Search results for: integrated health interventions
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12143

Search results for: integrated health interventions

11873 Enabling Integrated Production of Electric Vehicles in Automotive Final Assembly: Realization of an Expert Study

Authors: Achim Kampker, Heiner Hans Heimes, Mathias Ordung, Jan-Philip Ganser

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In the past years, the automotive industry has changed significantly. Innovative mobility concepts have become more important, and electric vehicles see a chance of replacing vehicles with combustion engines in the long term. However, the coming years will be characterized by coexistence. In this context, there are two possible production scenarios: One the one hand, electric vehicles could be manufactured in bespoke assembly lines. Concerning the uncertainty regarding sales figures development, this alternative boasts a high investment risk. Therefore, an integrated assembly building upon existing structures also seems a feasible solution. This empirical study aims at validating hypotheses concerning theoretical and practical challenges of the integrated production in the final assembly. In order to take a test of approaches of the research by analyzing censored feedback of professionals, these hypotheses are validated in the framework of an expert study. For this purpose, hypotheses have been generated on the basis of a requirements analysis and a concept specification. Thereupon, a list of question has been implemented and deduced from the hypotheses to execute an online- and written-survey and interviews with professionals. The interpretation and evaluation of the findings includes an inter-component comparison for the electric drivetrain. Furthermore, key drivers for a sufficient integrated product and process design are presented.

Keywords: automotive industry, final assembly, integrated manufacturing, product and process development

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11872 Occupational Heat Stress Related Adverse Pregnancy Outcome: A Pilot Study in South India Workplaces

Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

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11871 Immunization-Data-Quality in Public Health Facilities in the Pastoralist Communities: A Comparative Study Evidence from Afar and Somali Regional States, Ethiopia

Authors: Melaku Tsehay

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The Consortium of Christian Relief and Development Associations (CCRDA), and the CORE Group Polio Partners (CGPP) Secretariat have been working with Global Alliance for Vac-cines and Immunization (GAVI) to improve the immunization data quality in Afar and Somali Regional States. The main aim of this study was to compare the quality of immunization data before and after the above interventions in health facilities in the pastoralist communities in Ethiopia. To this end, a comparative-cross-sectional study was conducted on 51 health facilities. The baseline data was collected in May 2019, while the end line data in August 2021. The WHO data quality self-assessment tool (DQS) was used to collect data. A significant improvment was seen in the accuracy of the pentavalent vaccine (PT)1 (p = 0.012) data at the health posts (HP), while PT3 (p = 0.010), and Measles (p = 0.020) at the health centers (HC). Besides, a highly sig-nificant improvment was observed in the accuracy of tetanus toxoid (TT)2 data at HP (p < 0.001). The level of over- or under-reporting was found to be < 8%, at the HP, and < 10% at the HC for PT3. The data completeness was also increased from 72.09% to 88.89% at the HC. Nearly 74% of the health facilities timely reported their respective immunization data, which is much better than the baseline (7.1%) (p < 0.001). These findings may provide some hints for the policies and pro-grams targetting on improving immunization data qaulity in the pastoralist communities.

Keywords: data quality, immunization, verification factor, pastoralist region

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11870 Integrated Power Saving for Multiple Relays and UEs in LTE-TDD

Authors: Chun-Chuan Yang, Jeng-Yueng Chen, Yi-Ting Mai, Chen-Ming Yang

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In this paper, the design of integrated sleep scheduling for relay nodes and user equipments under a Donor eNB (DeNB) in the mode of Time Division Duplex (TDD) in LTE-A is presented. The idea of virtual time is proposed to deal with the discontinuous pattern of the available radio resource in TDD, and based on the estimation of the traffic load, three power saving schemes in the top-down strategy are presented. Associated mechanisms in each scheme including calculation of the virtual subframe capacity, the algorithm of integrated sleep scheduling, and the mapping mechanisms for the backhaul link and the access link are presented in the paper. Simulation study shows the advantage of the proposed schemes in energy saving over the standard DRX scheme.

Keywords: LTE-A, relay, TDD, power saving

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11869 A Comparative Study of the Use of Medicinal Plants and Conventional Medicine for the Treatment of Hepatitis B Virus in Ibadan Metropolis

Authors: Julius Adebayo John

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The objective of this study is to compare the use of medicinal plants and Conventional medicine intervention in the management of HBV among Ibadan populace. A purposive sampling technique was used to administer questionnaires at 2 places, namely, the University College Hospital and Total Healthcare Diagnostic Centre, Ibadan, where viral loads are carried out. A EuroQol (EQ – 5D) was adopted to collect data. Descriptive and inferential analyses were performed. Also, ANOVA, Correlation, charts, and tables were used. Findings revealed a high prevalence of HBV among female respondents and sample between ages 26years to 50years. Results showed that the majority discovered their health status through free HBV tests. Analysis indicated that the use of medicinal plant extract is cost-effective in 73% of cases. Rank order utility derived from medicinal plants is higher than other interventions. Correlation analysis performed for the current health status of respondents were significant at P<0.01 against the intervention management adopted (0.046), cost of treatment (0.549), utility (0.407) at P<0.00, duration of the treatment (0.604) at P<0.01; viral load before treatment (-0.142) not significant at P<0.01, the R2 (72.2%) showed the statistical variance in respondents current health status as explained by the independent variables. Respondents gained quality-adjusted life-years (QALYs) of between 1year to 3years. Suggestions were made for a public-private partnership effort against HBV with emphasis on periodic screening, viral load test subsidy, and free vaccination of people with –HBV status. Promoting phytomedicine through intensive research with strong regulation of herbal practitioners will go a long way in alleviating the burdens of the disease in society.

