Search results for: reduced private care use

Authors: Yung-Hui Tang, Yan-Chiou Ku, Li-Chi Huang

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Aim: The aim of this study is to explore the effect of the Humanoid Diagram Teaching (HDT) strategy on novice nurses’ care ability and retention rate. Methods: This study was a quasi-experimental study using two groups concurrently with repeat measurements sample consisted of 24 novice nurses (12 in each experimental and control group) in a medical center in southern Taiwan. Both groups all received regular training program (nursing standard techniques and practices, concept map, mini-CEX, CbD, and clinical education and training), and experimental group added the HDT program. The HDT strategy includes the contents of patients’ body humanoid drawing and discussion for 30 minutes each time, three times a week, and continually for four weeks. The effectiveness of ＨDT was evaluated by mini-CEX, CbD and clinical assessment and retention rate at the 3rd month and 6th month. Results: The novice nurses' care ability were examined, only CbD score in the control group was improved in the 3rd month and with statistical difference, p = .003. The mini-CEX and CbD in the experimental group were significantly improved in both the first and third month with statistical differences p = .00. Although mini-CEX and CbD in the experimental group were higher than the control group, but there was no significant difference p > .05. Retention rate of the experimental group in the third month and sixth month was significantly higher than the control group, and there was a statistically significant difference p < .05. Conclusions: The study reveals that HDT strategy can help novice nurses learning, enhancing their knowledge and technical capability, analytical skills in case-based caring, and retention. The HDT strategy can be served as an effective strategy for novice training for better nurse retention rate.

Keywords: humanoid diagram teaching strategy, novice nurses retention, teaching strategy of nurse retention, visual learning mode

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Authors: Syed Qasim Gilani, Muhammad Umair, Muhammad Noman, Syed Bilawal Shah, Aqib Abbasi, Muhammad Waheed

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Cardiovascular Diseases(CVD's) are the major cause of death in the world. The main reason for these deaths is the unavailability of first aid for heart failure. In many cases, patients die before reaching the hospital. We in this paper are presenting innovative online health service for Cardiac Patients. The proposed online health system has two ends. Users through device developed by us can communicate with their doctor through a mobile application. This interface provides them with first aid.Also by using this service, they have an easy interface with their doctors for attaining medical advice. According to the proposed system, we developed a device called Cardiac Care. Cardiac Care is a portable device which a patient can use at their home for monitoring heart condition. When a patient checks his/her heart condition, Electrocardiogram (ECG), Blood Pressure(BP), Temperature are sent to the central database. The severity of patients condition is checked using Artificial Intelligence Algorithm at the database. If the patient is suffering from the minor problem, our algorithm will suggest a prescription for patients. But if patient's condition is severe, patients record is sent to doctor through the mobile Android application. Doctor after reviewing patients condition suggests next step. If a doctor identifies the patient condition as critical, then the message is sent to the central database for sending an ambulance for the patient. Ambulance starts moving towards patient for bringing him/her to hospital. We have implemented this model at prototype level. This model will be life-saving for millions of people around the globe. According to this proposed model patients will be in contact with their doctors all the time.

Keywords: cardiovascular disease, classification, electrocardiogram, blood pressure

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Authors: Terigele

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Cultural products are always shelved into different classes of a hierarchy that separates so-called highbrow and lowbrow cultures. This study illustrated that audiences might even construct a hierarchy according to the origin countries when consuming certain products. Chinese audiences now have access to TV series from all around the world thanks to the internet. TV series from different origin countries show some particular features in terms of length, theme, plots, accessibility, seriousness etc. Their audiences were therefore stereotyped because of what they watch. Based on in-depth interviews with 20 participants, this research has following findings: 1) Most popular origin countries of foreign TV series in China are Korea, the United States, the United Kingdom, Japan and European countries in a descending order. Korean TV series are most popular because they are less serious and more accessible compared to others. 2) In the hierarchy of the TV series, European TV series stand on the top followed by British and American TV series. Japanese TV series are also categorized into highbrow class. Korean TV series are at the bottom and always seen as lowbrow cultural products. 3) Most audiences consume TV series from more than one origin countries and have different needs when watching them. Participants reported that they watch European TV series because those TV series are more artistic than their counterparts and of great quality. They watch British and American TV series mainly to improve their English and to learn about the culture. They find Japanese TV series very enjoyable with a large variety of themes and impressive lines. Audiences watch Korean TV series mostly to entertain and kill time. 4) Audiences do care about cultural taste. Especially those who watch European, British and American TV series usually tend to consider audiences who watch nothing but Korean TV series to be shallow. On the other hand, Korean TV series’ audiences seem to care less about the hierarchy of the TV series. Even when they discuss the hierarchy, they tend to accept the judgments with ironies and jokes. Future studies can dig deeply into the genre and content of TV series with different origin countries and also investigate more about the psychology of audiences regarding the gender, age, education, socioeconomic status etc.

Keywords: foreign TV series, hierarchy, popularity, uses and gratification

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Authors: Hannah Yael Ephraim

