Search results for: inclusive health care

Authors: Mari Murakami, Hiromi Kawasaki, Saori Fujimoto, Yoko Ueno

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Background: In Japan, one of the goals of midwifery education is the development of one’s ability to comprehensively support the child-rearing generation in collaboration with professionals from other disciplines. However, in order to prevent the spread of Covid-19, it has become extremely difficult to provide face-to-face support for mothers and children. Early on in the pandemic, we sought help from three parenting midwives as an alternative and attempted an online visit. Since midwives who are raising children respond to the training as both mothers who are care recipients and midwives as care providers. Therefore, we attempted to verify the usefulness of midwives experiencing training as mothers by clarifying the effects on those midwives who are raising children and who have experienced online visit training by students. Methods: The online visitations were conducted in June 2020. The collaborators were three midwives who were devoted to childcare. During the online visit training, we used the feedback records of their questions given by the collaborators (with their permission) to the students. The verbatim record was created from the records. Qualitative descriptive analysis was used, and subcategories and categories were extracted. This study was approved by the Ethical Committee for Epidemiology of Hiroshima University. Results: The average age of the three midwives was 36.3 years, with an average of 12.3 years of experience after graduation. They were each raising multiple children (ranging between a minimum of 2 and a maximum of 4 children). Their youngest infants were 6.7 months old on average for all. Five categories that emerged were: contributing to the development of midwifery students as a senior; the joy of accepting the efforts of a mother while raising children; recalling the humility of beginners through the integrity of midwifery students; learning opportunities about the benefits of online visits; and suggesting further challenges for online visits. Conclusion: The online visit training was an opportunity for midwives who are raising their own children to reinforce an honest and humble approach based on the attitude of the students, for self-improvement, and to reflect on the practice of midwifery from another person’s viewpoint. It was also noted that the midwives contributed to the education of midwifery students. Furthermore, they also agreed with the use of online visitations and considered the advantages and disadvantages of its use from the perspective of mothers and midwives. Online visits were seen to empower midwives on childcare leave, as their child-rearing was accepted and admired. Online visits by students were considered to be an opportunity to not only provide a sense of fulfillment as a recipient of care but also to think concretely about career advancement, during childcare leave, regarding the ideal way for midwifery training and teaching.

Keywords: child-rearing midwife, COVID-19 pandemic, online visit practice, qualitive descriptive study

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Authors: Chiu-Wen Chang, I-Yun Chang, Wei-Ting Chen, Hui-Ping Ho, Ruei-Hun Chang, Joh-Jong Huang

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Kaohsiung City is located in the tropical region where has Aedes aegypti and Aedes albopictus distributed; once the virus invades, it’s can easily trigger local epidemic. Besides, Kaohsiung City has a world-class airport and harbor, trade and tourism are close and frequently with every country, especially with the Southeast Asian countries which also suffer from dengue. Therefore, Kaohsiung City faces the difficult challenge of dengue every year. The objectives of this study was to enhance dengue clinical care, border management and vector surveillance in Kaohsiung City by establishing an larger scale, innovatively and more coordinated dengue prevention and control strategies in 2016, including (1) Integrated medical programs: facilitated 657 contract medical institutions, widely set up NS1 rapid test in clinics, enhanced triage and referrals system, dengue case daily-monitoring management (2) Border quarantine: comprehensive NS1 screening for foreign workers and fisheries when immigration, hospitalization and isolation for suspected cases, health education for high risk groups (foreign students, other tourists) (3) Mosquito control: Widely use Gravitrap to monitor mosquito density in environment, use NS1 rapid screening test to detect community dengue virus (4) Health education: create a dengue app for people to immediately inquire the risk map and nearby medical resources, routine health education to all districts to strengthen public’s dengue knowledge, neighborhood cleaning awards program. The results showed that after new integration of dengue prevention and control strategies fully implemented in Kaohsiung City, the number of confirmed cases in 2016 declined to 342 cases, the majority of these cases are the continuation epidemic in 2015; in fact, only two cases confirmed after the 2016 summer. Besides, the dengue mortality rate successfully decreased to 0% in 2016. Moreover, according to the reporting rate from medical institutions in 2014 and 2016, it dropped from 27.07% to 19.45% from medical center, and it decreased from 36.55% to 29.79% from regional hospital; however, the reporting rate of district hospital increased from 11.88% to 15.87% and also increased from 24.51% to 34.89% in general practice clinics. Obviously, it showed that under the action of strengthening medical management, it reduced the medical center’s notification ratio and improved the notification ratio of general clinics which achieved the great effect of dengue clinical management and dengue control.