Keywords: medicinal plant, HBV management interventions, utility, QALYs, ibadan metropolis

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11868 Fabrication and Characterization of Al2O3 Based Electrical Insulation Coatings Around SiC Fibers

Authors: S. Palaniyappan, P. K. Chennam, M. Trautmann, H. Ahmad, T. Mehner, T. Lampke, G. Wagner

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In structural-health monitoring of fiber reinforced plastics (FRPs), every single inorganic fiber sensor that are integrated into the bulk material requires an electrical insulation around itself, when the surrounding reinforcing fibers are electrically conductive. This results in a more accurate data acquisition only from the sensor fiber without any electrical interventions. For this purpose, thin nano-films of aluminium oxide (Al2O3)-based electrical-insulation coatings have been fabricated around the Silicon Carbide (SiC) single fiber sensors through reactive DC magnetron sputtering technique. The sputtered coatings were amorphous in nature and the thickness of the coatings increased with an increase in the sputter time. Microstructural characterization of the coated fibers performed using scanning electron microscopy (SEM) confirmed a homogeneous circumferential coating with no detectable defects or cracks on the surface. X-ray diffraction (XRD) analyses of the as-sputtered and 2 hours annealed coatings (825 & 1125 ˚C) revealed the amorphous and crystalline phases of Al2O3 respectively. Raman spectroscopic analyses produced no characteristic bands of Al2O3, as the thickness of the films was in the nanometer (nm) range, which is too small to overcome the actual penetration depth of the laser used. In addition, the influence of the insulation coatings on the mechanical properties of the SiC sensor fibers has been analyzed.

Keywords: Al₂O₃ thin film, electrical insulation coating, PVD process, SiC fibre, single fibre tensile test

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11867 Form and Content in Adonis Durado’s Poesy: Integrated Teaching Guide

Authors: Angen May T. Fabro

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This study analyzed how the form and content in Adonis Durado’s select poems revealed universal realities for a proposed integrated teaching guide. The study employed discourse analysis that generates verbal interpretation of data to answer the variables under study in order to satisfy the main problem. This method used analyses and interpretations of discourse texts of the literary work under study. This research made use of studies and research investigations relevant to the present investigation. Findings of the study showed that form and content play a significant role in identifying the universal realities found in the select poems of Adonis Durado.

Keywords: poems, poesy, integrated teaching guide, Adonis Durado’s poesy

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11866 From Protection of Sacrificial Self, to Critical Turning Points and Growth: Nurses’ Experiences of Caring for Patients on the Frontline in Ireland during the COVID-19 Pandemic

Authors: Sinead Creedon, Anna Trace

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Nurses were the most exposed of all frontline healthcare workers during the COVID-19 pandemic. Mainly female nurses working in the acute hospital sector formed the frontline defence in the Irish health service. They faced it with resilience and courage despite exposure to risk of burnout and threats to their mental health and wellbeing. Gaining an understanding of the nurses’ journey in adapting to this harsh climate could inform positive psychology interventions and / or support staff such as senior hospital managers in an adverse work situation. Furthermore, it would strengthen our insight and theoretical understanding on the use of positive psychology interventions in adverse work conditions. An interpretative phenomenological analysis was carried out to gain insight into how nurses adapted to the changing work environment during the pandemic. Online semi-structured interviews were done with six experienced female nurses who were all redeployed to the frontline from their own roles. The three themes representing the nurses’ journey were the Protection of Sacrificial Self, The Fortifying Effect of Us, and Critical Turning Points & Growth. Nurses revitalised themselves by creating a sense of ‘us’ to help them face a harsh climate against others, which enabled additional critical turning points. This study further enriches our understanding of personal growth and trauma in adverse work conditions by including an exploration of what sacrificial commitment adds to our understanding of physical and moral courage.

Keywords: COVID-19, nurses, positive psychology, resilience, sacrificial commitment, supports

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11865 Exercise Intervention For Women After Treatment For Ovarian Cancer

Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

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11864 Internal Concept of Integrated Health by Agrarian Society in Malagasy Highlands for the Last Century

