Search results for: smart home healthcare
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4207

Search results for: smart home healthcare

1267 Shape Memory Alloy Structural Damper Manufactured by Selective Laser Melting

Authors: Tiziana Biasutti, Daniela Rigamonti, Lorenzo Palmiotti, Adelaide Nespoli, Paolo Bettini

Abstract:

Aerospace industry is based on the continuous development of new technologies and solutions that allows constant improvement of the systems. Shape Memory Alloys are smart materials that can be used as dampers due to their pseudoelastic effect. The purpose of the research was to design a passive damper in Nitinol, manufactured by Selective Laser Melting, for space applications to reduce vibration between different structural parts in space structures. The powder is NiTi (50.2 at.% of Ni). The structure manufactured by additive technology allows us to eliminate the presence of joint and moving parts and to have a compact solution with high structural strength. The designed dampers had single or double cell structures with three different internal angles (30°, 45° and 60°). This particular shape has damping properties also without the pseudoelastic effect. For this reason, the geometries were reproduced in different materials, SS316L and Ti6Al4V, to test the geometry loss factor. The mechanical performances of these specimens were compared to the ones of NiTi structures, pointing out good damping properties of the designed structure and the highest performances of the NiTi pseudoelastic effect. The NiTi damper was mechanically characterized by static and dynamic tests and with DSC and microscope observations. The experimental results were verified with numerical models and with some scaled steel specimens in which optical fibers were embedded. The realized structure presented good mechanical and damping properties. It was observed that the loss factor and the dissipated energy increased with the angles of the cells.

Keywords: additive manufacturing, damper, nitinol, pseudo elastic effect, selective laser melting, shape memory alloys

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1266 Radio Frequency Identification Device Based Emergency Department Critical Care Billing: A Framework for Actionable Intelligence

Authors: Shivaram P. Arunachalam, Mustafa Y. Sir, Andy Boggust, David M. Nestler, Thomas R. Hellmich, Kalyan S. Pasupathy

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Emergency departments (EDs) provide urgent care to patients throughout the day in a complex and chaotic environment. Real-time location systems (RTLS) are increasingly being utilized in healthcare settings, and have shown to improve safety, reduce cost, and increase patient satisfaction. Radio Frequency Identification Device (RFID) data in an ED has been shown to compute variables such as patient-provider contact time, which is associated with patient outcomes such as 30-day hospitalization. These variables can provide avenues for improving ED operational efficiency. A major challenge with ED financial operations is under-coding of critical care services due to physicians’ difficulty reporting accurate times for critical care provided under Current Procedural Terminology (CPT) codes 99291 and 99292. In this work, the authors propose a framework to optimize ED critical care billing using RFID data. RFID estimated physician-patient contact times could accurately quantify direct critical care services which will help model a data-driven approach for ED critical care billing. This paper will describe the framework and provide insights into opportunities to prevent under coding as well as over coding to avoid insurance audits. Future work will focus on data analytics to demonstrate the feasibility of the framework described.

Keywords: critical care billing, CPT codes, emergency department, RFID

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1265 Predictive Analysis of Chest X-rays Using NLP and Large Language Models with the Indiana University Dataset and Random Forest Classifier

Authors: Azita Ramezani, Ghazal Mashhadiagha, Bahareh Sanabakhsh

Abstract:

This study researches the combination of Random. Forest classifiers with large language models (LLMs) and natural language processing (NLP) to improve diagnostic accuracy in chest X-ray analysis using the Indiana University dataset. Utilizing advanced NLP techniques, the research preprocesses textual data from radiological reports to extract key features, which are then merged with image-derived data. This improved dataset is analyzed with Random Forest classifiers to predict specific clinical results, focusing on the identification of health issues and the estimation of case urgency. The findings reveal that the combination of NLP, LLMs, and machine learning not only increases diagnostic precision but also reliability, especially in quickly identifying critical conditions. Achieving an accuracy of 99.35%, the model shows significant advancements over conventional diagnostic techniques. The results emphasize the large potential of machine learning in medical imaging, suggesting that these technologies could greatly enhance clinician judgment and patient outcomes by offering quicker and more precise diagnostic approximations.

Keywords: natural language processing (NLP), large language models (LLMs), random forest classifier, chest x-ray analysis, medical imaging, diagnostic accuracy, indiana university dataset, machine learning in healthcare, predictive modeling, clinical decision support systems

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1264 Childhood Warscape, Experiences from Children of War Offer Key Design Decisions for Safer Built Environments

Authors: Soleen Karim, Meira Yasin, Rezhin Qader

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Children’s books present a colorful life for kids around the world, their current environment or what they could potentially have- a home, two loving parents, a playground, and a safe school within a short walk or bus ride. These images are only pages in a donated book for children displaced by war. The environment they live in is significantly different. Displaced children are faced with a temporary life style filled with fear and uncertainty. Children of war associate various structural institutions with a trauma and cannot enter the space, even if it is for their own future development, such as a school. This paper is a collaborative effort with students of the Kennesaw State University architecture department, architectural designers and a mental health professional to address and link the design challenges and the psychological trauma for children of war. The research process consists of a) interviews with former refugees, b) interviews with current refugee children, c) personal understanding of space through one’s own childhood, d) literature review of tested design methods to address various traumas. Conclusion: In addressing the built environment for children of war, it is necessary to address mental health and well being through the creation of space that is sensitive to the needs of children. This is achieved by understanding critical design cues to evoke normalcy and safe space through program organization, color, and symbiosis of synthetic and natural environments. By involving the children suffering from trauma in the design process, aspects of the design are directly enhanced to serve the occupant. Neglecting to involve the participants creates a nonlinear design outcome and does not serve the needs of the occupant to afford them equal opportunity learning and growth experience as other children around the world.