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During reproductive age (between 15 and 44), women are particularly susceptible to psychiatric illness. Depression and anxiety disorders are especially common for women during reproductive age. Women of reproductive age are also at greater risk for multiple physical conditions during this time. Existing literature focuses on the impact of mental health on physical health, showing that people with anxiety and depression repeatedly show greater physical health risk among those with developing chronic medical illness. However, there is limited research on the impact physical health has on mental health in women of reproductive age, a large and vulnerable population. For this reason, the current study seeks to ask the following questions: are women of reproductive age with a diagnosis of a chronic physical condition more likely to experience symptoms of mental illness than women without a diagnosis of a chronic physical condition? Does the type of physical illness relate to signs and symptoms of depression and anxiety? A quasi-experimental research design was implemented to compare the mental health outcomes of women with the diagnosis of chronic medical conditions and women without the diagnosis of a chronic medical condition. Quantitative data was collected through an anonymous ten-minute Qualtrics survey. The survey was sent out through multiple online platforms. The sample includes two groups of women: one group with the diagnosis of a chronic medical illness, and one group without a diagnosis and/or symptoms (N = 541). Participants identify as a woman and are between the ages of 15 and 44. A comparison of women with a diagnosis of a chronic physical condition and those without a diagnosis will be conducted to explore differences in depression and anxiety symptoms between women with and without a chronic medical diagnosis. The impact race, SES, and occupation will also be addressed in relation to anxiety and/or depression in women of reproductive age. This study will further the understanding of the relationship between mental illness in women of reproductive age with chronic medical conditions. The results of this study will have implications for the integration of mental health care in women’s health centers and perhaps training of clinicians and physicians providing psychological and medical care to women of reproductive age.

Keywords: mental health, physical health, reproductive age, women

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Authors: Khomsan Laosillapacharoen

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This research paper was aimed to analyze the current situation of the furniture industry and embark a plan to enhance the export volume of Thai furniture. This is a qualitative research which utilized meta-analysis and focus group. A total of 24 experts in both government and private sectors were interviewed. The findings revealed that Thai furniture had some advantages of access to raw material, high quality of labors, and have a unique skill. However, the threat included a tendency to have more foreign competitors in domestic market. In addition, the strategies to enhance the level of export included increase the standard quality of Thai furniture, offer new and modern designs, use marketing on the internet, use modern technology, and gain tax incentive from the government.

Keywords: export, furniture, strategies, marketing

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Authors: Madre Paarlber, Alwiena Blignaut

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Background: Medication administration errors remains a global patient safety problem targeted by the WHO (World Health Organization), yet research on this matter is sparce within the South African context. Objective: The aim was to explore and describe nurses’ (medication administrators) perceptions regarding medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province of South Africa, and to determine any relationships between perceived variables concerned with medication safety (safety culture, incidences, causes, reporting of incidences, and reasons for non-reporting). Method: A quantitative research design was used through which self-administered online surveys were sent to 768 nurses (medication administrators) (n=217). The response rate was 28.26%. The survey instrument was synthesised from the Agency of Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture, the Registered Nurse Forecasting (RN4CAST) survey, a survey list prepared from a systematic review aimed at generating a comprehensive list of medication administration error causes and the Medication Administration Error Reporting Survey from Wakefield. Exploratory and confirmatory factor analyses were used to determine the validity and reliability of the survey. Descriptive and inferential statistical data analysis were used to analyse quantitative data. Relationships and correlations were identified between items, subscales and biographic data by using Spearmans’ Rank correlations, T-Tests and ANOVAs (Analysis of Variance). Nurses reported on their perceptions of medication administration safety-related culture, incidence, causes, and reporting in the Gauteng Province. Results: Units’ teamwork deemed satisfactory, punitive responses to errors accentuated. “Crisis mode” working, concerns regarding mistake recording and long working hours disclosed as impacting patient safety. Overall medication safety graded mostly positively. Work overload, high patient-nurse ratios, and inadequate staffing implicated as error-inducing. Medication administration errors were reported regularly. Fear and administrative response to errors effected non-report. Non-report of errors’ reasons was affected by non-punitive safety culture. Conclusions: Medication administration safety improvement is contingent on fostering a non-punitive safety culture within units. Anonymous medication error reporting systems and auditing nurses’ workload are recommended in the quest of improved medication safety within Gauteng Province private hospitals.

Keywords: incidence, medication administration errors, medication safety, reporting, safety culture

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Authors: Usha S. Adiga, Sachidanada Adiga

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Introduction: Diabetes Mellitus (DM) is one of the most common non-communicable diseases which imposes a large economic burden on the global health-care system. Cost of illness studies in India have assessed the health care cost of DM, but have certain limitations due to lack of standardization of the methods used, improper documentation of data, lack of follow up, etc. The objective of the study was to estimate the cost of illness of uncomplicated versus complicated type 2 diabetes mellitus in Coastal Karnataka, India. The study also aimed to find out the trend of cost of illness of the disease over a decade. Methodology: A prevalence based bottom-up approach study was carried out in two tertiary care hospitals located in Coastal Karnataka after ethical approval. Direct Medical costs like annual laboratory costs, pharmacy cost, consultation charges, hospital bed charges, surgical /intervention costs of 238 diabetics and 340 diabetic patients respectively from two hospitals were obtained from the medical record sections. Patients were divided into six groups, uncomplicated diabetes, diabetic retinopathy(DR), nephropathy(DN), neuropathy(DNeu), diabetic foot(DF), and ischemic heart disease (IHD). Different costs incurred in 2008 and 2017 in these groups were compared, to study the trend of cost of illness. Kruskal Wallis test followed by Dunn’s test were used to compare median costs between the groups and Spearman's correlation test was used for correlation studies. Results: Uncomplicated patients had significantly lower costs (p <0.0001) compared to other groups. Patients with IHD had highest Medical expenses (p < 0.0001), followed by DN and DF (p < 0.0001 ). Annual medical costs incurred were 1.8, 2.76, 2.77, 1.76, and 4.34 times higher in retinopathy, nephropathy, diabetic foot, neuropathy and IHD patients as compared to the cost incurred in managing uncomplicated diabetics. Other costs also showed a similar pattern of rising. A positive correlation was observed between the costs incurred and duration of diabetes, a negative correlation between the glycemic status and cost incurred. The cost incurred in the management of DM in 2017 was found to be elevated 1.4 - 2.7 times when compared to that in 2008. Conclusion: It is evident from the study that the economic burden due to diabetes mellitus is substantial. It poses a significant financial burden on the healthcare system, individual and society as a whole. There is a need for the strategies to achieve optimal glycemic control and operationalize regular and early screening methods for complications so as to reduce the burden of the disease.