Authors: O. R. Razanakoto, L. Temple

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Living in a least developed country, the Malagasy society has a weak capacity to internalize progress, including health concerns. Since the arrival in the fifteenth century of Arabic script, called Sorabe, that was mainly dedicated to the aristocracy, until the colonial era beginning at the end of the nineteenth century and that has popularized the current usual script of the occidental civilization, the upcoming manuscripts that deal with apparent scientific or at least academic issue have been slowly established. So that, the Malagasy communities’ way of life is not well documented yet to allow a precise understanding of the major concerns, reason, and purpose of the existence of the farmers that compose them. A question arises, according to literature, how does Malagasy community that is dominated by agrarian society conceive the conservation of its wellbeing? This study aims to emphasize the scope and the limits of the « One Health » concept or of the Health Integrated Approach (HIA) that evolves at global scale, with regard to the specific context of local Malagasy smallholder farms. It is expected to identify how this society represents linked risks and the mechanisms between human health, animal health, plant health, and ecosystem health within the last 100 years. To do so, the framework to conduct systematic review for agricultural research has been deployed to access available literature. This task has been coupled with the reading of articles that are not indexed by online scientific search engine but that mention part of a history of agriculture and of farmers in Madagascar. This literature review has informed the interactions between human illnesses and those affecting animals and plants (breeded or wild) with any unexpected event (ecological or economic) that has modified the equilibrium of the ecosystem, or that has disturbed the livelihoods of agrarian communities. Besides, drivers that may either accentuate or attenuate the devasting effects of these illnesses and changes were revealed. The study has established that the reasons of human worries are not only physiological. Among the factors that regulate global health, food system and contemporary medicine have helped to the improvement of life expectancy from 55 to 63 years in Madagascar during the last 50 years. However, threats to global health are still occurring. New human or animal illnesses and livestock / plant pathology or enemies may also appear, whereas ancient illnesses that are supposed to have disappeared may be back. This study has highlighted how much important are the risks associated to the impact of unmanaged externalities that weaken community’s life. Many risks, and also solutions, come from abroad and have long term effects even though those happen as punctual event. Thus, a constructivist strategy is suggested to the « One Health » global concept throughout the record of local facts. This approach should facilitate the exploration of methodological pathways and the identification of relevant indicators for research related to HIA.

Keywords: agrarian system, health integrated approach, history, madagascar, resilience, risk

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11863 Schema Therapy as Treatment for Adults with Autism Spectrum Disorder and Comorbid Personality Disorder: A Multiple Baseline Case Series Study Testing Cognitive-Behavioral and Experiential Interventions

Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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11862 End-Users Tools to Empower and Raise Awareness of Behavioural Change towards Energy Efficiency

Authors: G. Calleja-Rodriguez, N. Jimenez-Redondo, J. J. Peralta Escalante

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This research work aims at developing a solution to take advantage of the potential energy saving related to occupants behaviour estimated in between 5-30 % according to existing studies. For that purpose, the following methodology has been followed: 1) literature review and gap analysis, 2) define concept and functional requirements, 3) evaluation and feedback by experts. As result, the concept for a tool-box that implements continuous behavior change interventions named as engagement methods and based on increasing energy literacy, increasing energy visibility, using bonus system, etc. has been defined. These engagement methods are deployed through a set of ICT tools: Building Automation and Control System (BACS) add-ons services installed in buildings and Users Apps installed in smartphones, smart-TVs or dashboards. The tool-box called eTEACHER identifies energy conservation measures (ECM) based on energy behavioral change through a what-if analysis that collects information about the building and its users (comfort feedback, behavior, etc.) and carry out cost-effective calculations to provide outputs such us efficient control settings of building systems. This information is processed and showed in an attractive way as tailored advice to the energy end-users. Therefore, eTEACHER goal is to change the behavior of building´s energy users towards energy efficiency, comfort and better health conditions by deploying customized ICT-based interventions taking into account building typology (schools, residential, offices, health care centres, etc.), users profile (occupants, owners, facility managers, employers, etc.) as well as cultural and demographic factors. One of the main findings of this work is the common failure when technological interventions on behavioural change are done to not consult, train and support users regarding technological changes leading to poor performance in practices. As conclusion, a strong need to carry out social studies to identify relevant behavioural issues and to identify effective pro-evironmental behavioral change strategies has been identified.

Keywords: energy saving, behavioral bhange, building users, engagement methods, energy conservation measures

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11861 Performance Improvement of Information System of a Banking System Based on Integrated Resilience Engineering Design

Authors: S. H. Iranmanesh, L. Aliabadi, A. Mollajan

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Integrated resilience engineering (IRE) is capable of returning banking systems to the normal state in extensive economic circumstances. In this study, information system of a large bank (with several branches) is assessed and optimized under severe economic conditions. Data envelopment analysis (DEA) models are employed to achieve the objective of this study. Nine IRE factors are considered to be the outputs, and a dummy variable is defined as the input of the DEA models. A standard questionnaire is designed and distributed among executive managers to be considered as the decision-making units (DMUs). Reliability and validity of the questionnaire is examined based on Cronbach's alpha and t-test. The most appropriate DEA model is determined based on average efficiency and normality test. It is shown that the proposed integrated design provides higher efficiency than the conventional RE design. Results of sensitivity and perturbation analysis indicate that self-organization, fault tolerance, and reporting culture respectively compose about 50 percent of total weight.