Keywords: activist architecture, childhood education, childhood psychology, adverse childhood experiences

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1263 Key Drivers Influencing the Shopping Behaviour of Customers in Retail Store

Authors: Aamir Hasan, Subhash Mishra

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The purpose of the study was to determine the key drivers which influence the shopping behavior of the customers in the retail store. In today‟s competitive world with increasing number of retail stores, the retailers need to be more customer oriented. Retail has changed and expanded in all lines of business, be it apparel,jewelry, footwear, groceries etc. The modern consumer is posing a challenging task for the Indian retailer. More aware, more confident and much more demanding, therefore the retailers are looking for ways to deliver better consumer value and to increase consumer purchase intention. Retailers tend to differentiate themselves by making their service easier to consumers. The study aims to study the key drivers that can influence shopping behavior in retail store. A survey (store intercept) method was employed to elicit primary information from 300 shoppers in different retail stores of Lucknow. The findings reveal the factors that play a greater role in influencing the shopping behavior of customers in retail store. As such, a survey of retail store customers‟ attitude towards reduced price, sales promotion, quality of the products, proximity to the home, customer service, store atmospherics were analyzed to identify the key drivers influencing shopping behavior in retail store. A questionnaire based on a five-item Likert scale, as well as random sampling, was employed for data collection. Data analysis was accomplished using SPSS software. The paper has found shopping experience, store image and value for money as three important variable out of which shopping experience emerged as a dominant factor which influences the consumer's shopping behavior in the retail store. Since the research has established empirical evidences in determining the key drivers which influences the shopping behavior of the customers in the retail store, it serves as a foundation for a deeper probe into the shopping behavior of the customers in the retail store research domain in the Indian context.

Keywords: retail, shopping, customers, questionnaire

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1262 Avoiding Medication Errors in Juvenile Facilities

Authors: Tanja Salary

Abstract:

This study uncovers a gap in the research and adds to the body of knowledge regarding medication errors in a juvenile justice facility. The study includes an introduction to data collected about medication errors in a juvenile justice facility and explores contributing factors that relate to those errors. The data represent electronic incident records of the medication errors that were documented from the years 2011 through 2019. In addition, this study reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional healthcare facilities to juvenile justice residential facilities. The theoretical/conceptual framework for the research study pertains to Bandura and Adams’s (1977) framework of self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory (2005). Despite the lack of evidence in previous studies about addressing medication errors in juvenile justice facilities, this presenter will relay information that adds to the body of knowledge to note the importance of how assessing the potential relationship between medication errors. Implications for more research include recommendations for more education and training regarding increased communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.

Keywords: juvenile justice, medication errors, psychotropic medications, behavioral health, juveniles, incarcerated youth, recidivism, patient safety

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1261 Smart Oxygen Deprivation Mask: An Improved Design with Biometric Feedback

Authors: Kevin V. Bui, Richard A. Claytor, Elizabeth M. Priolo, Weihui Li

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Oxygen deprivation masks operate through the use of restricting valves as a means to reduce respiratory flow where flow is inversely proportional to the resistance applied. This produces the same effect as higher altitudes where lower pressure leads to reduced respiratory flow. Both increased resistance with restricting valves and reduce the pressure of higher altitudes make breathing difficultier and force breathing muscles (diaphragm and intercostal muscles) working harder. The process exercises these muscles, improves their strength and results in overall better breathing efficiency. Currently, these oxygen deprivation masks are purely mechanical devices without any electronic sensor to monitor the breathing condition, thus not be able to provide feedback on the breathing effort nor to evaluate the lung function. That is part of the reason that these masks are mainly used for high-level athletes to mimic training in higher altitude conditions, not suitable for patients or customers. The design aims to improve the current method of oxygen deprivation mask to include a larger scope of patients and customers while providing quantitative biometric data that the current design lacks. This will be accomplished by integrating sensors into the mask’s breathing valves along with data acquisition and Bluetooth modules for signal processing and transmission. Early stages of the sensor mask will measure breathing rate as a function of changing the air pressure in the mask, with later iterations providing feedback on flow rate. Data regarding breathing rate will be prudent in determining whether training or therapy is improving breathing function and quantify this improvement.

Keywords: oxygen deprivation mask, lung function, spirometer, Bluetooth

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1260 International Classification of Primary Care as a Reference for Coding the Demand for Care in Primary Health Care

Authors: Souhir Chelly, Chahida Harizi, Aicha Hechaichi, Sihem Aissaoui, Leila Ben Ayed, Maha Bergaoui, Mohamed Kouni Chahed

Abstract:

Introduction: The International Classification of Primary Care (ICPC) is part of the morbidity classification system. It had 17 chapters, and each is coded by an alphanumeric code: the letter corresponds to the chapter, the number to a paragraph in the chapter. The objective of this study is to show the utility of this classification in the coding of the reasons for demand for care in Primary health care (PHC), its advantages and limits. Methods: This is a cross-sectional descriptive study conducted in 4 PHC in Ariana district. Data on the demand for care during 2 days in the same week were collected. The coding of the information was done according to the CISP. The data was entered and analyzed by the EPI Info 7 software. Results: A total of 523 demands for care were investigated. The patients who came for the consultation are predominantly female (62.72%). Most of the consultants are young with an average age of 35 ± 26 years. In the ICPC, there are 7 rubrics: 'infections' is the most common reason with 49.9%, 'other diagnoses' with 40.2%, 'symptoms and complaints' with 5.5%, 'trauma' with 2.1%, 'procedures' with 2.1% and 'neoplasm' with 0.3%. The main advantage of the ICPC is the fact of being a standardized tool. It is very suitable for classification of the reasons for demand for care in PHC according to their specificity, capacity to be used in a computerized medical file of the PHC. Its current limitations are related to the difficulty of classification of some reasons for demand for care. Conclusion: The ICPC has been developed to provide healthcare with a coding reference that takes into account their specificity. The CIM is in its 10th revision; it would gain from revision to revision to be more efficient to be generalized and used by the teams of PHC.

Keywords: international classification of primary care, medical file, primary health care, Tunisia

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1259 Benefits of Occupational Therapy for Children with Intellectual Disabilities in the Aspects of Vocational Activities and Instrumental Activities of Daily Life

Authors: Shakhawath Hossain, Tazkia Tahsin

Abstract:

Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.

Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL

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1258 Effective Strategies Migrants Adopted to Improve Food Security in a Regional Area of Australia

Authors: Joanne Sin Wei Yeoh, Quynh Lê, Daniel R. Terry, Rosa Mc Manamey

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Food security is a global issue and one of the concerns in Australia, particularly in regional and rural areas. Despite Australia’s current ability to produce enough food to feed more than its current population, evidence has been accumulating over the last decade to demonstrate many Australians struggle to feed themselves, including immigrants from cultural and linguistically diverse (CALD) backgrounds. This study aims to identify the acculturation strategies used by migrants to enhance their approach to food security in Tasmania. The study employed a mixed methods approach that used both questionnaires and semi-structured interviews with migrants living in Tasmania. Descriptive and inferential statistics was used to analyse data collected from questionnaire, whereas, thematic analysis was employed to analyse the interview data. Migrants (n=301) completed the questionnaire with a response rate of 50.2% and 33 follow-up interviews were conducted. We found that majority of the migrants (70.0%) replaced food ingredients and went without the food they could not buy from shops with similar ingredients. Support and advice from friends were effective ways to improve their food access. Additionally, length of stays in Tasmania and region of origin were significantly associated with the ways migrants dealing with food security. The interview results revealed that migrants managed to adapt to the new food culture by using different acculturation strategies, including access food ingredients from other country; adjusting or adapting; home gardening and access to technology. In addition, social and cultural capitals were also treated as vital roles in improving migrants’ food security. To summarize, migrants employed different strategies for food security while acculturating into the new environment. Our findings could become the guidelines for migrants and relevant government or private sectors that address food security.

Keywords: food security, migrants, strategies, inferential statistics

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1257 Investigating Spatial Disparities in Health Status and Access to Health-Related Interventions among Tribals in Jharkhand

Authors: Parul Suraia, Harshit Sosan Lakra

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Indigenous communities represent some of the most marginalized populations globally, with India labeled as tribals, experiencing particularly pronounced marginalization and a concerning decline in their numbers. These communities often inhabit geographically challenging regions characterized by low population densities, posing significant challenges to providing essential infrastructure services. Jharkhand, a Schedule 5 state, is infamous for its low-level health status due to disparities in access to health care. The primary objective of this study is to investigate the spatial inequalities in healthcare accessibility among tribal populations within the state and pinpoint critical areas requiring immediate attention. Health indicators were selected based on the tribal perspective and association of Sustainable Goal 3 (Good Health and Wellbeing) with other SDGs. Focused group discussions in which tribal people and tribal experts were done in order to finalize the indicators. Employing Principal Component Analysis, two essential indices were constructed: the Tribal Health Index (THI) and the Tribal Health Intervention Index (THII). Index values were calculated based on the district-wise secondary data for Jharkhand. The bivariate spatial association technique, Moran’s I was used to assess the spatial pattern of the variables to determine if there is any clustering (positive spatial autocorrelation) or dispersion (negative spatial autocorrelation) of values across Jharkhand. The results helped in facilitating targeting policy interventions in deprived areas of Jharkhand.

Keywords: tribal health, health spatial disparities, health status, Jharkhand

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1256 Investigating the Relative Priority of the Factors Affecting Customer Satisfaction in Gaining the Competitive Advantage in Pars-Khazar Company

Authors: Samaneh Pouyanfar, Michael Oliff

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The industry of home appliances may beone of theindustries which has the highest competition, and actually what can guarantee the survival of this industry is discovering the superior services. A trend to provide quality products and services plays an important role in this industry because discovering the services is counted as a vital affair for Manufacturing Organizations’ survival and profitability. Given the importance of the topic, this paper attempts to investigate the relative priority of the factors influencing the customer satisfaction in gaining the competitive advantage in Pars-Khazar Company. In sum, 96 executives of Pars-Khazar Company where investigated in a census. For this purpose, after reviewing the research literature and performing deep interviews between pundits and experts active in the industry, the research questionnaire was made based on variables affecting customer satisfaction and components determining business competitive advantage. Determining the content validity took place by judgement of the experts. The reliability of each structure was measured based on Cronbach’s alpha coefficient. Since the value of Cronbach's alpha was higher than 0.7 for each structure, internal consistency of statements was high and the reliability of the questionnaire was acceptable. The data analysis was also done with Kulmgrf-asmyrnf test and Friedman test using SPSS software. The results showed that in dimension of factors affecting customer satisfaction, the History of trade name (brand), Familiarity with the product brand, Brand reputation and Safety have the highest value of priority respectively, and the variable of firm growth has the highest value of priority among the components determining the performance of competitive advantage.

Keywords: customer satisfaction, competitive advantage, brand history, safety, growth

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1255 Navigating the Nexus of HIV/AIDS Care: Leveraging Statistical Insight to Transform Clinical Practice and Patient Outcomes