Keywords: dengue control, integrated control strategies, clinical management, NS1

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Authors: Ogunnaiya Racheal Taiwo

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Children's formative years are crucial to their growth; it is, therefore, necessary for all the stakeholders to ensure that the pupils have an enabling quality of life which is essential for realizing their potential. For children to live and grow, they need a secure home, nutritious food, good health care, and quality education. This paper, therefore, investigates the implications of a depressed economy on the classroom learning of Nigerian children as it is clear that Nigeria is currently experiencing the worst economic depression in several decades, which affects a substantial proportion of children. The study is qualitative research, and it adopts a phenomenological approach where the experiences of respondents are examined qualitatively. Three senatorial districts in Oyo State were considered, and 50 teachers, both male, and female were chosen from each senatorial district for an interview through conversational key informants' interviews. The interviewees were recorded, transcribed, and presented using thematic analysis. Findings showed that more children have dropped out since the beginning of the year than in previous years. It was also recorded that learning has become challenging as children now find it harder to acquire learning materials. It was recommended that the government should reimburse early childhood schools to lessen the effect of the inability to purchase materials and pay school fees. It was also recommended that an intervention be made to approach and resolve issues associated with out-of-school children.

Keywords: childhood, classroom, education, depressed economy, poverty

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Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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Authors: Meryem Saban Guler, Saniye Bilici

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Malnutrition is a problem that significantly affects patients with cancer throughout the course of their illness, and it may be present from the moment of diagnosis until the end of treatment. We searched electronic databases using key terms such as ‘malnutrition in cancer patients’ or ‘nutritional status in cancer’ or ‘nutritional screening tools’ etc. Decline in nutritional status and continuing weight loss are associated with an increase in number and severity of complications, impaired quality of life and decreased survival rate. Nutrition is an important factor in the treatment and progression of cancer. Cancer patients are particularly susceptible to nutritional depletion due to the combined effects of the malignant disease and its treatment. With increasing incidence of cancer, identification and management of nutritional deficiencies are needed. Early identification of malnutrition, is substantial to minimize or prevent undesirable outcomes throughout clinical course. In determining the nutritional status; food consumption status, anthropometric methods, laboratory tests, clinical symptoms, psychosocial data are used. First-line strategies must include routine screening and identification of inpatients or outpatients at nutritional risk with the use of a simple and standardized screening tool. There is agreement among international nutrition organizations and accredited health care organizations that routine nutritional screening should be a standard procedure for every patient admitted to a hospital. There are f management of all cancer patients therefore routine nutritional screening with validated tools can identify cancer patients at risk.

Keywords: cancer, malnutrition, nutrition, nutritional screening

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Authors: Ow Tze Weng, Suhaila Isaak, Yusmeeraz Yusof

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The trend of health care screening devices in the world is increasingly towards the favor of portability and wearability, especially in the most common electrocardiogram (ECG) monitoring system. This is because these wearable screening devices are not restricting the patient’s freedom and daily activities. While the demand of low power and low cost biomedical system on chip (SoC) is increasing in exponential way, the front end ECG sensors are still suffering from flicker noise for low frequency cardiac signal acquisition, 50 Hz power line electromagnetic interference, and the large unstable input offsets due to the electrode-skin interface is not attached properly. In this paper, a high performance CMOS amplifier for ECG sensors that suitable for low power wearable cardiac screening is proposed. The amplifier adopts the highly stable folded cascode topology and later being implemented into RC feedback circuit for low frequency DC offset cancellation. By using 0.13 µm CMOS technology from Silterra, the simulation results show that this front end circuit can achieve a very low input referred noise of 1 pV/√Hz and high common mode rejection ratio (CMRR) of 174.05 dB. It also gives voltage gain of 75.45 dB with good power supply rejection ratio (PSSR) of 92.12 dB. The total power consumption is only 3 µW and thus suitable to be implemented with further signal processing and classification back end for low power biomedical SoC.

