Search results for: obstacles to healthcare accessibility

Authors: Brenda Thean I. Lim, Safurah Jaafar

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Augmented reality (AR) in the healthcare industry has been gaining popularity in recent years, principally in areas of medical education, patient care and digital health solutions. One of the drivers in deciding to invest in AR technology is the potential economic benefits it could bring for patients and healthcare providers, including the pharmaceutical and medical technology sectors. Works of literature have shown that the benefits and impact of AR technologies have left trails of achievements in improving medical education and patient health outcomes. However, little has been published on the economic impact of AR in healthcare, a very resource-intensive industry. This systematic review was performed on studies focused on the benefits and impact of AR in healthcare to appraise if they meet the founded quality criteria so as to identify relevant publications for an in-depth analysis of the economic impact assessment. The literature search was conducted using multiple databases such as PubMed, Cochrane, Science Direct and Nature. Inclusion criteria include research papers on AR implementation in healthcare, from education to diagnosis and treatment. Only papers written in English language were selected. Studies on AR prototypes were excluded. Although there were many articles that have addressed the benefits of AR in the healthcare industry in the area of medical education, treatment and diagnosis and dental medicine, there were very few publications that identified the specific economic impact of technology within the healthcare industry. There were 13 publications included in the analysis based on the inclusion criteria. Out of the 13 studies, none comprised a systematically comprehensive cost impact evaluation. An outline of the cost-effectiveness and cost-benefit framework was made based on an AR article from another industry as a reference. This systematic review found that while the advancements of AR technology is growing rapidly and industries are starting to adopt them into respective sectors, the technology and its advancements in healthcare were still in their early stages. There are still plenty of room for further advancements and integration of AR into different sectors within the healthcare industry. Future studies will require more comprehensive economic analyses and costing evaluations to enable economic decisions for or against implementing AR technology in healthcare. This systematic review concluded that the current literature lacked detailed examination and conduct of economic impact and benefit analyses. Recommendations for future research would be to include details of the initial investment and operational costs for the AR infrastructure in healthcare settings while comparing the intervention to its conventional counterparts or alternatives so as to provide a comprehensive comparison on impact, benefit and cost differences.

Keywords: augmented reality, benefit, economic impact, healthcare, patient care

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Authors: Mohammed Saeed Jawad

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Metaverse involves the convergence of three major technologies trends of AI, VR, and AR. Together these three technologies can provide an entirely new channel for delivering healthcare with great potential to lower costs and improve patient outcomes on a larger scale. Telepresence is the technology that allows people to be together even if they are physically apart. Medical doctors can be symbolic as interactive avatars developed to have smart conversations and medical recommendations for patients at the different stages of the treatment. Medical digital assets such as Medical IoT for real-time remote healthcare monitoring as well as the symbolic doctors’ avatars as well as the hospital and clinical physical constructions and layout can be immersed in extended realities 3D metaverse environments where doctors, nurses, and patients can interact and socialized with the related digital assets that facilitate the data analytics of the sensed and collected personal medical data with visualized interaction of the digital twin of the patient’s body as well as the medical doctors' smart conversation and consultation or even in a guided remote-surgery operation.

Keywords: personal healthcare, metaverse, telemedicine, telepresence, avatar, medical consultation, remote-surgery

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision-making, management, and planning of healthcare and related activities. However, user resistance, the unique position of medical data content, and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. The success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose an HA process model with features from the rational unified process (RUP) model and agile methodology.

Keywords: agile methodology, health analytics, unified process model, UML

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Authors: Assem El-Ansary

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This paper illustrates the event-oriented Behavioral Pattern Analysis (BPA) modeling approach using the Healthcare Multi-Agent System. The Event defined in BPA is a real-life conceptual entity that is unrelated to any implementation. The major contributions of this research are: The Behavioral Pattern Analysis (BPA) modeling methodology. The development of an interactive software tool (DECISION), which is based on a combination of the Analytic Hierarchy Process (AHP) and the ELECTRE Multi-Criteria Decision Making (MCDM) methods.

