Search results for: resource-limited care environments

Authors: Lisa Rudolfsson

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Socio-cognitive factors, such as social support and attribution of blame, influence the victim’s psychological adjustment after the abuse. Furthermore, the response from the person that the victim first confides to effect adjustment following the abuse. In Sweden, although police are investigating most of the reported cases of rape, very few rape-cases leads to trial and sentence. For many women who have been raped, contact with the police officer when reporting the crime will, therefore, be the most notable experience of how representatives for the Swedish society regard and handle what has happened. Hence, it seems urgent to gather information about these initial meetings. This study is part of a three-year research project, titled 'Female rape victims: Quality of initial police and medical care contact', funded by the Swedish Crime Victim and Support Authority. The focus of this study was on police officers in Sweden: their thoughts and experiences of meeting with raped women. Forthcoming are interviews with raped women about their experiences of meeting with police. Sixteen police officers participated in three focus groups and one interview. The participants consisted of five men and eleven women. Focus groups and interview were audio recorded and transcribed verbatim. The material was analyzed using thematic analysis. Participants described how violence against women was not a priority in Swedish society or within the Police Authority. They talked about rape cases as a Sisyphean work-task that put high demands on them, while they also lacked training and support. They expressed a wish to offer the woman some kind of restoration, and they talked about their work as potentially making a difference for the woman – even if she did not get juridical justice. However, participants also described that they did not feel validated in their hard work. They talked about working rape cases as causing them a great deal of frustration - directed towards the Police Authority, the juridical system, colleagues, and sometimes towards the woman. Participants also described how meeting with raped women was a work that affected them in a personal manner. Listening to stories about sexual violence made the participants sad, and they described it as a struggle to understand. They described wondering how the woman’s life turned out and how they sometimes questioned if they had done enough. Some of the conclusions concern the lack of prerequisites needed for police officers to be able to offer a good-enough treatment of raped women, as well as the lack of tools needed for police officers to care for themselves. In lack of training, validation, and support, the knowledge of how to offer a good- enough treatment of raped women becomes a task learned by doing. Attempts to offer, if not legal justice, then at least some kind of restoration becomes a personal task, dependent on individual police officers. It seems urgent that we address the risk of police officers’ frustration building up to be detrimental for both the crime victim and the officer her/himself.

Keywords: focus groups, police, raped women, restoration

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Authors: E. Tugba Topcu

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The emergency services are usually the first places to encounter forensic cases. Hence, it is important to consider forensics from the perspective of the emergency services staff and the physiological and psychological consequences that may arise as a result of behaviour by itself or another person. Accurate and detailed documentation of the situation in which the patient first arrives at the emergency service and preservation of the forensic findings is pivotal for the subsequent forensic investigation. The first step in determining whether or not a forensic case exists is to perform a medical examination of the patient. For each individual suspected to be part of a forensic case, police officers should be informed at the same time as the medical examination is being conducted. Violent events are increasing every year and with an increase in the number of forensic cases, emergency service workers have increasing responsibility and consequently play a key role in protecting, collecting and arranging the forensic evidence. In addition, because the emergency service workers involved in forensic events typically have information about the accused and/or victim, as well as evidence related to the events and the cause of injuries, police officers often require their testimony. However, both nurses and other health care personnel do not typically have adequate expertise in forensic medicine. Emergency nurses should take an active role for determining that whether any patient admitted to the emergency services is a clinical forensic patient the emergency service with injury and requiring possible punishment and knowing of their roles and responsibilities in this area provides legal protection as well as the protection of the judicial affair. Particularly, in emergency services, where rapid patient turnover and high workload exists, patient registration and case reporting may not exist. In such instances, the witnesses, typically the nurses, are often consulted for information. Knowledge of forensic medical matters plays a vital role in achieving justice. According to the Criminal Procedure Law, Article 75, Paragraph 3, ‘an internal body examination or the taking of blood or other biological samples from the body can be performed only by a doctor or other health professional member’. In favour of this item, the clinic nurse and doctor are mainly responsible for evaluating forensic cases in emergency departments, performing the examination, collecting evidence, and storing and reporting data. The courts place considerable importance on determining whether a suspect is the victim or accused and, thus, in terms of illuminating events, it is crucial that any evidence is gathered carefully and appropriately. All the evidence related to the forensic case including the forensic report should be handed over to the police officers. In instances where forensic evidence cannot be collected and the only way to obtain the evidence is the hospital environment, health care personnel in emergency services need to have knowledge about the diagnosis of forensic evidence, the collection of evidence, hiding evidence and provision of the evidence delivery chain.

Keywords: emergency department, emergency nursing, forensic cases, forensic nursing

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Authors: A. A. AlRasheed, A. Atkins, R. Campion

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This paper focuses on using knowledge management and visualisation concepts to improve the patients and hospitals employee’s workflow. Hospitals workflow is a complex and complicated process and poor patient flow can put both patients and a hospital’s reputation at risk, and can threaten the facility’s financial sustainability. Healthcare leaders are under increased pressure to reduce costs while maintaining or increasing patient care standards. In this paper, a framework is proposed to help improving patient experience, staff satisfaction, and operational efficiency across hospitals by using knowledge management based visualisation concepts. This framework is using real-time visibility to track and monitor location and status of patients, staff, rooms, and medical equipment.