Keywords: CMOS, ECG, amplifier, low power

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Authors: Ioannis Iglezakis, Theodoros D. Trokanas, Panagiota Kiortsi

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This paper aims to explore major legal issues arising from the collection and processing of Health Big Data in the light of the new European secondary legislation for the protection of personal data of natural persons, placing emphasis on the General Data Protection Regulation 679/2016. Whether Big Health Data can be characterised as ‘personal data’ or not is really the crux of the matter. The legal ambiguity is compounded by the fact that, even though the processing of Big Health Data is premised on the de-identification of the data subject, the possibility of a combination of Big Health Data with other data circulating freely on the web or from other data files cannot be excluded. Another key point is that the application of some provisions of GPDR to Big Health Data may both absolve the data controller of his legal obligations and deprive the data subject of his rights (e.g., the right to be informed), ultimately undermining the fundamental right to the protection of personal data of natural persons. Moreover, data subject’s rights (e.g., the right not to be subject to a decision based solely on automated processing) are heavily impacted by the use of AI, algorithms, and technologies that reclaim health data for further use, resulting in sometimes ambiguous results that have a substantial impact on individuals. On the other hand, as the COVID-19 pandemic has revealed, Big Data analytics can offer crucial sources of information. In this respect, this paper identifies and systematises the legal provisions concerned, offering interpretative solutions that tackle dangers concerning data subject’s rights while embracing the opportunities that Big Health Data has to offer. In addition, particular attention is attached to the scope of ‘consent’ as a legal basis in the collection and processing of Big Health Data, as the application of data analytics in Big Health Data signals the construction of new data and subject’s profiles. Finally, the paper addresses the knotty problem of role assignment (i.e., distinguishing between controller and processor/joint controllers and joint processors) in an era of extensive Big Health data sharing. The findings are the fruit of a current research project conducted by a three-member research team at the Faculty of Law of the Aristotle University of Thessaloniki and funded by the Greek Ministry of Education and Religious Affairs.

Keywords: big health data, data subject rights, GDPR, pandemic

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Authors: Yujun Liu, Maosheng Ran

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Background: Chinese rural-to-urban migrant workers’ mental health problems raise attentions from different social sectors. However, situation of present mental health services provided to this population has not been discovered. This study attempts to describe the current mental health service situation, identify the gaps and give the future directions based on the quantitative data. Methods: Questionnaire surveys were conducted among 2017 rural-to-urban migrant workers in 13 cities and 100 social work service organizations in 5 cities in 2014. Data was collected by face-to-face structured interview by trained interviewers. Findings: Migrant workers’ mental health status was not good. Compared to the severity of mental distress, mental health service for this population was lacking and insufficient, which accounted for only 14.4% of all services in our sample. And the group work and case work were the most frequently-used methods. By estimating a series of regression models, we revealed that life experiences and working conditions were significantly associated with migrant workers’ mental health status. Therefore, the macro social work practices aimed at this whole group were advocated to promote their mental wellbeing. That is, practitioners should not only focus on the improvement of migrant workers’ emotion management capacity, but also pay attention to raise awareness and improve their living and working condition; not only concentrate on the solving of individuals’ dilemma, but also promote gradual reformation of present labor regime and hukou system in China.

Keywords: Chinese rural-to-urban migrant workers, macro social work practice, mental health service needs, mental health status

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Authors: Tsega Asresa, Getahun Tigistu, Melaku Bayih

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Computer vision is a subfield of artificial intelligence that allows computers and systems to extract meaning from digital images and video. It is used in a wide range of fields of study, including self-driving cars, video surveillance, medical diagnosis, manufacturing, law, agriculture, quality control, health care, facial recognition, and military applications. Aromatic medicinal plants are botanical raw materials used in cosmetics, medicines, health foods, essential oils, decoration, cleaning, and other natural health products for therapeutic and Aromatic culinary purposes. These plants and their products not only serve as a valuable source of income for farmers and entrepreneurs but also going to export for valuable foreign currency exchange. In Ethiopia, there is a lack of technologies for the classification and identification of Aromatic medicinal plant parts and disease type cured by aromatic medicinal plants. Farmers, industry personnel, academicians, and pharmacists find it difficult to identify plant parts and disease types cured by plants before ingredient extraction in the laboratory. Manual plant identification is a time-consuming, labor-intensive, and lengthy process. To alleviate these challenges, few studies have been conducted in the area to address these issues. One way to overcome these problems is to develop a deep learning model for efficient identification of Aromatic medicinal plant parts with their corresponding disease type. The objective of the proposed study is to identify the aromatic medicinal plant parts and their disease type classification using computer vision technology. Therefore, this research initiated a model for the classification of aromatic medicinal plant parts and their disease type by exploring computer vision technology. Morphological characteristics are still the most important tools for the identification of plants. Leaves are the most widely used parts of plants besides roots, flowers, fruits, and latex. For this study, the researcher used RGB leaf images with a size of 128x128 x3. In this study, the researchers trained five cutting-edge models: convolutional neural network, Inception V3, Residual Neural Network, Mobile Network, and Visual Geometry Group. Those models were chosen after a comprehensive review of the best-performing models. The 80/20 percentage split is used to evaluate the model, and classification metrics are used to compare models. The pre-trained Inception V3 model outperforms well, with training and validation accuracy of 99.8% and 98.7%, respectively.