Keywords: analysis, modeling methodology, software modeling, event-oriented, behavioral pattern, use cases, Healthcare Multi-Agent System

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Joseph Udofia, Isaac Olufadewa

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Everyday, the size of Electronic Health Records data keeps increasing as new patients visit health practitioner and returning patients fulfil their appointments. As these data grow, so is their susceptibility to cyber-attacks from criminals waiting to exploit this data. In the US, the damages for cyberattacks were estimated at $8 billion (2018), $11.5 billion (2019) and $20 billion (2021). These attacks usually involve the exposure of PII. Health data is considered PII, and its exposure carry significant impact. To this end, an enhancement of Health Policy and Standards in relation to data security, especially among patients and their clinical providers, is critical to ensure ethical practices, confidentiality, and trust in the healthcare system. As Clinical accelerators and applications that contain user data are used, it is expedient to have a review and revamp of policies like the Payment Card Industry Data Security Standard (PCI DSS), the Health Insurance Portability and Accountability Act (HIPAA), the Fast Healthcare Interoperability Resources (FHIR), all aimed to ensure data protection and security in healthcare. FHIR caters for healthcare data interoperability, FHIR caters to healthcare data interoperability, as data is being shared across different systems from customers to health insurance and care providers. The astronomical cost of implementation has deterred players in the space from ensuring compliance, leading to susceptibility to data exfiltration and data loss on the security accuracy of protected health information (PHI). Though HIPAA hones in on the security accuracy of protected health information (PHI) and PCI DSS on the security of payment card data, they intersect with the shared goal of protecting sensitive information in line with industry standards. With advancements in tech and the emergence of new technology, it is necessary to revamp these policies to address the complexity and ambiguity, cost barrier, and ever-increasing threats in cyberspace. Healthcare data in the wrong hands is a recipe for disaster, and we must enhance its protection and security to protect the mental health of the current and future generations.

Keywords: cloud security, healthcare, cybersecurity, policy and standard

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Authors: Christos Karolemeas, Avgi Vassi, Georgia Christodoulopoulou

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Although the past decades, planning a cycle network became an inseparable part of all transportation plans, there is still a lot of room for improvement in the way planning is made, in order to create safe and direct cycling networks that gather the parameters that positively influence one's decision to cycle. The aim of this article is to study, evaluate and visualize the bikeability of cities. This term is often used as the 'the ability of a person to bike' but this study, however, adopts the term in the sense of bikeability as 'the ability of the urban landscape to be biked'. The methodology used included assessing cities' accessibility by cycling, based on international literature and corresponding walkability methods and the creation of a 'bikeability index'. Initially, a literature review was made to identify the factors that positively affect the use of bicycle infrastructure. Those factors were used in order to create the spatial index and quantitatively compare the city network. Finally, the bikeability index was applied in two case studies: two Greek municipalities that, although, they have similarities in terms of land uses, population density and traffic congestion, they are totally different in terms of geomorphology. The factors suggested by international literature were (a) safety, (b) directness, (c) comfort and (d) the quality of the urban environment. Those factors were quantified through the following parameters: slope, junction density, traffic density, traffic speed, natural environment, built environment, activities coverage, centrality and accessibility to public transport stations. Each road section was graded for the above-mentioned parameters, and the overall grade shows the level of bicycle accessibility (low, medium, high). Each parameter, as well as the overall accessibility levels, were analyzed and visualized through Geographic Information Systems. This paper presents the bikeability index, its' results, the problems that have arisen and the conclusions from its' implementation through Strengths-Weaknesses-Opportunities-Threats analysis. The purpose of this index is to make it easy for researchers, practitioners, politicians, and stakeholders to quantify, visualize and understand which parts of the urban fabric are suitable for cycling.

Keywords: accessibility, cycling, green spaces, spatial data, urban environment

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Authors: Lubowa Samuel

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Health information systems, often known as HIS, are critical components of the healthcare system to improve health policies and promote global health development. In a broader sense, HIS as a system integrates data collecting, processing, reporting, and making use of various types of data to improve healthcare efficacy and efficiency through better management at all levels of healthcare delivery. The aim of this study is to assess the adoption of health information systems (HIS) in a resource-constrained country drawing from the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. The results indicate that the user's perception of the technology and the poor information technology infrastructures contribute a lot to the low adoption of HIS in resource-constrained countries.