Keywords: COI, diabetes mellitus, a bottom up approach, economics

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Alessio Giovannelli, Claudia Cocozza, Enrico Marchi, Valerio Giorgio Muzzini, Eleftherios Touloupakis, Raffaella Margherita Zampieri

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In Mediterranean countries, forest fires are recurrent events that need to be considered as a central component of regional and global forest management strategies and biodiversity restoration programmes. The response of tree function to fire damage can vary widely, also taking into account species, season, age of the tree, etc. Trees that survive fire may have different levels of physiological functionality, which may result in reduced growth or increased susceptibility to delayed mortality. An approach to assessing irreversible physiological injury in trees could help to inform management decisions at burned sites for biodiversity restoration, environmental safety and understanding of ecosystem functional adaptations. Physiological proxies for latent tree mortality, such as cambial cell death, reduced or absent starch and soluble sugar content in C sinks, and ethanol accumulation in the phloem, are considered proxies for cell death. However, their determination requires time-consuming laboratory protocols, making the approach unfeasible as a practical option in the field, but recent findings have shown that biosensors could be usefully applied to overcome these limitations. The study will focus on the development of amperometric biosensors capable of detecting a few target molecules in the phloem and xylem (such as ethanol and glucose) that have recently been identified as proxies for latent tree mortality. The results of a specific experiment on a stand of Pinus pinaster subjected to prescribed fire are reported.

Keywords: enzymes, glucose, ethanol, prescribed fires

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Authors: Yesim Tumsek, Erkan Celebi

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In order to simulate the infinite soil medium for soil-foundation interaction problem, the essential geotechnical parameter on which the foundation stiffness depends, is the value of soil shear modulus. This parameter directly affects the site and structural response of the considered model under earthquake ground motions. Strain-dependent shear modulus under cycling loads makes difficult to estimate the accurate value in computation of foundation stiffness for the successful dynamic soil-structure interaction analysis. The aim of this study is to discuss in detail how to use the appropriate value of soil shear modulus in the computational analyses and to evaluate the effect of the variation in shear modulus with strain on the impedance functions used in the sub-structure method for idealizing the soil-foundation interaction problem. Herein, the impedance functions compose of springs and dashpots to represent the frequency-dependent stiffness and damping characteristics at the soil-foundation interface. Earthquake-induced vibration energy is dissipated into soil by both radiation and hysteretic damping. Therefore, flexible-base system damping, as well as the variability in shear strengths, should be considered in the calculation of impedance functions for achievement a more realistic dynamic soil-foundation interaction model. In this study, it has been written a Matlab code for addressing these purposes. The case-study example chosen for the analysis is considered as a 4-story reinforced concrete building structure located in Istanbul consisting of shear walls and moment resisting frames with a total height of 12m from the basement level. The foundation system composes of two different sized strip footings on clayey soil with different plasticity (Herein, PI=13 and 16). In the first stage of this study, the shear modulus reduction factor was not considered in the MATLAB algorithm. The static stiffness, dynamic stiffness modifiers and embedment correction factors of two rigid rectangular foundations measuring 2m wide by 17m long below the moment frames and 7m wide by 17m long below the shear walls are obtained for translation and rocking vibrational modes. Afterwards, the dynamic impedance functions of those have been calculated for reduced shear modulus through the developed Matlab code. The embedment effect of the foundation is also considered in these analyses. It can easy to see from the analysis results that the strain induced in soil will depend on the extent of the earthquake demand. It is clearly observed that when the strain range increases, the dynamic stiffness of the foundation medium decreases dramatically. The overall response of the structure can be affected considerably because of the degradation in soil stiffness even for a moderate earthquake. Therefore, it is very important to arrive at the corrected dynamic shear modulus for earthquake analysis including soil-structure interaction.

Keywords: clay soil, impedance functions, soil-foundation interaction, sub-structure approach, reduced shear modulus

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Authors: Burcu Babadağ Savaş, Nihal Orlu, Güler Balcı Alparslan, Ertuğrul Çolak, Cengiz Korkmaz

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Introduction/objectives: We aimed to investigate the effect of humor on pain and state anxiety in patients with rheumatoid arthritis (RA) receiving biologic intravenous (IV) infusion therapy. Method: The study sample consisted of 36 patients who met the classification criteria for RA and inclusion criteria in a rheumatology outpatient clinic at a university hospital between September 2020 and November 2021. Two sample groups were formed: the intervention group (watching a comedy movie) (n=18) and the control group (n=18). The intervention group consisted of the patient watching a comedy movie of his/her choice from an archive created by the researchers during the biological IV infusion therapy (approximately 90-120 minutes). The data collection instruments used before and after the test were the descriptive identification form, the visual analog scale (VAS), and the state anxiety scale. Results: The mean VAS scores of patients in the intervention group were 5.05 ± 2.01 in the pre-test and 2.61 ± 1.91 in the post-test. The mean state anxiety scores of patients in the intervention group were 45.94 ± 9.97 in the pre-test and 34.22 ± 6.57 in the post-test. Thus, patients who watched comedy movies during biologic IV infusion therapy in the infusion center had a greater reduction in pain scores than the control group and the effect size was small. Although there was a decrease in state anxiety scores in both groups, there was no significant difference between groups and the effect size was not relevant. Conclusions: During IV infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Keywords: watching comedy movie, humor, pain, anxiety, nursing, care