Keywords: banking system, Data Envelopment Analysis (DEA), Integrated Resilience Engineering (IRE), performance evaluation, perturbation analysis

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11860 Changing Behaviour in the Digital Era: A Concrete Use Case from the Domain of Health

Authors: Francesca Spagnoli, Shenja van der Graaf, Pieter Ballon

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Humans do not behave rationally. We are emotional, easily influenced by others, as well as by our context. The study of human behaviour became a supreme endeavour within many academic disciplines, including economics, sociology, and clinical and social psychology. Understanding what motivates humans and triggers them to perform certain activities, and what it takes to change their behaviour, is central both for researchers and companies, as well as policy makers to implement efficient public policies. While numerous theoretical approaches for diverse domains such as health, retail, environment have been developed, the methodological models guiding the evaluation of such research have reached for a long time their limits. Within this context, digitisation, the Information and communication technologies (ICT) and wearable, the Internet of Things (IoT) connecting networks of devices, and new possibilities to collect and analyse massive amounts of data made it possible to study behaviour from a realistic perspective, as never before. Digital technologies make it possible to (1) capture data in real-life settings, (2) regain control over data by capturing the context of behaviour, and (3) analyse huge set of information through continuous measurement. Within this complex context, this paper describes a new framework for initiating behavioural change, capitalising on the digital developments in applied research projects and applicable both to academia, enterprises and policy makers. By applying this model, behavioural research can be conducted to address the issues of different domains, such as mobility, environment, health or media. The Modular Behavioural Analysis Approach (MBAA) is here described and firstly validated through a concrete use case within the domain of health. The results gathered have proven that disclosing information about health in connection with the use of digital apps for health, can be a leverage for changing behaviour, but it is only a first component requiring further follow-up actions. To this end, a clear definition of different 'behavioural profiles', towards which addressing several typologies of interventions, it is essential to effectively enable behavioural change. In the refined version of the MBAA a strong focus will rely on defining a methodology for shaping 'behavioural profiles' and related interventions, as well as the evaluation of side-effects on the creation of new business models and sustainability plans.

Keywords: behavioural change, framework, health, nudging, sustainability

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11859 The Arts in Medicine and Health: A Necessity for Evidence-Based Health Systems

Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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11858 Digital Interventions for Older People Experiencing Homelessness (OPEH): A Systematic Scoping Review

Authors: Emily Adams, Eddie Donaghy, David Henderson, Lauren Ng, Caroline Sanders, Rowena Stewart, Maria Wolters, Stewart Mercer

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Ongoing review abstract: Older People Experiencing Homelessness (OPEH) can have mental and physical indicators of aging 10–20 years earlier than the general population and experience premature mortality due to age-related chronic conditions. Emerging literature suggests digital interventions could positively impact PEH’s well-being. However, the increased reliance on digital delivery may also perpetuate digital inequalities for socially excluded groups, including PEH. The potential triple disadvantage of being older, homeless, and digitally excluded creates a uniquely problematic situation that warrants further research. This scoping review aims to investigate and synthesise the range and type of digital interventions available to OPEH and the organisations that support OPEH. The following databases were searched on 28th July 2023: Medline, Scopus, International Bibliography of the Social Sciences (IBSS)‎, Applied Social Sciences Index & Abstracts (ASSIA)‎, Association for Computing Machinery Digital Library (ACMDL) and Policy commons. A search strategy was developed in collaboration with an academic librarian. The presentation will include: An introduction to OPEH and digital exclusion Overview of the results of this review: OPEH usage of digital platforms Current digital interventions available The role of support organisations Current gaps in the evidence, future research and recommendations for policy and practice

Keywords: homeless, digital exclusion, aging, technology

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11857 Fairness in Grading of Work-Integrated Learning Assessment: Key Stakeholders’ Challenges and Solutions

Authors: Geraldine O’Neill

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Work-integrated learning is a valuable learning experience for students in higher education. However, the fairness of the assessment process has been identified as a challenge. This study explored solutions to this challenge through interviews with expert authors in the field and workshops across nine different disciplines in Ireland. In keeping with the use of a participatory and action research methodology, the key stakeholders in the process, the students, educators, and practitioners, identified some solutions. The solutions included the need to: clarify the assessments’ expectations; enhance the flexibility of the competencies, reduce the number of competencies; use grading scales with lower specificity; support practitioner training, and empower students in the assessment process. The results are discussed as they relate to interactional, procedural, and distributive fairness.

Keywords: competencies, fairness, grading scales, work-integrated learning

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11856 Development and Validation of Integrated Continuous Improvement Framework for Competitiveness: Mixed Research of Ethiopian Manufacturing Industries

Authors: Haftu Hailu Berhe, Hailekiros Sibhato Gebremichael, Kinfe Tsegay Beyene, Haileselassie Mehari

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The purpose of the study is to develop and validate integrated literature-based JIT, TQM, TPM, SCM and LSS framework through a combination of the PDCA cycle and DMAIC methodology. The study adopted a mixed research approach. Accordingly, the qualitative study employed to develop the framework is based on identifying the uniqueness and common practices of JIT, TQM, TPM, SCM and LSS initiatives, the existing practice of the integration, identifying the existing gaps in the framework and practices, developing new integrated JIT, TQM, TPM, SCM and LSS practice framework. Previous very few studies of the uniqueness and common practices of the five initiatives are preserved. Whereas the quantitative study working to validate the framework is based on empirical analysis of the self-administered questionnaire using a statistical package for social science. A combination of the PDCA cycle and DMAIC methodology stand integrated CI framework is developed. The proposed framework is constructed as a project-based framework with five detailed implementation phases. Besides, the empirical analysis demonstrated that the proposed framework is valuable if adopted and implemented correctly. So far, there is no study proposed & validated the integrated CI framework within the scope of the study. Therefore, this is the earliest study that proposed and validated the framework for manufacturing industries. The proposed framework is applicable to manufacturing industries and can assist in achieving competitive advantages when the manufacturing industries, institutions and government offer unconditional efforts in implementing the full contents of the framework.