Keywords: health information systems, resource-constrained countries, health information systems

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Authors: Valeria Tatano, Francesca Guidolin, Francesca Peltrera

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The preservation of historical Italian heritage, at the urban and architectural scale, has to consider restrictions and requirements connected with conservation issues and usability needs, which are often at odds with historical heritage preservation. Recent decades have been marked by the search for increased accessibility not only of public and private buildings, but to the whole historical city, also for people with disability. Moreover, in the last years the concepts of Smart City and Healthy City seek to improve accessibility both in terms of mobility (independent or assisted) and fruition of goods and services, also for historical cities. The principles of Inclusive Design have introduced new criteria for the improvement of public urban space, between current regulations and best practices. Moreover, they have contributed to transforming “special needs” into an opportunity of social innovation. These considerations find a field of research and analysis in the historical city of Venice, which is at the same time a site of UNESCO world heritage, a mass tourism destination bringing in visitors from all over the world and a city inhabited by an aging population. Due to its conformation, Venetian urban fabric is only partially accessible: about four thousand bridges divide thousands of islands, making it almost impossible to move independently. These urban characteristics and difficulties were the base, in the last 20 years, for several researches, experimentations and solutions with the aim of eliminating architectural barriers, in particular for the usability of bridges. The Venetian Municipality with the EBA Office and some external consultants realized several devices (e.g. the “stepped ramp” and the new accessible ramps for the Venice Marathon) that should determine an innovation for the city, passing from the use of mechanical replicable devices to specific architectural projects in order to guarantee autonomy in use. This paper intends to present the state-of-the-art in bridges accessibility, through an analysis based on Inclusive Design principles and on the current national and regional regulation. The purpose is to evaluate some possible strategies that could improve performances, between limits and possibilities of interventions. The aim of the research is to lay the foundations for the development of a strategic program for the City of Venice that could successfully bring together both conservation and improvement requirements.

Keywords: accessibility of historical cities, historical heritage preservation, inclusive design, technological and social innovation

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Authors: Trina Isabel Santiago, Daniel Chua, Jumee Tayaban, Joseph Daniel Timbol, Joshua Yanes

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Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This brief aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: human rights violations, healthcare workers, COVID-19 pandemic, Philippines

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Authors: Pavlo Selyshchev, Tetiana Didenko

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Within the framework of the obstacle radiation hardening and the dislocation climb-glide model a theoretical approach is developed to describe peculiarities of transient plasticity of metal under irradiation. It is considered nonlinear dynamics of accumulation of point defects (vacancies and interstitial atoms). We consider metal under such stress and conditions of irradiation at which creep is determined by dislocation motion: dislocations climb obstacles and glide between obstacles. It is shown that the rivalry between vacancy and interstitial fluxes to dislocation leads to fractures of plasticity time dependence. Simulation and analysis of this phenomenon are performed. Qualitatively different regimes of transient plasticity under irradiation are found. The fracture time is obtained. The theoretical results are compared with the experimental ones.

Keywords: climb and glide of dislocations, fractures of transient plasticity, irradiation, non-linear feed-back, point defects

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Authors: Lana Dalawr Jalal

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This paper addresses the problem of offline path planning for Unmanned Aerial Vehicles (UAVs) in complex three-dimensional environment with obstacles, which is modelled by 3D Cartesian grid system. Path planning for UAVs require the computational intelligence methods to move aerial vehicles along the flight path effectively to target while avoiding obstacles. In this paper Modified Particle Swarm Optimization (MPSO) algorithm is applied to generate the optimal collision free 3D flight path for UAV. The simulations results clearly demonstrate effectiveness of the proposed algorithm in guiding UAV to the final destination by providing optimal feasible path quickly and effectively.

Keywords: obstacle avoidance, particle swarm optimization, three-dimensional path planning unmanned aerial vehicles

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Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

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Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

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Authors: Modesta E. Ezema, Chikwendu V. Alabekee, Victoria N. Ishiwu, Ifeyinwa NwosuArize, Chinedu I. Nwoye

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The advent of wireless networking in computing technology cannot be overemphasized, it opened up easy accessibility to information resources, networking made easier and brought internet accessibility to our doorsteps, but despite all these, some mishap came in with it that is causing mayhem in today ‘s overall information security. The cyber criminals will always compromise the integrity of a message that is not encrypted or that is encrypted with a weak algorithm.In other to correct the mayhem, this study focuses on cryptosystem and cryptography. This ensures end to end crypt messaging. The study of various cryptographic algorithms, as well as the techniques and applications of the cryptography for efficiency, were all considered in the work., present and future applications of cryptography were dealt with as well as Quantum Cryptography was exposed as the current and the future area in the development of cryptography. An empirical study was conducted to collect data from network users.