Authors: Nahashon Mwirigi

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The management of HIV/AIDS is a global challenge, demanding precise tools to predict disease progression and guide tailored treatment. CD4 cell count dynamics, a crucial immune function indicator, play an essential role in understanding HIV/AIDS progression and enhancing patient care through effective modeling. While several models assess disease progression, existing methods often fall short in capturing the complex, non-linear nature of HIV/AIDS, especially across diverse demographics. A need exists for models that balance predictive accuracy with clinical applicability, enabling individualized care strategies based on patient-specific progression rates. This study utilizes patient data from Kenyatta National Hospital (2003–2014) to model HIV/AIDS progression across six CD4-defined states. The Exponential, 2-Parameter Weibull, and 3-Parameter Weibull models are employed to analyze failure rates and explore progression patterns by age and gender. Model selection is based on Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to identify models best representing disease progression variability across demographic groups. The 3-Parameter Weibull model emerges as the most effective, accurately capturing HIV/AIDS progression dynamics, particularly by incorporating delayed progression effects. This model reflects age and gender-specific variations, offering refined insights into patient trajectories and facilitating targeted interventions. One key finding is that older patients progress more slowly through CD4-defined stages, with a delayed onset of advanced stages. This suggests that older patients may benefit from extended monitoring intervals, allowing providers to optimize resources while maintaining consistent care. Recognizing slower progression in this demographic helps clinicians reduce unnecessary interventions, prioritizing care for faster-progressing groups. Gender-based analysis reveals that female patients exhibit more consistent progression, while male patients show greater variability. This highlights the need for gender-specific treatment approaches, as men may require more frequent assessments and adaptive treatment plans to address their variable progression. Tailoring treatment by gender can improve outcomes by addressing distinct risk patterns in each group. The model’s ability to account for both accelerated and delayed progression equips clinicians with a robust tool for estimating the duration of each disease stage. This supports individualized treatment planning, allowing clinicians to optimize antiretroviral therapy (ART) regimens based on demographic factors and expected disease trajectories. Aligning ART timing with specific progression patterns can enhance treatment efficacy and adherence. The model also has significant implications for healthcare systems, as its predictive accuracy enables proactive patient management, reducing the frequency of advanced-stage complications. For resource limited providers, this capability facilitates strategic intervention timing, ensuring that high-risk patients receive timely care while resources are allocated efficiently. Anticipating progression stages enhances both patient care and resource management, reinforcing the model’s value in supporting sustainable HIV/AIDS healthcare strategies. This study underscores the importance of models that capture the complexities of HIV/AIDS progression, offering insights to guide personalized, data-informed care. The 3-Parameter Weibull model’s ability to accurately reflect delayed progression and demographic risk variations presents a valuable tool for clinicians, supporting the development of targeted interventions and resource optimization in HIV/AIDS management.

Keywords: HIV/AIDS progression, 3-parameter Weibull model, CD4 cell count stages, antiretroviral therapy, demographic-specific modeling

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1254 The Correlation of Environmental Risk Factors with Malaria at Tasikmalaya District, 2013

Authors: Destriyanti Sugiarti, Ririn A Wulandari

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Background: Malaria disease was widespread in many countries, both tropical and sub-tropical. Tasikmalaya is a region that experienced an increase in malaria cases over the last 5 years and highest in 2013, a total of 168 positive cases of malaria. Tasikmalaya region consists of coastal and mountain areas, it has a potential place for Anopheles mosquito breeding, i.e swamp, lagoon, andrice fields.The purpose of this study was to determine the correlation of environmental risk factors with the incidence of malaria in Tasikmalaya. Methods: The design of the study is case control study with 140 samples in 5 sub-district (Cineam, Cikatomas, Cipatujah, Salopa, and Jatiwaras). This study examines the environmental factors that influence the incidence of malaria in Tasikmalaya District in 2013. The research used 14 variables: individual characteristics (education, knowledge, occupation) and environmental risk factors (mobility to endemic areas, use mosquito nets, use of wire gauze at home, use mosquito repellent, repellent use, the presence of a large animal in a cage, breeding place, the presence of larvae, temperature and humidity chamber). Results: Results demonstrated an association between occupation (0.22; 0.10-0.47), the mobility of the population to the endemic areas (37.4; 14.29-98.18) ,the presence of larvae (5.26; 1.41-19.74), and the room temperature with optimum temperature for mosquito breeding is 25-30oC (3.25; 1.62- 6.50). Conclusion: The dominant factor affecting the spread of malaria in Tasikmalaya is the mobility of the population to endemic areas. The results of the study suggest migration survey conducted activity and health promotion for preventive efforts against malaria in malaria-endemic areas, and to encourage people to behave healthy life by freeing environment of mosquito larvae and protect themselves from mosquito bites.

Keywords: Environmental risk factors, malaria, correlation, Anopheles

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1253 Accuracy of Peak Demand Estimates for Office Buildings Using Quick Energy Simulation Tool

Authors: Mahdiyeh Zafaranchi, Ethan S. Cantor, William T. Riddell, Jess W. Everett

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The New Jersey Department of Military and Veteran’s Affairs (NJ DMAVA) operates over 50 facilities throughout the state of New Jersey, U.S. NJDMAVA is under a mandate to move toward decarbonization, which will eventually include eliminating the use of natural gas and other fossil fuels for heating. At the same time, the organization requires increased resiliency regarding electric grid disruption. These competing goals necessitate adopting the use of on-site renewables such as photovoltaic and geothermal power, as well as implementing power control strategies through microgrids. Planning for these changes requires a detailed understanding of current and future electricity use on yearly, monthly, and shorter time scales, as well as a breakdown of consumption by heating, ventilation, and air conditioning (HVAC) equipment. This paper discusses case studies of two buildings that were simulated using the QUick Energy Simulation Tool (eQUEST). Both buildings use electricity from the grid and photovoltaics. One building also uses natural gas. While electricity use data are available in hourly intervals and natural gas data are available in monthly intervals, the simulations were developed using monthly and yearly totals. This approach was chosen to reflect the information available for most NJ DMAVA facilities. Once completed, simulation results are compared to metrics recommended by several organizations to validate energy use simulations. In addition to yearly and monthly totals, the simulated peak demands are compared to actual monthly peak demand values. The simulations resulted in monthly peak demand values that were within 30% of the measured values. These benchmarks will help to assess future energy planning efforts for NJ DMAVA.

Keywords: building energy modeling, eQUEST, peak demand, smart meters

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1252 An Analysis of Prefabricated Construction Waste: A Case Study Approach

Authors: H. Hakim, C. Kibert, C. Fabre, S. Monadizadeh

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Construction industry is an industry saddled with chronic problems of high waste generation. Waste management that is to ensure materials are utilized in an efficient manner would make a major contribution to mitigating the negative environmental impacts of construction waste including finite resources depletion and growing occupied landfill areas to name a few. Furthermore, ‘material resource efficiency’ has been found an economically smart approach specially when considered during the design phase. One effective strategy is to utilizing off-site construction process which includes a series of prefabricated systems such as mobile, modular, and HUD construction (Department of Housing and Urban Development manufactured buildings). These types of buildings are by nature material and resource-efficient. Despite conventional construction that is exposed to adverse weather conditions, manufactured construction production line is capable of creating repetitive units in a factory controlled environment. A factory can have several parallel projects underway with a high speed and in a timely manner which simplifies the storage of excess materials and re-allocating to the next projects. The literature reports that prefabricated construction significantly helps reduce errors, site theft, rework, and delayed problems and can ultimately lead to a considerable waste reduction. However, there is not sufficient data to quantify this reduction when it comes to a regular modular house in the U.S. Therefore, this manuscript aims to provide an analysis of waste originated from a manufactured factory trend. The analysis was made possible with several visits and data collection of Homes of Merits, a Florida Manufactured and Modular Homebuilder. The results quantify and verify a noticeable construction waste reduction.