Keywords: aromatic medicinal plant, computer vision, convolutional neural network, deep learning, plant classification, residual neural network

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Authors: Sarwat Sultan, Muhammad Saleem, Frasat Kanwal

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Adolescence is a transition period of life that brings physical and psychological changes and always results in several challenges for an adolescent. An adolescent must learn life skills for a healthy transition from adolescence period to adulthood. Therefore this study was planned to examine the effects of life skill education on adolescents' mental health and academic benefits. A random sample of 720 school students aged between 13-17 years was categorized into two groups; experimental (n=360) and control (n=360). Life skill education was given to the students of the intervention group with repeated assessments of mental health and academic benefits at pre-intervention (T1) and post-intervention (T2) for both groups. Both groups were compared on scores of mental health and academic benefits across two times T1 and T2 by employing a mixed between-within-subjects analysis of variance. Findings showed the main effect of time suggesting the largest changes in mental health and academic benefits over time. Interaction effects between time and both groups were also found significant indicating the largest changes across time between both groups. Results of between-group comparisons showed significant values for Wilks’ Lambda and partial eta squared for students of the intervention group who scored higher on mental health and academic benefits after receiving life skills training than the students of the control group. Results of the present study determined the efficacy of life skill education and have implications for both teachers and psychotherapists to improve the students’ mental health and academic performance.

Keywords: academic benefits, life skills, mental health, adolescents

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Authors: Maedeh Gharazi

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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.

Keywords: diabetes, nutritious necessities, insulin resistance, glucose control

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Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo

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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).

Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation

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Authors: Menouni Aziza, Chbihi Kaoutar, El Jaafari Samir

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There is strong evidence connecting epidemics with the disruption of the human-animal-environment interaction. Despite the fact that several cases of emerging and endemic zoonotic diseases indifferent parts of Africa have been documented, there is limited data regarding which specific interventions are effective in preventing and managing the associated risks using a One Health approach. The aim of this study is to better understand perceptions and ongoing research related to interventions in Africa through the implementation of suitable projects and policies. A bibliometric review of the scientific literature on one health studies with a focus on African countries was conducted, followed by a qualitative survey among stakeholders involved in fields related to One Health research or management in the Africa, including veterinary experts, public health professionals, environmentalists and policy makers, to learn about determinants of their perceptions, as well as barriers to and promoters of successful interventions and governance. The project was concluded with an international workshop in March 2023, where a broad range of topics relevant to One Health were discussed. 94% of the respondents were aware of the importance of the One Health approach and strongly endorse it within their respective countries. The top reported barriers to One Health development in Africa included paucity of data, weak linkages and institutional communication between the different departments and the lack of funding. Key areas of improvement identified were the impact evaluation of current initiatives, awareness raising campaigns among citizens targeted at behavioral changes, capacity building of relevant professionals and stakeholders, as well as the implementation of adequate policies and enforcement of national and continental regulations, allowing for better coordination on the African level. All One Health sectors in Africa require strong governance and leadership, as well as inter-ministerial, inter-sectoral, and interdisciplinary cooperation.