Keywords: algorithm, cryptography, cryptosystem, network

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Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

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Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

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Authors: Jessica Hemberg, Mikaela Miller

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Unreasonable workload and work-related stress can reduce nurse leaders’ job satisfaction and productivity and can increase absence and burnout. Nurse leaders’ workload in public healthcare settings is relatively unresearched. The aim of this study was to investigate nurse leaders’ perceptions of workload and task distribution with relation to leading work tasks in public healthcare. A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N=8). The method was inspired by content analysis. The COREQ checklist was used. Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload, and Insufficient time for leadership mission. The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organizing more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders’ workload. Future research should focus on investigating workload and task distribution from nurses’ perspectives.

Keywords: nurse leaders, workload, task distribution, public healthcare, qualitative

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Authors: Huawei Ma, Wencai Du, Shengbin Liang

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Smart Home Healthcare technologies for the elderly represent a transformative paradigm that leverages emerging technologies to provide the elderly’ health indicators and daily life monitoring, emergency calls, environmental monitoring, behavior perception, and other services to ensure the health and safety of the elderly who are aging in their own home. However, the excessive complexity in the main adopted framework has affected the acceptance and adoption of the elderly. Therefore, this paper proposes a lightweight synergy architecture of IoT data and service for elderly home smart health environment. It includes the modeling of IoT applications and their workflows, data interoperability, interaction, and storage paradigms to meet the growing needs of older people so that they can lead an active, fulfilling, and quality life.

Keywords: smart home healthcare, IoT, independent living, lightweight framework

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Authors: Valentina Marutyan

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Healthcare data mining is a rapidly developing field at the intersection of technology and medicine that has the potential to change our understanding and approach to providing healthcare. Healthcare and data mining is the process of examining huge amounts of data to extract useful information that can be applied in order to improve patient care, treatment effectiveness, and overall healthcare delivery. This field looks for patterns, trends, and correlations in a variety of healthcare datasets, such as electronic health records (EHRs), medical imaging, patient demographics, and treatment histories. To accomplish this, it uses advanced analytical approaches. Predictive analysis using historical patient data is a major area of interest in healthcare data mining. This enables doctors to get involved early to prevent problems or improve results for patients. It also assists in early disease detection and customized treatment planning for every person. Doctors can customize a patient's care by looking at their medical history, genetic profile, current and previous therapies. In this way, treatments can be more effective and have fewer negative consequences. Moreover, helping patients, it improves the efficiency of hospitals. It helps them determine the number of beds or doctors they require in regard to the number of patients they expect. In this project are used models like logistic regression, random forests, and neural networks for predicting diseases and analyzing medical images. Patients were helped by algorithms such as k-means, and connections between treatments and patient responses were identified by association rule mining. Time series techniques helped in resource management by predicting patient admissions. These methods improved healthcare decision-making and personalized treatment. Also, healthcare data mining must deal with difficulties such as bad data quality, privacy challenges, managing large and complicated datasets, ensuring the reliability of models, managing biases, limited data sharing, and regulatory compliance. Finally, secret code of data mining in healthcare helps medical professionals and hospitals make better decisions, treat patients more efficiently, and work more efficiently. It ultimately comes down to using data to improve treatment, make better choices, and simplify hospital operations for all patients.

Keywords: data mining, healthcare, big data, large amounts of data

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Authors: Raed Alsufyani, Hissam Tawfik, Victor Chang, Muthu Ramachandran

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This study investigates the factors that influence the decision by players in the healthcare sector to embrace Cloud Business Intelligence Technology with a focus on healthcare organizations in Saudi Arabia. To bring this matter into perspective, this study primarily considers the Technology-Organization-Environment (TOE) framework and the Human Organization-Technology (HOT) fit model. A survey was hypothetically designed based on literature review and was carried out online. Quantitative data obtained was processed from descriptive and one-way frequency statistics to inferential and regression analysis. Data were analysed to establish factors that influence the decision to adopt Cloud Business intelligence technology in the healthcare sector. The implication of the identified factors was measured, and all assumptions were tested. 66.70% of participants in healthcare organization backed the intention to adopt cloud business intelligence system. 99.4% of these participants considered security concerns and privacy risk have been the most significant factors in the adoption of cloud Business Intelligence (CBI) system. Through regression analysis hypothesis testing point that usefulness, service quality, relative advantage, IT infrastructure preparedness, organization structure; vendor support, perceived technical competence, government support, and top management support positively and significantly influence the adoption of (CBI) system. The paper presents quantitative phase that is a part of an on-going project. The project will be based on the consequences learned from this study.