Keywords: construction waste, modular construction, prefabricated buildings, waste management

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1251 Cascade Screening for Beta-Thalassemia in Pakistan: Relatives’ Experiences of a Decision Support Intervention in Routine Practice

Authors: Shenaz Ahmed, Hussain Jafri, Muhammed Faran, Wajeeha Naseer Ahmed, Yasmin Rashid, Yasmin Ehsan, Shabnam Bashir, Mushtaq Ahmed

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Low uptake of cascade screening for βeta-Thalassaemia Major (β-TM) in the ‘Punjab Thalassaemia Prevention Project’ (PTPP) in Pakistan led to the development of a ‘decision support intervention for relatives’ (DeSIRe). This paper presents the experiences of relatives of children with β-TM of the DeSIRe following its use by PTPP field officers in routine clinical practice. Fifty-four semi-structured qualitative interviews were conducted (April to June 2021) with relatives in seven cities in the Punjab province (Lahore, Sheikhupura, Nankana Sahab, Kasur, Gujranwala, Multan, and Faisalabad). Thematic analysis shows that participants were satisfied with the content of the DeSIRe and its delivery by the field officers in a family meeting. They understood the main purpose of the DeSIRe was to improve their knowledge of β-TM and its inheritance, to enable them to make decisions about thalassemia carrier testing, particularly before marriage. While participants raised concerns about the stigma of testing positive, they believed the DeSIRe was an appropriate intervention, which supported relatives to make informed decisions. Our findings show the DeSIRe is appropriate for use by healthcare professionals in routine practice in a low-middle income country and has the potential to facilitate shared decision-making about cascade screening for thalassemia. Further research is needed to prove the efficacy of the DeSIRe.

Keywords: thalassemia, Pakistan, cascade screening, decision support

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1250 Analyzing the Food as a Form of Creativity: The Case of the Bijlmermeer in Amsterdam-Zuidoost

Authors: Marc Polo, Núria Arbonés Arán

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Amsterdam is considered one of the great European capitals, which concentrates the headquarters of various multinational companies and which, in addition, enjoys a huge tourist attraction. Its typical residential buildings next to the canals, the museums, or its striking "Red Light District" are a great focus of attraction. In 2019 almost 9 million tourists visited it, but few of them traveled to the farthest neighborhood in the city: Amsterdam-Zuidoost (Amsterdam-Southeast). This neighborhood is geographically separated from the urban core, which makes it an exclave of Amsterdam as it does not border any of the other boroughs. Bijlmermeer neighborhood is the largest of the Amsterdam-Zuidoost, and it was born in the 1960s with the expectations of becoming the city of the future. Its main architect, Siegfried Nassuth, was inspired by the Swiss Le Corbusier to design nearly 18,000 homes, most of which were in high-rise tower blocks and built together, forming a recognizable "honeycombed" pattern. For more than 40 years, a series of infrastructure and social vicissitudes have made the neighborhood outline quite different as it was expected to be. It helped also varied elements such as ethnicity, demolitions, or unoccupied apartments. The called “city of the future” became home to immigrants, drug addicts, and vandals, and the conflicts denigrated the Amsterdam-Zuidoost. This work analyzes the evolution of the Bijlmermeer from its origins and illustrates relevant international referents able to help the area. The purpose of the work is to show how different variations along the recent history didn't help enough, but how there are positive perspectives for the future taking advantage of the food as a creative issue. The research, based on academic literature, existing material in different stadiums, plus the analysis of the city imaginaries, will help to concrete relevant elements in terms of innovation, creativity, and disruption. Despite of radical renewal that is taking place, the research will demonstrate that there are still new opportunities for the old Bijlmermeer.

Keywords: amsterdam, bijlmermeer, creativity, food

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1249 Gender Identify and Agency of Traumatized Subjects in Incestuous Family

Authors: Jenyu Peng

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Incestuous abuse can be considered a form of domestic violence that exemplifies gender inequality. It challenges the common image of home as “haven of safety”. In Taiwan, even after years of feminist NGOs’ effort to encourage victims to speak up, the shared cultural representations of family, still praising piety towards the parents, seem to keep the incest trauma in secret. As clinical practitioners have observed, most devastating psychological sequels of incest trauma are often related to silencing. Thus one can expect that in families centered cultures, the difficulties for victims to disclose are greater, and the traumatic consequences more severe. This poses crucial therapeutic issues for clinicians working in those cultures. Since 2009, the author, a trained psychoanalyst and researcher, has been conducting “clinical fieldwork” on incest trauma in Taiwan. Employing ethnographical method, our theoretical references are both psychoanalytical and anthropological. The necessity of interdisciplinary efforts in incest trauma research will be addressed and discussed. The analyses of the present paper will focus on five incestuous families: four Han families, and one aboriginal. Although Taiwanese aboriginal peoples have been pretty much sinicized since decades, it is worth observing the convergent and divergent aspects in these two cultures. Moreover, findings of a previous research conducted in France during 2002-2004 will serve as background for the purpose of comparison. The results will be presented along with three questions: 1) How the perception of family influences the process of disclosure? 2) How the incestuous experience comes into play with victims’ gender identity and sexuality, pivotal for the subjectification? 3) How victims more successful in gendered subjectification modify their dynamics with their traumatizing family? This research finds that most victims tend to defend their own incestuous families, and that victims’ subjectivity and agency are actually entangled in the power structure of incestuous family.