Keywords: knowledge management, improvements, visualisation, workflow

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Authors: Michael T. Ajayi, Oluwakemi E. Fapojuwo

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Farmers are in need of regular and relevant information relating to new technologies. Production of extension materials has been found to be useful in facilitating the process. Extension materials help to provide information to reach large numbers of farmers quickly and economically. However, as good as extension materials are, previous materials produced are not used by farmers. The reasons for this include lack of involvement of farmers in the production of the extension materials, most of the extension materials are not relevant to the farmers’ environments, the agricultural extension agents lack capacity to prepare the materials, and many extension agents lack commitment. These problems led to this innovative capacity building of extension agents. This innovative approach involves five stages. The first stage is the diagnostic survey of farmers’ environment to collect useful information. The second stage is the development and production of draft extension materials. The third stage is the field testing and evaluation of draft materials by the same farmers that were involved at the diagnostic stage. The fourth stage is the revision of the draft extension materials by incorporating suggestions from farmers. The fifth stage is the action plans. This process improves the capacity of agricultural extension agents in the preparation of extension materials and also promotes engagement of farmers and beneficiaries in the process. The process also makes farmers assume some level of ownership of the exercise and the extension materials.

Keywords: capacity building, extension agents, dissemination, information/technologies

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Authors: Duy Nhat Tran, Van Tien Pham, Quang Trung Trinh, Tien Hai Tran, Van Cong Bui

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In recent years, artificial intelligence and the Internet of Things have experienced significant advancements. Collecting image data and real-time analysis and processing of tasks have become increasingly popular in various aspects of life. Optical scanning devices are widely used to observe and analyze different environments, whether fixed outdoors, mounted on mobile devices, or used in unmanned aerial vehicles. As a result, the interaction between the physical environment and these devices has become more critical in terms of safety. Two commonly used methods for addressing these challenges are active and passive approaches. Each method has its advantages and disadvantages, but combining both methods can lead to higher efficiency. One solution is to utilize direct-drive motors for position control and real-time feedback within the operational range to determine appropriate control parameters with high precision. If the maximum motor torque is smaller than the inertial torque and the rotor reaches the operational limit, the spring system absorbs the impact force. Numerous experiments have been conducted to demonstrate the effectiveness of device protection during operation.

Keywords: optical device, collision safety, collision absorption, precise mechanics

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Authors: Shunsuke Fujiwara, Takashi Kaburagi, Kazuyuki Kobayashi, Kajiro Watanabe, Yosuke Kurihara

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This paper describes a novel sensor device, a pressure pulse wave meter, which uses a bidirectional condenser microphone. The microphone work as a microphone as well as a sensor with high gain over a wide frequency range; they are also highly reliable and economical. Currently aging is becoming a serious social issue in Japan causing increased medical expenses in the country. Hence, it is important for elderly citizens to check health condition at home, and to care the health conditions through daily monitoring. Given this circumstances, we developed a novel pressure pulse wave meter based on a bidirectional condenser microphone. This novel pressure pulse wave meter device is used as a measuring instrument of health conditions.

Keywords: bidirectional microphone, pressure pulse wave meter, health condition, novel sensor device

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Authors: Shamsa Al Sharji, Athar Al Jabri, Haitham Al Dughaishi, Mirfat Al Barwani, Raja Al Rawahi, Raiya Al Rajhi, Shurooq Al Ruqaishi, Thamreen Al Zadjali, Iman Al Humaidi

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Background: External Ventricular Drains (EVDs) are critical in managing traumatic brain injuries and hydrocephalus by controlling intracranial pressure, but they carry a high risk of infection. Infection rates vary globally, ranging from 5% to 45%, leading to increased morbidity, prolonged hospital stays, and higher healthcare costs. Nursing protocols play a pivotal role in reducing these infection rates. This study investigates the impact of a structured nursing protocol on EVD-associated infections in adult neurosurgery patients at the Directorate General of Khoula Hospital, Oman, from January to September 2024. Methods: A cluster-randomized trial was conducted across neurosurgery wards and the ICU. The intervention group followed a comprehensive nursing protocol, including strict sterile insertion, standardized dressing changes, infection control training, and regular clinical audits. The control group received standard care. The primary outcome was the incidence of EVD-associated infections, with secondary outcomes including protocol compliance, infection severity, recovery times, length of stay, and 30-day mortality. Statistical analysis was conducted using Chi-square tests, paired t-tests, and logistic regression to assess the differences between groups. Results: The study involved 75 patients, with an overall infection rate of 13.3%. The intervention group showed a reduced infection rate of 8.9% compared to 20% in the control group. Compliance rates for key nursing actions were high, with 89.7% for hand hygiene and 86.2% for wound dressing. The relative risk of infection was 0.44 in the intervention group, reflecting a 55.6% reduction. Logistic regression identified obesity as a significant predictor of EVD infections. Although mortality rates were slightly higher in the intervention group, the number needed to treat (NNT) of 9 suggests that the nursing protocol may improve survival outcomes. Conclusion: This study demonstrates that structured nursing protocols can reduce EVD-related infections and improve patient outcomes in neurosurgery. While the findings are promising, further research with larger sample sizes is needed to confirm these results and optimize infection control strategies in neurosurgical care.