Keywords: cloud computing, business intelligence, HOT-fit model, TOE, healthcare and innovation adoption

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Authors: Teo Hao Jing, Shane Ho Ken Wae, Lee Jin Yu, Burra Venkata Durga Kumar

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Current distributed healthcare systems face the challenge of interoperability of health data. Storing electronic health records (EHR) in local databases causes them to be fragmented. This problem is aggravated as patients visit multiple healthcare providers in their lifetime. Existing solutions are unable to solve this issue and have caused burdens to healthcare specialists and patients alike. Blockchain technology was found to be able to increase the interoperability of health data by implementing digital access rules, enabling uniformed patient identity, and providing data aggregation. Consortium blockchain was found to have high read throughputs, is more trustworthy, more secure against external disruptions and accommodates transactions without fees. Therefore, this paper proposes a blockchain-based model for data management applications. In this model, a consortium blockchain is implemented by using a delegated proof of stake (DPoS) as its consensus mechanism. This blockchain allows collaboration between users from different organizations such as hospitals and medical bureaus. Patients serve as the owner of their information, where users from other parties require authorization from the patient to view their information. Hospitals upload the hash value of patients’ generated data to the blockchain, whereas the encrypted information is stored in a distributed cloud storage.

Keywords: blockchain technology, data management applications, healthcare, interoperability, delegated proof of stake

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Authors: Qirat Naz

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The aim of this research study is to explore the perspectives of migrants and interpreters from diverse backgrounds on language barriers, their English language proficiency and access to health care facilities. A qualitative research methodology was used including in-depth interviews and focus group discussions. Data was collected from 20 migrants who have difficulty conversing in the English language and 12 interpreters including family members and friends who provide translation services as part of accessing health care. The findings seek to address three key research questions: how language is a barrier for non-national language speakers to access the health care facilities, what is the impact of various socio-cultural and linguistic backgrounds on health compliance, and what is the role of interpreters in providing access to, usage of, and satisfaction with health-care facilities. The most crucial component of providing care was found to be effective communication between patient and health care professionals. Language barrier was the major concern for healthcare professionals in providing and for migrants in accessing sufficient, suitable, and productive health care facilities. Language and sociocultural background play a significant role in health compliance as this research reported; respondents believe that patients who interact with the doctors who have same sociocultural and linguistic background benefit from receiving better medical care than those who do not. Language limitations and the socio-cultural gap make it difficult for patients and medical staff to communicate clearly with one another, which has a negative effect on quality of care and patient satisfaction. The use of qualified interpreters was found to be beneficial but there were also drawbacks such as accessibility and availability of them in a timely manner for patient needs. The findings of this research can help health care workers and policy makers working to improve health care delivery system and to create appropriate strategies to overcome this challenge.

Keywords: migration, migrants, language barrier, healthcare access

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Authors: E. Kharaishvili, G. Erkomaishvili, M. Chavleishvili

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The importance of agribusiness development is proved in accordance with the trends in the agricultural sector of Georgia. Agribusiness environment and the consequences of the agricultural reforms are evaluated. The factors hindering the development of agribusiness are revealed and the ways for overcoming these problems are suggested. SWOT analysis is done in order to identify the needs of agribusiness. The needs of agribusiness development in Georgia are evaluated by priorities: prevention of diseases and reduction of the harm caused by these diseases, accessibility of long-term agricultural loans with low interest rates, improving qualification of farmers, the level of education and usage of modern technologies, changes in legislation, accessibility to high quality agricultural machinery, and the development of infrastructure. Based on the outcomes of the research, agribusiness development strategies in Georgia are suggested and appropriate priorities of economic policy are determined. Conclusions are made and based on these conclusions, some recommendations are suggested.