Keywords: one health, perceptions, governance, Africa

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Authors: Tacho Rubby Kong

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Community health workers’ performances are known to influence members’ behaviours and practices while translating policies into service delivery. However, little remains known about the extent to which this remains true within interventions aimed at addressing malaria burden in low-resource settings like Cameroon. The objective of this study was to examine the health workers’ performance and their influence on the adoption of strategies to address the malaria burden at a subnational level health system in Cameroon. A qualitative exploratory design was adopted on a purposively selected sample of 18 key informants. The study was conducted in Konye health district among sub-national health systems, managers, health facility in-charges, and frontline community health workers. Data was collected using semi-structured interview guides in a face-to-face interview with respondents. The analysis adopted a thematic approach utilising journals, credible authors, and peer review articles for data management. Participants acknowledged that workplace networks were influential during the implementation of policies to address malaria. The influence exerted was in form of linkage with other services, caution, and advice regarding strict adherence to policy recommendations, perhaps reflective of the level of trust in providers’ ability to adhere to policy provisions. At the district health management level and among non-state actors, support in perceived areas of weak performance in policy implementation was observed. In addition, timely initiation of contact and subsequent referral was another aspect where community health workers exerted influence while translating policies to address the malaria burden. While the level of support from among network peers was observed to influence community health workers’ adoption and implementation of strategies to address the malaria burden, different mechanisms triggered subsequent response and level of adherence to recommended policy aspects. Drawing from the elicited responses, it was infer that community health workers’ performance influence the direction and extent of success in policy implementation to address the malaria burden at the subnational level.

Keywords: subnational, community, malaria, strategy

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Authors: Argyro-Maria Skourmalla

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Today’s reality is characterized by diversity in different levels and aspects of everyday life. Focusing on the aspect of language and communication in Higher Education (HE), the present paper draws on the example of the University of Luxembourg as a multilingual and international setting. The University of Luxembourg, which is located between France, Germany, and Belgium, adopted its new multilingualism policy in 2020, establishing English, French, German, and Luxembourgish as the official languages of the Institution. In addition, with around 10.000 students and staff coming from various countries around the world, linguistic diversity in this university is seen as both a resource and a challenge that calls for an inclusive and multilingual approach. The present paper includes data derived from semi-structured interviews with lecturing staff from different disciplines and an online survey with undergraduate students at the University of Luxembourg. Participants shared their experiences and point of view regarding linguistic diversity in this context. Findings show that linguistic diversity in this university is seen as an asset but comes with challenges, and even though there is progress in the use of multilingual practices, a lot needs to be done towards the recognition of staff and students’ linguistic repertoires for inclusion and education equity.

Keywords: linguistic diversity, higher education, Luxembourg, multilingual practices, teaching, learning

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Authors: Fasanmi Samuel Sunday, Awosusi Omojola

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The aim of the present study was to investigate the effect of abusive supervision, interactional justice and supportive workplace supervision burnout among health workers in Makurdi, Benue State, Nigeria. Three hundred and twenty (320) health workers were sampled within Makurdi metropolis, Benue State, Nigeria. Standardized questionnaire on abusive supervision scale, interactional justice scale, supportive workplace supervision scale and employee burnout scale were used in the study. The research was a 2x2x2 factorial design. Four hypotheses were generated and were tested using Analysis of Variance (ANOVA). Scheffe’s post-hoc analysis was used to know the direction of the findings. Results revealed that there was a significant main effect of perceived abusive supervision on employee burnout among health workers. Also, there was a significant main effect of interactional justice on employee burnout among health workers. It was also found out that there was a significant interaction effect of supportive workplace supervision, interactional justice, and abusive supervision on employee burnout among health workers. Results were discussed in line with hypotheses; and recommendations on how to reduce employee burnout were suggested.

Keywords: employee burnout, abusive supervision, interactional justice, supportive workplace supervision

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

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Contraceptive methods play a fundamental role in preventing unwanted pregnancies and protecting users from sexually transmitted infections (STIs). Despite being known to almost the entire population of reproductive age living in Colombia, there are barriers, practices and complex notions about contraceptives that affect their desired mass use and effectiveness. This work aims to analyse some of the perceptions and practices discussed with young people (13-28 years old) living in Colombia regarding the use of contraceptives in their daily lives, preferences, needs and perceived side effects. This research also examines the perceived paradox in autonomy that young people experience regarding contraceptive use: in one hand, its use (or lack of it) is interpreted as an act of self-determination and primary example of reproductive agency, on the other hand, it was frequently associated with coercion and limited autonomy derived from the gaps in reliable information available for young people, the difficulty of accessing certain preferred methods, and sometimes the experienced coercion exercise by doctors, partners and/or family members. The data and analysis discussed in this work stems from a research project whose objective was to provide information about needs and preferences in sexual and reproductive health of young people living in Colombia in relation to a possible telehealth service that could close the gap in access to quality care and safe information. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 inperson interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings on contraception use in young people living in Colombia reveal that 85,8% of participants had used a contraceptive method in the last two years, and that the most commonly used methods were condoms, contraceptive pills, the morning-after pill and the method of interruption. The remaining 14,2% of respondents who declared to not have used contraceptives in the last two years expressed that the main four barriers to access were: "Lack of knowledge about contraceptive methods and where to obtain information and/or access them (13.9%)", "Have had sex with people who have vaginas (10.2%)", "Cost of contraceptive method (8.4%)" and "Difficulties in obtaining medical authorisations (7.6%)". These barriers coincided with the ones used to explain the non-use of contraceptives in young people, which reveals that limitations in information, cost, and quality care represent structural issues that need to be address in programmes, services, and public policy. Finally, interviews showed that young people perceive contraceptive use and non-use as an example of reaffirming reproductive agency and limitations to this can be explained through the widespread incomplete knowledge about how methods work and the prevalence of other social representations of contraception associated with trust, fidelity, and partner preferences, that in the end create limitations to young people’s autonomy.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