Keywords: EVD, CSF, nursing protocol, EVD infection

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Authors: Mika Kaufman

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Behavioral health in school-age children is a great concern. Negative behaviors can affect mental and physical health and, if ignored, can lead to further problems later in life. Rural communities often lack resources for counselors, social workers, and mental health care in the hopes of intervening with children who exhibit negative behaviors. Because of this, schools in rural communities are more likely to have children with behavioral issues. Prevention programs to recognize and address these behavioral concerns can educate teachers about mental health, different negative behaviors that students might exhibit, and how to manage those behaviors and engage with students in a positive way.

Keywords: prevention programs, behavioral health, resources for teachers, rural schools

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Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

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The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

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Authors: Netsanet Kebede Hundessa

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Substrate modification of thin film composite (TFC) membranes with various crosslinkers is typically necessary for organic solvent nanofiltration (OSN) applications. This modification is aimed at enhancing membrane stability and solvent resistance, but it often results in a decline in permeance. This study introduces a distinct approach by developing a coordination-crosslinked polyimide substrate, which differs from the covalently-crosslinked substrates traditionally used. This developed substrate achieves enhanced solvent resistance, improved hydrophilicity, and optimized porous microstructure simultaneously. The study investigates the effects of an alkaline coagulation bath, subsequent ion exchange, and further solvent activation. The resulting TFC membrane successfully overcomes the typical permeability-selectivity trade-off of OSN membranes. It demonstrates significantly improved solvent permeance (1.5–2 times higher than previously reported data) with values of 65.2 LMH/bar for methanol, 33.1 LMH/bar for ethanol, and 59.1 LMH/bar for acetone while maintaining competitive solute rejection (>98% for Rose Bengal). This research is expected to provide a new direction for developing high-performance OSN composite membranes and other separation applications.

Keywords: metal coordinatiom, thin film composite membrane, organic solvent nanofiltration, solvent activation

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Authors: Mehrnoosh Jafari, Zeinolabedin Amini Sabegh, Habibollah Azimian

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Background: Today variable and dynamic environment doubles importance of using suitable solutions for confronting these changes in th4e organizations. One of the best ways for coping with environmental changes is directing the organization towards agility. Current research aims at investigating status of organizational agility in Tehran municipality (22 districts). Research Methodology: This research is applied research in terms of purpose of study and it is survey in terms of collection of descriptive data. A sample (n = 377) was selected from Tehran Municipality (22 districts) employees using multistage sampling method (cluster and regular). Data were collected using organizational agility standard questionnaire, and they were analyzed using statistical tests in SPSS software as well as inferential statistics such as one-sample t-test and Friedman test and descriptive statistics such as mean and median. Findings: Research findings showed organizational agility status in the organizations under study is in relatively optimal status and competence has highest priority in terms of ranking and priority of organizational agility indexes. Conclusion: It is necessary that managers provide suitable conditions for promoting organizational agility status in the organizations under study by identifying factors affecting change in the organizational environments and using available potentials for better coping with changes and higher flexibility and speed.

Keywords: organizational, municipality, employer, agility

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Authors: Elisabet Liljeblad, Tomas Karlsson, Torbjorn Sundberg, Anita Kullen

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The magnetospheric magnetic field data from the MESSENGER spacecraft is investigated to establish the presence of ultra-low frequency (ULF) waves in connection to 131 previously observed nonlinear Kelvin-Helmholtz waves (KHWs) at Mercury. Distinct ULF signatures are detected in 44 out of the 131 magnetospheric traversals prior to or after observing a KHW. In particular, 39 of these 44 ULF events are highly coherent at the frequency of maximum power spectral density. The waves observed at the dayside, which appears mainly at the duskside and naturally following the KHW occurrence asymmetry, are significantly different to the events behind the dawn-dusk terminator and have the following distinct wave characteristics: they oscillate clearly in the perpendicular (azimuthal) direction to the mean magnetic field with a wave normal angle more in the parallel than the perpendicular direction, increase in absolute ellipticity with distance from noon, are almost exclusively right-hand polarized, and are observed mainly for frequencies in the range 0.02-0.04 Hz. These results indicate that the dayside ULF waves are likely to shear Alfvén waves driven by KHWs at the magnetopause, which in turn manifests the importance of the Kelvin-Helmholtz instability in terms of mass transport throughout the Mercury magnetosphere.