Keywords: agribusiness development, agribusiness strategy, agribusiness in Georgia

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Iris Xiaohong Quan, Sharon Qi, Kelly Tianqin Shi

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This study focuses on the critical role of insurance policies in a world grappling with increasing mental health challenges, as they significantly influence the dynamics of healthcare businesses and entrepreneurial ventures. The paper utilizes the mental health sector as a case to examine the impact of insurance policies on healthcare service providers, entrepreneurs, and individuals seeking mental health support. This paper addressed the following research questions: To what extent do changes in insurance reimbursement policies affect the accessibility and affordability of mental health services for patients, and how does this impact the overall demand for such services? What are the barriers and opportunities that mental health entrepreneurs face and what strategies and adaptations do mental health businesses employ when navigating the evolving landscape of insurance reimbursement policies? How do changes in insurance reimbursement policies, specifically related to mental health services, influence the financial viability and sustainability of mental health clinics and private practices? Employing a self-designed survey aimed at autism spectrum disorder (ASD) treatment companies, alongside two in-depth case studies and an analysis of pertinent insurance policies and documents, this research aims to elucidate the multifaceted influence of insurance policies on the mental health industry. The findings from this study reveal how insurance policies shape the landscape of mental health businesses and their operations. A total of 821 autism treatment organizations or offices were contacted by telephone between November 1, 2019, and January 31, 2020. About half of the offices (53.33%) were established in the past five years, and 80% were established in the past 15 years. There is a significant increase in the establishment of ABA service centers in the recent two decades as a result of autism insurance reform, the increasing social awareness of ASD, and the redefinition of autism. In addition, almost half of the ABA service providers we surveyed had a patient size ranging from 20 to 50 in the year when the residence state passed the legislation for autism insurance coverage. On average, an ABA service provider works with 5.3 insurance companies. This research find that insurance is the main source of revenue for most ABA service providers. However, our survey reveals that clients’ out of pocket payment has been the second main revenue sources. Despite the changes of regulations and insurance policies in all states, clients still have to pay a fraction of, if not all, the ABA treatment service fees out of pocket. This research shows that some ABA service providers seek federal and government funds and grants to support their services and businesses. Our further analysis with the in-depth case studies and other secondary data also indicate the rise of entrepreneurial startups in the mental health industry. Overall, this research sheds light on both the challenges and opportunities presented by insurance policies in the mental health sector, offering insights into the new industry landscape.

Keywords: entrepreneurship, healthcare policy, insurance policy, mental health industry

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Authors: Nipawan Tharasak, Sajeewan Darbavasu

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This research aims 1) to study the opinion, problems and obstacles to internal educational quality assurance system for individual and the university levels, 2) to propose an approach to the development of quality assurance system of Suan Sunandha Rajabhat University. A study of problems and obstacles to internal educational quality assurance system of the university conducted with sample group consisting of staff and quality assurance committee members of the year 2010. There were 152 respondents. 5 executives were interviewed. Tool used in the research was document analysis. The structure of the interview questions and questionnaires with 5-rate scale. Reliability was 0.981. Data analysis were percentage, mean and standard deviation with content analysis. Results can be divided into 3 main points: (1) The implementation of the internal quality assurance system of the university. It was found that in overall, input, process and output factors received high scores. Each item is considered, the preparation, planning, monitoring and evaluation. The results of evaluation to improve the reporting and improvement according to an evaluation received high scores. However, the process received an average score. (2) Problems and obstacles. It was found that the personnel responsible for the duty still lack understanding of indicators and criteria of the quality assurance. (3) Development approach: -Staff should be encouraged to develop a better understanding of the quality assurance system. -Database system for quality assurance should be developed. -The results and suggestions should be applied in the next year development planning.

Keywords: development system, internal quality assurance, education, educational quality assurance

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Authors: Siwei Chang, Heng Li, Haitao Wu, Xin Fang

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Construction robots are receiving more and more attention as a promising solution to the manpower shortage issue in the construction industry. The development of intelligent control techniques that assist in controlling the robots to avoid transparency and reflected building obstacles is crucial for guaranteeing the adaptability and flexibility of mobile construction robots in complex construction environments. With the boom of computer vision techniques, a number of studies have proposed vision-based methods for transparent obstacle avoidance to improve operation accuracy. However, vision-based methods are also associated with disadvantages such as high computational costs. To provide better perception and value evaluation, this study aims to analyze the performance of vision-based techniques for avoiding transparent building obstacles. To achieve this, commonly used sensors, including a lidar, an ultrasonic sensor, and a USB camera, are equipped on the robotic platform to detect obstacles. A Raspberry Pi 3 computer board is employed to compute data collecting and control algorithms. The turtlebot3 burger is employed to test the programs. On-site experiments are carried out to observe the performance in terms of success rate and detection distance. Control variables include obstacle shapes and environmental conditions. The findings contribute to demonstrating how effectively vision-based obstacle avoidance strategies for transparent building obstacle avoidance and provide insights and informed knowledge when introducing computer vision techniques in the aforementioned domain.