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Authors: Christian T. Lystbaek

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Background: The importance of innovation management has traditionally been ascribed to private production companies, however, there is an increasing interest in public services innovation management. One of the major theoretical challenges arising from this situation is to understand public values justifying public services innovation management. However, there is not single and stable definition of public value in the literature. The research question guiding this paper is: What is the supposed added value operating in the public sphere? Methodology: The study takes an action research strategy. This is highly contextualized methodology, which is enacted within a particular set of social relations into which on expects to integrate the results. As such, this research strategy is particularly well suited for its potential to generate results that can be applied by managers. The aim of action research is to produce proposals with a creative dimension capable of compelling actors to act in a new and pertinent way in relation to the situations they encounter. The context of the study is a workshop on public services innovation within elderly care. The workshop brought together different actors, such as managers, personnel and two groups of users-citizens (elderly clients and their relatives). The process was designed as an extension of the co-construction methods inherent in action research. Scenario methods and focus groups were applied to generate dialogue. The main strength of these techniques is to gather and exploit as much data as possible by exposing the discourse of justification used by the actors to explain or justify their points of view when interacting with others on a given subject. The approach does not directly interrogate the actors on their values, but allows their values to emerge through debate and dialogue. Findings: The public values related to public services innovation management in elderly care were identified in two steps. In the first step, identification of values, values were identified in the discussions. Through continuous analysis of the data, a network of interrelated values was developed. In the second step, tracking group consensus, we then ascertained the degree to which the meaning attributed to the value was common to the participants, classifying the degree of consensus as high, intermediate or low. High consensus corresponds to strong convergence in meaning, intermediate to generally shared meanings between participants, and low to divergences regarding the meaning between participants. Only values with high or intermediate degree of consensus were retained in the analysis. Conclusion: The study shows that the fundamental criterion for justifying public services innovation management is the capacity for actors to enact public values in their work. In the workshop, we identified two categories of public values, intrinsic value and behavioural values, and a list of more specific values.

Keywords: public services innovation management, public value, co-creation, action research

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Authors: Yi-Ting Liu, Pei-Ying Wen

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In order to improve the overall safety of chemotherapy, safety-protecting net was established for the whole process from prescribing by physicians, transcribing by nurses, dispensing by pharmacists to administering by nurses. The information system was used to check and monitor whole process of administration and related sheets were computerized to simplify the paper work.

Keywords: chemotherapy, bar code medication administration, medication safety

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Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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Authors: Arwa Alnowaiser, Hala Shoukri

Abstract:

The ‘FreeAITherapist’ is an artificial intelligence application that uses the power of AI to offer advice and mental health counseling to its users through its chatbot services. The AI therapist is designed to understand users' issues, concerns, and problems and respond appropriately; it provides empathy and guidance and uses evidence-based therapeutic techniques. With its user-friendly platform, it ensures accessibility for individuals in need, regardless of their geographical location. This website was created in direct response to the growing demand for mental health support, aiming to provide a cost-effective and confidential solution. Through promising confidentiality, it considers user privacy and data security. The ‘FreeAITherapist’ strives to bridge the gap in mental health services, offering a reliable resource for individuals seeking guidance and counseling to improve their overall well-being.