Keywords: ultra-low frequency waves, kelvin-Helmholtz instability, magnetospheric processes, mercury, messenger, energy and momentum transfer in planetary environments

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Authors: Abdul Rohim Tualeka, Erick Caravan K. Betekeneng, Ramdhoni Zuhro, Reko Triyono, M. Sahri

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It has been widely reported incidence caused by acute and chronic effects of exposure to ammonia in the working environment in Indonesia, but ammonia concentration was found to be below the threshold value. The purpose of this study was to determine the safety limit concentration of ammonia in the working environment through the expression of CD8 as a reference for determining the threshold value of ammonia in the working environment. This research was a laboratory experimental with post test only control group design using experimental animals as subjects experiment. From homogeneity test results indicated that the weight of white rats exposed and control groups had a homogeneous variant with a significant level of p (0.701) > α (0.05). Description of the average breathing rate is 0.0013 m³/h. Average weight rats based group listed exposure is 0.1405 kg. From the calculation IRS CD8, CD8 highest score in the doses contained 0.0154, with the location of the highest dose of ammonia without any effect on the lungs of rats is 0.0154 mg/kg body weight of mice. Safe Human Dose (SHD) ammonia is 0.002 mg/kg body weight workers. The conclusion of this study is the safety limit concentration of ammonia gas in the working environment of 0,025 ppm.

Keywords: ammonia, CD8, rats, safe limits concentration

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Authors: Balogun Azeez Olawale, Azeez S. A.

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Post occupancy evaluation (POE) is a process of assessing building performance for its users and intended function during the occupation. User satisfaction impacts the performance of educational environments and their users: students, faculty, and staff. In addition, buildings are maintained and managed by teams that spend a large amount of time and capital on their long-term sustenance. By evaluating the feedback from users of higher education facilities, university planning departments are more prepared to understand the inputs for programming and future project planning. In addition, university buildings will be closer to meeting user and maintenance needs. This paper reports on a research team made up of academics, facility personnel, and users that have developed a plan to improve the quality of campus facilities through a POE exercise on a recently built project. This study utilized a process of focus group interviews representing the different users and subsequent surveys. The paper demonstrates both the theory and practice of POE in higher education and learning environment through the case example of four universities in Nigeria's POE exercise.

Keywords: post occupancy evaluation, building performance, building analysis, building evaluation, quality control, building assessment, facility management, design quality

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Authors: Subodh Kumar, Amit Varde

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Typical on-premises high-performance computing (HPC) environments consist of a fixed number and a fixed set of computing hardware. During the design of the HPC environment, the hardware components, including but not limited to CPU, Memory, GPU, and networking, are carefully chosen from select vendors for optimal performance. High capital cost for building the environment is a prime factor influencing the design environment. A class of software called “Job Schedulers” are critical to maximizing these resources and running multiple workloads to extract the maximum value for the high capital cost. In principle, schedulers work by preventing workloads and users from monopolizing the finite hardware resources by queuing jobs in a workload. A cloud-based HPC environment does not have the limitations of fixed (type of and quantity of) hardware resources. In theory, users and workloads could spin up any number and type of hardware resource. This paper discusses the limitations of using traditional scheduling algorithms for cloud-based HPC workloads. It proposes a new set of features, called “HPC optimizers,” for maximizing the benefits of the elasticity and scalability of the cloud with the goal of cost-performance optimization of the workload.

Keywords: high performance computing, HPC, cloud computing, optimization, schedulers

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Authors: Lukáš Mazánek, Zdeňka Konečná

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The article is devoted to the area of personnel marketing. A comprehensive review of scientific literature and articles published predominantly in personnel-oriented journals was carried out, followed by a qualitative exploratory research with the aim to explore and explain the perception of personnel marketing. Due to the lack of research in this field in Czech Republic, we have focused on Czech HR managers, more specifically, on how they understand the tasks of personnel marketing, which tools they use and whether the companies they work for try to be a preferred employer. The answers from our respondents were used to help us determine what is important within this field. All of the respondents strive to be a preferred employer and try to achieve it by using an extensive range of marketing tools. The most frequently used tools are advertising, job fairs presentations, employee care and employer brand promotion.

Keywords: Czech Republic, personnel marketing, preferred employer, qualitative research study

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Authors: Sally J. Price, Greg F. Walker, Weiyi Liu, Craig R. Bunt

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Plastics, due to their long lifespan, are becoming more of an environmental concern once their useful life has been completed. There are a vast array of different types of plastic, and they can be found in almost every ecosystem on earth and are of particular concern in terrestrial environments where they can become incorporated into the food chain. Hence bioplastics have become more of interest to manufacturers and the public recently as they have the ability to (bio)degrade in commercial and in home composting situations. However, tools in which to quantify how they degrade in response to environmental variables are still being developed -one such approach is texture analysis using a TA.XT Texture Analyser, Stable Microsystems, was used to determine the force required to break or punch holes in standard ASTM D638 Type IV 3D printed bioplastic “dogbones” depending on the thicknesses of them. Manufacturers’ recommendations for calibrating the Texture Analyser are one such approach for standardising results; however, an independent technique using dummy dogbones and a substitute for the bioplastic was used alongside the samples. This approach was unexpectedly more valuable than realised at the start of the trial as irregular results were later discovered with the substitute material before valuable samples collected from the field were lost due to possible machine malfunction. This work will show the value of having an independent approach to machine calibration for accurate sample analysis with a Texture Analyser when analysing bioplastic samples.