Keywords: construction robot, obstacle avoidance, computer vision, transparent obstacle

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Authors: Tianyi Wang, Hieyong Jeong, An Guo, Yuko Ohno

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Healthcare robot for assisting sit-to-stand (STS) performance had aroused numerous research interests. To author’s best knowledge, knowledge about how evaluating healthcare robot is still unknown. Robot should be labeled as fault if users feel demanding during STS when they are assisted by robot. In this research, we aim to propose a method to evaluate sit-to-stand assist robot through center of pressure (CoP), then classify different STS performance. Experiments were executed five times with ten healthy subjects under four conditions: two self-performed STSs with chair heights of 62 cm and 43 cm, and two robot-assisted STSs with chair heights of 43 cm and robot end-effect speed of 2 s and 5 s. CoP was measured using a Wii Balance Board (WBB). Bayesian classification was utilized to classify STS performance. The results showed that faults occurred when decreased the chair height and slowed robot assist speed. Proposed method for fault classification showed high probability of classifying fault classes form others. It was concluded that faults for STS assist robot could be detected by inspecting center of pressure and be classified through proposed classification algorithm.

Keywords: center of pressure, fault classification, healthcare robot, sit-to-stand movement

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Authors: Qing Wu, Xuchun Ye, Kirsten Corazzini

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Objective: It is increasingly recognized that patients’ rational and meaningful engagement in healthcare could make important contributions to their health care and safety management. However, recent evidence indicated that patients' actual roles in healthcare didn’t match their desired roles, and many patients reported a less active role than desired, which suggested that patient engagement in healthcare may be influenced by various factors. This study aimed to analyze influencing factors on patient engagement and explore the influence mechanism, which will be expected to contribute to the strategy development of patient engagement in healthcare. Methods: On the basis of analyzing the literature and theory study, the research framework was developed. According to the research framework, a cross-sectional survey was employed using the behavior and willingness of patient engagement in healthcare questionnaire, Chinese version All Aspects of Health Literacy Scale, Facilitation of Patient Involvement Scale and Wake Forest Physician Trust Scale, and other influencing factor related scales. A convenience sample of 580 patients was recruited from 8 general hospitals in Shanghai, Jiangsu Province, and Zhejiang Province. Results: The results of the cross-sectional survey indicated that the mean score for the patient engagement behavior was (4.146 ± 0.496), and the mean score for the willingness was (4.387 ± 0.459). The level of patient engagement behavior was inferior to their willingness to be involved in healthcare (t = 14.928, P ＜ 0.01). The influencing mechanism model of patient engagement in healthcare was constructed by the path analysis. The path analysis revealed that patient attitude toward engagement, patients’ perception of facilitation of patient engagement and health literacy played direct prediction on the patients’ willingness of engagement, and standard estimated values of path coefficient were 0.341, 0.199, 0.291, respectively. Patients’ trust in physician and the willingness of engagement played direct prediction on the patient engagement, and standard estimated values of path coefficient were 0.211, 0.641, respectively. Patient attitude toward engagement, patients’ perception of facilitation and health literacy played indirect prediction on patient engagement, and standard estimated values of path coefficient were 0.219, 0.128, 0.187, respectively. Conclusions: Patients engagement behavior did not match their willingness to be involved in healthcare. The influencing mechanism model of patient engagement in healthcare was constructed. Patient attitude toward engagement, patients’ perception of facilitation of engagement and health literacy posed indirect positive influence on patient engagement through the patients’ willingness of engagement. Patients’ trust in physician and the willingness of engagement had direct positive influence on the patient engagement. Patient attitude toward engagement, patients’ perception of physician facilitation of engagement and health literacy were the factors influencing the patients’ willingness of engagement. The results of this study provided valuable evidence on guiding the development of strategies for promoting patient rational and meaningful engagement in healthcare.