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Authors: Baluku Nathan

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Transferring critically ill patients from one health facility to another poses a major risk to the patient because of increased oxygen demands. transferring patients with critical COVID-19 from a rural health canter in a rural district to a national referral hospital over 350 km in 7 hours would require three size H oxygen cylinders for successful transfer. It was always difficult to arrange the three size cylinders in the ambulance as workspace was greatly compromised for the ambulance assistant. Purpose: The purpose of this study was to investigate the impact and effectiveness of transport ventilators on the transportation of the critically ill patients from rural health canters to national referral hospitals in Uganda. Methodology: This was a descriptive cross-sectional study conducted in sept 2022 among critical care nurses and ambulance assistants who had used both methods of transportation (ventilators and cylinders). A semi structured questionnaire was used to collect quantitative data after informed consent. Results: From the findings, distribution of transport ventilators to the regional referral hospitals by the Ministry of Health has gradually improved patient transfer as the team requires less than one size oxygen cylinder to successfully transfer a patient. We use two ambulance assistants (a critical care nurse and another nurse who has been trained on use of the ventilator) when transferring patients with critical COVID-19 as the teams have to interchange over the long distance. Conclusions: Transport ventilators are effective and efficient in transferring critically ill patients, therefore should be rolled out to lower levels coupled with user training to improve outcomes of patients transferred in ambulances in lower income countries.

Keywords: emergency medical technician, critically ill, COVID-19, transport ventilator

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Authors: Zeytu G. Asfaw, Serkalem K. Abrha, Demisew G. Degefu

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Background: HIV/AIDS remains a major public health problem in Ethiopia and heavily affecting people of productive and reproductive age. We aimed to compare the performance of Parametric Survival Analysis and Bayesian Survival Analysis using simulations and in a real dataset application focused on determining predictors of HIV patient survival. Methods: A Parametric Survival Models - Exponential, Weibull, Log-normal, Log-logistic, Gompertz and Generalized gamma distributions were considered. Simulation study was carried out with two different algorithms that were informative and noninformative priors. A retrospective cohort study was implemented for HIV infected patients under Highly Active Antiretroviral Therapy in Alamata General Hospital, North Ethiopia. Results: A total of 320 HIV patients were included in the study where 52.19% females and 47.81% males. According to Kaplan-Meier survival estimates for the two sex groups, females has shown better survival time in comparison with their male counterparts. The median survival time of HIV patients was 79 months. During the follow-up period 89 (27.81%) deaths and 231 (72.19%) censored individuals registered. The average baseline cluster of differentiation 4 (CD4) cells count for HIV/AIDS patients were 126.01 but after a three-year antiretroviral therapy follow-up the average cluster of differentiation 4 (CD4) cells counts were 305.74, which was quite encouraging. Age, functional status, tuberculosis screen, past opportunistic infection, baseline cluster of differentiation 4 (CD4) cells, World Health Organization clinical stage, sex, marital status, employment status, occupation type, baseline weight were found statistically significant factors for longer survival of HIV patients. The standard error of all covariate in Bayesian log-normal survival model is less than the classical one. Hence, Bayesian survival analysis showed better performance than classical parametric survival analysis, when subjective data analysis was performed by considering expert opinions and historical knowledge about the parameters. Conclusions: Thus, HIV/AIDS patient mortality rate could be reduced through timely antiretroviral therapy with special care on the potential factors. Moreover, Bayesian log-normal survival model was preferable than the classical log-normal survival model for determining predictors of HIV patients survival.

Keywords: antiretroviral therapy (ART), Bayesian analysis, HIV, log-normal, parametric survival models

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Authors: Yah-Ling Hung

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eHealth is undoubtedly emerging as a promising vehicle to provide information for individual self-care management. However, the accessing ability, reading strategies and navigating behavior between higher literacy users and lower literacy users are significantly different. Yet, ways to tailor audiences’ health literacy and develop appropriate eHealth to feed their need become a big challenge. The purpose of this study is to compare the educational effectiveness of eHealth to deliver health knowledge between higher literacy users and lower literacy users, thus establishing useful design strategies of eHealth for users with different level of health literacy. The study was implemented in four stages, the first of which developed a website as the testing media to introduce health care knowledge relating to children’s allergy. Secondly, a reliability and validity test was conducted to make sure that all of the questions in the questionnaire were good indicators. Thirdly, a pre-post knowledge test was conducted with 66 participants, 33 users with higher literacy and 33 users with lower literacy respectively. Finally, a usability evaluation survey was undertaken to explore the criteria used by users with different levels of health literacy to evaluate eHealth. The results demonstrated that the eHealth Intervention in both groups had a positive outcome. There was no significant difference between the effectiveness of eHealth intervention between users with higher literacy and users with lower literacy. However, the average mean of lower literacy group was marginally higher than the average mean of higher literacy group. The findings also showed that the criteria used to evaluate eHealth could be analyzed in terms of the quality of information, appearance, appeal and interaction, but the users with lower literacy have different evaluation criteria from those with higher literacy. This is an interdisciplinary research which proposes the sequential key steps that incorporate the planning, developing and accessing issues that need to be considered when designing eHealth for patients with varying degrees of health literacy.

Keywords: eHealth, health intervention, health literacy, usability evaluation

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Authors: Muhammad Shahbaz Akhtar

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Background; Tuberculosis remains a significant public health challenge in Pakistan, with high incidence and prevalence rates, particularly among vulnerable populations. Addressing the TB burden requires comprehensive efforts to improve healthcare infrastructure, increase access to quality diagnosis and treatment services, raise public awareness, and address socioeconomic determinants of health. Objective; To assess the knowledge and practices of healthcare workers and patients regarding prevention of tuberculosis at a tertiary care hospital of Southern Punjab.Material and methods; Data will be collected from 135 healthcare workers and 135 TB patients visiting Nishtar Hospital, Multan in this descriptive cross – sectional study using non – probability consecutive sampling technique. Proper approval will be taken from Hospital authorities to conduct this study. Study participants will be recruited after taking informed written consent, describing them objectives of this study. The study participants will be ensured of their confidentiality of the data and interviewed to assess their knowledge and practices regarding prevention of tuberculosis. Data Analysis Procedure; Data will be entered and analyzed by using SPSS version 25 to calculated mean and standard deviation for the numerical data such as age, duration of disease and duration of experience. Frequencies and percentages will be calculated for gender, age groups, level of knowledge, qualification, designation and practices. Impact of confounders like gender, age groups, duration of experience, disease duration, years of experience and designation will be assessed by stratification. Post stratification chi – square test will be applied at 0.05 level of significance at 95 % CI.