Keywords: bioplastic, degradation, environment, texture analyzer

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Authors: Haitham S. Hamza, Mohamed Maher, Shourok Alaa, Aya Khattab, Hadeal Ismail, Kamilia Hosny

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Radio Frequency Identification (RFID) has become a key technology in the margining concept of Internet of Things (IoT). Naturally, business applications would require the deployment of various RFID systems that are developed by different vendors and use various data formats. This heterogeneity poses a real challenge in developing large-scale IoT systems with RFID as integration is becoming very complex and challenging. Semantic integration is a key approach to deal with this challenge. To do so, ontology for RFID systems need to be developed in order to annotated semantically RFID systems, and hence, facilitate their integration. Accordingly, in this paper, we propose ontology for RFID systems. The proposed ontology can be used to semantically enrich RFID systems, and hence, improve their usage and reasoning. The usage of the proposed ontology is explained through a simple scenario in the health care domain.

Keywords: RFID, semantic technology, ontology, sparql query language, heterogeneity

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Authors: Olu Akande

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This study explores the effectiveness of a community-based hand hygiene education and awareness program in reducing community-acquired infections among children with limited access to healthcare services. Utilizing the PICOT framework, this research evaluates the impact of targeted hand hygiene interventions compared to standard care on infection rates, specifically respiratory and gastrointestinal diseases, over a six-month period. The findings aim to inform public health strategies to improve health outcomes in underserved communities. This study highlights the importance of preventative measures in addressing healthcare disparities and enhancing community resilience.

Keywords: community-based education, hand hygiene, infection prevention, underserved communities

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Authors: Waqas Abrar

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Background: Pakistan is confronted with a formidable challenge to increase uptake of modern contraceptive methods. USAID, through its flagship Maternal and Child Survival Program (MCSP), in Pakistan is determined to support provincial Departments of Health and Population Welfare to increase the country's contraceptive prevalence rates (CPR) in Sindh, Punjab and Balochistan to achieve FP2020 goals. To inform program design and planning, a Rapid Situation Assessment (RSA) of family planning was carried out in Rawalpindi and Lahore districts in Punjab and Karachi district in Sindh. Methodology: The methodology consisted of comprehensive desk review of available literature and used a qualitative approach comprising of in-depth interviews (IDIs) and focus group discussions (FGDs). FGDs were conducted with community women, men, and mothers-in-law whereas IDIs were conducted with health facility in-charges/chiefs, healthcare providers, and community health workers. Results: Some of the oft-quoted reasons captured during desk review included poor quality of care at public sector facilities, affordability and accessibility in rural communities and providers' technical incompetence. Moreover, providers had inadequate knowledge of contraceptive methods and lacked counseling techniques; thereby, leading to dissatisfied clients and hence, discontinuation of contraceptive methods. These dissatisfied clients spread the myths and misconceptions about contraceptives in their respective communities which seriously damages community-level family planning efforts. Private providers were found reluctant to insert Intrauterine Contraceptive Devices (IUCDs) due to inadequate knowledge vis-à-vis post insertion issues/side effects. FGDs and IDIs unveiled multi-faceted reasons for poor contraceptives uptake. It was found that low education and socio-economic levels lead to low contraceptives uptake and mostly uneducated women rely on condoms provided by Lady Health Workers (LHWs). Providers had little or no knowledge about postpartum family planning or lactational amenorrhea. At community level family planning counseling sessions organized by LHWs and Male Mobilizers do not sensitize community men on permissibility of contraception in Islam. Many women attributed their physical ailments to the use of contraceptives. Lack of in-service training, job-aids and Information, Education and Communications (IEC) materials at facilities seriously comprise the quality of care in effective family planning service delivery. This is further compounded by frequent stock-outs of contraceptives at public healthcare facilities, poor data quality, false reporting, lack of data verification systems and follow-up. Conclusions: Some key conclusions from this assessment included capacity building of healthcare providers on long acting reversible contraceptives (LARCs) which give women contraception for a longer period. Secondly, capacity building of healthcare providers on postpartum family planning is an enormous challenge that can be best addressed through institutionalization. Thirdly, Providers should be equipped with counseling skills and techniques including inculcation of pros and cons of all contraceptive methods. Fourthly, printed materials such as job-aids and Information, Education and Communications (IEC) materials should be disseminated among healthcare providers and clients. These concluding statements helped MCSP to make informed decisions with regard to setting broad objectives of project and were duly approved by USAID.

Keywords: capacity building, contraceptive prevalence rate, family planning, Institutionalization, Pakistan, postpartum care, postpartum family planning services

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Authors: Aziza Tahar Djebbar

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Throughout American history, many American presidents have tried to create new reforms to enhance the living conditions of the American citizens and promote their welfare. Among these reforms were those dealing with health care, education, as well as social security, which would facilitate accordingly the evolution of the American welfare state. After the New Deal, from 1945 to 1969, American presidents sought to carry out and enlarge the scope of the welfare state that emerged during the Roosevelt Administration by introducing new social reforms. Yet, there were some American presidents who succeeded, and there were some presidents who failed.The task of this research work is to depict the postwar period from 1945 to 1969. Some light will be shed on the main causes that led to the delay of many programs from 1945 to 1960. Further, the focus will be on the main factors that contributed to the reappearance of many social reforms and the dramatic expansion of the welfare state all along the 1960s.