Keywords: healthcare, patient engagement, influencing factor, the mechanism

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Authors: Maria Ahmad, Michael Page, Danë Goodsman

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‘Educational’ debriefing – a construct distinct from clinical debriefing – is used following simulated scenarios and is central to learning and development in fields ranging from aviation to emergency medicine. However, little research into educational debriefing in prehospital medicine exists. This qualitative study explored the facilitation and effects of prehospital educational debriefing and identified obstacles to debriefing, using the London’s Air Ambulance Pre-Hospital Care Course (PHCC) as a model. Method: Ethnographic observations of moulages and debriefs were conducted over two consecutive days of the PHCC in October 2019. Detailed contemporaneous field notes were made and analysed thematically. Subsequently, seven one-to-one, semi-structured interviews were conducted with four PHCC debrief facilitators and three course participants to explore their experiences of prehospital educational debriefing. Interview data were manually transcribed and analysed thematically. Results: Four overarching themes were identified: the approach to the facilitation of debriefs, effects of debriefing, facilitator development, and obstacles to debriefing. The unpredictable debriefing environment was seen as both hindering and paradoxically benefitting educational debriefing. Despite using varied debriefing structures, facilitators emphasised similar key debriefing components, including exploring participants’ reasoning and sharing experiences to improve learning and prevent future errors. Debriefing was associated with three principal effects: releasing emotion; learning and improving, particularly participant compound learning as they progressed through scenarios; and the application of learning to clinical practice. Facilitator training and feedback were central to facilitator learning and development. Several obstacles to debriefing were identified, including mismatch of participant and facilitator agendas, performance pressure, and time. Interestingly, when used appropriately in the educational environment, these obstacles may paradoxically enhance learning. Conclusions: Educational debriefing in prehospital medicine is complex. It requires the establishment of a safe learning environment, an understanding of participant agendas, and facilitator experience to maximise participant learning. Aspects unique to prehospital educational debriefing were identified, notably the unpredictable debriefing environment, interdisciplinary working, and the paradoxical benefit of educational obstacles for learning. This research also highlights aspects of educational debriefing not extensively detailed in the literature, such as compound participant learning, display of ‘professional honesty’ by facilitators, and facilitator learning, which require further exploration. Future research should also explore educational debriefing in other prehospital services.

Keywords: debriefing, prehospital medicine, prehospital medical education, pre-hospital care course

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Authors: Hend Albassam, Nouf Alrumaih

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Nowadays we are in the age of technologies and communication and there is no doubt that technologies such as the Internet can offer many advantages for many business fields, and the health field is no execution. In fact, using the Internet provide us with a new path to improve the quality of health care throughout the world. The e-healthcare offers many advantages such as: efficiency by reducing the cost and avoiding duplicate diagnostics, empowerment of patients by enabling them to access their medical records, enhancing the quality of healthcare and enabling information exchange and communication between healthcare organizations. There are many problems that result from using papers as a way of communication, for example, paper-based prescriptions. Usually, the doctor writes a prescription and gives it to the patient who in turn carries it to the pharmacy. After that, the pharmacist takes the prescription to fill it and give it to the patient. Sometimes the pharmacist might find difficulty in reading the doctor’s handwriting; the patient could change and counterfeit the prescription. These existing problems and many others heighten the need to improve the quality of the healthcare. This project is set out to develop a distributed e-healthcare system that offers some features of e-health and addresses some of the above-mentioned problems. The developed system provides an electronic health record (EHR) and enables communication between separate health care organizations such as the clinic, pharmacy and laboratory. To develop this system, the Service Oriented Architecture (SOA) is adopted as a design approach, which helps to design several independent modules that communicate by using web services. The layering design pattern is used in designing each module as it provides reusability that allows the business logic layer to be reused by different higher layers such as the web service or the website in our system. The experimental analysis has shown that the project has successfully achieved its aims toward solving the problems related to the paper-based healthcare systems and it enables different health organization to communicate effectively. It implements four independent modules including healthcare provider, pharmacy, laboratory and medication information provider. Each module provides different functionalities and is used by a different type of user. These modules interoperate with each other using a set of web services.

Keywords: e-health, services oriented architecture (SOA), web services, interoperability

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