Keywords: integrated continuous improvement framework, just in time, total quality management, total productive maintenance, supply chain management, lean six sigma

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11855 Understanding the Issue of Reproductive Matters among Urban Women: A Study of Four Cities in India from National Family Health Survey-4

Authors: Priyanka Dixit

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Reproductive health problem is an important public health issue in most of the developing countries like India. It is a common problem in India for women in the reproductive age group to suffer from reproductive illnesses and not seek care. Existing literatures tell us very little about the several dimensions of reproductive morbidity. In addition the general perception says, metros have better medical infrastructure, so its residents should lead a healthier life. However some of the studies reveal a very different picture. Therefore, the present study is conducted with the specific objectives to find out the prevalence of reproductive health problem and treatment seeking behavior of currently married women in four metro cities in India namely; Mumbai, Delhi, Chennai and Kolkata. In addition, this paper also examines the effect of socio-economic and demographic factors on self-reported reproductive health problems. Bi-variate and multivariate regression have been applied to achieve the proposed objectives. Study is based on National Family Health Survey 2015-16 data. The analysis shows that the prevalence of any reproductive health problem among women is the highest in Mumbai followed by Delhi, Chennai, and Kolkata. A bulk of women in all four metro cities has reported abdominal pain, itching and burning sensation as the major problems while urinating. However, in spite of the high prevalence of reproductive health problems, a huge proportion of such women in all these cities do not seek any advice or treatment for these problems. This study also investigates determinants that affect the prevalence of reproductive health problem to policy makers plan for proper interventions for improving women’s reproductive health.

Keywords: reproductive health, India, national family health survey-4, city

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11854 Exercise Intervention for Women After Treatment for Ovarian Cancer: Realist Evaluation of a Co-Designed Implementation Process

Authors: Deirdre Mc Grath, Joanne Reid

Abstract:

Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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11853 Adult-Child Relationships: Nurturing Development and Well-Being

Authors: Obafemi Richard Jegede

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The relationship between adults and children is pivotal for the social, emotional, and cognitive development of the latter. This paper explores the multifaceted dynamics of adult-child relationships, emphasizing their significance in fostering positive outcomes for children's well-being. It delves into dimensions such as attachment, communication, and parenting styles, addressing their impact on children's mental health and development. Furthermore, the role of supportive environments and interventions in enhancing adult-child relationships is examined. Understanding the complexities of these relationships is crucial for promoting healthy and nurturing interactions that contribute to children's holistic development. Positive interactions with caring adults promote children's self-regulation, empathy, and resilience, while negative or inconsistent relationships can lead to emotional distress and impaired social skills. Creating supportive environments that prioritize positive adult-child relationships is essential for promoting children's well-being. By comprehensively understanding the factors that shape adult-child relationships, we can better support children's development and well-being. This paper aims to provide insights into the complexities of adult-child relationships and their profound impact on children's development and overall well-being.

Keywords: impact on children's development, supportive environments and interventions, parenting style, communication between adult and children

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11852 The Efficacy of Mindfulness-Based Interventions on Occupational Stress and Burnout among K-12 Educators: A Review of the Literature

Authors: Kailen Krame

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This paper presents a review of the literature on the efficacy of mindfulness-based interventions for reducing occupational stress and burnout among K-12 educators. An in-depth discussion of the incidence and impact of teacher stress and burnout is provided, as a wealth of literature indicates that this issue is of growing concern and has important implications not only for individual educators but also for students and the school as an organization. Given the evidence of a link between teacher wellbeing and student outcomes, this topic is worth further investigation in order to better understand sources of stress and burnout and propose adequate coping strategies for today’s educators. As a potential solution to teacher stress and burnout, mindfulness-based interventions are reviewed in-depth, and an overview of the history, diverse application, and effects of mindfulness practice are provided. Relevant outcomes of educator mindfulness training presented in the literature include increased emotional regulation, self-efficacy, and personal wellbeing, among several others. Lastly, additional implications and benefits of educator mindfulness training are explored, limitations of the current research are reviewed, and apparent best practices are proposed.