Keywords: tuberculosis, data analysis, HIV/AIDS, preventable

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Beyene Daniel, Herbert Ntuli

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Agritourism in Eritrea is increasingly threatened by climate change, manifesting through rising temperatures, shifting rainfall patterns, and resource scarcity. This study employs quantitative methods to assess the economic and environmental impacts of climate change on agritourism, utilizing metrics such as annual income fluctuations, changes in visitor numbers, and energy consumption patterns. The methodology relies on secondary data sourced from the World Bank, government reports, and academic publications to analyze the economic viability of integrating solar energy into agritourism operations. Key variables include the Benefits from Renewable Energy (BRE), encompassing cost savings from reduced energy expenses and the monetized value of avoided greenhouse gas emissions. Using a net present value (NPV) framework, the research compares the impact of solar energy against traditional fossil fuel sources by evaluating the Value of Reduced Greenhouse Gas Emissions (CO2) and the Value of Health-Related Costs (VHRC) due to air pollution. The preliminary findings of this research are of utmost importance. They indicate that the adoption of solar energy can enhance energy independence by up to 40%, reduce operational costs by 25%, and stabilize agritourism activities in climate-sensitive regions. This research aims to provide actionable insights for policymakers and stakeholders, supporting the sustainable development of agritourism in Eritrea and contributing to broader climate adaptation strategies. By employing a comprehensive cost-benefit analysis, the study highlights the economic advantages and environmental benefits of transitioning to renewable energy in the face of climate change.

Keywords: climate change, renewable energy, resilience, cost-benefit analysis

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Authors: ATM Emdadul Haque

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Phosphorus is an essential nutrient which is regularly consumed with food and exists in the body as phosphate. Phosphate is an important component of cellular structures and needed for bone mineralization. Excessive accumulation of phosphate is an important driving factor of mortality in chronic renal failure patients; of relevance, these patients are usually provided health care by doctors, nurses, and pharmacists. Hence, this study was planned to determine the level of awareness of the future healthcare providers about the phosphate-containing foods and beverages and to access their knowledge on the harmful effects of excess phosphate consumption. A questionnaire was developed and distributed among the year-1 medical, nursing and pharmacy students. 432 medical, nursing and pharmacy students responded with age ranging from 18-24 years. About 70% of the respondents were female with a majority (90.7%) from Malay ethnicity. Among the respondents, 29.9% were medical, 35.4% were the pharmacy and 34.7% were nursing students. 79.2% students knew that phosphate was an important component of the body, but only 61.8% knew that consuming too much phosphate could be harmful to the body. Despite 97% of the students knew that carbonated soda contained high sugar, surprisingly 77% of them did not know the presence of high phosphate in the same soda drinks; in the similar line of observation, 67% did not know the presence of it in the fast food. However, it was encouraging that 94% of the students wanted to know more about the effects of phosphate consumption, 74.3% were willing to give up drinking soda and eating fast food, and 52% considered taking green coconut water instead of soda drinks. It is, therefore, central to take an educational initiative to increase the awareness of the future healthcare providers about phosphate-containing food and its harmful effects in excessive consumptions.

Keywords: high phosphate containing foods and beverages, excessive consumption, future health care providers, phosphorus

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Authors: Annur Suhadi, Haris B. Harahap, Zaim Arrosyidi, Epan, Darmapala

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Oilfields under waterflood often face the problem of plugging injectors either by internal filtration or external filter cake built up inside pore throats. The content of suspended solids shall be reduced to required level of filtration since corrective action of plugging is costly expensive. The performance of nutshell filters, where filtration takes place, is good using pecan and walnut shells. Candlenut shells were used instead of pecan and walnut shells since they were abundant in Indonesia, Malaysia, and East Africa. Physical and chemical properties of walnut, pecan, and candlenut shells were tested and the results were compared. Testing, using full-scale nutshell filters, was conducted to determine the oil content, turbidity, and suspended solid removal, which was based on designed flux rate. The performance of candlenut shells, which were deeply bedded in nutshell filters for filtration process, was monitored. Cleaned water outgoing nutshell filters had total suspended solids of 17 ppm, while oil content could be reduced to 15.1 ppm. Turbidity, using candlenut shells, was below the specification for injection water, which was less than 10 Nephelometric Turbidity Unit (NTU). Turbidity of water, outgoing nutshell filter, was ranged from 1.7-5.0 NTU at various dates of operation. Walnut, pecan, and candlenut shells had moisture content of 8.98 wt%, 10.95 wt%, and 9.95 wt%, respectively. The porosity of walnut, pecan, and candlenut shells was significantly affected by moisture content. Candlenut shells had property of toluene solubility of 7.68 wt%, which was much higher than walnut shells, reflecting more crude oil adsorption. The hardness of candlenut shells was 2.5-3 Mohs, which was close to walnut shells’ hardness. It was advantage to guarantee the cleaning filter cake by fluidization process during backwashing.

