the highest quality of service to our customers – the doctors, nurses and patients at Moffitt who are fighting every day for the prevention and cure of cancer. This paper reports on the transition from a vertical to a horizontal IT infrastructure. We discuss how the new frameworks and methods such as public, private and hybrid cloud, brokering cloud services are replacing the traditional vertical paradigm for computing. We also report on the impact of containers, micro services, and the shift to continuous integration/continuous delivery. These impacts and changes in delivery methodology for computing are driving how we accomplish our strategic IT goals across the enterprise.

Keywords: cloud computing, IT infrastructure, IT architecture, healthcare

Procedia PDF Downloads 381