Keywords: educator burnout, emotional regulation, mindfulness, self-efficacy, stress-reduction

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11851 Health Care Providers' Perceptions on mHealth Workplace Nutrition Wellness Program: A Thematic Analysis

Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

Abstract:

Background: Health care providers have been identified as an at-risk group for obesity. Mobile health technology can be used to motivate lifestyle behavioral changes. The aim of this study was to investigate hospital-based health care providers’ perceptions of mHealth Workplace Nutrition Wellness Program. Methods: This qualitative study was conducted at a regional hospital in Hong Kong. Ten health care providers were purposively selected for the study. Qualitative data was collected by individual face-to-face semi-structured interviews which were audio-taped, transcribed verbatim and analyzed by thematic analysis. Results: Four themes were identified: (1) mobile health technology motivates lifestyle changes, (2) self-perceived body weight initiates health behavioral changes, (3) organizational support promotes healthy behavior, (4) lack of self-confidence hinders lifestyle modification. The health care providers’ perceptions of mobile health technology, barriers, and facilitators to participation in the mHealth Workplace Nutrition Wellness Program were discussed in the study. Conclusions: Barriers, facilitators, self-perceived body weight and experiences of mobile health technology were associated with intention of participation in mHealth Workplace Nutrition Wellness Program. The knowledge generated from the study could be used to guide the design and implementation of effective interventions, strategies and policies of workplace wellness programs to promote participation for hospital’s employees.

Keywords: workplace wellness program, mobile health, barriers, facilitators, qualitative

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11850 Exploring the Effects of Transcendental Mindfulness Meditation on Anxiety Symptoms in Young Females

Authors: Claudia Cedeno Nadal, Mei-Ling Villafana, Griela Rodriguez, Jessica Martin, Jennifer Martin, Megan Patel

Abstract:

This study systematically examines the impact of Transcendental Mindfulness Meditation on anxiety symptoms in young females aged 18-25. Through a comprehensive literature review, we found consistent evidence supporting the positive influence of Transcendental Mindfulness Meditation on reducing anxiety, enhancing overall well-being, and decreasing perceived stress levels within this demographic. The mechanisms underlying these effects include heightened self-awareness, improved emotional regulation, and the development of effective stress-coping strategies. These findings have significant implications for mental health interventions targeting young females. However, the reviewed studies had some limitations, such as small sample sizes and reliance on self-report measures. To advance this field, future research should focus on larger sample sizes and utilize a broader range of measurement methods, including neuroscience assessments. Additionally, investigating the temporal relationships between Transcendental Mindfulness Meditation, proposed mediators, and anxiety symptoms will help establish causal specificity and a deeper understanding of the precise mechanisms of action. The development of integrative models based on these mechanisms can further enhance the effectiveness of Transcendental Mindfulness Meditation as an intervention for anxiety in this demographic. This study contributes to the current knowledge on the potential benefits of Transcendental Mindfulness Meditation for reducing anxiety in young females, paving the way for more targeted and effective mental health interventions in this population.

Keywords: mindfulness, meditation, anxiety, transcendental mindfulness

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11849 Modelling Optimal Control of Diabetes in the Workplace

Authors: Eunice Christabel Chukwu

Abstract:

Introduction: Diabetes is a chronic medical condition which is characterized by high levels of glucose in the blood and urine; it is usually diagnosed by means of a glucose tolerance test (GTT). Diabetes can cause a range of health problems if left unmanaged, as it can lead to serious complications. It is essential to manage the condition effectively, particularly in the workplace where the impact on work productivity can be significant. This paper discusses the modelling of optimal control of diabetes in the workplace using a control theory approach. Background: Diabetes mellitus is a condition caused by too much glucose in the blood. Insulin, a hormone produced by the pancreas, controls the blood sugar level by regulating the production and storage of glucose. In diabetes, there may be a decrease in the body’s ability to respond to insulin or a decrease in insulin produced by the pancreas which will lead to abnormalities in the metabolism of carbohydrates, proteins, and fats. In addition to the health implications, the condition can also have a significant impact on work productivity, as employees with uncontrolled diabetes are at risk of absenteeism, reduced performance, and increased healthcare costs. While several interventions are available to manage diabetes, the most effective approach is to control blood glucose levels through a combination of lifestyle modifications and medication. Methodology: The control theory approach involves modelling the dynamics of the system and designing a controller that can regulate the system to achieve optimal performance. In the case of diabetes, the system dynamics can be modelled using a mathematical model that describes the relationship between insulin, glucose, and other variables. The controller can then be designed to regulate the glucose levels to maintain them within a healthy range. Results: The modelling of optimal control of diabetes in the workplace using a control theory approach has shown promising results. The model has been able to predict the optimal dose of insulin required to maintain glucose levels within a healthy range, taking into account the individual’s lifestyle, medication regimen, and other relevant factors. The approach has also been used to design interventions that can improve diabetes management in the workplace, such as regular glucose monitoring and education programs. Conclusion: The modelling of optimal control of diabetes in the workplace using a control theory approach has significant potential to improve diabetes management and work productivity. By using a mathematical model and a controller to regulate glucose levels, the approach can help individuals with diabetes to achieve optimal health outcomes while minimizing the impact of the condition on their work performance. Further research is needed to validate the model and develop interventions that can be implemented in the workplace.