Keywords: candlenut shells, filtration, nutshell filter, pecan shells, walnut shells

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Authors: Yazidu Saidi Mbalamula

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Free Basic Education (FBE) policy implementation in Secondary Schools has been one of thrilled undertaking both to the government and household in Tanzania. On the one hand, the government has achieved citizenry acceptance to responsibility and accountability, and on the other hand, the household has been relieved from social costs that were unbearable and deprived many Tanzanians access to basic education and secondary education in particular. Specifically, this study presents a descriptive survey conducted in two districts of Kagera region located at the northern part of Tanzania. Three objectives were pursued to identify achievements realized and challenges in the FBE implementation, and also stakeholders’ proposals were explored on how to improve FBE implementation. A sample of 91 respondents, including school managers, teachers, students, and parents, were involved in the study. Both questionnaires and interviews were used whereby the quantitative data were analyzed using Statistical Package for Social Sciences (SPSS), and content analysis was used to analyze the qualitative data. The results show that implementation of free education policy in secondary schools had far positive impact on the improvement of school management, school attendance, reduced school drop-out, reduced parents-school managers conflicts, and increased enrollment rates. Notwithstanding that, the political machinery remains instrumental to instigate policy reforms in education sector. Nevertheless, the alienating interests of politibureau, often top-down and blanketed by superficial government redness, can hardly be feasible to wield such huge programme given staggering stakeholders’ awareness of the actual requirements and unlatching resources to back up policy implementation. The study recommends that further studies on stakeholders’ conceptions on the FBE and equity of financing of basic education in Tanzania.

Keywords: capitation grant, CCM, free basic education, kagera, education policy

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Authors: Sonia Mannan

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A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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Authors: Behrang Ekrami, Amin Tamadon

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Persian fallow deer (Dama dama mesopotamica) is belonging to the family Cervidae and is only found in a few protected areas in the northwest, north, and southwest of Iran. The aims of this study were analysis of inbreeding and morphometric parameters of semen in male Persian fallow deer to investigate the cause of reduced fertility of this endangered species in Dasht-e-Naz National Refuge, Sari, Iran. The Persian fallow deer semen was collected from four adult bucks randomly during the breeding and non-breeding season from five dehorned and horned deer's BY an artificial vagina. Twelve blood samples was taken from Persian fallow deer and mitochondrial DNA was extracted, amplified, extracted, sequenced, and then were considered for genetic analysis. The Persian fallow deer semen, both with normal and abnormal spermatozoa, is similar to that of domestic ruminants but very smaller and difficult to observe at the primary observation. The post-mating season collected ejaculates contained abnormal spermatozoa, debris and secretion of accessory glands in horned bucks and accessory glands secretion free of any spermatozoa in dehorned or early velvet budding bucks. Microscopic evaluation in all four bucks during the mating season showed the mean concentration of 9×106 spermatozoa/ml. The mean ±SD of age, testes length and testes width was 4.60±1.52 years, 3.58±0.32 and 1.86±0.09 cm, respectively. The results identified 1120 loci (assuming each nucleotide as locus) in which 377 were polymorphic. In conclusion, reduced fertility of male Persian fallow deer may be caused by inbreeding of the protected herd in a limited area of Dasht-e-Naz National Refuge.

Keywords: Persian fallow deer, spermatozoa, reproductive characteristics, morphometric parameters

Procedia PDF Downloads 577

Authors: Sulyman Abdulhakeem Olarewaju, S. O. Malomo, M. T. Yakubu, J. O. Akolade

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The ameliorative effect of Celosia argentea var. cristata leaf extract against cadmium (Cd) induced oxidative stress and toxicity in selected tissues of rats was investigated. Toxicity coupled with oxidative stress was induced in rats by oral administration of Cd (8 mg/kg b. wt). Preliminary quantitative phytochemical and in vitro antioxidant analyses showed that the methanolic extract of C. argentea leaves was constituted by polyphenols (5.72%), saponins (3.20%), tannins (0.65%) and cadenolides (0.006%). IC50 of 9800, 7406, and 45.04 μg/ml were recorded for inhibition of linoleic acid oxidation, 2, 2-diphenyl-1-picrylhydrazyl and hydrogen peroxide radicals respectively. Simultaneous administration of C. argentea leaf extract with Cd significantly attenuated Cd-induced elevation of serum enzyme markers such as aspartate and alanine transaminase, alkaline and acid phosphatase as well as γ-glutaryltransferase in a dose-dependent fashion, while their reduced level in the liver were significantly increased. Higher levels of enzymatic antioxidants; superoxide dismutase and catalase activities were observed in the liver, brain, kidney and testes of the Cd-induced rats treated with C. argentea extract, while lipid peroxidation expressed in malondialdehyde concentrations were lower when compared to values in rats administered Cd only. Other Cd-induced toxicity and stress markers in the serum viz. reduced uric acid and albumin levels as well as elevated total and unconjugated bilirubin were attenuated by the extract and their values compared favorably with those animals co-administered cadmium with ascorbic acid. Data from the study showed that oral administration of extract from the leaf C. argentea may ameliorate Cd-induced oxidative stress and toxicity in rats.