Keywords: new deal, great society, medicaid, medicare, war on poverty, social reforms, welfare reforms

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Authors: Franco Lorenzo D. Morales

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‘Toshi-no-sakon,’ which translates to as ‘age gap marriage,’ is a term that has been popularized by celebrity couples in the Japanese entertainment industry. Japan is distinct for a developed nation for its rapidly aging population, declining marital and fertility rates, and the reinforcement of traditional gender roles. Statistical data has shown that the average age of marriage in Japan is increasing every year, showing a growing tendency for late marriage. As a result, the government has been trying to curb the declining trends by encouraging marriage and childbirth among the populace. This graduate thesis seeks to analyze the ‘toshi-no-sakon’ phenomenon in lieu of Japan’s current economic and social situation, and to see what the implications are for these kinds of married couples. This research also seeks to expound more on age gaps within married couples, which is a factor rarely-touched upon in Japanese family studies. A literature review was first performed in order to provide a framework to study ‘toshi-no-sakon’ from the perspective of four fields of study—marriage, family, aging, and gender. Numerous anonymous online statements by ‘toshi-no-sakon’ couples were then collected and analyzed, which brought to light a number of concerns. Couples wherein the husband is the older partner were prioritized in order to narrow down the focus of the research, and ‘toshi-no-sakon’ is only considered when the couple’s age gap is ten years or more. Current findings suggest that one of the perceived merits for a woman to marry an older man is that financial security would be guaranteed. However, this has been shown to be untrue as a number of couples express concern regarding their financial situation, which could be attributed to their husband’s socio-economic status. Having an older husband who is approaching the age of retirement presents another dilemma as the wife would be more obliged to provide care for her aging husband. This notion of the wife being a caregiver likely stems from an arrangement once common in Japanese families in which the wife must primarily care for her husband’s elderly parents. Childbearing is another concern as couples would be pressured to have a child right away due to the age of the husband, in addition to limiting the couple’s ideal number of children. This is another problematic aspect as the husband would have to provide income until his child has finished their education, implying that retirement would have to be delayed indefinitely. It is highly recommended that future studies conduct face-to-face interviews with couples and families who fall under the category of ‘toshi-no-sakon’ in order to gain a more in-depth perspective into the phenomenon and to reveal any undiscovered trends. Cases wherein the wife is the older partner in the relationship should also be given focus in future studies involving ‘toshi-no-sakon’.

Keywords: age gap, family structure, gender roles, marriage trends

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Authors: S. Selman, T. Gout

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Microbial keratitis is a serious complication of contact lens wear that can be vision and eye-threatening. Diverse presentations relating to contact lens wear include dry corneal surface, corneal infiltrate, ulceration, scarring, and complete corneal melt leading to perforation. Contact lens wear is a major risk factor and, as such, is an important consideration in any patient presenting with a red eye in the primary care setting. This paper aims to provide an overview of the risk factors, common organisms, and spectrum of contact lens-associated keratitis (CLAK) complications. It will highlight some of the salient points relevant to the assessment and workup of patients suspected of CLAK in the emergency department based on the recent literature and therapeutic guidelines. An overview of the management principles will also be provided.

Keywords: microbial keratitis, corneal pathology, contact lens-associated complications, painful vision loss

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Authors: Michael Smalenberger

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Intelligent tutoring systems (ITS) are computer-based platforms which can incorporate artificial intelligence to provide step-by-step guidance as students practice problem-solving skills. ITS can replicate the benefits of one-on-one tutoring, foster transactivity in collaborative environments, and lead to substantial learning gains when used to supplement the instruction of a teacher or when used as the sole method of instruction. Developments improving the ease of ITS creation have recently increased their proliferation, leading many K-12 schools and institutions of higher education in the United States to regularly use ITS within classrooms. We investigated how students perceive their experience using an ITS. In this study, 111 undergraduate students used an ITS in a college-level introductory statistics course and were subsequently asked for feedback on their experience. Results show that their perceptions were generally favorable of the ITS, and most would seek to use an ITS both for STEM and non-STEM courses in the future. Along with detailed transaction-level data, this feedback also provides insights on the design of user-friendly interfaces, guidance on accessibility for students with impairments, the sequencing of exercises, students’ expectation of achievement, and comparisons to other tutoring experiences. We discuss how these findings are important for the creation, implementation, and evaluation of ITS as a mode and method of teaching and learning.