Keywords: mathematical model, blood, insulin, pancreas, model, glucose

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11848 How to Empower People to Provide Good Nutrition to Children: Bengkel Gizi Terpadu (Integrated Nutrition Workshop)

Authors: Anggun Yuliana Putri, Melisa Rahmadini

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The Ministry of National Development Planning in Indonesia has reported that more than eight million Indonesian children are still malnourished. Based on national statistics, and a recent ranking from NGO Save the Children, Indonesia is one of 15 countries making the fastest gains in cutting child malnutrition among 165 developing countries. According to a United Nations Children’s Fund, at least 7.6 million Indonesian children under the age of 5 or one out of every three suffer from stunted growth, a primary manifestation of malnutrition in early childhood, the report ranked Indonesia as having the fifth largest number of children under 5 suffering from stunted growth worldwide. Addressing the problem of malnutrition in Indonesia, Aksi Cepat Tanggap (ACT) Foundation, a humanitarian organization working with Carrefour, acts as donor and pursues several solutions to the problem, especially of malnourished children and infants in South Tangerang area, Indonesia. The objective of this study was to examine the community empowerment driven by ACT Foundation in order to maintain the good status continuity of child and toddler after the children malnutrition recovered. Research was conducted using qualitative approach through in-depth interview and observation to find out how the Bengkel Gizi Terpadu (Integrated Nutrion Workshop) programs make people empowered. Bengkel Gizi Terpadu (BGT) is divided into 3 sequences of activities, there were: integrated malnutrition rehabilitation; provision of health education to mothers of infants and young children; and family economic empowerment to head of household. Results showed that after empowerment process has been done through training and provision of knowledge to the mothers and families about the important of nutrition and health, there were 30 of 100 mothers who participated actively. Then, there were 45 of 100 heads of household who participated in business training were able to open a business on their own which provided and controlled by ACT as stakeholder in this program. The further findings revealed that BGT programs are able to form community health workers and provide employment opportunities to community. This study believes that integrated nutrition workshop program is the solution to maintain good nutrition among children in South Tangerang, through empowerment of parents and community members, via education and business training program. Both programs prepared parents with economic sustenance and necessary information, a pre-requisite to end malnutrition in children.

Keywords: community, empowerment, malnutrition, training

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11847 A Meta-Analysis of School-Based Suicide Prevention for Adolescents and Meta-Regressions of Contextual and Intervention Factors

Authors: E. H. Walsh, J. McMahon, M. P. Herring

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Post-primary school-based suicide prevention (PSSP) is a valuable avenue to reduce suicidal behaviours in adolescents. The aims of this meta-analysis and meta-regression were 1) to quantify the effect of PSSP interventions on adolescent suicide ideation (SI) and suicide attempts (SA), and 2) to explore how intervention effects may vary based on important contextual and intervention factors. This study provides further support to the benefits of PSSP by demonstrating lower suicide outcomes in over 30,000 adolescents following PSSP and mental health interventions and tentatively suggests that intervention effectiveness may potentially vary based on intervention factors. The protocol for this study is registered on PROSPERO (ID=CRD42020168883). Population, intervention, comparison, outcomes, and study design (PICOs) defined eligible studies as cluster randomised studies (n=12) containing PSSP and measuring suicide outcomes. Aggregate electronic database EBSCO host, Web of Science, and Cochrane Central Register of Controlled Trials databases were searched. Cochrane bias tools for cluster randomised studies demonstrated that half of the studies were rated as low risk of bias. The Egger’s Regression Test adapted for multi-level modelling indicated that publication bias was not an issue (all ps > .05). Crude and corresponding adjusted pooled log odds ratios (OR) were computed using the Metafor package in R, yielding 12 SA and 19 SI effects. Multi-level random-effects models accounting for dependencies of effects from the same study revealed that in crude models, compared to controls, interventions were significantly associated with 13% (OR=0.87, 95% confidence interval (CI), [0.78,0.96], Q18 =15.41, p=0.63) and 34% (OR=0.66, 95%CI [0.47,0.91], Q10=16.31, p=0.13) lower odds of SI and SA, respectively. Adjusted models showed similar odds reductions of 15% (OR=0.85, 95%CI[0.75,0.95], Q18=10.04, p=0.93) and 28% (OR=0.72, 95%CI[0.59,0.87], Q10=10.46, p=0.49) for SI and SA, respectively. Within-cluster heterogeneity ranged from no heterogeneity to low heterogeneity for SA across crude and adjusted models (0-9%). No heterogeneity was identified for SI across crude and adjusted models (0%). Pre-specified univariate moderator analyses were not significant for SA (all ps < 0.05). Variations in average pooled SA odds reductions across categories of various intervention characteristics were observed (all ps < 0.05), which preliminarily suggests that the effectiveness of interventions may potentially vary across intervention factors. These findings have practical implications for researchers, clinicians, educators, and decision-makers. Further investigation of important logical, theoretical, and empirical moderators on PSSP intervention effectiveness is recommended to establish how and when PSSP interventions best reduce adolescent suicidal behaviour.