Keywords: incestuous family, subjectification, gender identity, agency

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1248 Controlling Fear: Jordanian Women’s Perceptions of the Diagnosis and Surgical Treatment of Early Stage Breast Cancer

Authors: Rana F. Obeidat, Suzanne S. Dickerson, Gregory G. Homish, Nesreen M. Alqaissi, Robin M. Lally

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Background: Despite the fact that breast cancer is the most prevalent cancer among Jordanian women, practically nothing is known about their perceptions of early stage breast cancer and surgical treatment. Objective: To gain understanding of the diagnosis and surgical treatment experience of Jordanian women diagnosed with early stage breast cancer. Methods: An interpretive phenomenological approach was used for this study. A purposive sample of 28 Jordanian women who were surgically treated for early stage breast cancer within 6 months of the interview was recruited. Data were collected using individual interviews and analyzed using Heideggerian hermeneutical methodology. Results: Fear had a profound effect on Jordanian women’s stories of diagnosis and surgical treatment of early stage breast cancer. Women’s experience with breast cancer and its treatment was shaped by their pre-existing fear of breast cancer, the disparity in the quality of care at various health care institutions, and sociodemographic factors (e.g., education, age). Conclusions: Early after the diagnosis, fear was very strong and women lost perspective of the fact that this disease was treatable and potentially curable. To control their fears, women unconditionally trusted God, the health care system, surgeons, family, friends, and/or neighbors, and often accepted treatment offered by their surgeons without questioning. Implications for practice: Jordanian healthcare providers have a responsibility to listen to their patients, explore meanings they ascribe to their illness, and provide women with proper education and support necessary to help them cope with their illness.

Keywords: breast cancer, early stage, Jordanian, experience, phenomenology

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1247 Determining the Prevalence and Risk Factors of Postpartum Depression

Authors: Gerald H. Artisen, Miah Joy O Awing, Elydia O. Ayat, Rachel L. Ayangwa, Zeah D. Baggas, Aspen S. Baguiyac, Delight D. Baguiyac, Kristine G. Bakidan, Nemesis B. Bakidan, Ketly B. Balanggao, Rhea G. Bala-Is, Hope Lulet A. Lomioan

Abstract:

The study investigated the prevalence and risk factors associated with postpartum depression among mothers in the Pasil, Kalinga, contributing to a better understanding of the mental health challenges faced by this specific population. This research utilized a cross-sectional descriptive study to assess postpartum depression prevalence and identify contributing factors in Pasil, utilizing a quantitative approach and collecting data on sociodemographic characteristics, obstetric data, and the Edinburgh Postnatal Depression Scale. The study concluded that probable depression can be seen among mothers in the Pasil, which resulted in a risk of suicidality with a percentage of 40.08. Additionally, most of the respondents are aged 28–32, married, have a college degree, are unemployed, have a monthly income of 1,000–5,000, are female, have hypertension, gave birth naturally, have two children, have a planned pregnancy, and are currently breastfeeding. Lastly, the study found that mothers in Pasil who have unplanned pregnancies under obstetric factors are at high risk of developing postpartum depression, with a p-value below the 0.05 level. The study recommends barangay health professionals develop initiatives to inform aspiring mothers about postpartum depression (PPD) and resources to help them adjust to motherhood. It also recommends frequent check-ins with new mothers to identify special healthcare needs. Programs should be independently funded by LGUs, and support from family and relatives is recommended to prevent PPD.

Keywords: maternal health, postpartum depression, mothers, Pasil

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1246 Public Perception and Willingness to Undergo Cosmetic Procedures during COVID-19 Pandemic: A Questionnaire-Based Study Applied to Asymptomatic Individuals

Authors: Ibrahim Alreshidi, Aseel Albrekeit, Ruaa Alharthi

Abstract:

Background: As a result of the spread of COVID-19 at the beginning of 2020, many governments, including Saudi Arabia, have suspended operations in many agencies. Most dermatologists have restricted their practice, including cosmetic procedures, to ensure social distancing. On the 7th of May 2020, Saudi authorities reduced the restriction of COVID-19 virus preventative measures, allowing clinics to start accepting patients following the ministry of health protocols. Objectives: Evaluation of the public's perception and willingness to undergo cosmetic procedures during COVID-19 outbreaks in Saudi Arabia. Materials and methods: A descriptive, cross-sectional, questionnaire-based study was carried out among the individuals who lack typical symptoms of COVID-19 infection in Saudi Arabia. A self-designed web-based questionnaire was developed; content face validity and a pilot study were done. The questionnaire was distributed electronically from the 8th of May until the 31st of May 2020. Results: A total of 656 individuals who lack typical symptoms of COVID-19 infection were included in this analysis. Only 10.5% of participants expressed their will to do cosmetic procedures during the COVID-19 pandemic. More than 90% of the participants believed that the COVID-19 pandemic was either somewhat serious (52.9%) or very serious (38.7%). The willingness to do cosmetic procedures during the COVID-19 pandemic remained unaltered when the price was discounted (p<0.001) and when infection control measures were ensured (p<0.001). Conclusion: The COVID-19 pandemic had a negative impact on the practice of cosmetic dermatology. Fear of transferring the infection to a beloved home member is the main reason to avoid these procedures. Generating well-structured safety guidelines to decrease the risk of this unusual virus transmission in dermatology practice and creating financial incentives may help increase the public willingness to do these cosmetic procedures during this pandemic.