Keywords: artificial intelligence, mental health, AI therapist, website, counseling

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Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

Abstract:

Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

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Authors: Kemka C. Ihemelandu, Chukwuemeka U. Ihemelandu

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The incidence of melanoma has been increasing rapidly over the past two decades, making melanoma a current public health crisis. Unfortunately, even as screening efforts continue to expand in an effort to ameliorate the death rate from melanoma, there is a need to improve diagnostic accuracy to decrease misdiagnosis. Artificial intelligence (AI) a new frontier in patient care has the ability to improve the accuracy of melanoma diagnosis. Convolutional neural network (CNN) a form of deep neural network, most commonly applied to analyze visual imagery, has been shown to outperform the human brain in pattern recognition. However, there are noted limitations with the accuracy of the CNN models. Our aim in this study was the optimization of convolutional neural network algorithms for the automated diagnosis of melanoma. We hypothesized that Optimal selection of the momentum and batch hyperparameter increases model accuracy. Our most successful model developed during this study, showed that optimal selection of momentum of 0.25, batch size of 2, led to a superior performance and a faster model training time, with an accuracy of ~ 83% after nine hours of training. We did notice a lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone. Training set image transformations did not result in a superior model performance in our study.

Keywords: melanoma, convolutional neural network, momentum, batch hyperparameter

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Authors: Joseph Osafo, Winifred Asare-Doku, Charity Akotia

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Decriminalizing suicide is one of the major goals of suicide prevention worldwide. In Ghana, suicide is legally prescribed and there is a wide-spread societal condemnation of the act, the survivor and families share the stigma. Evidence and advocacy continue to mount towards pressuring the government, the legal fraternity and lawmakers to consider decriminalizing the act. However, within this discourse, the views of families of attempt survivors are absent. The purpose of this study was to explore from relatives of suicide attempters their reactions towards the criminality of suicide attempt in the country. A total of 10 relatives of suicide attempters were interviewed using a semi-structured interview guide. Thematic analysis was used to analyze the data. We found that there were divergent views from families on decriminalizing suicide. We generated two major themes; Out-group bias versus In-group bias. Half of the participants opined that suicide attempt should not be decriminalized and others advocated for help and mental health care for victims of the suicide attempt. It was generally observed that although all 10 participants were cognizant that suicide attempt is a crime in Ghana, they preferred their relatives were spared from prosecution. The findings indicate incongruity, especially when participants want their relatives to avoid jail term but want the law that criminalizes suicide to remain. Findings are explained using the Fundamental Attribution Error and the concept of Kin selection. Implications for public education on decriminalization and advocacy are addressed.

Keywords: decriminalization, families, Ghana suicide, suicide attempt

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Authors: Asnakech Zekiwos

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Background: Stress in nursing refers to the reactions nurses experience when faced with work demands that exceed their knowledge, skills, or ability to cope. Nursing, as a profession, is particularly susceptible to work-related stress. Methods: A cross-sectional study was conducted among 405 randomly selected nurses working in Hadiya Zone Public Hospitals from March 1 to 30, 2023. Data were collected using a pre-tested self-administered questionnaire. The data were entered using Epi-data version 3.1 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was performed to identify factors associated with the level of work stress. Variables with a p-value <0.05 were considered statistically significant. Results: In this study, 56% (95% CI 50.9-61.2) of the participants reported being stressed in their work. Several factors were found to be associated with work stress, including being female (AOR=1.94, 95% CI 1.19-3.16), rotating shifts (AOR=2.06, 95% CI 1.31-3.25), working in the intensive care unit (AOR=3.42, 95% CI 1.20-9.73), and having post-basic training (AOR=0.55, 95% CI 0.34-0.92). Conclusion: The study revealed a high level of work stress among nurses in the study area. The zonal health unit takes measures to address work stress by providing job orientation during the hiring process, rotation, and on-the-job training to help nurses cope with and manage stressful events. Stress in public hospitals and among nurses is an important issue that needs attention.

Keywords: stress, nurses, public hospitals, expanded stress scale

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Authors: Zolzaya Badmaavanchig, Shoko Miyamoto

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In recent years, universal design for learning (hereinafter referred to as "UDL"), which aims to establish an inclusive education system and to make all children, regardless of their disabilities, experts in learning, has been attracting attention, and there have been some attempts to incorporate it into regular classrooms where children with developmental disabilities and those who show such tendencies are enrolled. The purpose of this study was to examine the effectiveness and challenges of implementing UDL in Japanese elementary schools based on the previous literature. As a method, we first searched for articles on UDL for learning and UDL in the classroom from 2010 to 2022. In addition, we selected practice studies that targeted children with special educational support needs and the classroom as a whole. In response to the extracted literature, this bridge examined the following five perspectives: (1) subjects and grades in which UDL was practiced, (2) methods to grasp the actual conditions of the children, (3) consideration for children with special needs during class, (4) form of class, and (5) effects of the practice. Based on the results, we would like to present issues related to future UDL efforts in Japanese elementary schools.