Keywords: toxicity, cadmium, celosia, antioxidants, oxidative stress

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Authors: Williams A. Adu, Cynthia A. Danquah, Paul P. S. Ossei, Selase Ativui, Michael Ofori, James Asenso, George Owusu

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Background Silicosis is an occupational disease of the lung that is caused by chronic exposure to silica dust. There is a higher frequency of co-existence of silicosis with tuberculosis (TB), ultimately resulting in lung fibrosis and respiratory failure. Chronic intake of synthetic drugs has resulted in undesirable side effects. Diosgenin is a steroidal saponin that has been shown to exert a therapeutic effect on lung injury. Therefore, we investigated the ability of diosgenin to reduce the susceptibility of silica-induced TB in rats. Method Silicosis was induced by intratracheal instillation of 50 mg/kg crystalline silica in Sprague Dawley rats. Different doses of diosgenin (1, 10, and 100 mg/kg), Mycobacterium smegmatis and saline were administered for 30 days. Afterwards, 5 of the rats from each group were sacrificed, and the 5 remaining rats in each group, except the control, received Mycobacterium smegmatis. Treatment of diosgenin continued until the 50th day, and the rats were sacrificed at the end of the experiment. The result was analysed using a one-way analysis of variance (ANOVA) with a Graph-pad prism Result At a half-maximal inhibition concentration of 48.27 µM, diosgenin inhibited the growth of Mycobacterium smegmatis. There was a marked decline in the levels of immune cell infiltration and cytokines production. Lactate dehydrogenase and total protein levels were significantly reduced compared to control. There was an increase in the survival rate of the treatment group compared to the control. Conclusion Diosgenin ameliorated silica-induced pulmonary tuberculosis by declining the levels of inflammatory and pro-inflammatory cytokines and, in effect, significantly reduced the susceptibility of rats to pulmonary TB.

Keywords: silicosis, tuberculosis, diosgenin, fibrosis, crystalline silica

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Authors: Obaidul Fattah Tanvir, Zinat Ara Afroze

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Community living adjacent to forests and Protected Areas, especially in South Asian countries, have a common practice in extracting resources for their living and livelihoods. This extraction of resources, because the way it is done, destroys the biophysical features of the area. Deforestation, wildlife poaching, illegal logging, unauthorized hill cutting etc. are some of the serious issues of concern for the sustainability of the natural resources that has a direct impact on environment and climate as a whole. To ensure community involvement in conservation initiatives of the state, community based forest management, commonly known as Comanagement, has been in practice in 6 South Asian countries. These are -India, Nepal, Sri Lanka, Pakistan, Bhutan and Bangladesh. Involving community in forestry management was initiated first in Bangladesh in 1979 and reached as an effective co-management approach through a several paradigm shifts. This idea of Comanagement has been institutionalized through a Government Order (GO) by the Ministry of Environment and Forests, Government of Bangladesh on November 23, 2009. This GO clearly defines the structure and functions of Co-management and its different bodies. Bangladesh Forest Department has been working in association with community to conserve and manage the Forests and Protected areas of Bangladesh following this legal document. Demographically young people constitute the largest segment of population in Bangladesh. This group, if properly sensitized, can produce valuable impacts on the conservation initiatives, both by community and government. This study traced the major factors that motivate community youths to work effectively with different tiers of comanagement organizations in conservation of forests and Protected Areas of Bangladesh. For the purpose of this study, 3 FGDs were conducted with 30 youths from the community living around the Protected Areas of Cox’s bazar, South East corner of Bangladesh, who are actively involved in Co-management organizations. KII were conducted with 5 key officials of Forest Department stationed at Cox’s Bazar. 2 FGDs were conducted with the representatives of 7 Co-management organizations working in Cox’s Bazar region and approaches of different community outreach activities conducted for forest conservation by 3 private organizations and Projects have been reviewed. Also secondary literatures were reviewed for the history and evolution of Co-management in Bangladesh and six South Asian countries. This study found that innovative community outreach activities that are financed by public and private sectors involving youths and community as a whole have played a pivotal role in conservation of forests and Protected Areas of the region. This approach can be replicated in other regions of Bangladesh as well as other countries of South Asia where Co-Management exists in practice.

Keywords: community, co-management, conservation, forests, protected areas, youth

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Authors: Majid Mardaniyan Ghahfarokhi, Abdolhamid Habibi, Majid Mohammad Shahi

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The combination of exercise and diet as the most important strategy to reduce weight and control obesity-related factors, including Irisin, Insulin, and Glucose was raised. The aim of this study was to investigate the effect of aerobic exercise combined with four different diets on serum levels of Irisin, Insulin, and Glucose in overweight men. Methods: In this quasi-experimental study, 8 overweight men (BMI 29.23±0.47) with average age of (23±1.6) voluntarily participated in 4 sessions by one-week interval. The study was done in exercise physiology lab. In each session, subjects performed a 30 minutes treadmill test with 60-70% of maximum heart rate, after consuming a high carbohydrate, high-fat, high-protein and normal diet. For biochemical measurement, three blood samples were taken in fasting state, two hours after meals and after exercise Results: Statistical analysis of data showed that the serum levels of Irisin after consumption all four diets had been reduced which this reduce as a result of high-fat diet that were significantly (p ≤ 0/038). Serum concentration of Insulin and Glucose increased after consuming four diets. However, increase in serum Insulin and Glucose was significant only after consuming high-carbohydrate diet (Respectively p ≤ 0/001, p ≤ 0/042). In addition, during exercise after consuming all four regular diet, high carbohydrate, high-protein and high-fat, Irisin significant increased significantly (Respectively p ≤ 0/021, p ≤ 0/049, p ≤ 0/001, P ≤ 0/003), Insulin decreased significantly (Respectively p ≤ 0/002, p ≤ 0/001, p ≤ 0/001, p ≤ 0/002) and Glucose were significantly reduced (Respectively p ≤ 0/001, p ≤ 0/001, P ≤ 0/001, p ≤ 0/002). After aerobic activity following the consumption of a high protein diet the highest increase in irisin levels, and after aerobic exercise following consumption of high carbohydrate diet the greatest decrease in insulin and glucose levels were observed. Conclusion: It seems that diet alone and exercises following different consumption diets can have a significant effect on Irisin, Insulin, and Glucose serum levels in overweight young men.