Keywords: COVID-19 pandemic, cosmetic procedures, questionnaire, dermatology

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1245 Price Effect Estimation of Tobacco on Low-wage Male Smokers: A Causal Mediation Analysis

Authors: Kawsar Ahmed, Hong Wang

Abstract:

The study's goal was to estimate the causal mediation impact of tobacco tax before and after price hikes among low-income male smokers, with a particular emphasis on the effect estimating pathways framework for continuous and dichotomous variables. From July to December 2021, a cross-sectional investigation of observational data (n=739) was collected from Bangladeshi low-wage smokers. The Quasi-Bayesian technique, binomial probit model, and sensitivity analysis using a simulation of the computational tools R mediation package had been used to estimate the effect. After a price rise for tobacco products, the average number of cigarettes or bidis sticks taken decreased from 6.7 to 4.56. Tobacco product rising prices have a direct effect on low-income people's decisions to quit or lessen their daily smoking habits of Average Causal Mediation Effect (ACME) [effect=2.31, 95 % confidence interval (C.I.) = (4.71-0.00), p<0.01], Average Direct Effect (ADE) [effect=8.6, 95 percent (C.I.) = (6.8-0.11), p<0.001], and overall significant effects (p<0.001). Tobacco smoking choice is described by the mediated proportion of income effect, which is 26.1% less of following price rise. The curve of ACME and ADE is based on observational figures of the coefficients of determination that asses the model of hypothesis as the substantial consequence after price rises in the sensitivity analysis. To reduce smoking product behaviors, price increases through taxation have a positive causal mediation with income that affects the decision to limit tobacco use and promote low-income men's healthcare policy.

Keywords: causal mediation analysis, directed acyclic graphs, tobacco price policy, sensitivity analysis, pathway estimation

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1244 Being an Afghan Woman in Australia; Stereotypes, Gender Roles, and Adaption with New Context

Authors: Rojan Afrouz

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Introduction: The immigration is a complex process of transitioning and transformation. Immigrants are more likely to come from the patriarchal and hierarchical society with traditional gender roles and women’s stereotypes. Changing the perception of women’s gender roles may result in challenges between women and their family and community. In this article, Afghan women’s perspectives on gender roles and stereotypes have been investigated as well as their experience of changes in the new context of Australia. Australian initiatives of challenging gender roles have provided the opportunities for Afghan women to emancipate from the traditional gender roles and pursue the value of gender equality. In this process, they may face many challenges in intersectional levels within their family, community and wider society which is a complex conflate of oppressive factors that may not be addressed easily and straightforward. Methods: This qualitative study has been conducted among Afghan women who have lived in Australia less than ten years. Semi-structured interviews either face to face or by phone have been used to collect data for this study. The interviews have been audio-recorded and transcribed verbatim. Nvivo software has been used for data analysis. Findings: Many participants mentioned that they had been taught that a good Afghan woman is devoted, obedient and loyal to their family and community. They believed that for many Afghan families, Afghan women's natural place was inside the home as a housewife, mother, daughter involving so many responsibilities and expectation of making sacrifices. Many women stated that their attitudes toward gender roles and their feeling of being a woman had been changed since they came to Australia although the process of change for women was complex and diverse. Some had to deal with conflicts with their stereotypes, traditional gender roles as well as strong disagreement with their family and community. Conclusion: Moving to a different country with more gender equality is an opportunity for Afghan women to change their perceptions of gender roles and stereotypes. However, challenging traditional stereotypes and gender roles in the new context is a complex process comprising intersectional levels.

Keywords: stereotypes, gender role, immigration, Afghan women

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1243 Optimizing Multimodal Teaching Strategies for Enhanced Engagement and Performance

Authors: Victor Milanes, Martha Hubertz

Abstract:

In the wake of COVID-19, all aspects of life have been estranged, and humanity has been forced to shift toward a more technologically integrated mode of operation. Essential work such as Healthcare, business, and public policy are a few notable industries that were initially dependent upon face-to-face modality but have completely reimagined their operation style. Unique to these fields, education was particularly strained because academics, teachers, and professors alike were obligated to shift their curriculums online over the course of a few weeks while also maintaining the expectation that they were educating their students to a similar level accomplished pre-pandemic. This was notable as research indicates two key concepts: Students prefer face-to-face modality, and due to the disruption in academic continuity/style, there was a negative impact on student's overall education and performance. With these two principles in mind, this study aims to inquire what online strategies could be best employed by teachers to educate their students, as well as what strategies could be adopted in a multimodal setting if deemed necessary by the instructor or outside convoluting factors (Such as the case of COVID-19, or a personal matter that demands the teacher's attention away from the classroom). Strategies and methods will be cross-analyzed via a ranking system derived from various recognized teaching assessments, in which engagement, retention, flexibility, interest, and performance are specifically accounted for. We expect to see an emphasis on positive social pressure as a dominant factor in the improved propensity for education, as well as a preference for visual aids across platforms, as research indicates most individuals are visual learners.

Keywords: technological integration, multimodal teaching, education, student engagement

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1242 Depression among Pregnant Women with Husbands Abroad during the Pregnancy

Authors: Usama Bin Zubair, Syed Azhar Ali

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Introduction: Depression is emerging as a major public health problem in all parts of the world. Developing countries have a unique socioeconomic structure that affects the lives of its inhabitants in several ways. Going abroad for employment is one of the common social problems which have been faced by young males in developing countries. This included both highly qualified individuals as well as the labor class. Objective: To determine the difference in the presence of depressive symptoms among pregnant women with husbands living abroad and those with husbands living with them in Azad Jammu and Kashmir. Methods: The sample population comprised of pregnant women reporting for an antenatal checkup at Amna hospital Rawalakot. Cases constituted the pregnant women with husbands living abroad while controls were the pregnant women with husbands living with them. Patient health questionnaire-9 (PHQ-9) was used to record the presence and severity of depressive symptoms. Age, gestation, parity, rural or urban origin, education, level of family income, daily contact hours on the telephone or what’s app, previous pregnancy loss or complications, number of years abroad and visits to home per year were associated with the presence of depressive symptoms. Findings: The mean age of the study participants was 29.73 ±5.395 years. Sixty-six had significant depression in the case group, while 14 had in the control group (p-value<0.001). Education and rural background had a significant difference between the case and the control group. Less number of visits per year of the husband was strongly linked with the presence of depressive symptoms among the cases. Conclusion: Pregnant women with husbands abroad were found more prone to develop depressive symptoms as compared to those with husbands living with them. Special attention should be paid to the women whose husband had a lesser number of visits to the country.