Keywords: universal design for learning, regular elementary school class, children with special education needs, special educational support

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Lukman Oyelami

Abstract:

Studies have identified trade as a veritable tool for inclusive economic growth and poverty reduction in developing countries. However, contrary to the overwhelming pieces of evidence of the Asian tiger as a success story of beneficial trade, many African countries still experience poverty unabatedly despite active engagement in trade. Consequently, this study seeks to investigate the contributory effect of technological innovation on total export performance and specifically manufacturing exports of African countries. This is with a view to exploring manufacturing exports as a viable option for diversification. To achieve the empirical investigation this study, require Systems Generalized Method of Moments (sys-GMM) estimation technique was adopted based on the econometric realities inherent in the data utilized. However, the static technique of panel estimation of the Fixed Effects (FE) model was utilized for baseline analysis and robustness check. The conclusion from this study is that innovation generally impacts export performance of African countries positively, however, manufacturing export shows more sensitivity to innovation than total export. And, this provides a clear pathway for export diversification for many African countries that run a resource-based economy.

Keywords: innovation, export, GMM, Africa

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Authors: Haiyoung Jung, Mi Joung Leem, Sun Hwa Lee

Abstract:

Background & Objective: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a genetic abnormality that results in an inadequate amount of G6PD, leading to increased susceptibility of red blood cells to reactive oxygen species and hemolysis. The present study aimed to evaluate the careSTARTTM S1 analyzer for measuring G6PD activity to hemoglobin (Hb) ratio. Methods: Precision for G6PD activity and hemoglobin measurement was evaluated using control materials with two levels on five repeated runs per day for five days. The analytic performance of the careSTARTTM S1 analyzer was compared with spectrophotometry in 40 patient samples. Reference ranges suggested by the manufacturer were validated in 20 healthy males and females each. Results: The careSTARTTM S1 analyzer demonstrated precision of 6.0% for low-level (14~45 U/dL) and 2.7% for high-level (60~90 U/dL) control in G6PD activity, and 1.4% in hemoglobin (7.9~16.3 u/g Hb). A comparison study of G6PD to Hb ratio between the careSTARTTM S1 analyzer and spectrophotometry showed an average difference of 29.1% with a positive bias of the careSTARTTM S1 analyzer. All normal samples from the healthy population were validated for the suggested reference range for males (≥2.19 U/g Hb) and females (≥5.83 U/g Hb). Conclusion: The careSTARTTM S1 analyzer demonstrated good analytical performance and can replace the current spectrophotometric measurement of G6PD enzyme activity. In the aspect of the management of clinical laboratories, it can be a reasonable option as a point-of-care analyzer with minimal handling of samples and reagents, in addition to the automatic calculation of the ratio of measured G6PD activity and Hb concentration, to minimize any clerical errors involved with manual calculation.

Keywords: POCT, G6PD, performance evaluation, careSTART

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Authors: Daniel Walker, Adam Qureshi, David Marchant, Alex Bahrami Balani

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The present study aimed to assess the impact of concussion and physical pain on depression and health-related quality of life. Depressive symptoms were assessed using the Center for Epidemiological Studies' Depression Scale, and scores of health-related quality of life were measured by health-related quality of life short form-12. Data analysis of 67 participants (concussed 32 vs. 35 non-concussed) revealed that (i) 52% were displaying depressive symptoms (concussed 30% vs. non-concussed 22%) (ii) concussion had a significant effect on depressive symptoms when controlling for pain but no effect on the quality of life scores when controlling the same variable (iii) pain had a significant effect on depressive symptoms and quality of life. With this, both concussion and physical pain seem to have a negative impact on mental health; however, individuals may only recognise a reduction in quality of life with increased physical pain, hence a deterioration in mental well-being could be disregarded as a factor of health-related quality of life.

Keywords: depression, quality of life, concussion, physical pain

Procedia PDF Downloads 147