Keywords: acute aerobic exercise, diet, irisin, overweight

Procedia PDF Downloads 259

Authors: Khalid Alshaikh

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In recent years, leadership, Corporate Governance (CG) and Corporate Social Responsibility (CSR) have been under scrutiny in the Libyan society. Scholars and institutions have commenced investigating the possible resolutions they can arrange to alleviate the economic, social and environmental problems the war has produced. Thus far, these constructs requisite an in-depth reinvestigation, reconceptualization, and analysis to clearly reconstruct their rules and regulations. With the demise of Qaddafi’s regime, levels, degrees, and efforts to apply CG regulations have varied in public and private commercial banks. CSR is a new organizational culture that still designs its route within these financial institutions. Detaching itself from any notion of dictatorship and autocratic traits, leadership counts on transformational and transactional styles. Therefore, this paper investigates the extent to which the Board of Directors and Chief Executive Officers (CEOs) redefine these concepts and how they entrench CSR within the framework of CG. The research methodology used both public and private banks as a case study and qualitative research to interview ten Board of Directors (BoDs) and eleven Chief executive managers to explore how leadership, CG, and CSR are defined and how leadership integrates CSR into CG structures. The findings suggest that the CG framework in Libya still requires great efforts to be developed. Full CG code implementation appears daunting. Also, the CSR is still influenced by the power of religion. Nevertheless, the Islamic perspective is more consistent with the social contract concept of the CSR. The Libyan commercial banks do not solely focus on the economic side of maximizing profits, but also concentrate on its morality. The issue is that CSR activities are not enough to achieve good charity publicly and needs strategies to address major social issues. Moreover, leadership is more transformational and transactional and endeavors to make economic, social and environmental changes, but these changes are curtailed by tradition and traditional values dominating the Libyan social life where religious and tribal practices establish the relationship between leaders and their subordinates. Finally, the findings reveal that transformational and transactional leadership styles encourage the incorporation of CSR into the CG regulations. The boardroom and executive management have such a particular role in flagging up how embedded corporate Social responsibility is in organizational culture across the commercial banks, yet it is still important that the BoDs and CEOs need to do much more to embed corporate social responsibility through their core functions. They need to boost their standing to be more influential and make sure that the right discussions about CSR happen with the right stakeholders involved.

Keywords: board of directors, chief executive officers, corporate governance, corporate social responsibility

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Authors: Olusola Abiodun Arinde

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This research work was prompted by the very important role e-commerce plays in every organization, be it private or public. The underlying objective of this study is to have a critical appraisal of the extent to which e-commerce impacts on organizational effectiveness. This research was carried out using Zenith Bank Plc as a case study. Relevant data were collected through structured questionnaire, oral interview, journals, newspapers, and textbooks. The data collected were analyzed and hypotheses were tested. Based on the result of the hypotheses, it was observed that e-commerce is significant to every organization. Through e-commerce, fast services delivery would be guaranteed to customers, this would lead to higher productivity and profit for organizations. E-commerce should be managed in such a way that it does not alienate customers; it should also prevent enormous risks that are associated with e-commerce.

Keywords: e-commerce, fast service, productivity, profit

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Authors: Malika Yaici, Feriel Lalaoui, Lydia Belhoul

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As a new distributed point-to-point (P2P) technology, blockchain has become a very broad field of research, addressing various challenges including privacy preserving as is the case in all other technologies. In this work, a study of the existing solutions to the problems related to private life in general and in blockchains in particular is performed. User anonymity and transaction confidentiality are the two main challenges for the protection of privacy in blockchains. Mixing mechanisms and cryptographic solutions respond to this problem but remain subject to attacks and suffer from shortcomings. Taking into account these imperfections and the synthesis of our study, we present a mixing model without trusted third parties, based on group signatures allowing reinforcing the anonymity of the users, the confidentiality of the transactions, with minimal turnaround time and without mixing costs.

Keywords: anonymity, blockchain, mixing coins, privacy

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Authors: Halimat M. Ajose-Adeogun, Zaynab A. Bello

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Artificial Intelligence (AI) and Natural Language Processing (NLP) have transformed computer language comprehension, allowing computers to comprehend spoken and written language with human-like cognition. NLP, a multidisciplinary area that combines rule-based linguistics, machine learning, and deep learning, enables computers to analyze and comprehend human language. NLP applications in medicine range from tackling issues in electronic health records (EHR) and psychiatry to improving diagnostic precision in orthopedic surgery and optimizing clinical procedures with novel technologies like chatbots. The technology shows promise in a variety of medical sectors, including quicker access to medical records, faster decision-making for healthcare personnel, diagnosing dysplasia in Barrett's esophagus, boosting radiology report quality, and so on. However, successful adoption requires training for healthcare workers, fostering a deep understanding of NLP components, and highlighting the significance of validation before actual application. Despite prevailing challenges, continuous multidisciplinary research and collaboration are critical for overcoming restrictions and paving the way for the revolutionary integration of NLP into medical practice. This integration has the potential to improve patient care, research outcomes, and administrative efficiency. The research methodology includes using NLP techniques for Sentiment Analysis and Emotion Recognition, such as evaluating text or audio data to determine the sentiment and emotional nuances communicated by users, which is essential for designing a responsive and sympathetic chatbot. Furthermore, the project includes the adoption of a Personalized Intervention strategy, in which chatbots are designed to personalize responses by merging NLP algorithms with specific user profiles, treatment history, and emotional states. The synergy between NLP and personalized medicine principles is critical for tailoring chatbot interactions to each user's demands and conditions, hence increasing the efficacy of mental health care. A detailed survey corroborated this synergy, revealing a remarkable 20% increase in patient satisfaction levels and a 30% reduction in workloads for healthcare practitioners. The poll, which focused on health outcomes and was administered to both patients and healthcare professionals, highlights the improved efficiency and favorable influence on the broader healthcare ecosystem.

Keywords: natural language processing, artificial intelligence, healthcare communication, electronic health records, patient care

Procedia PDF Downloads 76