Keywords: depression, pregnancy, lack of support, war zone

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1241 Smart Wheel Chair: A Design to Accommodate Vital Sign Monitoring

Authors: Stephanie Nihan, Jayson M. Fadrigalan, Pyay P. San, Steven M. Santos, Weihui Li

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People of all ages who use wheelchairs are left with the inconvenience of not having an easy way to take their vital signs. Typically, patients are required to visit the hospital in order to take the vital signs. VitalGO is a wheel chair system that equipped with medical devices to take vital signs and then transmit data to a mobile application for convenient, long term health monitoring. The vital signs include oxygen saturation, heart rate, and blood pressure, breathing rate and body temperature. Oxygen saturation and heart rate are monitored through pulse oximeter. Blood pressure is taken through a radar sensor. Breathing rate is derived through thoracic impedance while body temperature is measured through an infrared thermometer. The application receives data through bluetooth and stores in a database for review in a simple graphical interface. The application will have the ability to display this data over various time intervals such as a day, week, month, 3 months, 6 months and a year. The final system for the mobile app can also provide an interface for both the user and their physician(s) to record notes or keep record of daily symptoms that a patient might be having. The user’s doctor will be granted access by the user to view the patient information for assistance with a more accurate diagnosis. Also, this wheelchair accessory conveniently includes a foldable table/desk as somewhere to place an electronic device that may be used to access the app. The foldable table will overall contribute to the wheelchair user’s increased comfort and will give them somewhere to place food, a book, or any other form of entertainment that would normally be hard to juggle on their lap.

Keywords: wheel chair, vital sign, mobile application, telemedicine

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1240 Relationships among Sleep Quality and Quality of Life in Oncology Nurses

Authors: Yi-Fung Lin, Pei-Chen Tsai

Abstract:

Background: The hospital healthcare team provides 24-hour patient care, and therefore shift-work is inevitable in the nursing field. There is an increased awareness that shift-work affecting circadian rhythms may cause various health problems, especially in poor sleep quality, which may harm the quality of life. Purposes: The purpose of this study was to investigate the influences of demographic characteristics on nurses’ sleep quality and quality of life and the relationship between these predictors of nurses’ quality of life. Methods: A cross-sectional, descriptive correlational study was conducted with purposive sampling of 520 female nurses in a medical center in north Taiwan from July to September 2014. Data were collected with structured questionnaires using Psychometric Evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the World Health Organization Quality of Life (WHOQOL-BREF). Outcomes: The main results include: 1) Irregular menstruation, non-regular exercisers, and more daily caffeine consumption have negative impacts on sleep quality. 2) Younger age, fewer children, low education level, low annual income, irregular menstruation, pain during menstrual cycles, non-regular exercisers, constipation, and poor sleep quality all contribute negative impacts on the quality of life. 3) The odds ratio of sleep disturbance between 12-hour shifts and 8-hour shifts was 2.26, but there was no significant difference regarding their quality of life scores. Conclusion: This study showed that there is a strong correlation between oncology nurses’ sleep quality and quality of life. Sleep quality is a significant predictor of quality of life in oncology nurses.

Keywords: oncology nurses, sleep quality, quality of life, shift-work

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1239 Discrimination Faced by Dalit Women in India

Authors: Soundarya Lahari Vedula

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Dalit women make up a significant portion of the Indian population. However, they are victims of age old discrimination. This paper presents a brief background of the Indian caste system which is a hierarchical division placing Dalits at the lowest rank. Dalits are forced to perform menial and harsh tasks. They often face social ostracism. The situation of Dalit women is of unique significance as they face triple discrimination due to their caste, gender, and class. Dalit women are strictly withheld by the rigid boundaries of the caste system. They are discriminated at every stage of their life and are denied access to public places, education and healthcare facilities among others. They face the worst forms of sexual violence. In spite of legislations and international conventions in place, their plight is not adequately addressed. This paper discusses, in brief, the legal mechanism in place to prohibit untouchability. Furthermore, this paper details on the specific human rights violations faced by Dalit women in the social, economic and political spheres. The violations range from discrimination in public places, denial of education and health services, sexual exploitation and barriers to political representation. Finally, this paper identifies certain lacunae in the existing Indian statutes and broadens on the measures to be taken to improve the situation of Dalit women. This paper offers some recommendations to address the plight of Dalit women such as amendments to the existing statutes, effective implementation of legal mechanisms and a more meaningful interpretation of the international conventions.

Keywords: Dalit, caste, class, discrimination, equality

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1238 IRIS An Interactive Video Game for Children with Long-Term Illness in Hospitals

Authors: Ganetsou Evanthia, Koutsikos Emmanouil, Austin Anna Maria

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Information technology has long served the needs of individuals for learning and entertainment, but much less for children in sickness. The aim of the proposed online video game is to provide immersive learning opportunities as well as essential social and emotional scenarios for hospital-bound children with long-term illness. Online self-paced courses on chosen school subjects, including specialised software and multisensory assessments, aim at enhancing children’s academic achievement and sense of inclusion, while doctor minigames familiarise and educate young patients on their medical conditions. Online ethical dilemmas will offer children opportunities to contemplate on the importance of medical procedures and following assigned medication, often challenging for young patients; they will therefore reflect on their condition, reevaluate their perceptions about hospitalisation, and assume greater personal responsibility for their progress. Children’s emotional and psychosocial needs are addressed by engaging in social conventions, such as interactive, daily, collaborative mini games with other hospitalised peers, like virtual competitive sports games, weekly group psychodrama sessions, and online birthday parties or sleepovers. Social bonding is also fostered by having a virtual pet to interact with and take care of, as well as a virtual nurse to discuss and reflect on the mood of the day, engage in constructive dialogue and perspective taking, and offer reminders. Access to the platform will be available throughout the day depending on the patient’s health status. The program is designed to minimise escapism and feelings of exclusion, and can flexibly be adapted to offer post-treatment and a support online system at home.

Keywords: long-term illness, children, hospital, interactive games, cognitive, socioemotional development

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