Keywords: adolescents, contextual factors, post-primary school-based suicide prevention, suicide ideation, suicide attempts

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11846 Integrated Coastal Management for the Sustainable Development of Coastal Cities: The Case of El-Mina, Tripoli, Lebanon

Authors: G. Ghamrawi, Y. Abunnasr, M. Fawaz, S. Yazigi

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Coastal cities are constantly exposed to environmental degradation and economic regression fueled by rapid and uncontrolled urban growth as well as continuous resource depletion. This is the case of the City of Mina in Tripoli (Lebanon), where lack of awareness to preserve social, ecological, and historical assets, coupled with the increasing development pressures, are threatening the socioeconomic status of the city residents, the quality of life and accessibility to the coast. To address these challenges, a holistic coastal urban design and planning approach was developed to analyze the environmental, political, legal, and socioeconomic context of the city. This approach aims to investigate the potential of balancing urban development with the protection and enhancement of cultural, ecological, and environmental assets under an integrated coastal zone management approach (ICZM). The analysis of Mina's different sectors adopted several tools that include direct field observation, interviews with stakeholders, analysis of available data, historical maps, and previously proposed projects. The findings from the analysis were mapped and graphically represented, allowing the recognition of character zones that become the design intervention units. Consequently, the thesis proposes an urban, city-scale intervention that identifies 6 different character zones (the historical fishing port, Abdul Wahab island, the abandoned Port Said, Hammam el Makloub, the sand beach, and the new developable area) and proposes context-specific design interventions that capitalize on the main characteristics of each zone. Moreover, the intervention builds on the institutional framework of ICZM as well as other studies previously conducted for the coast and adopts nature-based solutions with hybrid systems for providing better environmental design solutions for developing the coast. This enables the realization of an all-inclusive, well-connected shoreline with easy and free access towards the sea; a developed shoreline with an active local economy, and an improved urban environment.

Keywords: blue green infrastructure, coastal cities, hybrid solutions, integrated coastal zone management, sustainable development, urban planning

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11845 An Integrative Review on Effects of Educational Interventions for Children with Eczema

Authors: Nam Sze Cheng, P. C. Janita Chau

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Background: Eczema is a chronic inflammatory disease with high global prevalence rates in many childhood populations. It is also the most common paediatric skin problem. Although eczema education and proper skin care were effective in controlling eczema symptoms, the lack of both sufficient time for patient consultation and structured eczema education programme hindered the transferability of knowledge to patients and their parents. As a result, these young patients and their families suffer from a significant physical disability and psychological distress, which can substantially impair their quality of life. Objectives: This integrative review is to examine the effects of educational interventions for children with eczema and identify the core elements associated with an effective intervention. Methods: This integrative review targeted all articles published in 10 databases between May 2016 and February 2017 that reported the outcomes of disease interventions of any format for children and adolescents with the clinical diagnosis of eczema who were under 18 years of age. Five randomized controlled trials (RCT) and one systematic review of 10 RCTs were identified for review. All these publications had high methodological quality, except one study of web-based eczema education that was limited by selection bias and poor subject blinding. Findings: This review found that most studies adopted nurse-led or multi-disciplinary parental eczema education programme at the outpatient clinic setting. The format of these programmes included individual lectures, demonstration and group sharing, and the educational materials covered basic eczema knowledge and management as well as methods to interrupt itch-scratch cycle. The main outcome measures of these studies included severity of eczema symptoms, treatment adherence and quality of life of both patients and their families. Nine included studies reported statistically significant improvement in the primary outcome of symptom severity of these eczematous children. On the other hand, all these reviews failed to identify an effective dosage of intervention under these educational programmes that was attributed to the heterogeneity of the interventions. One study that was designed based on the social cognitive theory to guide the interventional content yielded statistically significant results. The systematic review recommended the importance of measuring parental self-efficacy. Implication: This integrative review concludes that structured educational programme can help nurses understand the theories behind different health interventions. They can then deliver eczema education to their patients in a consistent manner. These interventions also result in behavioral changes through patient education. Due to the lack of validated educational programmes in Chinese, it is imperative to conduct an RCT of eczema educational programme to investigate its effects on eczema severity, quality of life and treatment adherence in Hong Kong children as well as to promote the importance of parental self-efficacy.

Keywords: children, eczema, education, intervention

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11844 A Polynomial Approach for a Graphical-based Integrated Production and Transport Scheduling with Capacity Restrictions

Authors: M. Ndeley

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The performance of global manufacturing supply chains depends on the interaction of production and transport processes. Currently, the scheduling of these processes is done separately without considering mutual requirements, which leads to no optimal solutions. An integrated scheduling of both processes enables the improvement of supply chain performance. The integrated production and transport scheduling problem (PTSP) is NP-hard, so that heuristic methods are necessary to efficiently solve large problem instances as in the case of global manufacturing supply chains. This paper presents a heuristic scheduling approach which handles the integration of flexible production processes with intermodal transport, incorporating flexible land transport. The method is based on a graph that allows a reformulation of the PTSP as a shortest path problem for each job, which can be solved in polynomial time. The proposed method is applied to a supply chain scenario with a manufacturing facility in South Africa and shipments of finished product to customers within the Country. The obtained results show that the approach is suitable for the scheduling of large-scale problems and can be flexibly adapted to different scenarios.

Keywords: production and transport scheduling problem, graph based scheduling, integrated scheduling

Procedia PDF Downloads 450