Keywords: college statistics course, intelligent tutoring systems, in vivo study, student perceptions of tutoring

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Authors: Dejene Ermias Mekango, Mussie Alemayehu, Gebremedhin Berhe Gebregergs, Araya Abrha Medhanye, Gelila Goba

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Background: Maternal near miss (MNM) can be used as a proxy indicator of maternal mortality ratio. There is a huge gap in life time risk between Sub-Saharan Africa and developed countries. In Ethiopia, a significant number of women die each year from complications during pregnancy, childbirth and the post-partum period. Besides, a few studies have been performed on MNM, and little is known regarding determinant factors. This study aims to identify determinants of MNM among women in Tigray region, Northern Ethiopia. Methods: a case-control study in hospital found in Tigray region, Ethiopia was conducted from January 30 - March 30, 2016. The sample included 103 cases and 205 controls recruited from women seeking obstetric care at six public hospitals. Clients having a life-threatening obstetric complication including haemorrhage, hypertensive diseases of pregnancy, dystocia, infections, and anemia or clinical signs of severe anemia in women without haemorrhage were taken as cases and those with normal obstetric outcomes were considered as controls. Cases were selected based on proportional to size allocation while systematic sampling was employed for controls. Data were analyzed using SPSS version 20.0. Binary and multiple variable logistic regression (odds ratio) analyses were calculated with 95% CI. Results: The largest proportion of cases and controls was among the ages of20–29 years, accounting for37.9 %( 39) of cases and 31.7 %( 65) of controls. Roughly 90% of cases and controls were married. About two-thirds of controls and 45.6 %( 47) of cases had gestational age between 37-41 weeks. History of chronic medical conditions was reported in 55.3 %(57) of cases and 33.2%(68) of controls. Women with no formal education [AOR=3.2;95%CI:1.24, 8.12],being less than 16 years old at first pregnancy [AOR=2.5; 95%CI:1.12,5.63],induced labor[AOR=3; 95%CI:1.44, 6.17], history of Cesarean section (C-section) [AOR=4.6; 95%CI: 1.98, 7.61] or chronic medical disorder[AOR=3.5;95%CI:1.78, 6.93], and women who traveled more than 60 minutes before reaching their final place of care[AOR=2.8;95% CI: 1.19,6.35] all had higher odds of experiencing MNM. Conclusions: The Government of Ethiopia should continue its effort to address the lack of road and health facility access as well as education, which will help reduce MNM. Work should also be continued to educate women and providers about common predictors of MNM like the history of C-section, chronic illness, and teenage pregnancy. These efforts should be carried out at the facility, community, and individual levels. The targeted follow-up to women with a history of chronic disease and C-section could also be a practical way to reduce MNM.

Keywords: maternal near miss, severe obstetric hemorrhage, hypertensive disorder, c-section, Tigray, Ethiopia

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Authors: Nermeen Elbeltagy, Helmy abd Elsatar, Sara Hassan, Mohamed Darwish

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Introduction: with the inial appearance in Wuhan, China, in December 2019, the coronavirus disease-related respiratory infection (COVID-19) has rapidly spread among people all over the world. The WHO considered it a pandemic in March 2020. The severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreaks have proved that pregnant females as well as their fetuses are exposed to adverse outcomes, including high rates of intensive care unit (ICU) admission and case fatality. Physiological changes occurring during pregnancy such as the increased transverse diameter of the thoracic cage as well as the elevation of the diaphragm can expose the mother to severe infections because of her decreased tolerance for hypoxia. Furthermore, vasodilation and changes in lung capacity can cause mucosal edema and an increase in upper respiratory tract secretions. In addition, the increased susceptibility to infection is enhanced by changes in cellmediated immunity. Aim of the work: to study the effect of COVID-19 on pregnant females admitted to El-Shatby Maternity University Hospital regarding maternal antepartum, intrapartum and postpartum adverse effects on the mothers and their neonates. Method: A retrospective cohort study was done between October 2020 and October 2022. Maternal characteristics and associated health conditions of COVID-19 positive parents were investigated. Also, the severity of their conditions and me of infection (first or second or third trimester)were explored. Cases were diagnosed based on presence of symptoms suggestive of COVID-19, laboratory tests (other than PCR) and radiological findings.all cases were confirmed by positive PCR test results. Results: The most common adverse maternal outcomes were pre-term labor (11.6%) followed by premature rupture of membranes (5.7%), post-partum hemorrhage (5.4%), preeclampsia (5.0%) and placental abrupon (4.3%). One sixth of the neonates of the studied paents were admied to NICUs and 6.5% of them had respiratory distress with no neonatal deaths. The majority of neonates (85.4%) had a birth weight of 2500- 4000g (normal range). Most of the neonates (77.9%) had an APGAR score of equal or more than 7 in 5 minutes. Conclusion: the most common comorbidity that might increase the incidence of COVID-19 before pregnancy were diabetes, cardiac disorders/ chronic hypertension and chronic obstructive lung diseases (non-asthma). During pregnancy, anemia followed by gestational diabetes and pre-eclampsia/gestational hypertension were the most prevalent comorbidity. So, severity of infection can be reduced by good antenatal care.

Keywords: COVID-19, pregnancy outcome, complicated pregnancy., COVID in Egypt

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Authors: Lindani Mbatha, Suvendi Rimer, Mpho Gololo

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Image segmentation is the process of dividing an image into several sections, such as the object's background and the foreground. It is a critical technique in both image-processing tasks and computer vision. Most of the image segmentation algorithms have been developed for gray-scale images and little research and algorithms have been developed for the color images. Most image segmentation algorithms or techniques vary based on the input data and the application. Nearly all of the techniques are not suitable for noisy environments. Most of the work that has been done uses the Markov Random Field (MRF), which involves the computations and is said to be robust to noise. In the past recent years' image segmentation has been brought to tackle problems such as easy processing of an image, interpretation of the contents of an image, and easy analysing of an image. This article reviews and summarizes some of the image segmentation techniques and algorithms that have been developed in the past years. The techniques include neural networks (CNN), edge-based techniques, region growing, clustering, and thresholding techniques and so on. The advantages and disadvantages of medical ultrasound image segmentation techniques are also discussed. The article also addresses the applications and potential future developments that can be done around image segmentation. This review article concludes with the fact that no technique is perfectly suitable for the segmentation of all different types of images, but the use of hybrid techniques yields more accurate and efficient results.

Keywords: clustering-based, convolution-network, edge-based, region-growing

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Authors: Era Dorihi Kale, Sabina Gero, Uly Agustine

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Asylum seekers are people who come to other countries to get asylum. In line with that, they also carry the culture and health behavior of their country, which is very different from the new country they currently live in. This situation raises problems, also in the health sector. The approach taken must also be a culturally sensitive approach, where the culture and habits of the refugee's home area are also valued so that the health services provided can be right on target. Some risk factors that already exist in this group are lack of activity, consumption of fast food, smoking, and stress levels that are quite high. Overall this condition will increase the risk of an increased incidence of cardiovascular disease. This research is a descriptive and experimental study. The purpose of this study is to identify health status and develop a culturally sensitive health promotion model, especially related to the risk of cardiovascular disease for asylum seekers in detention homes in the city of Kupang. This research was carried out in 3 stages, stage 1 was conducting a survey of health problems and the risk of asylum seeker cardiovascular disease, Stage 2 developed a health promotion model, and stage 3 conducted a testing model of health promotion carried out. There were 81 respondents involved in this study. The variables measured were: health status, risk of cardiovascular disease and, health promotion models. Method of data collection: Instruments (questionnaires) were distributed to respondents answered for anamnese health status; then, cardiovascular risk measurements were taken. After that, the preparation of information needs and the compilation of booklets on the prevention of cardiovascular disease is carried out. The compiled booklet was then translated into Farsi. After that, the booklet was tested. Respondent characteristics: average lived in Indonesia for 4.38 years, the majority were male (90.1%), and most were aged 15-34 years (90.1%). There are several diseases that are often suffered by asylum seekers, namely: gastritis, headaches, diarrhea, acute respiratory infections, skin allergies, sore throat, cough, and depression. The level of risk for asylum seekers experiencing cardiovascular problems is 4 high risk people, 6 moderate risk people, and 71 low risk people. This condition needs special attention because the number of people at risk is quite high when compared to the age group of refugees. This is very related to the level of stress experienced by the refugees. The health promotion model that can be used is the transactional stress and coping model, using Persian (oral) and English for written information. It is recommended for health practitioners who care for refugees to always pay attention to aspects of culture (especially language) as well as the psychological condition of asylum seekers to make it easier to conduct health care and promotion. As well for further research, it is recommended to conduct research, especially relating to the effect of psychological stress on the risk of cardiovascular disease in asylum seekers.

Keywords: asylum seekers, health status, cardiovascular disease, health promotion

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Authors: Pırıl Tekin, Rızvan Erol

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Risk management has become very important and popular in developing countries in recent years. Especially making patient and employee health and safety issues compulsory in the hospitals, raised the number of studies in Turkey. Also risk management become more important for hospital senior management from clinics to the laboratories. Because quality is really important to be chosen for both patients to consult and employees to prefer to work. And also risk management studies can lead to hospital management team about future works and methods. By this point of view, this study is the risk assessment carried out in the biggest dental hospital in the south part of Turkey. This study was conducted as a research case study, covering two different health care place; A Clinic and A Laboratory. It shows that the problems in this dental hospital and how it can solve all.

Keywords: risk management, healthcare, dental hospital, quality management

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Authors: Med. A. Djeridane, M. Ferhat, H. A. Benhorma, O. Bouledroua

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This research is dedicated to exploring the failure of a turbine blade within a gas transportation plant, with a primary focus on conducting a comprehensive examination through advanced metallurgical and mechanical analyses of the identified failed blade. Crafted from the nickel superalloy Inconel IN738LC, the turbine engine had accumulated approximately 61,000 operational hours before the blades failed, causing severe damage to the transportation plant and necessitating a prolonged shutdown. The investigative procedure commenced with an in-depth visual inspection of the blade surfaces, succeeded by fractography analysis of the fracture surfaces, microstructural investigations, chemical analysis, and hardness measurements. The findings unveiled distinctive fatigue marks on the fracture surface. Critical microstructural changes were identified as a consequence of the blade's operation at high temperatures. The investigation determined that the crack initiation resulted from coating damage at the leading edge, subsequently propagating through fatigue. Ultimately, due to a reduction in cross-sectional area, the fracture was completed. This comprehensive analysis sheds light on the intricate factors contributing to turbine blade failure and offers valuable insights for enhancing operational reliability in similar environments.

Keywords: gas turbine, blade failure, TCP phases, fatigue, quantitative analysis

Procedia PDF Downloads 65